Accid Anal Prev. 2025 Nov 9;224:108303. doi: 10.1016/j.aap.2025.108303. Online ahead of print.
ABSTRACT
BACKGROUND: Child restraints (car seats) reduce pediatric injury and death. Assistance and education from certified car seat technicians, either onsite or remotely, improves immediate restraint installation/use, but evaluation of whether caregivers learn to independently install restraints following technician interactions is lacking. This study evaluated whether caregivers learn to install/use child restraints following interaction with certified technicians.
METHODS: From 2020 to 2024, 931 individuals in 7 US cities interacted with certified technicians to install restraints either onsite or remotely via interactive virtual presence. Four months later, restraint installation/use was assessed twice: (a) upon arrival, assessing restraints as traveling on roadways, and (b) after uninstallation and unassisted re-installation by caregivers, assessing caregiver capacity to install restraints 4 months post-training.
RESULTS: Upon arrival, participants assigned four months earlier to onsite and in-person interactions had mean = 90.56 % (SD = 10.74) installation/use components correct; participants randomized to remote interactions had 92.19 % (SD = 9.02) correct, a significant difference (-1.591, SE = 0.632, p < 0.001). After uninstallation and unassisted reinstallation, onsite participants had mean = 92.64 % (SD = 10.14) correct and remote 94.11 % (SD = 7.88), also significant (-1.809, SE = 0.508, p < 0.001).
CONCLUSIONS: Child restraint installation/use was good but not perfect both four months following engagement with technicians and after reinstallation. Participants assigned to remote technician interactions achieved noninferior and, in fact, superior scores, perhaps reflecting the value of physically completing installation tasks themselves rather than relying on technicians to help. Results confirm the value of interaction with certified technicians not just to assure proper immediate installation/use of child restraints but also to train caregivers on proper installation/use.
PMID:41213195 | DOI:10.1016/j.aap.2025.108303
