Northwest Portland Area Indian Health Board: Indian Leadership for Indian Health

Native CARS Study

Native CARS Study
(Children Always Ride Safe)

To design, implement, and test effectiveness of interventions to improve the use of child passenger restraints among American Indian children in six tribes that have agreed to participate. Motor vehicle injuries are currently the leading cause of death for American Indian/Alaska Native children. One of the goals of Healthy People 2010 is the universal use of child safety seats. The use of child safety seats has been proven to reduce child injury and death by 71% for infants and by 54% for toddlers (1-4 years old) in passenger cars. Booster seats reduce the risk of serious injury by 59%, and seat belts reduce injury risk by 69%. Given the high mortality rate of American Indian children in motor vehicle injuries, we hope to increase the use of child safety restraints, and therefore decrease this excessive mortality rate.

1. Determine the knowledge of American Indian community members in the six participating tribes about child passenger restraint systems, and determine barriers and facilitators that effect consistent and appropriate use.
2. Work with members of the six participating tribes to determine effective methods to increase child safety seat use, developing tailored community intervention programs that work with tribal communities to address unique needs.
3. Implement and evaluate the programs in the Northwest tribal communities, comparing improvement in child passenger restraint use to three comparison tribes in the Northwest through a controlled community trial.

1. Qualitative analysis of barriers to child safety seat use in tribal communities. The fist year will be a formative research phase, consisting of elicitation interviews conducted with individual tribal community members, both professional (e.g. health workers) and lay (e.g. parents and other child caregivers). This will be followed by structured focus groups at each tribe.
2. Tribe-specific intervention development. Investigators will guide the development of tribe-specific interventions in the six participating tribal communities (three tribes each in two rounds of interventions). This process will begin starting with the individual tribes