Community norms and transportation safety behaviors among caregivers of children 6 months to 10 years old in chicago.

OBJECTIVE: Motor vehicle collisions are a leading cause of death for children. Risks of driver speeding, distraction, and impairment and protective benefits of following child passenger safety guidelines are well established, as are differences in safety behaviors and crash outcomes for child passengers across racial, ethnic, and linguistic groups. Persistent disparities warrant contemporary exploration of potentially modifiable factors across groups. In this study we examine differences in community transportation safety norms in relation to caregiver-reported risky driving behaviors, restraint use, and child passenger safety guideline adherence across racial, ethnic, and linguistic groups. METHODS: We conducted a secondary analysis of baseline data collected in the Tiny Cargo, Big Deal/Abróchame Bien, Cuídame Bien clinical trial (NCT04238247). We examined caregiver-reported agreement with eight statements about community norms for transportation safety (e.g., acceptability of cell phone use and adherence to child passenger safety guidelines) and their self-reported engagement in six risky driving behaviors (e.g., speeding and cell phone distractions), two seat belt use situations, and three child passenger safety behaviors. In complete case chi-square and Fisher's exact tests analyses, we compared transportation behaviors and community norms across race, ethnicity, and preferred language. We also tested for associations between agreement with community norm statements and caregiver-reported engagement in related transportation safety behaviors using unadjusted logistic regression and logistic regression adjusted for caregiver demographic characteristics and child age. Analyses were conducted in Stata 18.0. RESULTS: Complete responses from 474 caregivers of children 6-months to 10-years-old were analyzed. Most participants identified as mothers (93.2%), 64.1% were married, and 60.97% completed a bachelor's, graduate or professional degree. The median caregiver age was 36 years (interquartile range (IQR) 21, 50). One in ten participants preferred Spanish (n = 52) and among caregivers who preferred English, most identified as white (n = 175) or Hispanic/Latine (n = 138). Racial, ethnic, and linguistic group variation was observed for ten of eleven transportation behaviors and six of eight community norms for transportation safety (p < 0.05). Traveling unrestrained was most common among caregivers who preferred Spanish. However, speeding and cell phone use while driving were more common among caregivers who identified as white and preferred English. Several risky transportation behaviors were associated with related community norms (e.g., caregivers who perceived texting while driving as unacceptable in their community had higher odds of reporting never checking their phone while driving and their car was moving) (Adjusted Odds Ratio 3.61, 95% Confidence Interval: 2.18, 5.99, p < 0.001). CONCLUSIONS: Caregiver reported engagement in risky transportation behaviors varied by race, ethnicity, and preferred language and was associated with community norms. Linguistically and culturally tailored campaigns seeking to modify community norms may be a strategy to reduce risky transportation behaviors among caregivers of young children.