Level of adherence and determinants of practicing child restraint system in the vehicle among guardians of children attending kindergarten schools in the western sector of makkah city, january 2020. A cross-sectional study

Background: Motor Vehicle Crash (MVC) is the second leading cause of morbidity and mortality in children. Therefore, it is essential to keep children protected in the car by practicing child passenger safety arrangements known as Child Restraint System (CRS). Objectives: To assess the level of adherence and determinants of practicing CRS in the vehicle among guardians of children. Subjects and Methods: Analytic cross-sectional study has been conducted among the guardians of children attending Kindergarten (KG) schools in the western sector of Makkah city, Saudi Arabia. A self-administered validated questionnaire was used for data collection. It consists of two sections: socio-demographic data and general information of the participants and apart assessed the practicing and the application of CRS. Results: The study included 342 guardians. The age of more than half of them (57%) ranged between 30 and 50 years and almost three-quarters (75.1%) of them were females. Always using the seat belt was mentioned by slightly more than half of the participants (52.4%). Almost half of the participants (49.4%) reported the current existence of the children's car seats. Adherence to the Child Restraint System in the Vehicle was reported by almost half of the participants (50.9%). The highest rate of adherence to the CRS in the Vehicle was observed among participants aged between 20 and 29 years (63.8%) whereas the lowest rate was observed among those aged over 50 years (39.2%), p=0.011. Regarding the marital status, single participants had the highest rate of adherence to the CRS (60%) whereas divorced participants had the lowest rate (20.8%), p=0.005. Postgraduate participants had a higher rate of adherence to the CRS compared to university or below university graduated (65.6% versus 47.1% and 50%, respectively), p=0.038. Participants whose income exceeded 20000 SR/month were more adherent to the CRS (60%) than those with lower income, p=0.046. Conclusion: Adherence of guardians to CRS in the vehicle was not enough in comparison to the level of adherence in the US which was around 65%, and further reconsideration is needed for the safety of children in vehicles in Makkah city.