Caregivers’ Use of Child Passenger Safety Resources and Quality of Future Child Restraint System Installations

Objectives: Child Restraint System (CRS) misuse is common. We characterized caregivers’ use of child passenger safety informational and instructional resources and determined whether there were differences in the quality of CRS installations associated with prior exposure to specific resources as evaluated in a standardized CRS installation environment. Methods: Caregivers completed self-report surveys and installed a forward-facing CRS in a controlled environment. Installations were evaluated for security (tightness) and accuracy (no errors) by a child passenger safety technician (CPST). Results: CRS manuals were the most common way caregivers learned to install a CRS. Primary care providers (PCP)s were the most frequently endorsed source of CRS safety information. There was no strong pattern of associations between prior exposure to resources and installation quality (security or accuracy), although some evidence supports protective effects of learning from CPSTs; 13% (19 out of 151) installations were secure and 57% (86 out of 151) installations were accurate. Conclusions: A focus on developing effective and lasting behavioral interventions is needed.