Smith M L, Berger L R
Spokane District Office, Portland Area Indian Health Service, Spokane, Washington, USA.
Inj Prev. 2002 Dec;8(4):289-92. doi: 10.1136/ip.8.4.289.
To identify strengths and weaknesses in community based child passenger safety programs by developing a scoring instrument and conducting observations of child restraint use in three Native American communities.
The three communities are autonomous Tribal reservations in the Pacific Northwest. Their per capita incomes and rates of unemployment are comparable.
In each community, 100 children under 5 years old were observed for car seat use. A six item community assessment tool (100 points maximum) awarded points for such items as the type (primary or secondary) and enforcement of child restraint laws; availability of car seats from distribution programs; extent of educational programs; and access to data on vehicle injuries.
For children from birth to 4 years, the car seat use rate ranged from 12%-21%. Rates for infants (71%-80%) far exceeded rates for 1-4 year old children (5%-14%). Community scores ranged from 0 to 31.5 points. There was no correlation between scores and observed car seat use. One reason was the total lack of enforcement of restraint laws.
A community assessment tool can highlight weaknesses in child passenger efforts. Linking such a tool with an objective measure of impact can be applied to other injury problems, such as fire safety or domestic violence. The very process of creating and implementing a community assessment can enhance agency collaboration and publicize evidence based "best practices" for injury prevention. Further study is needed to address methodologic issues and to examine crash and medical data in relation to community child passenger safety scores.
通过开发一种评分工具并对三个美洲原住民社区儿童约束装置的使用情况进行观察，以确定基于社区的儿童乘客安全计划的优势和不足。
这三个社区是太平洋西北部的自治部落保留地。它们的人均收入和失业率相当。
在每个社区，观察了100名5岁以下儿童的汽车座椅使用情况。一个六项社区评估工具（满分100分）根据儿童约束法律的类型（主要或次要）和执行情况、分发计划中汽车座椅的可获得性、教育计划的程度以及获取车辆伤害数据等项目来打分。
对于出生至4岁的儿童，汽车座椅使用率在12%至21%之间。婴儿的使用率（71%至80%）远远超过1至4岁儿童的使用率（5%至14%）。社区得分在0至31.5分之间。得分与观察到的汽车座椅使用情况之间没有相关性。一个原因是约束法律完全没有得到执行。
社区评估工具可以突出儿童乘客安全工作中的薄弱环节。将这样的工具与客观的影响衡量指标相结合，可以应用于其他伤害问题，如消防安全或家庭暴力。创建和实施社区评估的过程本身可以加强机构间的合作，并宣传基于证据的伤害预防“最佳实践”。需要进一步研究以解决方法学问题，并检查与社区儿童乘客安全得分相关的碰撞和医疗数据。
