Are mHealth Interventions to Improve Child Restraint System Installation of Value? A Mixed Methods Study of Parents

In the International Journal of Environmental Research and Public Health, Linda Fleisher and colleagues, including Danielle Erkoboni and Flaura Winston, identify gaps in parental knowledge about and perceived challenges in the use of appropriate child restraints in motor vehicles. They also explore the acceptability of using a mobile app to guide car seat installation. Injuries to passengers in motor vehicle crashes remain a leading cause of child mortality. As such, the delivery of information about proper child restrain systems (CRS) use remains a critical public health issue.

The authors conducted eight focus groups with 21 parents and caregivers who were recruited from five outpatient pediatric primary care practices. The authors also administered a survey (n = 1,251) to a national sample of parents and caregivers of young children using car seats. Overall, there was a great deal of consistency in the need for more timely and personalized information about CRS. While a significant minority of participants reported challenges with installing a car seat (36.2% agree/strongly agree that “it is a hassle”), the majority reported that they always have their child ride in a seat, both in their own vehicle (95.8%) and in other vehicles (91.4%). Barriers to installation, such as too many people in a car, appeared highly situational. Almost half of participants said an app about car seats would be useful (46.9%), but many also said an app would not be useful after the first few uses (48.8%). Parents raised concerns about a mobile application for the purpose of CSR alone, and over half (54%) said they would prefer to use a website to find information about car seats. The study reinforces that stakeholder input is critical to guide the development and delivery of acceptable and useful child safety education.