Abstract
OBJECTIVE: To determine whether asking for a $5.00 donation for bicycle helmets, compared with distribution free of charge, would affect helmet use among children receiving helmets and an educational intervention from public health clinics. SETTING: Six public health clinic sites in King County, Washington. METHODS: Six participating clinic sites were randomly assigned to either free helmet distribution or to a $5.00 suggested donation for the helmets, stratified by whether a helmet law was in place. Three sites were assigned to each arm. Children who were between 6 and 12 years of age and who reported riding bicycles, but having no bicycle helmets, were eligible. Clinicians distributed helmets and delivered an educational intervention to 506 eligible children, or siblings of children seen at the clinic between March and July 1993. Parents were contacted after helmet distribution to ascertain helmet use. RESULTS: 82% of children whose parents were asked for a copayment and 77% of children who received free helmets were reported to wear their helmets every time they rode their bicycles (p=0.20). The adjusted odds ratio for the association between copayment compared with free helmets and helmet use was 1.66 (95% confidence interval 0.94 to 2.92). CONCLUSIONS: Helmet use was not significantly different among children whose parents were asked for a small copayment, compared with those who received helmets free. Use of copayments can increase helmet use by increasing the number of helmets given to low income children.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bergman A. B., Rivara F. P., Richards D. D., Rogers L. W. The Seattle children's bicycle helmet campaign. Am J Dis Child. 1990 Jun;144(6):727–731. doi: 10.1001/archpedi.1990.02150300127033. [DOI] [PubMed] [Google Scholar]
- Coté T. R., Sacks J. J., Lambert-Huber D. A., Dannenberg A. L., Kresnow M. J., Lipsitz C. M., Schmidt E. R. Bicycle helmet use among Maryland children: effect of legislation and education. Pediatrics. 1992 Jun;89(6 Pt 2):1216–1220. [PubMed] [Google Scholar]
- Cushman R., James W., Waclawik H. Physicians promoting bicycle helmets for children: a randomized trial. Am J Public Health. 1991 Aug;81(8):1044–1046. doi: 10.2105/ajph.81.8.1044. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dannenberg A. L., Gielen A. C., Beilenson P. L., Wilson M. H., Joffe A. Bicycle helmet laws and educational campaigns: an evaluation of strategies to increase children's helmet use. Am J Public Health. 1993 May;83(5):667–674. doi: 10.2105/ajph.83.5.667. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DiGuiseppi C. G., Rivara F. P., Koepsell T. D. Attitudes toward bicycle helmet ownership and use by school-age children. Am J Dis Child. 1990 Jan;144(1):83–86. doi: 10.1001/archpedi.1990.02150250093041. [DOI] [PubMed] [Google Scholar]
- DiGuiseppi C. G., Rivara F. P., Koepsell T. D., Polissar L. Bicycle helmet use by children. Evaluation of a community-wide helmet campaign. JAMA. 1989 Oct 27;262(16):2256–2261. [PubMed] [Google Scholar]
- Morris B. A., Trimble N. E. Promotion of bicycle helmet use among schoolchildren: a randomized clinical trial. Can J Public Health. 1991 Mar-Apr;82(2):92–94. [PubMed] [Google Scholar]
- Parkin P. C., Spence L. J., Hu X., Kranz K. E., Shortt L. G., Wesson D. E. Evaluation of a promotional strategy to increase bicycle helmet use by children. Pediatrics. 1993 Apr;91(4):772–777. [PubMed] [Google Scholar]
- Pendergrast R. A., Ashworth C. S., DuRant R. H., Litaker M. Correlates of children's bicycle helmet use and short-term failure of school-level interventions. Pediatrics. 1992 Sep;90(3):354–358. [PubMed] [Google Scholar]
- Rivara F. P., Thompson D. C., Thompson R. S., Rogers L. W., Alexander B., Felix D., Bergman A. B. The Seattle children's bicycle helmet campaign: changes in helmet use and head injury admissions. Pediatrics. 1994 Apr;93(4):567–569. [PubMed] [Google Scholar]
- Robitaille Y., Legault J., Abbey H., Pless I. B. Evaluation of an infant car seat program in a low-income community. Am J Dis Child. 1990 Jan;144(1):74–78. doi: 10.1001/archpedi.1990.02150250084038. [DOI] [PubMed] [Google Scholar]
- Schneider M. L., Ituarte P., Stokols D. Evaluation of a community bicycle helmet promotion campaign: what works and why. Am J Health Promot. 1993 Mar-Apr;7(4):281–287. doi: 10.4278/0890-1171-7.4.281. [DOI] [PubMed] [Google Scholar]
- Thompson R. S., Rivara F. P., Thompson D. C. A case-control study of the effectiveness of bicycle safety helmets. N Engl J Med. 1989 May 25;320(21):1361–1367. doi: 10.1056/NEJM198905253202101. [DOI] [PubMed] [Google Scholar]
- Weiss B. D. Trends in bicycle helmet use by children: 1985 to 1990. Pediatrics. 1992 Jan;89(1):78–80. [PubMed] [Google Scholar]
- Wood T., Milne P. Head injuries to pedal cyclists and the promotion of helmet use in Victoria, Australia. Accid Anal Prev. 1988 Jun;20(3):177–185. doi: 10.1016/0001-4575(88)90002-4. [DOI] [PubMed] [Google Scholar]
- Zeger S. L., Liang K. Y. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986 Mar;42(1):121–130. [PubMed] [Google Scholar]