title: Effect of a bicycle safety program and free bicycle helmet distribution on the use of bicycle helmets by elementary school children.
abstract: OBJECTIVE
  Each year in the United States, 300,000 children are treated in emergency departments for bicycle injuries; one third have head injuries. The purpose of this study was to determine the effectiveness of educational interventions and free helmet distribution in increasing the use of helmets by elementary school children.
  
  
  METHODS
  Self-report questionnaires on the use of bicycle helmets were used for students at two elementary schools (n = 1610). Testing was done both before and after the administration of a bicycle safety program and the distribution of free helmets. Pretest and posttest answers were then compared for changes in helmet use.
  
  
  RESULTS
  Helmet usage increased significantly after the bicycle safety program, from 38% to 46% overall (p < 0.005). Children who were given free helmets were significantly more likely to wear their helmets (61.4%) than children who already owned helmets (43.4%) (p > 0.016). Children who attended the school in which free helmets were distributed showed a significant increase in helmet use (p < 0.01), whereas those at the school that had a safety program alone did not show a significant increase (p > 0.17).
  
  
  CONCLUSIONS
  The results of this study suggest that bicycle safety programs and free helmet distribution may increase the consistent use of helmets in elementary school children.
authors.affiliation: Inova Regional Trauma Center, Falls Church, Virginia, USA.
authors.forename: D
authors.initials: D
authors.lastname: Watts
authors.forename: N
authors.initials: N
authors.lastname: O'Shea
authors.forename: E
authors.initials: E
authors.lastname: Flynn
authors.forename: A
authors.initials: A
authors.lastname: Trask
authors.forename: D
authors.initials: D
authors.lastname: Kelleher
mesh_terms: D001642:Bicycling / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006260:Head Protective Devices; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D015397:Program Evaluation; D012449:Safety; D012572:School Health Services; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000517:prevention & control