Objectives Safety restraints reduce injuries from motor vehicle collisions (MVCs) but are often improperly applied or not used. The Childhood Opportunity Index (COI) reflects social determinants of health and its study in pediatric trauma is limited. We hypothesized that MVC patients from low-opportunity neighborhoods are less likely to be appropriately restrained. Methods A retrospective cross-sectional study was performed on children/adolescents ≤18 years old in MVCs between January 1, 2011 and December 31, 2021. Patients were identified from the Children’s Hospital Los Angeles trauma registry. The outcome was safety restraint use (appropriately restrained, not appropriately restrained). COI levels by home zip codes were stratified as very low, low, moderate, high, and very high. Multivariable regression controlling for age identified factors associated with safety restraint use. Results Of 337 patients, 73.9% were appropriately restrained and 26.1% were not appropriately restrained. Compared with appropriately restrained patients, more not appropriately restrained patients were from low-COI (26.1% vs 20.9%), high-COI (14.8% vs 10.8%) and very high-COI (10.2% vs 3.6%) neighborhoods. Multivariable analysis demonstrated no significant associations in appropriate restraint use and COI. There was a non-significant trend that children/adolescents from moderate-COI neighborhoods were more likely than those from very low-COI neighborhoods to be appropriately restrained (OR=1.82, 95% CI 0.78, 4.28). Conclusion Injury prevention initiatives focused on safety restraints should target families of children from all neighborhood types. Level of evidence III. Data are available upon reasonable request.

中文翻译：

---

童年时期的机会以及在机动车碰撞中适当使用儿童安全约束装置

目标 安全约束装置可减少机动车辆碰撞 (MVC) 造成的伤害，但常常应用不当或未使用。童年机会指数（COI）反映了健康的社会决定因素，其在儿科创伤方面的研究有限。我们假设来自机会少的社区的 MVC 患者不太可能受到适当的限制。方法 对 2011 年 1 月 1 日至 2021 年 12 月 31 日期间 MVC 中 ≤ 18 岁的儿童/青少年进行回顾性横断面研究。患者来自洛杉矶儿童医院创伤登记处。结果是安全约束的使用（适当约束，不适当约束）。按家庭邮政编码划分的 COI 水平分为极低、低、中等、高和极高。控制与安全约束使用相关的年龄识别因素的多变量回归。结果 337例患者中，73.9%得到适当约束，26.1%未得到适当约束。与适当约束的患者相比，未适当约束的患者更多来自低 COI（26.1% vs 20.9%）、高 COI（14.8% vs 10.8%）和极高 COI（10.2% vs 3.6%）社区。多变量分析表明，适当的约束使用和 COI 之间没有显着关联。有一个不显着的趋势，即来自中等 COI 社区的儿童/青少年比来自极低 COI 社区的儿童/青少年更有可能受到适当限制（OR=1.82，95% CI 0.78，4.28）。结论 以安全约束为重点的伤害预防举措应针对所有社区类型儿童的家庭。证据级别 III.数据可根据合理要求提供。