Table 3. Summary of Evidence Quality, by Key Questiona
| Key Question |
Age Group |
Overall USPSTF Qualityb |
Summary of Results |
| KQ1 |
| Occupant restraint use |
Infants and children (age 0-4 y) |
Fair |
1 fair-quality, group-level CCT (36) reported a lower incidence of MVOI among children age 0-5 y in intervention communities compared with control communities during the 2-y study period. |
| Children (age 4-8 y), older children, adolescents, and adults |
Poor |
No trials |
| Alcohol-related driving |
All ages |
Poor |
No trials |
| KQ2 |
Children (age 0-4 y) |
Fair |
13 trials (6 RCTs27-32 and 7 CCTs36-42), all fair or fair to poor quality, demonstrate evidence of short-term, increased correct use of child safety seats at discharge or at 2 mo and diminished effects at later initial or follow-up time points. Several trials reporting successful interventions included a demonstration of correct child safety seat use, and the trials demonstrating the largest effects included education plus a child safety seat distribution program.29,31,39 Most trials were conducted before the widespread enactment of child safety seat legislation. |
| Children (age 4-8 y) |
Fair to poor |
1 fair to poor-quality RCT of an education plus booster seat distribution program reported a large increase in booster seat use at 1 mo after an intervention.33 |
| Older children or adolescents (age 9-19 y) |
Fair |
2 fair-quality trials (1 CCT43 and 1 RCT34): The CCT reported increased observed use of seat belts immediately after the visit among those not using them when arriving to clinic. The RCT reported no
difference in self-reported use at 12-, 24-, and 36-mo of follow-up in an intensive, office-based behavioral counseling intervention targeting 5th and 6th graders. |
| Adults |
Fair to poor |
1 fair to poor-quality RCT35 reported no difference between the intervention and control groups. |
| KQ3 |
All ages |
Poor |
No trials |
| KQ4 |
All ages |
Poor |
No trials |
a. CCT = controlled clinical trial; KQ = key question; MVOI = motor vehicle occupant injury; RCT = randomized controlled trial; USPSTF = U.S. Preventive Services Task Force.
b. The USPSTF quality criteria are described in Appendix Table 5.
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