CIHR Team in Traffic and Road Injury Prevention (TRIP) Program for Canadian Children

Principal Investigators: Dr. Anne W. Snowdon and Dr. Andrew W. Howard
University of Windsor

For the vast majority of parents, their child’s safety in a vehicle is paramount—especially during that first ride home from the hospital. But for preterm or low birthweight babies, ensuring this safety can be challenging.

“The problem was that were no car seats designed specifically for babies weighing less than five pounds [2.23 kg],” explains Dr. Anne Snowdon, professor at the Odette School of Business, University of Windsor, and co-leader of the CIHR Team in Traffic and Road Injury Prevention Program for Canadian Children (TRIP Team).

Without a special car seat, parents received varying instructions when they left the hospital about how to use towels and other materials to “pad out” the regular car seat for their small bundle. Understandably, some parents later reported being too scared to leave the house with the baby afterward, as they weren’t sure that they could transport their child safely.

To address this issue, the TRIP Team worked with mechanical engineer, Dr. Bill Altenhof to develop the “preemie positioning device” for car travel. The device, which is being tested with neonatal intensive-care units (NICUs) now, is a foam insert that works with regular car seats. It positions the baby’s head and neck for proper breathing, and it’s comfortable for babies because they fit nicely in the device to improve baby’s fit in commercial infant seats.

Sometimes, however, the right devices do exist but are underused. By partnering with the Ontario Coroners Office, the TRIP Team found that babies are over-represented in child deaths caused by vehicle crashes. Dr. Andrew Howard, senior scientist and orthopaedic surgeon at the Hospital for Sick Children (Toronto) and TRIP Team co-leader, reviewed baby and child deaths from car crashes over five years—including where and how they were seated in the car. The results showed that a surprising number of parents are still holding babies in their arms instead of putting them in car seats, which is a recipe for disaster.

As part of their strategy to encourage parents to use car seats all the time, the TRIP Team partnered with the Ontario Provincial Police to develop a program similar to the Reduce Impaired Driving Everywhere (RIDE) program that has been used in Ontario for decades. With RIDE, roadside spot-checks are set up on major roadways and all drivers are stopped by police to be questioned; drivers suspected of being intoxicated may be tested, and impaired drivers are taken off the road. The TRIP Team’s program uses similar principles to conduct spot-checks on the proper use of car seats and booster seats for young passengers.

“A program like this is wonderful for building community awareness,” says Dr. Snowdon. “People tell their friends and family when they get stopped for a check, which helps rapidly build awareness [in the community] that safety seat regulations are enforceable. It also lets us know where the challenges are so that we can figure out which groups of families need more support to use safety seats effectively for children traveling in vehicles.”

But what if, as a parent, you simply aren’t sure which car seat to use? There’s now an app for that. Dr. Chris Thrasher and Dr. Bob Kent, TRIP Team members from the University of Windsor, developed an evidence-based car seat safety app to help children and their parents choose the right safety seat. Enter the child’s height, weight, and age, and then the app will provide a recommendation for seat type and how long it should be used.

The team also wanted to address issues in First Nations communities, which have significant but distinct patterns of injury. “We know what the data says, but we went to the communities and asked them to help us understand it,” explains Dr. Snowdon. “It was very much a ‘how can we help you help your community’ approach from the team because we wanted the communities to be able to develop their own injury strategies to find the best fit both culturally and socially.”

It quickly became clear that there was a strong desire to keep kids safe in each community, but the necessary resources weren’t always available. So, Dr. Brent Angell, TRIP Team member and professor of Social Work at the University of Windsor, launched the First Nations Children’s Safety Project in 2014. Through it, he established a new trust fund with the goal of ensuring that every child living on a reserve community in Canada can get car seats, booster seats, and even helmets for cycling and skateboarding. The fund is used to purchase these items for kids who need them, and community residents, researchers, and many other organizations and corporations have all contributed to the fund to date.

Bringing together a diverse group of researchers, parents, and private sector partners has been the team’s goal from the start. “Involving key stakeholders is the only way you get any impact or sustainability,” says Dr. Snowdon. “And car seat safety is as much an engineer’s problem as a trauma nurse or a surgeon. With a multi-stakeholder approach to research, we can understand where to make an impact. It’s never going to be a single discipline that figures all of this out.”

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