Abstract
The application of rewards to increase use of child safety seats is reported. The A-B-A reversal design included observations of seat usage at the parent's and children's arrival at two day care centers (baseline, reward intervention and return to baseline). Categorization of parents as compliant with safety rules followed strict criteria. During the reward phase, compliant parents received lottery tokens redeemable for prizes. The rewards increased compliance from a baseline of 48.7% up to 80% after 2 weeks at one center and from 11.3% up to 63.5% at the other center. Return to baseline evidenced decreased at both centers. The increased seat usage for the safely secured children has obvious and important health implications.