Project Need and Approach
In 2021, the Texas A&M Transportation Institute’s (TTI’s) Center for Transportation Safety launched a project to address the ongoing issue of child safety seat (CSS) misuse in Texas. The initiative focused on providing pediatric clinics in Houston, Texas, and San Antonio, Texas, with clear, concise materials to facilitate anticipatory guidance on CSS use during well-child visits. Although the lingering effects of the COVID-19 pandemic limited the health care community’s capacity for in-person initiatives, lessons from the 2021 pilot laid a strong foundation for future efforts. The project’s primary goal was to equip family health care providers with tools to initiate timely discussions about proper CSS fit and selection based on developmental milestones, such as weight and height.
The pilot identified key gaps, including the need for multilingual resources to better serve Houston’s diverse population. Feedback from participating clinics highlighted the importance of visual materials and more detailed content for children outside the 50th percentile in growth. One of the most frequently asked questions regarded the right time to transition a child to a forward-facing seat.
The project’s work plan for revising and distributing CSS materials was divided into three phases: revising the materials based on prior research, distributing the outreach materials to medical clinics, and gathering feedback from caregivers and clinic staff to guide future improvements.
Project Activities
The project began by revising educational materials based on feedback from the fiscal year 2021 pilot. Updates included age-based handouts, exam room posters, height check cards, and a Houston-specific website featuring child passenger safety resources. To enhance accessibility, the materials were redesigned to prioritize graphics over text, making the information easier to understand for caregivers unfamiliar with CSS guidelines. Additionally, all materials were translated into Spanish and Vietnamese. Further efforts to reflect the diversity of the community included using imagery from the National Highway Traffic Safety Administration’s image gallery and Safe Kids Worldwide.
To support implementation, TTI recorded an orientation for clinic staff that covered CSS types and transitions, Texas car seat laws, and strategies for integrating the materials into clinic workflows. Online feedback surveys were developed for caregivers and clinic staff to complete at any time during the grant year. Additional feedback was gathered through virtual feedback sessions, one-on-one conversations with clinic staff, a cognitive review of the Spanish materials, and a caregiver focus group. This comprehensive feedback process informed any revisions to the materials before each distribution round.
Benefits to Texas Transportation Safety
This research supported the goal of conducting research to reduce deaths and injuries in traffic crashes through dissemination of educational materials created specifically for underserved populations of childcare providers and transporters. By working directly with the medical community, this project also promoted collaboration among professionals from different disciplines in the cause of transportation safety.
Project Title: Anticipatory Guidance on Child Passenger Safety Triggered through Pediatric Clinic Visits
Project Start and End Dates: October 1, 2023 – September 30, 2024
Author List: Katie Womack
Sponsor/Funding Source: Texas Department of Transportation (TxDOT)