Motor vehicle crashes are the leading cause of unintentional injury-related death among children ages 14 and under and of these children who were fatally injured more that 60 % were not using safety restraints at the time of the collision. Children who are too large for child safety seats are often restrained improperly or not at all. In addition, many children are being shifted from child safety seats to adult safety belts prematurely. For proper protection, children who have outgrown child safety seats require booster seats combined with vehicle lap/shoulder belts. A booster seat raises a child up so that the lap and shoulder belts fit properly. The current research went through a systematic approach, from several perspectives, to develop an effective pamphlet to increase behavioral compliance of purchasing a booster seat. The pamphlet developed throughout these studies had a substantial and positive effect on intention and perceived control as well as a meaningful and substantial impact on actual purchase behavior. In addition, the associated guidelines that were developed allow others to produce effective printed educational materials. This research consisted of five studies described below. Study 1 consisted of 43 subject matter experts who were used to determine pertinent information that should be included in a complete booster seat pamphlet. Nine of the 20 items showed significance and were included in the first iteration of the pamphlet. Study 2 consisted of 5 parents of children who should be in booster seats and were not at the time of the study, evaluated the usability of the first iteration pamphlet. A total of 18 items were changed in the pamphlet and a subsequent second iteration of the pamphlet was developed. Study 3 consisted of 30 parents of children who should be in booster seats and were not at the time of the study, were used to assess the comprehensibility (Cloze test), hazard-risk judgments (carefulness ratings), and understandability (questionnaire) of three booster seat pamphlets. Significance was found for the second iteration pamphlet in both comprehensibility and understandability, but no significance was found in risk perception. Study 4 consisted of 8 human factors graduate students who were used to assess the reading level (SMOG test), instructional design and inclusion of learning principles (BIDS-3 test), and readability (RAINS test) of three booster seat pamphlets. The second iteration pamphlet and two existing industry pamphlets were used in Studies 3 and 4 and significance was found for the second iteration pamphlet in both instructional design and learning principles as well as readability and was the only pamphlet to have a reading level under 8th grade. Subsequent to these studies a third iteration of the new pamphlet was developed. Study 5 consisted of 45 parents of children who should be in booster seats and were not at the time of the study. Three booster seat pamphlets, two from the child passenger safety industry and the third iteration pamphlet were used as treatments (15 participants per group). Effectiveness of the intervention was tested by assessing three variables, intent to purchase (revealed that when intent was high purchase was high), perceived control of purchasing (revealed that when perceived control was high purchase was high), and actual purchase behavior (third iteration pamphlet showed a significantly higher purchase rate than the industry pamphlets). Of the 19 participants who purchased a booster seat, there were 12 (63%) in the third iteration pamphlet group, 2 (11%) in the alternate 1 pamphlet group, and 5 (26%) in the alternate 2 pamphlet group, and 100% of those who purchased, reported that they use them each time their child rides in a vehicle. This research increased our understanding of information design and well as generating general design guidelines for pamphlets. In addition, this research produced a pamphlet for credible sources to use as an education tool for parents who have children who should be in booster seats and are not placed in them when riding in a vehicle. / Ph. D.

The "Actively Caring for KIDS Process," a multi-component program that taught retail store sales associates to act as behavior-change agents for child passenger safety, was implemented at a nationwide-chain discount store and evaluated with an interrupted time series design and a similar control site for comparison. Key components of the KIDS Process included a) training of sales associates to act as behavior-change agents at the point-of-purchase, b) the use of in-store awareness and supportive materials such as posters and sales associate buttons, and c) incentives for participation in checkpoints. Safety-seat checks (n = 31) were held in store parking lots, where caregivers' safety-seat installations (n = 241) were recorded as safe or at-risk for a variety of criteria and then the seats were reinstalled correctly. Research assistants posing as child caregivers visited the retail stores (n = 156) with the purported objective of obtaining information about selecting and installing a safety seat. Information given by sales associates was systematically recorded as safe or at-risk on a checklist. A 2 (Store) x 2 (Phase) ANOVA on sales associates' percent safe information scores revealed a significant interaction and no main effects. The Control store did not differ across the two phases, but scores at the intervention store were significantly higher after the intervention than during pre-intervention and when compared to the Control store during post-intervention. The training of sales associates resulted in an average 65% increase in percent safe scores. At the parking lot checks, 93 percent of seats checked were misused in one or more ways, with an average of four errors per seat. ANOVA and Chi-square analyses indicated that the intervention failed to have an impact on child safety-seat misuse observed or on the number of participants attending the checkpoints. This is likely a result of few parents attending the checkpoints who had talked to our trained associates. To target more parents, this intervention might be better placed at well-baby checkups. / Ph. D.

Motor vehicle crashes remain a leading cause of death and injury for US children, despite improved crashworthiness of vehicles and effective restraint systems for children of all ages. Children who are too large for child safety seats (a child restraint system for children from birth to 4 years old) are often restrained improperly or not at all. These children should be restrained in a booster seat which is a type of child safety seat designed for children who have out grown their convertible seat and are not large enough to fit properly in an adult seat belt. For this reason, the use and correct use of occupant protection for 4-9 year old children in particular needs to be addressed. For proper restraint, children who have outgrown child safety seats require booster seats used with vehicle lap/shoulder belts. This present study attempted to determine if raising risk perception and/or lowering cost of compliance would influence more parents to purchase booster seats for their children who should be restrained in them. A field study with 128 participants with four treatment groups was conducted to test the following two hypotheses. 1) Informational pamphlets and dollars off coupons will reduce compliance cost and thereby induce the purchase of booster seats, 2) informational pamphlets will increase risk perception. Of the 128 participants, 37 (from various treatment groups) purchased booster seats, and 100% of those who purchased, reported that they use them each time their child rides in a vehicle. Unlike previous studies on risk perception of consumers, this study went beyond post measures of attitude change and assessed actual purchase behavior through self-reports from the participants. In so doing, this study was able to draw inferences about the effects of the interventions on purchase behavior. The analyses indicated that intervention of any kind was more effective than no intervention in influencing the purchase of a booster seat. Thus, the intervention encouraged adoption of a safety product. This study hopes to achieve a change in people's perception of booster seats regarding the safety of children in vehicles. In addition, possibly influencing future legislation regarding child passenger safety. / Master of Science