Abstract
OBJECTIVE: To assess the effect of a community bicycle helmet education and subsidy program and the further effect of a bicycle rodeo on helmet ownership and use among elementary schoolchildren. The unanticipated effect of a child cyclist fatality was also measured. DESIGN: Helmet ownership and use were measured in two ways: a questionnaire was sent to all elementary schoolteachers asking about helmet ownership and use by their students; and volunteers counted the children riding their bicycles to school. SETTING: Elementary schools in the town of Goderich, population 7400, and the town of Kincardine, population 6227, both on Lake Huron in southwestern Ontario. PARTICIPANTS: More than 80% of the 1050 elementary school students in Goderich and, for comparison, more than 90% of the 1439 elementary school students in Kincardine. INTERVENTIONS: An extensive education campaign with programs, assemblies, teaching aids, speakers, and a colouring and poster contest, coupled with a discount helmet offer in October 1991. Incentives to helmet use, such as bicycle rodeos, took place in May 1992 and 1993. A child cyclist not wearing a helmet was fatally injured in September 1992. MAIN OUTCOME MEASURES: Teachers polled students on helmet use and student volunteers counted children riding bicycles and noted helmet use. RESULTS: A total of 250 helmets were purchased, and helmet use was observed to increase among 5- to 14-year-old children from 0.75% to 12.8% during 9 months. Program effect was significantly greater on younger children, and girls used helmets more often than boys did. The cycling fatality in Goderich was associated with a dramatic increase in helmet use (to more than 50%), a significantly higher rate than in Kincardine. A second subsidy and rodeo did not further increase helmet use. CONCLUSIONS: A small community with limited resources can mount a bicycle helmet education and incentive program with high exposure and participation rates by children. Despite an initial 17-fold increase in observed helmet use, more than 87% of cyclists still did not wear helmets. The cycling fatality was associated with a significant increase in helmet use.
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]
- Björnstig U., Oström M., Eriksson A., Sonntag-Oström E. Head and face injuries in bicyclists--with special reference to possible effects of helmet use. J Trauma. 1992 Dec;33(6):887–893. doi: 10.1097/00005373-199212000-00016. [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., Down J., MacMillan N., Waclawik H. Bicycle-related injuries: a survey in a pediatric emergency department. CMAJ. 1990 Jul 15;143(2):108–112. [PMC free article] [PubMed] [Google Scholar]
- Cushman R., Down J., MacMillan N., Waclawik H. Helmet promotion in the emergency room following a bicycle injury: a randomized trial. Pediatrics. 1991 Jul;88(1):43–47. [PubMed] [Google Scholar]
- Cushman R., Down J., Macmillan N., Waclawik H. Bicycle helmet use in Ottawa. Can Fam Physician. 1990 Apr;36:697–700. [PMC free article] [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]
- Cushman R., Pless R., Hope D., Jenkins C. Trends in bicycle helmet use in Ottawa from 1988 to 1991. CMAJ. 1992 May 1;146(9):1581–1585. [PMC free article] [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]
- Kimmel S. R., Nagel R. W. Bicycle safety knowledge and behavior in school age children. J Fam Pract. 1990 Jun;30(6):677–680. [PubMed] [Google Scholar]
- Nakayama D. K., Pasieka K. B., Gardner M. J. How bicycle-related injuries change bicycling practices in children. Am J Dis Child. 1990 Aug;144(8):928–929. doi: 10.1001/archpedi.1990.02150320092035. [DOI] [PubMed] [Google Scholar]
- Otis J., Lesage D., Godin G., Brown B., Farley C., Lambert J. Predicting and reinforcing children's intentions to wear protective helmets while bicycling. Public Health Rep. 1992 May-Jun;107(3):283–289. [PMC free article] [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]
- Runyan C. W., Runyan D. K. How can physicians get kids to wear bicycle helmets? A prototypic challenge in injury prevention. Am J Public Health. 1991 Aug;81(8):972–973. doi: 10.2105/ajph.81.8.972. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sacks J. J., Holmgreen P., Smith S. M., Sosin D. M. Bicycle-associated head injuries and deaths in the United States from 1984 through 1988. How many are preventable? JAMA. 1991 Dec 4;266(21):3016–3018. [PubMed] [Google Scholar]
- Scheidt P. C., Wilson M. H., Stern M. S. Bicycle helmet law for children: a case study of activism in injury control. Pediatrics. 1992 Jun;89(6 Pt 2):1248–1250. [PubMed] [Google Scholar]
- Spence L. J., Dykes E. H., Bohn D. J., Wesson D. E. Fatal bicycle accidents in children: a plea for prevention. J Pediatr Surg. 1993 Feb;28(2):214–216. doi: 10.1016/s0022-3468(05)80278-7. [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]
- Wasserman R. C., Waller J. A., Monty M. J., Emery A. B., Robinson D. R. Bicyclists, helmets and head injuries: a rider-based study of helmet use and effectiveness. Am J Public Health. 1988 Sep;78(9):1220–1221. doi: 10.2105/ajph.78.9.1220. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Winn G. L., Jones D. F., Bonk C. J. Taking it to the streets. Helmet use and bicycle safety as components of inner-city youth development. Clin Pediatr (Phila) 1992 Nov;31(11):672–677. doi: 10.1177/000992289203101106. [DOI] [PubMed] [Google Scholar]