A Cochrane review [Abstract] 1 included 5 studies on promoting use of booster seats, with a total of 3 070 subjects. Booster seats in motor vehicles are designed to raise four to eight year olds off the vehicle seat, allowing them to use adult seat belts more safely and comfortably. All interventions demonstrated a positive effect (relative risk (RR) 1.43; 95% confidence intervals (CI) 1.05 to 1.96). Incentives combined with education demonstrated a beneficial effect (RR 1.32, 95% CI 1.12 to 1.55; n = 1,898). Distribution of free booster seats combined with education also had a beneficial effect (RR 2.34; 95% CI 1.50 to 3.63; n = 380) as did education-only interventions (RR 1.32; 95% CI 1.16 to 1.49; n = 563). One study which evaluated enforcement of booster seat law met the criteria for inclusion in the meta-analysis, but demonstrated no marked beneficial effect.
Comment: The quality of evidence is downgraded by limitations in study quality (e.g., results partly based on self-reports, significant attrition rates in some studies).
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