Background Certified Child Passenger Safety Technicians (CPSTs) provide hands-on training to families to ensure children are safely and appropriately restrained in motor vehicles. It is estimated that only 10–20% of families in the U.S. utilize car seat checks. Further, lower access to child passenger safety information and resources and increased restraint errors have been reported in lower socioeconomic neighborhoods.

Safe Kids Worldwide (SKW) is the certifying body of CPSTs in the U.S. It is hypothesized that differential access to car seat checks is an important factor in explaining inequities. A national workforce analysis of the Certification program had not been undertaken and is a key step in understanding and addressing underserved areas.

Objective To assess the distribution of CPSTs and CPST instructors, potential reach with respect to the pediatric population, and CPST retention at the state and county level.

Methods Records for 187,354 CPSTs certified during 2001–2021 were aggregated at the county level. Potential reach was assessed as the proportion of children at key ages of <1, 2, and 5 years within the county that could be reached if each CPST conducted a minimum of 50 seat checks per year. Retention was assessed as the county-average length in years of certification among CPSTs.

Results In 2021, there were a total of 43,525 CPSTs nationally and counties on average had the potential to reach 27% of children in key ages and half had the potential to reach less than 20%. Potential reach was higher for rural compared to urban counties (29% and 23%). Counties on average had a CPST retention length of 1.8 years with state level proportion of CPSTs that never recertify ranging from 47% to 73%. The number of CPSTs in 2021 was 16% lower than in 2019, highlighting the impact of COVID on this specialized workforce.

Conclusions Half of counties in 2021 had the potential to reach less than 20% of children in key ages for child seat transition periods, and nationally 58% of CPSTs do not recertify beyond their initial certification. These findings provide insights to guide workforce planning activities.