Evaluation of a distribution, education and awareness intervention for child passenger safety in Lebanon: a low-income and middle-income country setting.

Background: The Eastern Mediterranean Region suffers disproportionately from paediatric traffic-related injuries. Despite governmental laws, Lebanon-an eastern Mediterranean country-has low child restraint (CR) use prevalence. This study examined the impact of using car seat distribution, and child passenger safety education and awareness intervention to improve child passenger safety knowledge and practices among caregivers.

Methods: This study recruited Lebanese caregivers with one child or more, using a 4-wheel motor vehicle, and not using a car seat. The intervention comprised an educational session followed by a car seat or booster seat distribution and installation check by a certified child passenger safety technician. A baseline assessment questionnaire was used to identify reasons for prior CR non-use. A child passenger safety knowledge test was administered before, immediately after and 3 months postintervention to assess child passenger safety knowledge retention and compare it to the baseline using the conditional logit model for pre-post interventions.

Results: Fifty-eight participants underwent the intervention. Affordability was identified as the primary reason for car seat non-use. Three months after the intervention, compliance with CRs use was reported at 100%, and correct responses on the knowledge test significantly increased (p<0.05) for all items except for harness tightness (p=0.673).

Conclusion: Our child passenger safety intervention resulted in improved knowledge and increased self-reported use of CRs in a caregivers' cohort in Lebanon. Further efforts should address sociocultural and economic barriers and the lack of local child passenger safety technicians to mitigate the region's paediatric road traffic injury and death toll.