Predictors of child restraint usage among Chinese parents

Objective: To investigate psychological predictors of the use of child restraints among Chinese parents following passage of national law requiring their use. Methods: Grounded in the Prototype Willingness Model (PWM) and guidance from previous research, we developed and administered a questionnaire to assess child restraint usage and understand psychological factors that predict usage. 413 parents with child(ren) aged 0–8 years completed the questionnaire through the WenJuanXing online survey platform. Results: Among the 413 parents, 321 (77.7%) used child restraints regularly when taking their children on car trips, with the highest use reported among parents with children under 1 year (83.8%). Among the psychological predictors, willingness to use a restraint was the strongest predictor of intention and self-reported behavior to use restraints, but the predictive effect of intention on behavior was not significant. Descriptive norms – a belief that trusted friends and family use restraints – was the strongest predictor of behavior to use child restraints, and prototype favorability – the belief that prototypical parents of similar age and gender use restraints – also showed significant effects in predicting behavior. Conclusions: Following the passage of national laws requiring child restraints in China, it is becoming more common for parents to use restraints when their children travel by car. Parents’ use of child restraints for children follows a socially reactive (through willingness) decision-making path rather than a reasoned (through intention) decision-making pattern. The influence of the behavior of others, both trusted friends and family (descriptive norms) and prototypical similar parents (prototype favorability) are strong predictive factors for use of child restraints, suggesting prevention programs might leverage behavior of others to impact parents and encourage use of child restraints.