| Objective1.The aim of the study was to develop a conceptual framework of the influencing factors of Child Safety Seat used among children aged 0-6 year guided by the theoretical model of Information-Motivation-Behavioral skills and the Extended Parallel Process Model.Sinicization and development of relevant investigation tools,to investigate the current state of 0-6 years old children’s safety seat usage after national legislation.The primary influencing factors were explored and countermeasures and suggestions were put forward to provide the basis for medical staff and relevant departments to formulate measures to prevent the occurrence of injuries caused by children riding in cars.MethodsA literature review and theoretical study were conducted to develop the conceptual framework for influencing factors of Child Safety Seat use behavior among children aged0-6 years.The following studies are carried out based on this framework and the study was divided into three parts.1.After acquiring authorization,the CRRBDS was translated,back-translated and cross-cultural adjusted according to Brislin’s classical translation model to form a Chinese version of the scale.Using the convenient sampling method,from July to October 2021,394 parents of children aged 0-6 who received child health care management in the child health department from a tertiary comprehensive hospital in Qingdao and parents of children aged 0-6 who were vaccinated at a community health service center were investigated by questionnaire.The scale was tested using item analysis,reliability test,exploratory and confirmatory factor analysis.2.Based on the Information-Motivation-Behavioral skills model,The child riding safety knowledge,motivation and behavior skills questionnaire was developed through a literature review,Delphi method and small sample tests.From January to May 2022,604 parents of children aged 0 to 6 years old were surveyed using this questionnaire.The questionnaire was tested by item analysis,reliability test,exploratory and confirmatory factor analysis.3.From June to October 2022,618 parents of children aged 0-6 who received child health care management in the child health department from a tertiary comprehensive hospital in Qingdao and the parents of children aged 0-6 who were vaccinated in a community health service center were surveyed using the general information questionnaire,the Child Riding Safety Knowledge,Motivation and Behavior Skills Questionnaire,and the CRRBDS to investigate the use status of safety seats for children aged 0-6 and analyze the influencing factors.SPSS 26.0 was used to analyze the data.The statistical methods were descriptive statistical analysis,single factor analysis and ordered logistic regression analysis.Result1.Translation and reliability and validity test of the CRRBDSThe Chinese version of the CRRBDS scale consists of 5 dimensions and 16 items,including type selection cognition,response efficacy,self-efficacy,perceived susceptibility and perceived severity.Item analysis showed that the scale had a critical value of5.744～10.407(P<0.05),and a correlation coefficient between each item and the scale score was 0.502～0.697(P<0.05).Five common factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 72.939%.Confirmatory factor analysis showed a good fit for the model,with a Cronbach’s α coefficient of 0.886 for the scale,0.778～0.876 for each dimension,and retest reliability of 0.862.2.The reliability and validity test of The Child Riding Safety Knowledge,Motivation and Behavior Skills QuestionnaireA total of 5 common factors were extracted from the questionnaire,which were named use motivation,riding safety cognition,seat replacement cognition,self-efficacy and objective skill,and the cumulative variance contribution rate was 69.958%.The Cronbach’sα coefficient of internal consistency was 0.878,and the retest reliability was 0.936.The content validity of the questionnaire was 0.968.The results of confirmatory factor analysis showed that the model fit well and the reliability and validity of the questionnaire were good.3.Research on the current situation and influencing factors of the use of safety seats for children aged 0-6 years(1)Current situation of safety seat use for children aged 0-6: A total of 618 valid questionnaires were collected in this study.The use rate of child safety seats was 52.75%,with a high-frequency use rate was 24.92%.(2)Univariate analysis showed that educational background,family type,child age,private car price,participation experience in child accident injury training,use motivation,riding safety cognition,seat replacement cognition,objective skills,type selection cognition,response efficacy,self-efficacy,perceived susceptibility and perceived severity had statistical significance in different use rates of child safety seats(P<0.05).(3)Multivariate analysis revealed that fathers with a college,bachelor’s degree or above education,the family type of only child,the participation experience of accidental injury training,and parents scored high on perceived severity,response efficacy,selfefficacy,riding safety cognition,use motivation and objective skills were the factors to promote the usage of safety seats for children aged 0-6.Conclusions1.The Chinese version of CRRBDS has been proven to be reliable and valid,which can be used to assess the risk perception of children’s parents on the safety of child riding.2.Child Riding Safety Knowledge,Motivation and Behavior Skills questionnaire has good reliability and validity,which can be used to evaluate parents’ knowledge,motivation and behavior skills related to Child Safety Seats.3.After the national legislation,the use rate and high-frequency use rate of child safety seats for children aged 0-6 years have increased compared to the previous year,but there is still room for improvement;In addition to the general information,knowledge and objective skills of parents,the study clarified the impact of psychosocial factors such as risk perception and use motivation on the use of Child Safety Seats.In addition to strengthening the popularization of relevant laws,knowledge and skills training should be carried out by the coalition government,hospitals,communities and children’s education centers.At the same time,we should give full play to the guiding role of medical staff and experts in various fields,increase the motivation and risk perception of parents to use CSS,and cultivate awareness of safety prevention. |
PDF Full Text Request