ΟΑ2063. Facilitators & Barriers to occupant restraint system use in the Eastern Med Reg: A scoping review

Abstract Background Road traffic injury is a public health concern preventable by occupant restraint systems (ORS), i.e., child car seats and seatbelts. In the Eastern Mediterranean Region (EMR), road injuries are high while ORS use is low. This scoping review aims to identify facilitators/barriers, map and describe intervention studies improving ORS use in the EMR. Methods Ovid Medline, SafetyLit, Embase, Global Health, and Cochrane were systematically searched for articles focusing on facilitators/barriers to using ORS or outcomes of interventions promoting their use, without date limits. Covidence was used to screen and extract data from 429 articles complemented by second-generation searching. Extracted data were compiled, visualized, and thematically analyzed. Results were categorized into “Facilitators and Barriers (including predictors)” to ORS use and “Interventions (including law enforcement evaluation)” to improve ORS safety knowledge and practices. Results Seventy-seven articles were included, with the majority from high-income countries (55%). Weak law enforcement, cultural norms, car seat costs, seat belt discomfort to occupants, and poor knowledge were among the foremost reported barriers across studies from all income levels. Improper law enforcement emerged as a more prominent barrier in studies from lower- and upper-middle-income countries, whereas cultural barriers were more frequently emphasized as the top barriers in studies from high-income countries. Facilitators included proper law enforcement and policy-maker engagement, awareness and training campaigns, and culturally adapted interventions. While some studies reported on implementing multifaceted interventions to increase ORS use, most interventions solely focused on “Education.” Conclusions Sustainable, culturally tailored implementation strategies, coupled with law enforcement, are needed in the EMR for adopting regular ORS use that could reduce road injury. Key messages • Most studies addressing facilitators and barriers to the use of occupant restraint systems, or interventions promoting their use, predominantly originate from high-income countries in the Eastern Mediterranean Region. However, there is a critical need for additional research from low- and middle-income countries to investigate these facilitators and barriers across the region and guide evidence-based interventions. • The identified facilitators and barriers spanned all levels of the socioecological model, ranging from individual knowledge and attitudes to enforcement of seat belts and child car seat laws, as well as cost concerns, emphasizing the need for multifactorial, culturally adapted implementation mapping efforts. Topic Seat Belts, Child Restraint Systems, Eastern Mediterranean Region.