Abstract Objective: China has a high fatality rate for child pedestrians, which highlights the necessity of implementing more effective pedestrian safety training programs in elementary schools. We thus investigated the efficacy of using virtual reality (VR) as an instructional technology to identify and modify risky pedestrian behaviors among Chinese children. Methods: Seventy-nine children (grades 1 through 3) from three elementary schools in Hubei province participated and were categorized into urban (n = 20), migrant (n = 29), or rural ...