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ObjectiveThe use of telehealth has been a common approach to deliver health education before and during the COVID-19 pandemic. However, its ability to apply behavioral skills training (BST) for CRS education has been undocumented. This study assessed the efficacy of telehealth to deliver in-situ behavioral skills training (BST) to teach expectant parents how to install and use their child restraint system (CRS) to reduce misuse and improve retention during the COVID-19 pandemic.MethodA repeated measures group design was used to evaluate 171 individual participants, in a 37-step CRS task analysis for baseline, BST, and follow-up. Performance across all participants was aggregated for each task analysis. Participants were recruited from National Highway Traffic Safety Administration car seat fitting stations during the Covid-19 pandemic between March through July, 2020.ResultsBaseline results identified significant critical misuse across participants. With BST, delivered with telehealth, misuse decreased by 97% among 37 task objectives. A 2-week follow-up evaluation concluded that 100% of participants retained the skills they mastered during BST.ConclusionsThis study suggests the use of telehealth, as a method of BST delivery for CRS education, is an effective approach to reduce CRS misuse and the burden of child occupant motor vehicle injury. It was found to empower participants and improve their self-confidence, while ensuring the safety of their child occupant. While it was found to be an effective approach for expectant parents during the COVID-19 pandemic, it also has broader child passenger safety program and train-the-trainer implications beyond the COVID-19 pandemic.

scared to walk on narrow roadsides because of speeding vehicles. They also found crossing the road dangerous because of the lack of designated pedestrian crossings and disregard shown by drivers. Poor visibility caused by random roadside parking and trees also increased the sense of road danger. Conclusion Children expressed multiple concerns which made the journey difficult and dangerous. Some of these issues could be addressed through improved road infrastructure, whilst others would require a change in driver's behaviour. Learning Outcomes Children's views are often ignored in issues pertaining to their health and well-being. PEI is an engaging method that encourages children to express concerns about their safety.

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