Doctor's advice may boost car seat use

NEW YORK, Aug 18 (Reuters) While a doctor's advice can encourage people to use car seats for children younger than four, there is less data on the effectiveness of counseling on motor vehicle restraint use for older kids and adults, according to a new study. And there's no evidence that doctors can help prevent alcohol-related car crashes by warning patients about the risks of drunk driving, the study team found.

Motor vehicle accidents are the leading killer of people between 3 and 33 years of age in the US, the researchers note in their study, which was commissioned by the US Preventive Services Task Force (USPSTF).

In 1996, the USPSTF issued a recommendation urging primary care doctors to counsel their patients about using seatbelts, booster seats and car seats to help prevent car crash injuries.

Dr Selvi B Williams of the Kaiser Permanente Center for Health Research in Portland, Oregon and colleagues reviewed all available studies to see whether this counseling had any independent effect on increasing proper restraint use, and also to determine if counseling on the risks of drinking and driving was effective.

Eighty per cent of adults use seatbelts, while car seat use is 90 per cent and use of booster seats is rising, the USPSTF notes in a statement accompanying the study, but proper use of car seats and booster seats remains low.

In their review, Williams and colleagues found that interventions that included demonstrations of proper restraint use were more effective than counseling alone, as were approaches that included distributing free or reduced-price car safety seats.

Among parents of children younger than 4, counseling did indeed increase correct use of car safety seats in the short term. The researchers found just two studies on the effect of counseling 4- to 8-year-olds on booster seat use, and just three studies of counseling older kids, teens and adults on proper seatbelt use. There were no studies at all on the effectiveness of counseling on alcohol-related driving.

Based on other research on drunk driving, the researchers say, ''Screening all patients for alcohol misuse and then intervening with risky and harmful users (instead of counseling all primary care patients about reducing alcohol-related driving) may be the best evidence-based approach that is currently available for primary care clinicians.'' In order to ensure widespread and appropriate use of motor vehicle restraints by adults and children, the USPSTF concludes, a multi-pronged approach including legislation, counseling, community-based efforts, and enforcement is necessary.

REUTERS AE VV0846