When used correctly, child restraint systems (CRS) effectively reduce the risk of serious injury and death to child passengers in motor vehicle crashes. However, error rates in CRS use among caregivers are extremely high. Consultation with child passenger safety technicians (CPST) reduces misuse rates, but access to CPST is limited, particularly in rural areas. Remote consultation via interactive virtual presence (IVP) may increase access to CPST. One hundred and fifty caregivers in Southeast Montana completed remote consultation with CPST via IVP. Errors in CRS selection, installation, and child positioning were coded at baseline and postintervention in a within-subjects, pretest–posttest design. The proportion of caregivers making one or more errors in CRS selection (McNemar’s test p < .001) and installation (McNemar’s test p < .001), but not child positioning, significantly decreased following remote consultation. IVP is a promising mobile health (mHealth) strategy for providing remote consultation with CPST to improve rates of correct CRS use and mitigate child injury risk.

Background: Child pedestrian injuries in China result from crashes not just with cars. We considered how Chinese youth and young adults perceive pedestrian risk from four vehicle types-bicycles, electric bicycles, cars, buses-evaluating perceptions for two factors that may influence pedestrian behavior and risk-taking, perception of road environment risk and responsibility to avoid crashes. Understanding how pedestrians perceive risk, and how these perceptions change as children grow older, could guide prevention efforts. Methods: 383 children (grades 3-4, 5-6, 8) and university students completed self-report surveys. We analyzed overall responses, plus age/gender differences in risk perception and responsibility attribution, across vehicle types and number of vehicles approaching, using multivariate analysis of variance (MANOVA) and generalized estimating equation (GEE) models. Results: Overall, larger vehicles were perceived as riskier (p less than .001). Compared to children, university students perceived bicycles and electric bicycles as less risky (Mean=2.66 vs. 3.69, 3.34 vs. 3.62, respectively, p less than .05). Cars and buses were perceived as equally risky across age groups. Across all vehicle types and number of vehicles traversing the road, both children and young adults perceived more pedestrian responsibility to avoid collisions relative to drivers (p less than .001). Children attributed less personal responsibility to avoid pedestrian-vehicle crashes than university students (e.g., buses odds ratio (OR)=0.20, p less than .001; OR=0.26, p less than .01; OR=0.28, p less than .01 for third/fourth, fifth/sixth, eighth graders, respectively). University students and fifth/sixth graders also identified greater pedestrian responsibility to avoid collisions with multiple vs. one vehicle approaching (e.g., university students/cars OR=4.17, p less than .001). Conclusions: We discuss cognitive and perceptual development factors in childhood, adolescence, and young adulthood that may contribute to differences in risk perception and responsibility attribution among Chinese pedestrians and suggest future research should explore those processes and subsequently develop evidence-based interventions to reduce pedestrian injury risk.