2005 Model Practice Application (Public)

Child Passenger Safety Partnership of Maricopa County

Maricopa County Deparment of Public Health

The Child Passenger Safety Partnership of Maricopa Country targets low income, low literacy, rural and outlaying communities. The seminal question of the program is regarding the basic attitudes on the use of car seats; one hundred percent of respondents reported feeling their child is more safe in their car seat. One hundred percent of respondents reported, after receiving training, they would recommend the program and the use of car seats to friends and family members.

Outcomes of practice: Ninety-eight percent of participants who received a new seat from the program reported always using their car seat post training, 94% indicate they find it easy to install their car seat, 98% are satisfied with the information and instruction they were given about how to install the car seat in their car and how to secure the child in the seat.

According to the Arizona Child Fatality Review Team in 2003, motor vehicle crashes were the largest cause of preventable child deaths in Arizona, accounting for 43.3% of the total. Hispanic, African American and Native American ethnic groups ranked among the highest for preventable motor vehicle fatalities. In 2004, the SAFE KIDS campaign reported motor vehicle fatalities for Hispanic children ages four and under were 27% higher than for non-Hispanic children. The National Highway Traffic Safety Administration (NHTSA) reported the proper use of child restraints could reduce fatalities among infants by 71%, and by 54% in children ages one to four. NHTSA estimates the national misuse rate is about 85%. In an observational study conducted by a Phoenix hospital, it was determined that 70% of children observed were riding without safety restraints.

Many of the families that have car seats are using ones that are old, not up to current safety standards, not age appropriate, and not installed properly- all of which put the child at extreme risk for serious injury or death. The National SAFE KIDS Campaign estimates that approximately 90% of car seats they check are misused or incorrectly installed. Often these families do not utilize proper safety restraints for their children and the adults do not practice good safety behaviors themselves. This behavior reflects a lack of information, language barriers and conflicting cultural norms. Many families cannot afford to buy new car seats and therefore either do not buy seats, or buy used seats. This puts these children at risk of using inadequate restraints, or no restraint at all.

Other programs that advocate for child passenger safety provide information and limited resources to small pockets of communities with which they have immediate dealings. For example, Indian Health Services provide education and resources to Native American tribes, or hospitals that provide car seat information and resources only to their patients.

The Child Passenger Safety Partnership’s Childhood Injury Prevention Program (CIPP) is the first in Maricopa County that is able to provide child passenger safety information, and car seats, to qualifying participants throughout the entire county. CIPP staff are active certified car seat instructors, keeping current technicians updated as well as training new technicians. In addition, CIPP staff is multicultural and multilingual which aids in keeping with cultural competency practices.

The practice costs associated with sustaining the Child Passenger Safety Program are as follows:

• Funding to support the Child Passenger Safety Program at Maricopa County Department of Public Health comes from a grant managed by the Arizona Department of Health Services (ADHS). The Child Health Block Grant funds are allocated by ADHS to a select few programs throughout the state of Arizona; the grant funds the program for three years with annual reviews.
  
  
• The program budget is approximately $150,000, and the funds are used for a full-time health educator’s salary and additional trainings and workshops to ensure the information given to the community is current and accurate. The costs for resources consist of purchasing car seats, education/promotional materials and installation materials. There are four types of car seats the program purchases for distribution to qualified participants: high back boosters, low back boosters, combination seats and convertible seats. The seats are purchased in bulk directly from the manufacture to reduce cost.
  
  
• Education and promotion materials include pamphlets written and printed by the National SAFE KIDS Campaign. In addition, small incentives are purchased such as coloring books, crayons, pencils and stickers, all which carry vehicle safety messages and are used to entice participation and interest mainly when out at community functions such as health fairs.
  
  
• In-kind contributions to the program include office space and supplies, and other operational costs, materials, warehouse space and personnel, administrative support and meeting costs all provided by the Maricopa County Department of Public Health. Other contributions come from SAFE KIDS Coalition of Maricopa County, who donate installation materials and volunteer time while assisting with Maricopa County sponsored events.

CIPP staff will reach 3,000 families by December 31, 2005. To accomplish this objective as proposed, program staff schedules and implements car seat education, distributions and checks at identified sites for parents/caregivers. Staff participates in planning and implementing community awareness events and activities with key community stakes holders in the county. Program staff will stay current and certified on car seat inspection/installation skills and distribute car seats to qualified program participants. At least seventy-five percent of program participants must be Hispanic and/or from an outlaying/rural community. And program staff will help instruct two NHTSA-certification trainings each year in English and/or Spanish.

Geographically, Phoenix, Arizona is very spread out and pockets of communities are scattered throughout, therefore one of the most challenging tasks for program staff is to find qualified communities to serve. Having strong community relationships helps reveal areas, agencies and communities that may not have been easily discovered otherwise. The annual evaluation report revealed that the majority (43%) of program participants reported that they heard about the program through word of mouth. Many requests for programs at new venues reveal they heard about the program either from a client or a co-worker who previously received program services.

Program staff is very much vested in child passenger safety activities and with various community agencies throughout the Maricopa County. In keeping with that practice, program staff has, and will continue to, participate in the planning and implementation of community partners’ car seat activities and events. In doing so, these same community partners actively participate with the planning and implementation of CIPP activities and events as well. The give and take nature of these collaborations builds relationships that are trusted to last for many years.

As stated earlier, program staff is dedicated to building strong relationships with other local child passenger safety advocate agencies. With mutual participation, consistency and support, true community partnerships have been formed and nurtured. In the event that grant funding is cut or reduced, other community partners are willing and able step up their programs to make up for the loss.

Families are selected randomly to participate in a survey that is conducted three months post- car seat distribution. An independent research firm, in consultation with program staff, collects, enters and analyzes the survey indicators to identify trends in consistent utilization of the car seats provided by the program.

Each client information form collected is logged in the data base and that information is used by the outside evaluation team to randomly select the participants that will be used for the outcome evaluation.

Outcome evaluation reports reveal that ninety-eight percent of participants who received a new seat from the program reported always using their car seat, ninety-four percent indicate they find it easy to install their car seat, ninety-eight percent are satisfied with the information and instruction they were given about how to install the car seat in their car and how to secure the child in the seat. The seminal question of the program is regarding the basic attitudes on the use of car seats; one hundred percent of respondents reported feeling their child is more safe in their car seat. One hundred percent of respondents reported, after receiving training, they would recommend the program and the use of car seats to friends and family members.

Key elements needed to replicate the practice: Strong community relationships and active participation in local child passenger safety advocacy coalitions, i.e. local SAFE KIDS Coalition, culturally aware staff, current and certified car seat technicians.