Determinants of parents’ preferences for child restraint systems (CRS) in low-and-middle income urban settings

Background: Road traffic injuries constitute a major threat to children’s health and well-being. Adopting child restraint systems (CRS) represents a substantial injury prevention measure to curtail the burden of child road injuries and deaths. Using a choice experiment (CE) approach, this study aims to investigate parents’ perceptions and attitudes toward child safety through the usage of CRS and examine factors influencing their decisions to purchase and install a CRS. Methods: Two focus group discussions were conducted among parents of children (12 years and below) to identify choices of attributes that influence parents’ use of a child’s car seat. The selected attributes were then adopted to build CE scenarios that were administered to parents online. Collected data were compiled, aggregated, and analyzed using the mixed logit (MXL) model for discrete choice analysis. Results: A total of 120 parents participated in the study. 74.8 % were females with a mean age of 36.1 years. The CE experiment showed that parents in Lebanon are more likely to buy and use car seats that are convenient (ease of washing) and comfortable for their children (cushioning and adjustability of headrest), tending to prioritize these features over safety attributes (harnesses, ‘stroller-friendliness’). Conclusion: Parents in Lebanon are generally interested in using a child restraint system. Concerted educational awareness initiatives are recommended to impact adults’ perceptions of CRSs, overcome barriers to CRS installation to increase the use of CRS, and ultimately reduce child road injuries and fatalities.