Parental Driving Behaviors of Child Passengers Ages 4-10 Years

Principal Investigator: Catherine McDonald, PhD, RN, Children’s Hospital of Philadelphia and the University of Pennsylvania

Below is an executive summary of this project. Please note that this summary describes results and interpretation that may not be final. Final interpretation of results will be in the peer-reviewed literature.


Motor vehicle crashes (MVCs) remain a leading cause of injury and death in children. Parental driving behaviors, such as improper child passenger restraint use and distracted driving can contribute to crash-related injury. Describing behaviors of parents may lead to more precise prevention efforts that target high-risk groups. We used a cross-sectional survey design to collect data on caregiver utilization of child restraint system use, carpooling behaviors and distracted driving behaviors. We recruited through TurkPrime and the screener survey was completed by 4,327 participants on mTurk; the analytic sample included 783 participants (n=409 are used in analysis of situational use of booster use and car seat).

Situational use of booster seat and car seat users

Booster seat users were more willing to have their child not fully buckled among situations involving rental cars, driving just around the corner, car too crowded to fit the child restraint system, not enough child restraint systems in the vehicle, the child restraint system is missing from the car, or the child is in someone else’s car without a child restraint system. Caregivers who typically do not use booster seats for their own child are significantly less likely to use booster seats for other children ages 4-10 then than caregivers who use a booster seat for their own child. Caregivers who typically use booster seats for their oldest child between ages 4-10 years do no consistently ask others to use a booster seat for their child or give one to others. Caregivers engages in cell phone distracted driving while the car was moving and children were in the car: over 50% of the sample engaged in hands-free calls, ~45% engaged in hand-held calls, ~35% read a text and >25% sent a text. Those who did not always use their typical child restraint system were more likely to engage in hands-free calls, reading a text, sending a text and using social media while driving (car moving and children were in the car).

Efforts to increase booster seat use should focus on the practical barriers identified in this survey—such as practical issues related to lack of booster seats in a vehicle or not enough room. Likewise, when prevention efforts target proper child restraint use, distracted driving behaviors should also be addressed.

Project Team Members

Linda Fleisher, PhD, Children’s Hospital of Philadelphia; Mark Zonfrillo, MD, Children’s Hospital of Philadelphia


Roxanne Esquivel, University of Pennsylvania; Venessa Le, Temple University; Erin Kennedy, University of Pennsylvania; Kehinde Oyekanmi, Temple University; Devan Russo, Temple University; Maggie Staubel, University of Pennsylvania

IAB Mentors

Jon Sumroy, Mifold