Discordance between age- and size-based criteria of child passenger restraint appropriateness.
Discordance between age- and size-based criteria of child passenger restraint appropriateness.
复制标题
基于年龄和体型的儿童乘客约束装置适当性标准之间的不一致。
DOI：
10.1080/15389588.2017.1403016
复制
发表时间：
2018
影响因子：
2
通讯作者：
Macy,MichelleL
中科院分区：
文献类型：
--
作者：
Smiley,MaryL;Bingham,CRaymond;Jacobson,PeterD;Macy,MichelleL
目的：在本研究中，我们试图实现以下目标：(1)计算在8个限制增加的标准中被认为适当限制的儿童的百分比；(2)检查基于年龄和尺寸的合适标准之间的一致性；(3)评估2011年（美国指南更新后不久）至2015年间，被认为受到8项标准适当约束的儿童百分比的变化。方法：2017年对928名12岁以下儿童家长（2011年n= 591, 2015年n= 337）的2份横断面调查数据进行分析。在急诊就诊时测量儿童的年龄、体重和身高，并根据8项标准确定家长报告的儿童乘客约束是否适当。基于年龄的标准来源于密歇根州法律和美国的指导方针。基于体重、身高和尺寸的标准来源于美国2007年和2011年的典型约束。为每个标准计算适当约束使用的百分比。kappa统计量用于衡量标准之间的一致性。2011 - 2015年的适宜性变化采用卡方统计进行评估。结果：适当约束使用的百分比从2011年较高重量限制的19%低到2015年密歇根州法律的91%高不等。标准之间的一致性是轻微到中度的。最低的kappa是2011年密歇根州法律和更高的体重限制（κ = 0.06），最高的是2011年美国指南和更低的体重限制（κ = 0.60）。2015年适当约束使用百分比高于2011年以下标准：美国指南（74%对58%，P< 0.001），体重较低（57%对47%，P= 0.005），体重较高（25%对19%，P= 0.03），身高较高（39%对26%，P< 0.001），体型较大（42%对30%，P= 0.001）。结论：被认为使用适当约束的儿童百分比在不同的标准上有很大差异。将适当使用约束装置的定义与现行的美国指导方针保持一致，将提高美国儿童乘客安全研究报告结果的一致性。2011年至2015年间，被认为适当约束的儿童比例增加的潜在解释包括采用最新的美国指南，以及使用更高体重和身高限制的儿童乘客约束装置。
Objectives: In this study, we sought to accomplish the following objectives: to (1) calculate the percentage of children considered appropriately restrained across 8 criteria of increasing restrictiveness; (2) examine agreement between age- and size-based appropriateness criteria; (3) assess for changes in the percentage of children considered appropriately restrained by the 8 criteria between 2011 (shortly after updates to U.S. guidelines) and 2015.Methods: Data from 2 cross-sectional surveys of 928 parents of children younger than 12 years old (n= 591 in 2011,n= 337 in 2015) were analyzed in 2017. Child age, weight, and height were measured at an emergency department visit and used to determine whether the parent-reported child passenger restraint was considered appropriate according to 8 criteria. Age-based criteria were derived from Michigan law and U.S. guidelines. Weight, height, and size-based criteria were derived from typical restraints available in the United States in 2007 and 2011. The percentage appropriate restraint use was calculated for each criterion. The kappa statistic was used to measure agreement between criteria. Change in appropriateness from 2011 to 2015 was assessed with chi-square statistics.Results: Percentage appropriate restraint use varied from a low of 19% for higher weight limits in 2011 to a high of 91% for Michigan law in 2015. Agreement between criteria was slight to moderate. The lowest kappa was for Michigan law and higher weight limits in 2011 (κ = 0.06) and highest for U.S. guidelines and lower weight limits in 2011 (κ = 0.60). Percentage appropriate restraint use was higher in 2015 than 2011 for the following criteria: U.S. guidelines (74 vs. 58%,P< .001), lower weight (57 vs. 47%,P= .005), higher weight (25 vs. 19%,P= .03), greater height (39 vs. 26%,P< .001), and greater size (42 vs. 30%,P= .001).Conclusions: The percentage of children considered to be using an appropriate restraint varied substantially across criteria. Aligning the definition of appropriate restraint use with current U.S. guidelines would increase consistency in reporting results from studies of child passenger safety in the United States. Potential explanations for the increased percentage of children considered appropriately restrained between 2011 and 2015 include adoption of the updated U.S. guidelines and the use of child passenger restraints with higher weight and height limits.