@article{ref1,
title="Reliability and validity of child passenger safety restraint observations by community observers",
journal="Traffic injury prevention",
year="2010",
author="Brixey, Suzanne N. and Guse, Clare E. and Gorelick, Marc H.",
volume="11",
number="6",
pages="573-577",
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.<p /> <p>Language: en</p>",
language="en",
issn="1538-9588",
doi="10.1080/15389588.2010.508083",
url="http://dx.doi.org/10.1080/15389588.2010.508083"
}