Siéntelos Seguros (Seat Them Safely) Car Seat Safety Campaign

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Arizona Republic reporter Bob Ortega uncovered research that has led to a Valley-wide community project focused on car seat safety. The result of discussions with the community was the creation of “Siéntelos Seguros”- Seat Them Safely campaign. Arizona Republic reporter Bob Ortega, Will Humble, with the Center for Population Science and Discovery at the University of Arizona Health Sciences Center, Dr. Sydney Vail, director of trauma for the Maricopa Integrated Health System, and Cristofer Pereyra, director of the Hispanic mission office for the Roman Catholic Diocese of Phoenix discuss the campaign.

JOSE CARDENAS: Thank you for joining us. Arizona Republic reporter Bob Ortega uncovered research that has led to a valley-wide community project focused on car seat safety. The result of discussions with community groups was the creation of SienteLosSeguros, seat them safely. Here is a PSA about the campaign.

JOSE CARDENAS: Joining me to talk about the SienteLosSeguros car seat safety campaign is Will Humble with the center for population science and discovery at the university of Arizona. Dr. Sydney Vail, director of trauma for the Maricopa integrated health system. And Cristofer Pereyra, director of the Hispanic mission office for the Roman Catholic diocese of Phoenix. Gentlemen, thanks for joining us on "Horizonte." Cristofer, the PSA that we saw for SienteLosSeguros really captured the issue in the very first lines, which is that at least half of Hispanic parents don't use car safety seats for their children and that's why we're all here tonight.

CRISTOFER PEREYRA: That's right. And when they use it importantly they're not using them properly. So what we're trying to accomplish with the PSA and with the larger campaign is to create that cultural shift in which Latino families will realize that this isn't an option, not just because it's the law but because it's about taking care of our children. It's all about protecting their lives.

JOSE CARDENAS: And while this is not a new issue, It's been around for a while. You were actively involved in this. And you've been tracking this, the state has, for a number of years. Why the push now?

WILL HUMBLE: Well, there's been various efforts through the years to try to get better car seat use among Hispanic families but this is the first time in many years in public health that I've seen this level of interagency coordination and getting the diocese involved and really getting the republic and La Vos behind it the full effort in terms of coordination and drilling down to the family level for the awareness and what we've seen so far is truly just the beginning of the campaign. This is going to be going on for many months.

JOSE CARDENAS: Before we get into the specifics of the campaign, give us a sense of the scope of the problem and what you were seeing over the years in your career in public health.

WILL HUMBLE: So this has been a problem for many, many years. There's a report that comes out every year called the child fatality review report which looks at every single child death in Arizona. They go into depth to figure out you know, what caused the death and were they preventable and makes policy recommendations. And the lack of the use of child restraints has been a problem generally in Arizona but what we have seen over the last many years is that Hispanic families tend to use the car seats less frequently than other demographic groups, and while there have been efforts to make changes there, I think this is really the first well-coordinated effort really focused on Hispanic families and so it's an area of real need. In fact, three times more kids die in car accidents than with drownings. People are really aware of the issue of drownings, but the lack of child restraints is just not drilled at the community level the way it needs to be, and I think this is a really good, well-coordinated effort that's going to make a difference.

JOSE CARDENAS: And Dr. Vail, you see the results of this lack of use of child safety restraints at the hospital.

SYDNEY VAIL: Unfortunately, we do. And it's really a terrible thing when you have to go out and tell a family that somebody has died and that it's a child that was injured and it's preventable. That's the whole coordinated effort, if we can treat this on the prevention side instead of the treatment side we're going to be so much further ahead in terms of our community safety and that's really all of our goals.

JOSE CARDENAS: So bob, you did the investigative reporting on this and this is not something you did last weekend and the article appeared in the Sunday paper. Give us a sense of the genesis of this story.

BOB ORTEGA: Well, so about a little more than a year ago I was down working on some other stories on the border and I just noticed that there were -- that it seemed to me that I would see families pretty regularly that did not have their kids properly secured and a lot of those families were Hispanic and it made me wonder whether, in fact, this was an issue. I had a conversation with will actually pretty early on in the process and had looked at a lot of data and realized that, in fact, this was a problem and it isn't a problem only in Arizona by the way. This is also true in Southern California, it's true -- it's true all over the country.

JOSE CARDENAS: This disparity between Hispanic families and non-Hispanic families?

BOB ORTEGA: Yes, exactly but it seemed to me that there would be a good opportunity to address that here and I very quickly thought that it wasn't enough simply to report this is a problem but to try to figure out some way to address that problem. So with the support of the national health journalism fellowship. I was able to spend some time working on this, decided very early on to try to recruit a lot of community organizations to help prepare a campaign so that we could launch that at the same time as the reporting, as we started our reporting. And put the pieces out in the paper and recruited other media partners like La Voz and Univisión who have been very active in this. We've tried to make a coordinated effort in this case.

JOSE CARDENAS: And Cristofer, how did the diocese get involved?

CRISTOFER PEREYRA: The church has always had this interest in protecting every human life so to us, this seemed like a natural fit. But from the beginning, what we talked about was how could we do this so that it actually creates a cultural change? Because there's a lot of good work being done that has been done for several years regarding car seats. So what we are trying to do here is unite efforts, unite resources and at the same time, really strive to get that mindset to change in the minds of Latino parents.

JOSE CARDENAS: We've got some pictures that kind of illustrate what we've been talking about and I want to start with one, Bob, it's actually of you. I don't think you're conducting an interview here but kids like that, that's what we're talking about here, and then in the pictures we've been coming up, these are efforts that show proper seating, including the fact Dr. Vail that at least up to a certain age or depending upon height and weight. These kids need to be seated backwards.

SYDNEY VAIL: Part of it is just the education of understanding when they should be backwards, facing the rear and when they should be facing forward. And the general rule is two years of age, 49 inches, or a weight of 40 to 50 pounds. The problem is the car seats change and the rules change. So you have to be very aware as a parent what car seat did you buy, what age, height and weight is responsible in that car seat and when to change the kid? So it's not just put it in and forget about it. It's being aware of when you're supposed to change things but rear facing is very safe, up to a point of maybe keeping the kid a little longer in the rear-facing seat.

BOB ORTEGA: And if I could just jump in for a second, one of the interesting things that I found in talking with a lot of people who are working in this field on a regular basis. I ask them all, what do you do with your kids? And uniformly, they said yes, the rule is two years but I kept my kid in the rear facing car seat until he was three. The general rule is keep them in the rear facing car seat as long as you can, as long as they fit the seat. Keep them in the forward casing seat as long as you can and move them to the booster only when they can't fit in that seat anymore and keep them in a booster. The law here is, for example, booster seat until they're eight but what they've been telling me is that a lot of kids really aren't big enough at eight to be able to sit safely with a regular shoulder to lap belt. So I've talked to a lot of emergency room and trauma physicians who have kids nine and 10 that are using boosters because that's the safest thing for the kid.

JOSE CARDENAS: We had a couple of other pictures up there showing some of the programs that we're talking about where people can go and get instruction, where they can get free car seats. These are programs that have been going on for a number of years. It doesn't seem to have caught on quite as you would have hoped.

BOB ORTEGA: Well, there's two aspects of this. There have been a lot of groups doing very good work. The governor's office of highway safety, the Phoenix fire and Phoenix police, lots of other fire departments around the valley and also in Arizona. The challenge with the specific regard to Hispanics is in outreach to them. So in many of these cases, the materials may be in English rather than in Spanish, there may be a shortage of trained technicians who can explain in Spanish how to install and use a car seat, which is very important and when to move up to the next type of seat, etc. So that's an issue that we're hoping this campaign will help address.

JOSE CARDENAS: So you've seen campaigns somewhat like this. What's different about this one?

WILL HUMBLE: What's exciting about this one is that the focus is really on that cultural change component and to do that, it needs to be a long-term effort. And that's what this is. This isn't just some brochures, you know, and PSAs for a little bit. But we've got the diocese engaged. This is going to be a long-term effort and that's what's really required to build that cultural change and change the mindset of the use of car seats and that kind of change will last generations, once this is successful. Then you start to see it propagate through the generations. That's really the key is the sustainability and that cultural change.

JOSE CARDENAS: Cristofer, what is the cultural issue?

CRISTOFER PEREYRA: You see Hispanic families really know they're supposed to use car seats. They know they're supposed to have it. They know it's the law but they just do not have the mindset of understanding how crucial it is. Many of us parents don't realize that driving with our children in the car could be the most dangerous things we ever do with our children. So that's what we need to aim at because back in Latin America, Mexico, wherever families might come from if they're recent immigrants, unfortunately either they don't have the laws in place or they just don't enforce them. They're not used to it. So my thought is that what Hispanics are going through right now is probably what the general public, the Anglo population here in the United States, went through maybe 30 or 40 years ago.

BOB ORTEGA: I think that's very true. There are also a couple of specific issues that we've identified, one of them being that there is often among Hispanics this sort of belief that a baby is safest in its mother's arms, therefore it's good to hold your child in your arms in the car and this is not unique to Hispanics. This is also true among Chinese immigrants, for example. But it is a particular problem. Part of it is trying to get people to understand the physics that are involved, that that 15-pound baby turns into a 300-pound projectile when you smack into another car going 30 miles an hour. And so that's very important. And then one other part of it that's very important that we've identified is to a lot of Hispanics tend to make exceptions to when they put kids in car seats. It's just a short trip. Well, it's a lot of trouble to move the car seat over to grandma's car. Or well if the kid is trying to sleep, let them be on the seat. And so the thing is those exceptions increase the risk to the child every single time. It should be completely nonnegotiable.

JOSE CARDENAS: And Dr. Vail, Maricopa gives out free car seats once a month?

SYDNEY VAIL: We do it quite often. We give out 300 a year approximately and it is free, whether you have a child at our hospital, you come to our hospital as a patient or whatever, we give these seats away. We give them all the instructions, how to put it in the car correctly, we go to their car. Fundamentally as a verified trauma center we have an obligation, a mandate that we must do community outreach and what's so phenomenal having such partnerships to be able to make this go widespread instead of such a small segment, make it the whole community and get them in the heart, if you will. Whether it's through the diocese, through the religious background, through just appealing, it's your child. This is a life that you now have to take care of. It's being able to give back to the community but on a much bigger scale, so Maricopa does a wonderful job as other hospitals do. We need to do it even better.

JOSE CARDENAS: So -- I'm sorry, go ahead.

BOB ORTEGA: In fact, one of the car seat technicians I talked to said she often hears this from people like well whether we live or die is god's will. She responds let god protect your soul, you protect your kids.

JOSE CARDENAS: Is as I understand it from discussion we had off-camera, this is not the end of the coverage. This is going to be an ongoing effort. What are we going to be seeing in the weeks ahead?

BOB ORTEGA: There's a lot of issues we'll be looking at. This is also a significant issue among the Native American communities so we'll be looking at that more closely. There are issues with kids riding in the back of pickup trucks, because Arizona allows that, and it's very dangerous. We're going to be talking about a program to donate used car seats to Mexico to help people in Sonora, which is very important and there are a lot more seats that could be contributed than are being right now and every one of those can help save a life and there's some other reporting that I'm going to be looking at systemic design issues and flaws that make car seats harder to use than they need to. So there's a lot of things we'll be looking at.

JOSE CARDENAS: Last question here. The point about the Navajos. The problem's gotten worse there. It's improved slightly amongst Hispanics, but it's getting worse there. Why is that?

WILL HUMBLE: In the last couple of years its gotten a little better with Hispanic families, still a disproportionate problem. Where we've seen it getting worse in the last few years is among Native American families. So same thing a lot of cultural barriers, a lot of logistical things. The type of vehicle that you buy might not be appropriate for a larger family, and that's some of the things I think that we see.

JOSE CARDENAS: We'll have you all back to discuss the other efforts because there's kinds of cars and Consumer Reports maybe evaluating cars for ease of inserting car seats, but we're out of time for tonight. Thank you so much for joining us on "Horizonte" to talk about this very important subject.

Arizona Republic reporter Bob Ortega, Will Humble, with the Center for Population Science and Discovery at the University of Arizona Health Sciences Center, Dr. Sydney Vail, director of trauma for the Maricopa Integrated Health System, and Cristofer Pereyra, director of the Hispanic mission office for the Roman Catholic Diocese of Phoenix discuss the campaign.

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