Barriers and facilitators of using child restraint systems (CRS) on airplanes: Perspectives of caregivers and airline personnel

Abstract

Introduction

Families flying with young children face several options regarding their method of restraint on the aircraft. Travel decisions are often driven by a variety of factors and no study has explored the factors associated with families' choices of travel modes or the airline staff's role in these decisions. The objective of this work is to identify strengths and opportunities for improvement in perception and knowledge about in-flight child restraint system (CRS) use.

Methods

A focus group was conducted with United States (US)-based airline personnel (n = 16) and an online survey was conducted with US caregivers who had recently flown with young children (n = 786). Qualitative and quantitative data about restraint decisions, in-flight experiences, and injuries while traveling were collected.

Results

Airline personnel felt that caregivers often do not know best practices for keeping their child safe in-flight and do not recognize flight attendants as highly trained safety professionals. Airline personnel often feel discord between the priorities of the caregivers and the safety rules enforced by the airline. Of caregiver survey respondents, 29% reported using a CRS on their flight, 32% held their child in their lap, and 39% had the child seated in their own seat without a CRS. The primary reason for using a CRS was safety, followed by ease of travel. Barriers to usage include cost and difficulty in logistics of carrying/traveling with the CRS itself. Those who planned to use their own CRS at their destination were five times more likely to use a CRS during the flight compared with those not needing a CRS at their destination (p < 0.05).

Conclusions

Flight attendants are trained extensively in safety measures, but caregivers may not be aware of best in-flight practices. Additional educational efforts, clarity/accessibility of airline policies, and assistance with airport logistics might enable more caregivers to make safe decisions for their children.