Looking Back on Rear-Facing Car Seats: Surveying US Parents in 2011 and 2013

Abstract

Objective: We sought to determine the age at which US parents first turned their child's car seat to face forward and information sources used to make that decision at the time of the release of the 2011 guidelines for child passenger safety and 30 months later.

Methods: We administered 2 separate cross-sectional Web-based surveys of nationally representative panels of US parents in May 2011 and November 2013. Survey participation rate was 54% in both years. Parents of children ≤4 years old responded to questions about transitioning from rear-facing to forward-facing car seats (n = 495 in 2011; n = 521 in 2013).

Results: In 2011, 33% of parents of 1- to 4-year-old children who had been turned to face forward (n = 409) turned at or before 12 months and 16% turned at 2 years or older. In 2013, 24% of parents of 1- to 4-year-old children who had been turned to face forward (n = 413) turned at or before 12 months and 23% turned at 2 years or older. Car seat packaging and clinicians were the most common information sources. Demographic characteristics associated with turning to face forward at or before 12 months of age in 2011 (parent age, education, household income, rural residence) were not significantly associated with transitioning at or before 12 months in 2013.

Conclusions: Delaying the transition to a forward-facing car seat still represents an opportunity to improve passenger safety in the United States. As common sources of information, clinicians may be influential in a parent's decision to turn their child's car seat to face forward.

Keywords: car seats; child passenger safety; parent survey.

Figure 1. Survey Respondent Flow Diagram

Percentages reflect weighted results. *Subsample of parents included in analyses of information sources used by parents when deciding to turn their child’s car seat to face forward. °Subsample of parents included in bivariate and multivariate analyses of predictors of turning child’s car seat to face forward at or before 12 months.

Figure 2. Information Sources Regarding When to Turn Car Seats to Face Forward, by Survey Year

Bars indicate the proportion of parents who selected information source among parents who indicated the age at which their child’s car seat was turned to face forward. Dark bars indicate responses of parents in 2011 (n=419). Light bars indicate responses from parents in 2013 (n=421). Information sources are listed in order from most frequently selected to least frequently selected response options in 2011. National Organizations, Police Officer/Firefighter, Daycare Provider/Teacher were not offered as options in 2013. State Law, Internet/Social Media and American Academy of Pediatrics were not offered as options in 2011.

Figure 3. Child Age When Car Seat Was Turned to Face Forward, by Survey Year

Bars indicate the proportion of parents selecting the age category among parents who indicated the age at which their child’s car seat was turned to face forward. Dark bars indicate responses of parents in 2011 (n=409). Light bars indicate responses from parents in 2013 (n=413).