An assessment of child passenger safety levels of service in Michigan

Michelle L. Macy*, Shannon J. Brines, Acham Gebremariam, Miriam A. Manary, Halimat Olaniyan, Kathleen D. Klinich

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: The purpose of this article was to assess the match between child passenger safety resources (child passenger safety technicians [CPSTs], car seat checks, and child restraint system [CRS] distribution programs) and the child population in Michigan by utilizing geographic information systems approaches and to analyze the impact of Michigan’s CPSTs on child passenger safety behaviors on departure from a seat check. Methods: Data were collected from administrative sources and a survey of CPSTs to determine the number and location of child passenger safety resources and children in Michigan. The main analyses used data from 2014. The child population ≤4 years old per county and per traffic safety region was determined from census data. CPST and car seat check locations were determined from a list from the Michigan Office of Highway Safety Planning (Mi-OHSP) and a survey of CPSTs who coordinate seat checks. Summary sheets from Mi-OHSP served as the data source for CRSs distributed through their occupant protection program. Data from child passenger safety checklists completed with seat checks were obtained from Safe Kids Michigan. Addresses were geocoded using Google Maps Geocoding API and then mapped at the county level using ArcGIS Desktop 10.3.1. Descriptive statistics were calculated and levels of service were determined at the county and regional levels. Results: In 2014, there were 570,929 children ≤4 years old in Michigan and 979 CPSTs who worked at 209 known seat check locations. An average of 6,854 seats was checked per year through Safe Kids Michigan Coalitions. All but 3 regions met an intermediate service level for seat check locations by offering one or more per 5,000 children ≤4 years old. There was at least one CPST in 80 of 83 counties (median 5; interquartile range, 2, 10.5). Assuming that an average Michigan CPST provides 10 h of service each year, all but 2 regions reached an intermediate service level of at least one technician hour per 90 children ≤4 years old. Fewer regions reached a basic level of service for the number of seat checks. Almost half (49.5%) of Safe Kids Michigan seat checks resulted in a change in child passenger safety behaviors. Conclusions: Child passenger safety resources in Michigan are not evenly distributed yet most regions and counties meet intermediate levels of service. Reallocating resources to areas that are providing basic levels of service could help reduce disparities in child passenger safety behaviors.

Original languageEnglish (US)
Pages (from-to)289-295
Number of pages7
JournalTraffic Injury Prevention
Issue number3
StatePublished - Mar 18 2019


  • Children
  • child restraints
  • child safety
  • child seat
  • misuse

ASJC Scopus subject areas

  • Safety Research
  • Public Health, Environmental and Occupational Health


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