TSCNewsletter:Contra Costa

Checkups for Kids—and Their
Car Seats

A Contra Costa County prevention specialist talks about the Child Passenger Safety Initiative

Nancy Baer manages injury prevention programs for Contra Costa Health Services in the Community Wellness & Prevention Program. She is coordinating the implementation of the Child Passenger Safety Initiative for her agency. (see related story in this issue:"Making Child Safety Seats Part of a Prescription for Good Health) She spoke with the Traffic Safety Center newsletter about her agency's participation.

In the context of this initiative, how would you characterize Contra Costa Health Services? What kinds of patients does it serve?

Contra Costa Health Services is a very broad, very comprehensive health care system. What's important in this context is that it includes a new hospital, with an obstetric delivery unit and a nursery. In addition, we have seven community clinics spread out throughout the county that provide medical care and preventive programs at the community level. We have the WIC (women, infants and children) nutrition program; we have Healthy Start, which is a peri-natal program, and we have the Child Health Disability Prevention Program, which works on a variety of issues to help prevent disabilities. We also have the Community Wellness and Prevention Program, which houses several preventive programs, such as Injury Prevention, Nutrition/Physical Activity, and Lead Poisoning Prevention. As a department, our priority is the low-income, under-served populations of Contra Costa County. We serve a large number of Spanish-speaking residents, in addition to people of other ethnic backgrounds.

Would you consider this initiative a good fit?

This initiative is a really good fit for us because we're reaching people who are already using our services, and it's relatively easy to partner within our own organization. That's helpful in an initiative like this, which is actually fairly complex.

How is the Child Passenger Safety Initiative deployed in your organization?

We have three basic services: one is that we educate the medical and social work providers about child passenger safety in all of these different settings; the second is that we hold classes for parents and other caregivers (they could be an aunt or uncle or grandparent), and the third is that we conduct a follow-up safety seat check.

How do you get clients?

We make providers aware of the service and set up referral mechanisms. The WIC program is for children under 6; Healthy Start is a peri-natal program—pregnant women, newborns and children in the first year of life. We also get referrals from the Child Health Disability Prevention Program, who serves foster families. Because these programs already have classes, we are piggybacking off existing classes with people who are already participating in classroom sessions. Sometimes we set up special sessions for clinics or programs that don't regularly do classes.

We also have a toll-free number that people can call and get signed up.

In the classes we get very specific about helping people choose the right car seat for the age and weight of their child, about why it's important, and about what can happen to a child in a crash. It's an hour-long presentation. We emphasize hands-on practice in the classroom setting. We bring several kinds of car seats, including booster seats, to the classroom and talk about the characteristics of all of them. We show clients how to tighten the belts, how to position the seat correctly. They get to try that a little bit in the classroom setting.

But it's very different when you try to wrestle the car seat into the car, so, following the class, we strongly urge people to attend a car seat checkup where they can make sure their car seat is installed correctly. The checkups take place at the community clinics either in a parking lot on the grounds of the clinic or nearby. All of this is because about 80 percent of all car seats are not installed correctly, and this makes the children less safe. We use NHTSA-certified Child Passenger Safety Technicians in all of these activities, so people are getting advice from the experts.

How often do you do this?

We have two to three presentations and checkups each week. Usually there are up to eight to 10 people at a meeting—about 60 people a month. Now that the rain has started, we're going to have to be flexible and creative about our car seat checkups, since they are held outside. We have purchased a canopy, but when the weather's really bad we'll just need to cancel.

What are some of the challenges to success?

For a while we weren't getting many people to come to the checkups, so during the presentations we worked with people on that. After they signed up for a checkup, we called them to remind them, and the numbers increased significantly. We learned how to frame our request and encourage people.

Are there other challenges?

The biggest challenge is that the people we're serving have big transportation barriers of their own. Usually the family has only one car and one job, if that. Dad goes to work, and mom stays home. Transportation is a constant issue. For example, low-income people don't just hop in the car and go somewhere. They might take public transportation to a clinic one way and have a friend pick them up. The children and the car seat move around, which is why we have them practice, why we encourage the hands-on approach—so they'll be ready to do it on their own.

Another challenge is we're dealing with older cars. Some only have lap belts in the back seat. And for older children there's only one model booster seat that works with lap belts; the Britax, but it's being discontinued. We have no choice but to tell parents they should have their children over six wear just the lap belt in these older cars, which is legal, but not safe.

What kinds of feedback have you gotten from clients and providers?

The clients all seem to really like it. The providers are really glad to see this service for their clients because they are very busy providing other services and it's not something they can offer.

How do you make sure people have car seats for their children?

There are two ways people can get seats from us. The primary way is that we distribute vouchers to those who attend our class, and this pays $35 toward the cost of a seat. That usually covers a booster seat or about half a car seat. We do pretty extensive interviewing over the phone to see if the voucher works for them. The alternative is to give them a seat, and we have a very limited number of seats for giving away. We have to purchase and store the seats, then transport them to the check-up site, so there's a whole bunch of logistics to deal with when we give seats away.

What next steps do you see taking?

Before the project is over, we are going to start reaching people through our pediatric clinics as well, but we have to develop a structure there because they don't already have classes. We will also review all the written policies. The policies we have now comply with state law, but we would like to explore whether there are things that we can do within Contra Costa Health Services that go beyond state law.

We're also beginning to strategize about how to continue this project after the money runs out in June. We want to go a little further in the direction of encouraging the providers in our system to learn more about car seats and incorporate little things into their existing systems and practices. We're also considering more partnerships with agencies like the Child Care Council, a resource agency for child care providers, or with community based organizations that have a similar population and interest in child safety. Depending on what funding is available in the future, we may do one or both. Or we may need to shrink ourselves and do some very basic work. We will work hard and hope that the latter is not the case, but funding is getting tighter and tighter.

Related Links:

Pre-Intervention Assessment of the Initiative

California Child Restraint Laws (PDF, 100KB)

Oct 1, 2001 Press Release announcing Child Passenger Safety Iniaitive (Word Doc.)

UC Berkeley Press Release on Pre-Intervention findings


Online newsletter Volume 1, Number 2: December 2002
Related Links: Making Child Safety Seats Part of a Prescription for Good Health A new initiative brings awareness of their correct use to hospitals and clinics. Oct 1, 2001 Press Release announcing Child Passenger Safety Iniaitive (Word Doc.) Pre-Intervention Assessment of the Initiative UC Berkeley Media Relations Press Release on Pre-Intervention findings Contra Costa Community and Wellness & Prevention Program NHTSA's Child Safety Seat Inspection Station Locator Other stories this issue: Getting People To Buckle Up Seat belts are still the best way to save lives Measuring Safety Measures A new toolkit for local agencies to evaluate their interventions The "Forgotten Child" Is Getting Some Attention at Last Booster seats now the law in some states An Interview with David Manning Administrator of NHTSA's Region 9 talks about improving occupant safety in California Teresa Becher on Traffic Safety in California An interview with the Interim Director of the Office of Traffic Safety Printable PDF version of this article Printable PDF of newsletter (789 KB) Send us your comments or email a letter to the editor Traffic Safety Center Home *Other issues of the TSC newsletter* Top of page	Checkups for Kids—and Their Car Seats A Contra Costa County prevention specialist talks about the Child Passenger Safety Initiative Nancy Baer manages injury prevention programs for Contra Costa Health Services in the Community Wellness & Prevention Program. She is coordinating the implementation of the Child Passenger Safety Initiative for her agency. (see related story in this issue:"Making Child Safety Seats Part of a Prescription for Good Health) She spoke with the Traffic Safety Center newsletter about her agency's participation. In the context of this initiative, how would you characterize Contra Costa Health Services? What kinds of patients does it serve? Contra Costa Health Services is a very broad, very comprehensive health care system. What's important in this context is that it includes a new hospital, with an obstetric delivery unit and a nursery. In addition, we have seven community clinics spread out throughout the county that provide medical care and preventive programs at the community level. We have the WIC (women, infants and children) nutrition program; we have Healthy Start, which is a peri-natal program, and we have the Child Health Disability Prevention Program, which works on a variety of issues to help prevent disabilities. We also have the Community Wellness and Prevention Program, which houses several preventive programs, such as Injury Prevention, Nutrition/Physical Activity, and Lead Poisoning Prevention. As a department, our priority is the low-income, under-served populations of Contra Costa County. We serve a large number of Spanish-speaking residents, in addition to people of other ethnic backgrounds. Would you consider this initiative a good fit? This initiative is a really good fit for us because we're reaching people who are already using our services, and it's relatively easy to partner within our own organization. That's helpful in an initiative like this, which is actually fairly complex. How is the Child Passenger Safety Initiative deployed in your organization? We have three basic services: one is that we educate the medical and social work providers about child passenger safety in all of these different settings; the second is that we hold classes for parents and other caregivers (they could be an aunt or uncle or grandparent), and the third is that we conduct a follow-up safety seat check. How do you get clients? We make providers aware of the service and set up referral mechanisms. The WIC program is for children under 6; Healthy Start is a peri-natal program—pregnant women, newborns and children in the first year of life. We also get referrals from the Child Health Disability Prevention Program, who serves foster families. Because these programs already have classes, we are piggybacking off existing classes with people who are already participating in classroom sessions. Sometimes we set up special sessions for clinics or programs that don't regularly do classes. We also have a toll-free number that people can call and get signed up. In the classes we get very specific about helping people choose the right car seat for the age and weight of their child, about why it's important, and about what can happen to a child in a crash. It's an hour-long presentation. We emphasize hands-on practice in the classroom setting. We bring several kinds of car seats, including booster seats, to the classroom and talk about the characteristics of all of them. We show clients how to tighten the belts, how to position the seat correctly. They get to try that a little bit in the classroom setting. But it's very different when you try to wrestle the car seat into the car, so, following the class, we strongly urge people to attend a car seat checkup where they can make sure their car seat is installed correctly. The checkups take place at the community clinics either in a parking lot on the grounds of the clinic or nearby. All of this is because about 80 percent of all car seats are not installed correctly, and this makes the children less safe. We use NHTSA-certified Child Passenger Safety Technicians in all of these activities, so people are getting advice from the experts. How often do you do this? We have two to three presentations and checkups each week. Usually there are up to eight to 10 people at a meeting—about 60 people a month. Now that the rain has started, we're going to have to be flexible and creative about our car seat checkups, since they are held outside. We have purchased a canopy, but when the weather's really bad we'll just need to cancel. What are some of the challenges to success? For a while we weren't getting many people to come to the checkups, so during the presentations we worked with people on that. After they signed up for a checkup, we called them to remind them, and the numbers increased significantly. We learned how to frame our request and encourage people. Are there other challenges? The biggest challenge is that the people we're serving have big transportation barriers of their own. Usually the family has only one car and one job, if that. Dad goes to work, and mom stays home. Transportation is a constant issue. For example, low-income people don't just hop in the car and go somewhere. They might take public transportation to a clinic one way and have a friend pick them up. The children and the car seat move around, which is why we have them practice, why we encourage the hands-on approach—so they'll be ready to do it on their own. Another challenge is we're dealing with older cars. Some only have lap belts in the back seat. And for older children there's only one model booster seat that works with lap belts; the Britax, but it's being discontinued. We have no choice but to tell parents they should have their children over six wear just the lap belt in these older cars, which is legal, but not safe. What kinds of feedback have you gotten from clients and providers? The clients all seem to really like it. The providers are really glad to see this service for their clients because they are very busy providing other services and it's not something they can offer. How do you make sure people have car seats for their children? There are two ways people can get seats from us. The primary way is that we distribute vouchers to those who attend our class, and this pays $35 toward the cost of a seat. That usually covers a booster seat or about half a car seat. We do pretty extensive interviewing over the phone to see if the voucher works for them. The alternative is to give them a seat, and we have a very limited number of seats for giving away. We have to purchase and store the seats, then transport them to the check-up site, so there's a whole bunch of logistics to deal with when we give seats away. What next steps do you see taking? Before the project is over, we are going to start reaching people through our pediatric clinics as well, but we have to develop a structure there because they don't already have classes. We will also review all the written policies. The policies we have now comply with state law, but we would like to explore whether there are things that we can do within Contra Costa Health Services that go beyond state law. We're also beginning to strategize about how to continue this project after the money runs out in June. We want to go a little further in the direction of encouraging the providers in our system to learn more about car seats and incorporate little things into their existing systems and practices. We're also considering more partnerships with agencies like the Child Care Council, a resource agency for child care providers, or with community based organizations that have a similar population and interest in child safety. Depending on what funding is available in the future, we may do one or both. Or we may need to shrink ourselves and do some very basic work. We will work hard and hope that the latter is not the case, but funding is getting tighter and tighter. Related Links: Pre-Intervention Assessment of the Initiative California Child Restraint Laws (PDF, 100KB) Oct 1, 2001 Press Release announcing Child Passenger Safety Iniaitive (Word Doc.) UC Berkeley Press Release on Pre-Intervention findings NHTSA's Child Safety Seat Inspection Station Locator Top of page Printable PDF version of this article Printable PDF of newsletter (789 KB) Send us your comments or email a letter to the editor Back to Front Page Traffic Safety Center Home *Other issues of the TSC newsletter*