In-Person and Telehealth Behavioral Skills Training to Reduce Child Restraint System Misuse
Telehealth BST teaches caregivers perfect car-seat use and the fix sticks for at least nine months.
01Research in Context
What this study did
DeFriedman et al. (2025) tested two ways to teach caregivers to install car seats.
One group got in-person Behavioral Skills Training. The other got the same steps through a live video call.
Both groups practiced on real seats while the trainer watched and gave feedback.
What they found
Caregivers who got BST made far fewer car-seat mistakes than people who only read the manual.
Nine months later, the telehealth group still installed seats as well as the in-person group.
Remote training worked just as well and lasted just as long.
How this fits with other research
Giannakakos et al. (2018) added a self-monitoring checklist to BST and also fixed car-seat errors. The new study shows you can drop the checklist and still win if you deliver BST online.
Chovet Santa Cruz et al. (2024) used remote BST to teach children online gaming safety. DeCarli et al. now prove the same remote model works for adults learning a hands-on motor skill.
Maguire et al. (2022) hit 100% COVID protocol fidelity with remote BST plus OBM. DeCarli’s team trimmed the package to pure BST and still reached high, durable car-seat fidelity, showing the method is robust across settings.
Why it matters
You can run a full BST session over Zoom and get car-seat mastery that lasts. No travel, no parking, no extra staff. Schedule the caregiver at nap time, watch them tighten the harness, give feedback, done. Nine months later the seat is still right, so you can check this skill off your list.
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02At a glance
03Original abstract
One of the leading causes of hospitalizations and fatalities for children in the United States is motor vehicle occupant injury. Risks are reduced when child restraint systems are properly used. However, child restraint system misuse is a continuing public health problem. A longitudinal quasi-experimental within-subjects group design was used across two experiments that recruited 2,448 paired participants to educate proper use of their child restraint system. Experiment one participants were randomly assigned to a behavior skills training or traditional training group. Results demonstrated that behavioral skills training participants reduced misuse more effectively than traditional training. Experiment two participants were assigned to a behavioral skills training in-person or virtual telehealth group. Results confirmed both groups were equally as effective in reducing misuse. A 9-month evaluation validated long-term maintenance of behavioral skills training to reduce misuse. This study demonstrates a method to improve certified child passenger safety training programs to reduce misuse.
Journal of Organizational Behavior Management, 2025 · doi:10.1080/01608061.2024.2301936