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A comparison of self-report and direct observation of booster seat use in Latino families
  1. D Alex Quistberg1,2,
  2. Paula Lozano3,4,
  3. Christopher D Mack2,
  4. Rachel Schwartz2,
  5. Beth E Ebel1,2,3,4
  1. 1Department of Epidemiology, University of Washington, Seattle, Washington, USA
  2. 2Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington, USA
  3. 3Department of Pediatrics, University of Washington, Seattle, Washington, USA
  4. 4Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle, Washington, USA
  1. Correspondence to Beth E Ebel, Harborview Injury Prevention & Research Center, 325 Ninth Avenue, Box 359960, Seattle, WA 98104-2499, USA; bebel{at}


Objective To develop a reliable self-report tool for measuring child booster seat use among Latino families.

Design Cross-sectional and observational survey of a convenience sample.

Setting Five retail stores in King County, Washington.

Participants 50 parents of children 4–8 years old that self-identified as Latino or Hispanic.

Main exposures Parent-reported measures of how often the child uses a booster seat, if the child used a booster seat on the last trip, how often the child complains about using a booster seat, how often the child asks to not use a booster seat, and how often other families they know use a booster seat.

Outcome measure Observed booster seat use by child.

Results 26 children (52%) were observed using a booster seat. Parent-reported booster seat use was a poor predictor of observed booster seat use. Although 34 parents reported that their child ‘always’ uses a booster seat, 8 (24%) of these children were not using a booster seat. A logistic model to predict booster seat use had a sensitivity of 81% and a specificity of 71%, and misclassified 24% of the participants' observed use.

Conclusions Reliance on parent-reported booster seat use significantly overstated observed booster seat use in the study. Among this study population, accurate determination of booster seat use required direct observation.

  • health behaviour, ethnology
  • Hispanic Americans, psychology
  • seatbelts
  • child passenger safety
  • behavioural
  • child
  • passenger
  • race
  • restraint

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  • Funding This research project was supported by funding from the Robert Wood Johnson Foundation, grant # 051072. BEE was the Principal Investigator for this grant.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Washington.

  • Provenance and peer review Not commissioned; externally peer reviewed.