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Traffic Inj Prev. 2010 Dec;11(6):573-7. doi: 10.1080/15389588.2010.508083.

Reliability and validity of child passenger safety restraint observations by community observers.

Author information

  • 1Department of Pediatrics, Medical College of Wisconsin, and Children's Research Institute, Milwaukee, Wisconsin 53233, USA. sbrixey@mcw.edu

Abstract

OBJECTIVE:

To compare the accuracy of trained community observers for direct observation of child passenger restraint use to certified child passenger safety technicians who are either professional observers or community-based technicians, and to compare these three groups with a gold standard.

METHODS:

This is a cross-sectional study of interobserver agreement and accuracy in which 75 photos of children depicted in different child passenger restraint systems were rated by 9 observers total, with 3 representing professional observers, 3 representing certified child passenger safety technicians, and 3 representing trained community observers. For each photo, observers indicated type of restraint; the appropriateness of the harness, if applicable; and overall appropriateness of the restraint. A gold standard was established by consensus agreement of 2 certified car seat technician instructors.

RESULTS:

The sensitivity and specificity for trained community observers in identifying broad groupings of restraint types was good (78-100% sensitivity; 93-99% specificity), but they had low agreement with the gold standard for overall appropriateness of the child passenger restraints (kappa = 0.28). The community observer group was 42 percent less likely to code the photo depiction of appropriate restraint use as appropriate.

CONCLUSION:

Community trained observers do show good sensitivity and specificity for identifying the type of restraint but have a trend toward poorer judgment when determining harness appropriateness and overall appropriateness. They may be a cost-effective option for limited restraint identification.

PMID:
21128186
DOI:
10.1080/15389588.2010.508083
[PubMed - indexed for MEDLINE]
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