How one ambitious reporting campaign worked to get Latino children into car seats

Writing about border and immigration isssues for the Arizona Republic, I spent plenty of time visiting twin communities along the U.S.-Mexico border such as Nogales, Ariz., and Nogales, Sonora.

I began to notice, on these visits, how frequently, even on the U.S. side, I’d see Hispanic families in pickup trucks or SUVs with the mothers holding their children on their laps, or the kids bouncing around in the back seat, unsecured by any sort of car seat.

Once I started paying attention, the same phenomenon was glaringly obvious around the roads in Phoenix. Some digging into car-seat usage surveys and traffic-accident statistics and a bit of number crunching confirmed my suspicions: Latino parents were significantly less likely to put their kids in car seats; and Latino parents who did have car seats were less likely than other parents to install and use them correctly.

An analysis of studies, surveys and other data showed that, depending on the child's age, the type of seat and other factors, Hispanic and Native American children were from two times to as much as 10 times likelier not to be properly restrained.

As a result, Latino and Native American children were being injured and dying in car accidents – unnecessarily, avoidably – at a disproportionately high rate. While overall, in Arizona, only 5 percent of children under 5 years old in vehicle accidents weren’t restrained in child seats, those children accounted for 44 percent of the deaths.

And the studies and data suggested that this same phenomenon was happening not only in Phoenix, but in nearly all communities with large Hispanic populations – and that the rates of misuse were high both among immigrant and U.S.-born Hispanic families.

It wasn’t enough simply to report the fact of these low rates of car-seat usage and high rates of misuse. The bigger questions were how to reach those parents who tended not to use child car seats, and how to get them to install and use them properly.

We also found that repeated studies, going back more than three decades, showed a consistently high rate of car-seat misuse among all American families, regardless of ethnicity, income or education levels. On average, decade after decade, 80 percent of families don’t consistently install and use car seats properly. Some mistakes only have a negligible effect, but others can make the seats ineffective.

But, of course, confirming these facts was just the starting point for my National Health Journalism Fellowship project on child car-seat safety, which was supported both by the Dennis A. Hunt Fund for Health Journalism and by a Community Engagement grant.

It wasn’t enough simply to report the fact of these low rates of car-seat usage and high rates of misuse. The bigger questions were how to reach those parents who tended not to use child car seats, and how to get them to install and use them properly.

For those parents already buying seats, the key lay in making them aware of how to check their seats for proper installation, and how to make sure they were using the right seat for the size and age of their children.

Among Hispanics not using seats at all, the challenge was greater. Across much of Latin America, it still isn’t the norm to use car seats. Many Hispanics, including many U.S. citizens, believe wrongly that a baby is safest when held in his or her mother’s arms. To change these people’s behaviors, we’d need to shift their beliefs — something I didn’t believe we could do with a couple of stories.

My approach was strongly influenced by regular discussions with Kate Long, a Charleston Gazette reporter and 2012 National Health Journalism Fellow who was assigned by the Center for Health Journalism to coach me as I developed and pursued my project. Kate’s own project had tackled West Virginia’s flood of chronic disease caused by a staggeringly high obesity rate; she gave me many very helpful suggestions on how to bring to life the issues I was reporting, and on ways to engage others in the community to address them effectively.

So, with the support of my editors and the charitable-causes arm of The Republic, we modeled our approach on tactics that had been used by medical groups in Dallas, Cincinnatti and Philadelphia to boost rates of car-seat use within Hispanic communities in those cities.

Before publishing a single story, we spent months recruiting leaders from groups infuential in the Hispanic community. We met with this growing core group frequently, and they worked with us to create a stand-alone nonprofit organization, Sientelos Seguros/Seat Them Safely, to carry out an ongoing campaign of fundraising, education and outreach. A Hispanic-owned PR firm, Torres Multicultural, helped us, as a contribution to the campaign, come up with the name, a logo and designs for outreach materials, including information brochures and PSA materials. We relied on the Community Engagement and Dennis A. Hunt grants to print and produce these various materials, and to travel to and report from Nogales, Sonora for a portion of the series relating to car-seat usage in northern Mexico.

Because so many Hispanics are active Roman Catholics, we worked with the Diocese of Phoenix (which covers half of Arizona) to engage parish priests throughout the diocese. The diocese helped recruit parishes to sponsor car-seat training events. Parish newsletters published announcements about our reporting (along with links to a Spanish-language website we created), and information in English and Spanish telling people where they could get training and free seats.

Following an example from a Dallas medical group, we also asked parish priests to hold public blessings of car seats to encourage people to use them. We recruited leaders of other denominations and nondenominational groups active in predominantly Hispanic areas of South Phoenix too.

We set up partnerships with the largest Spanish-language newspaper in Phoenix, La Voz, and with the television network Univision, to team up on reporting and to provide public-service announcements and on-air telethons in support of the campaign. I wrote Spanish-language versions of every story in the series, for use by our partners. These steps helped ensure that our stories and information about car-seat resources reached far beyond our readership base, to the people who most needed to see them.

We worked with fire and police departments around the Phoenix metropolitan area to set up and staff additional car-seat events. And, because many Hispanics in Arizona are undocumented and avoid police officers, we also set up events without police participation, to which parents could come without fear of being asked about their immigration status.

With the help of Spanish-language media partners and the Sientelos Seguros group, the reporting and the campaign has succeeded in reaching tens of thousands of Hispanics who were not readers of the Arizona Republic or our azcentral.com website.

Thanks to committed help from The Republic’s charitable causes arm, and in part to seed funds from the two grants that accompanied the fellowship, we secured a $25,000 matching grant from a local trust, the BHHS Legacy Foundation, to match donations from our readers to promote safer car-seat use, training events, and donations of seats.

To help on the other side of the border, we teamed up with several Arizona fire departments to send donations of refurbished used seats to fire departments and hospitals with trained car-seat technicians in several communities in Sonora, the Mexican state that borders Arizona.  

As I write this essay, three months after our initial publications, the Sientelos Seguros/Seat Them Safely campaign continues in full swing in Arizona. With the help of Spanish-language media partners and the Sientelos Seguros group, the reporting and the campaign has succeeded in reaching tens of thousands of Hispanics who were not readers of the Arizona Republic or our azcentral.com website.

The project continues, and is working on regularly scheduled car-seat training events throughout 2016, along with car-seat donations and fundraising to help provide seats to families. This will be an ongoing, long-term effort.  

(Even as the project was being published, I was offered and accepted a position as the managing editor of an online news organization in Hawaii, Honolulu Civil Beat; but even from Hawaii, I am, with the blessing of my new newsroom, working on continuing reporting for this project.)

With the help of the Arizona Hispanic Chamber of Commerce, we recruited a dozen Spanish-speaking volunteers who completed the nearly 40-hour training course necessary to become certified car seat technicians, so that they could support the Sientelos Seguros campaign.

It’s far too early to say whether this project will affect the rates of vehicle-accident deaths and injuries among Hispanic children in the Phoenix area. But, at the very least, thanks to the Center for Health Journalism and the Dennis Hunt Fund for Health Journalism, it is increasing awareness among Hispanics, making hundreds of car seats available to families who would not otherwise have them, and helping hundreds of additional people learn how to install and use seats properly.  

One thing that is crystal clear from our research is that similar problems exist across the United States in states and communities with large populations of Hispanics and/or Native Americans. There are plenty of opportunities for other reporters and news organization to do similar, valuable work elsewhere.

Key points for other reporters:

• Obviously, one powerful way to drive home the deadly consequences of failing to use car seats properly is to profile a family that lost a child who wasn’t in a seat, or who wasn’t correctly secured. Finding parents in that situation wasn’t that hard; but persuading any to step up in public and admit that their mistake had contributed to the death of their child proved damn near impossible, at least for me. Even when I tried to make the point that they could help prevent a future tragedy, it was simply too much for them to contemplate. Maybe you’ll have better luck.

• But if, like me, you don’t find such willing families, then you can try Plans B and C: Use police reports and publicly available information to provide examples, and feature others who bring the story to life — people who’ve experienced firsthand the devastation of children dying avoidably (emergency-room doctors and nurses, first responders, etc.).

• Start with the National Highway Transportation Safety Administration data, which includes occupant restraint and vehicle accident statistics from around the country. SafeKids Worldwide, a child-safety nonprofit, compiles annual motor vehicle data as well.

• Most states perform annual child mortality reviews. Here’s one for Arizona, for instance, and for Texas. The availability of data varies enormously by state. Some state data may be years out of date, which means you’ll need to track current accidents to find timely example. As a result of budget cuts, California, for example, does a relatively poor job of collecting statewide vehicle-accident death and injury data categorized by age, ethnicity and car-seat use. However, you can also turn to statewide traffic safety reports. Here’s California’s 2014 report.

• There are numerous valuable studies looking at the cultural and social reasons for lower rates of car-seat use within specific ethnic and immigrant groups. See, for example, these links to studies in Michigan, Chicago, and Dallas.  

• If you want to help change behavior, don’t reinvent the wheel. We looked at what has worked in car-seat promotion campaigns elsewhere, including in Dallas, in Seattle, in Cincinnati and Philadelphia.

• Enroll organizations that are engaged and active in your target community. We enrolled groups already involved in promoting car-seat use, including the Phoenix Police Department, the Phoenix Fire Department, the Governor’s Office of Highway Safety, Phoenix Children’s Hospital, Maricopa Integrated Health Systems (a public-hospital network) and AAA Arizona. We also recruited the Arizona Hispanic Chamber of Commerce, which reached out to its members to recruit Spanish speakers willing to take a 40-hour training to become certified car-seat technicians. And we brought on board other groups active in the Hispanic community, such as Friendly House and the Roman Catholic Diocese of Phoenix.

• If you are reaching out to a group whose members may not typically read, watch or listen to your media outlet, enroll partners who can help you get their attention. We recruited broadcast, and online and print Spanish-language media partners to reach those who we hoped to inform and affect.

• Think about other ways to reach out to your target community. For example, members of the NGO we helped create launched a YouTube video challenge in which a parent would show him or herself securing their son or daughter in a car seat, then let the kid crack a raw egg on the parent’s head. Sounds goofy, but it garnered attention. When we ran our stories, we reached out to all the member organizations in Sientelos Seguros and asked them to have their people promote the stories through their social media accounts.

• Keep the effort alive by creating a dedicated web page or site, and by keeping the information (about upcoming events and opportunities) current. Provide links to relevant resources. For example, we created or adapted how-to videos and graphics in English and Spanish that show the proper way to install various types of car seat and check for proper fit and usage.

• We created and then handed off the outreach campaign to a new NGO whose leaders were willing to take ownershipf of an ongoing community effort. This isn’t easy; you’ve got to secure adequate funding for a long-term effort and at least a couple of member organizations that are in it for the long haul. But with adequate planning, it can be done, and it makes it likelier your work will have more impact.

• Recruit help: As reporters, we tend to fly solo in our reporting and writing. But this sort of project works better the more people you involve. Reporting the situation is just the starting point. It is absolutely essential, if you're going to have any real and lasting impact, to find and bring on board individuals and organizations who can help you reach more people and help you promote changes to address the problem you're describing. Figure out who they are, and start talking to them as early as you can in the process.

I’ll be happy to talk with any reporter or editor interested in pursuing similar efforts. I can be reached at bortega [AT] civilbeat.com, or at (808) 377-0248.

[Photo courtesy Cheryl Evans/Arizona Republic]