Using interactive virtual presence to support accurate installation of child restraints: Efficacy and parental perceptions.

Academic Article


  • INTRODUCTION: Child restraint systems (car seats) reduce injury risk for young children involved in motor-vehicle crashes, but parents experience significant difficulty installing child restraints correctly. Installation by certified child passenger safety (CPS) technicians yields more accurate installation, but is impractical for broad distribution. A potential solution is use of interactive virtual presence via smartphone application (app), which permits "hands on" teaching through simultaneous and remote joint exposure to 3-dimensional images. METHOD: In two studies, we examined the efficacy of remote communication via interactive virtual presence to help parents install child restraints. Study 1 was conducted at existing car seat checkpoints and Study 2 at preschools/daycare centers. In both cases, existing installations were assessed by certified CPS technicians using an objective coding scheme. Participants then communicated with remotely-located certified CPS technicians via a smartphone app offering interactive virtual presence. Technicians instructed participants to install child restraints and then the installation was inspected by on-site technicians. Both before and after the remote interaction, participants completed questionnaires concerning perception of child restraints and child restraint installation, self-efficacy to install child restraints, and perceived risk of injury to children if they were in a crash. RESULTS: In both studies, accuracy of child restraint installations improved following the remote interaction between participants and certified CPS technicians. Together, the two samples achieved a weighted average of 90% correct installations across a multi-point inspection. Both samples reported increased self-efficacy to install child restraints and altered perceptions about the accuracy of the child restraint installations in their vehicles. CONCLUSIONS: Findings support use of interactive virtual presence as a strategy to realize accurate installation of child restraints. PRACTICAL APPLICATIONS: Interactive virtual presence between certified CPS technicians and the public via smartphone app has potential to improve proper child restraint installations broadly, including to vulnerable and underserved rural populations.
  • Authors

    Published In


  • Child restraint systems, child passenger safety, M-health, Motor vehicle safety, Smartphone app, Accidents, Traffic, Adult, Aged, Alabama, Child Restraint Systems, Communication, Female, Florida, Humans, Male, Middle Aged, Parents, Perception, User-Computer Interface, Young Adult
  • Digital Object Identifier (doi)

    Author List

  • Schwebel DC; Tillman MA; Crew M; Muller M; Johnston A
  • Start Page

  • 235
  • End Page

  • 243
  • Volume

  • 62