Objectives To evaluate the effectiveness of parent-based child restraint system (CRS) intervention so as to promote the parents’ knowledge, attitude, and use of CRS.

Methods We conducted a randomized trial with cluster sampling in 8 selected kindergarteners in Shantou and Chaozhou, China (4 from each city). Parents were randomly assigned to receive 1 of the 4 conditions: education intervention, behavioral education intervention, biomechanical visualization intervention, or control.

Results Six months after the intervention, multivariate logistic regression models showed that child gender of boy, parents’ higher education level, accept the intervention and different interventions were had a higher probability of using CRS, in which, the probability of intervention group tending to use CRS was significantly higher than the control group (biomechanical visualization (OR=2.57,95%CI=1.72–3.85), education (OR=2.27,95%CI=1.52–3.39), behavioral education(OR=2.01,95%CI=1.35–3.02)), but there was no significant difference in the pairwise comparisons between the intervention groups. The ratings on child passenger safety knowledge and attitude increased significantly in both intervention groups (P<0.001) but remained unchanged in the control group after the intervention, the ratings are higher in biomechanical visualization intervention group than the education intervention group (p< 0.05).

Conclusions Both parent-based child restraint system intervention helped to promote the parents’ knowledge, attitude, and use of CRS. Biomechanical visualization could be an effective intervention to improve the use of CRS in the future.