Background Enhancing caregivers’ awareness of children's injury risks and increasing knowledge about strategies for injury prevention often involve presenting parents with written materials and accompanying images.

Objectives To assess parents’ appraisals of different variations of images and identify those features that enhance their attention to safety messages.

Methods Eight images showing risk situations were taken from the A Million Messages safety education parent-directed programme in Canada and modified to create a corresponding image that clearly showed negative consequences for the child, and facial expressions of fear and/or upset. Mothers with young children were presented with the eight pairs of images (negative consequence vs risk situation) and asked to select the best accompaniment to a safety message and to provide an explanation for their choice. Each image was then also rated for fit to the safety message, communication of danger, emotional arousal and attention elicitation.

Results The images depicting negative consequences were chosen for most comparisons (78%) and higher scores were assigned to these images for all four features rated by parents (danger communicated, emotions evoked, attention elicitation and fit to the safety message). Moreover, ratings of danger, emotions and attention predicted ‘fit to safety message’ scores.

Conclusions Depicting negative consequences and showing negative emotions is important to maximise the effectiveness of images in communicating danger and evoking attention and concern when targeting parents with child-safety messaging.