The use of car safety seats for children in China: A questionnaire survey based on the theory of planned behavior.

OBJECTIVE: The purpose of this study was to analyze the psychological characteristics underlying Chinese parents' behaviors in using child car seats and to understand their decision-making processes. Based on the theory of planned behavior (TPB), three extended variables of perceived accident severity, perceived benefits, and perceived barriers were introduced. From the perspective of social psychology, the psychological factors that influence parents' use of child car seats and their interrelationships were explored. METHODS: A questionnaire was designed to collect data, including information on demographic characteristics, basic components of the TPB, and relevant extension variables. Using on online survey, 585 valid questionnaires were collected. Structural equation modeling was used to calibrate the data, and multiple group analysis was performed on the demographic variables. RESULTS: The extended TPB can effectively explain and predict parents' behaviors when using children's car seats. The results of the model show that parents' positive attitudes toward child safety seats (CSSs), others' recognition of their own use and perceptual control of the use of CSSs increase their willingness to use CSSs. Parents' willingness to use has a positive impact on the use of CSSs. Additionally, for the three extended variables introduced, perceived benefit significantly promoted parental intention and behavior to use CSS for children; perceived barriers significantly reduced parental use of CSS; and perceived accident severity had no significant effect on parental use of CSS. CONCLUSIONS: This study established the validity of the extended TPB model in predicting parents' behaviors in using car seats for their children. In addition, the current findings may provide a theoretical basis for policy development to promote CSS use.