Journal article
Interactive Virtual Presence to Remotely Assist Parents With Car Seat Installation
Pediatrics (Evanston), Vol.156(5), e2025071867
11/01/2025
DOI: 10.1542/peds.2025-071867
PMID: 41077424
Abstract
OBJECTIVES
Motor vehicle crashes are a leading cause of preventable pediatric death. Child restraints (car seats) reduce risk, but ∼80% are installed and/or used incorrectly. Individualized appointments with certified child passenger safety technicians improve installation and usage, but access is inadequate.
METHODS
A phase III randomized noninferiority clinical trial was conducted from 2020 to 2023 at 7 US locations with 1509 individuals who regularly drove vehicles with child restraints installed (booster seats excluded). Participants were randomly assigned to install a child restraint with assistance from a certified technician either live and on-site or remotely via interactive virtual presence, a smartphone app offering simultaneous verbal and visual communication plus the ability to interact virtually, telestrate, and freeze screens. The accuracy of restraint installation/usage was scored objectively.
RESULTS
Mixed model analyses were conducted with technicians nested in the research site as a random effect, and with technician, site, and child restraint installation type as covariates. The on-site group had an unadjusted mean of 97.7% (SD = 3.5) of installation/usage facets correct following the intervention, and the remote group had an unadjusted mean of 95.6% (SD = 5.8). The adjusted difference of 1.80 fell within the a priori noninferiority margin of 2.5% (upper bound = 2.34; P = .006). Sensitivity analyses controlling for demographics, how the restraint was previously installed, and installation type yielded comparable findings.
CONCLUSIONS
The accuracy of restraint installation and usage following education with a remotely located technician via interactive virtual presence was not inferior to accuracy with an on-site technician. Uptake by industry, nonprofit, or government agencies could dramatically improve pediatric public health, especially among underserved populations.
Details
- Title: Subtitle
- Interactive Virtual Presence to Remotely Assist Parents With Car Seat Installation
- Creators
- David C Schwebel - University of Alabama at BirminghamMorag MacKay - Safe Kids WorldwideT Mark Beasley - University of Alabama at BirminghamAnna Johnston - University of Alabama at BirminghamKristen Beckworth - Texas Children's HospitalAbby Beerman - University of Vermont Medical CenterMikayla HarrisElizabeth KoldoffSanny Rivera - Texas Children's HospitalJanice Williams - Carolinas Medical Center
- Resource Type
- Journal article
- Publication Details
- Pediatrics (Evanston), Vol.156(5), e2025071867
- DOI
- 10.1542/peds.2025-071867
- PMID
- 41077424
- NLM abbreviation
- Pediatrics
- ISSN
- 1098-4275
- eISSN
- 1098-4275
- Publisher
- American Academy of Pediatrics; Itasca
- Grant note
- UAB Youth Safety Lab
The authors thank the UAB Youth Safety Lab, including Aeriel Chavarin and Jenni Liveoak; Safe Kids Worldwide, including Alexis Kagiliery and Cass Herring; remote technicians, including Carrisa Johns, Casie Morgan, Cher Philio, Marissa Swanson, and Wanda Vazquez; Safe Kids Alabama, including Marie Crew, Lisa Hanvey, and Julia Farmer; Safe Kids Los Angeles West, including Helen Arbogast, Abigail Kim, Chantel Lowery, and Alejandra Mateos; Safe Kids Charlotte-Mecklenburg; Safe Kids Oklahoma, including Jo Fendrych, Kim Gray, and Shannon Powers; Safe Kids Greater Houston, including Megan Rasmussen; Safe Kids Vermont, including Maureen Johnson; Safe Kids Lower Columbia, including Brandi Ballinger, Abbey Laberge; and HelpLightning.
- Language
- English
- Electronic publication date
- 10/13/2025
- Date published
- 11/01/2025
- Academic Unit
- Research Administration; Psychological and Brain Sciences
- Record Identifier
- 9985014901202771
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