Evaluation of give kids a boost: A school-based program to increase booster seat use among urban children in economically disadvantaged areas

Objective: This study evaluated the effectiveness of a series of 1-year multifaceted school-based programs aimed at increasing booster seat use among urban children 4–7 years of age in economically disadvantaged areas.

Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P₀), 1–4 weeks after the completion of project implementation (P₁), and 4–5 months later (P₂). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.

The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.

The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.

Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P₀ and P₁ (P₀ = 4.8%, P₁ = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P₂ time period (P₂ = 25.7%; P < .001, for P₀ vs. P₂) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P₀ time period and compared to the comparison schools.

Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings.     

Lethal and sub-lethal effects of the fungicide chlorothalonil on three life stages of the grass shrimp,Palaemonetes pugio

Chlorothalonil (2,4,5,6-tetrachloroisophthalonitrile) is the second most widely used fungicide in the United States. Due to the widespread use of chlorothalonil, it is important to investigate the effects chlorothalonil may have on estuarine species such as the grass shrimp, Palaemonetes pugio. This study examined the toxicity of chlorothalonil to three life-history stages (embryo, larvae, adult) of the grass shrimp. Also, molting frequency, growth response and metamorphosis from a larval life cycle pulsed exposure assay were examined as sub-lethal indicators of chlorothalonil exposure. Results showed embryos were the least sensitive with a 96-h Median Lethal Concentration (LC50) of 396.0 microg/L (95% Confidence Interval [CI] 331.3-472.4 microg/L). The adult 96-h LC50 was 152.9 microg/L (95% CI 120.3-194.5 microg/L). Larvae were the most sensitive to chlorothalonil exposure with a 96-h LC50 of 49.5 microg/L (95% CI 44.4-55.27 microg/L). In the life cycle pulsed exposure assay, all surviving larvae in the treatments required significantly more molts to reach postlarvae than the control. Other measured parameters showed differences between treatments and control but there was no statistical significance. This research demonstrated that chlorothalonil is highly toxic to grass shrimp and that larval grass shrimp would be the most appropriate life stage to use for chlorothalonil risk assessments since that stage is the most sensitive.