Remote Telehealth Continues to Show Efficacy in Reducing Car Seat Misuse

12/2/2025

As a leader in child passenger safety and injury prevention, we were pleased to learn that the recently published Schwebel et al. (2026) paper was released, with our longitudinal study, DeCarli et al. (2024), being cited within their article.

We are encouraged to find that their results, similar to ours, demonstrate that remote/telehealth car seat educational services are just as effective—and in many cases, even more so—than in-person sessions. As noted in our paper, remote/telehealth approaches empower parents and caregivers by enabling them to learn and perform each car seat task correctly on their own. Since there is no Certified Child Passenger Safety Technician (CPST) physically present, the technician guides and teaches virtually, which aligns with our general approach to training and empowering parents.

Furthermore, we appreciated that Schwebel et al. (2026) emphasized both car seat installation and proper use. Too often, there is an overemphasis on installation alone, with insufficient attention to actual use. Based on our experience and recent research, approximately 30% of misuse errors relate to installation, while roughly 70% stem from improper use—such as not restraining the child correctly. Through our study, DeCarli et al. (2024), which utilized CPST training in Behavioral Skills Training (BST) to deliver a standardized curriculum, we found a significant benefit of BST over non-BST methods in reducing car seat misuse (We are currently working on Continuing Education Unit (CEU) classes for CPSTs on BST/CPS training).

We are continuing to validate our methodology through longitudinal follow-up with previous participants and by including new participants to assess the generalizability of our findings, both in in-person and remote/telehealth settings. Interestingly, we observe similar results over time. Notably, between 6 and 14 months, as parents transition from infant to convertible car seats, many contact us again for additional training or to confirm the most appropriate seat. This ongoing engagement illustrates the value of having a CPST available via text or phone, providing support during these critical transition periods.

While it was encouraging to see that Schwebel et al. (2026) reported similar positive outcomes with their remote/telehealth approach, we must emphasize the importance of measuring follow-up duration and sustainability in research—such as at 4, 6, or 9 months—to truly assess long-term impact. Overall, the findings of both Schwebel et al. (2026) and DeCarli et al. (2024) validate the remote/telehealth approach and support the continued expansion of our National Telehealth Car Seat Call Center, which offers BST services both in-person and via remote/telehealth nationwide. The Call Center serves the continental United States, including Alaska, Hawaii, and U.S. Territories such as Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, and Puerto Rico.

How Can Your Organization and those you Serve, Benefit from the National Telehealth Car Seat Call Center?
The Call Center partners with a broad network of certified organizations, including public agencies, health departments, hospitals, schools, and law enforcement, all of which have certified child passenger safety technicians. These organizations play a crucial role in instructing parents on proper car seat installation, testing, and use.

The Call Center acts as a centralized resource—not only providing car seat information and answering questions but also offering in-person or remote/telehealth training conducted by certified technicians. Through BST, these trainings empower parents and caregivers to install their car seats correctly and restrain their children properly. This comprehensive approach aims to significantly reduce misuse and improve child passenger safety.

Additionally, the resource can be linked to the websites of participating agencies and organizations, facilitating easy access to services—especially in rural areas, among military families, Native American communities, and other regions with limited coverage of certified CPSTs. This connectivity helps extend vital safety services to underserved populations, broadening the reach and impact of our efforts.

Questions? Call 323-491-6197.

References

DeCarli JM, Aclan MD, Lindgren NA, Diaz C. In-person and tele health behavioral skills training to reduce child restraint system misuse. J Organ Behav Manage. 2025;45(1):48–79. doi: 10.1080/ 01608061.2024.2301936
Schwebel, D. C., MacKay, M., Beasley, T. M., Johnston, A., Beckworth, K., Beerman, A., Harris, M., Koldoff, E., Rivera, S., & Williams, J. (2025). Interactive virtual presence to remotely assist parents with car seat installation. PEDIATRICS, 156(5). https://doi.org/10.1542/peds.2025-071867

1 Comment

Author

Dr. DeCarli is an injury and neuroepidemiologist with over 15 years of public health expertise. He is the founder of Pro Consumer Safety and Public Health Behavior Solutions, focusing on behavioral interventions to reduce childhood injuries and improve health globally. He provides car seat safety training locally and nationwide via the Telehealth Car Seat Call Center, and regularly presents at news interviews, and national and international conferences. An educator and leader, he teaches courses on parenting, child development, and health promotion. With degrees from University of Southern California, George Washington University, and University of Oxford, and recent induction into the Delta Omega Honor Society, he is dedicated to advancing safer, healthier environments for children and communities worldwide.

Joyce Myrick

12/7/2025 03:34:26 pm

I am an instructor and my desire for hands on instructor is still primary. I would like to get more training on telehealth and the training for car seats installation and education. I will download and read for more understanding. Thank you for publishing.