Evaluation of a promotional strategy to increase bicycle helmet use by children.
Bicycle-related head injuries are an important cause of death and disability, despite the availability of helmets. The objective of this study was to evaluate the effectiveness of a school-based bicycle helmet promotion program in increasing helmet use by children while controlling for secular trends. Two high-income and two low-income schools in an urban Canadian community were selected to receive a bicycle helmet promotion intervention, with the remaining 18 schools serving as controls. Approximately 1800 observations of bicycling children were made at randomly selected observational sites 2 to 5 months after the intervention to assess changes in behavior. Helmet use at all observation sites tripled from 3.4% (1990, preintervention) to 16% (1991, postintervention). In the high-income intervention area, observed helmet use rose dramatically from 4% to 36% in contrast to the more modest increase in the high-income control area from 4% to 15%. In the low-income intervention area, there was a modest increase from 1% to 7%, but it did not differ from the increase in the low-income control area from 3% to 13%. The program was highly successful in children of high-income families but not in children of low-income families. Developing strategies for low-income families remains a priority.
Parkin
P C
PC
Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Spence
L J
LJ
Hu
X
X
Kranz
K E
KE
Shortt
L G
LG
Wesson
D E
DE
D000056:Accident Prevention; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006293:Health Promotion; D006801:Humans; D015397:Program Evaluation; D011446:Prospective Studies; D012959:Socioeconomic Factors