Low rates of child restraint system use in cars may be due to fatalistic beliefs and other factors

Restraining children in cars has proven to save lives during car crashes. However, not all drivers of cars with children in them comply with the law regarding child restraint system (CRS) use. The aim of this study was to measure the rate of child and adult CRS use and to identify associations between fatalistic beliefs and CRS use among Arab children. A random sample of 380 Arab drivers transporting children 8 years and younger in Israel were interviewed after observing 835 children traveling in 400 vehicles. Proper restraint ranged from 41% among children aged one to three to 9% among booster seat-eligible children. In a logistic regression model driver seat belt use, fatalistic beliefs, knowledge regarding the law on CRS, number of children in the car, age and gender were associated with all the children being restrained in the car. Drivers with higher levels of fatalistic beliefs had a lower odds ratio of restraining their children in the car, after adjusting for the other confounding variables (OR = 0.80, CI = 0.65, 0.97). High levels of fatalism and low levels of knowledge in addition to other factors may inhibit Israeli Arab parents from restraining their children in cars. Therefore, children in these communities are at risk of injury or death in motor vehicle crashes and there is a need for tailored interventions specific for this population.