title: Bicycle helmet promotion among low income preschool children.
abstract: OBJECTIVE
  To evaluate the effectiveness of a multifaceted bicycle helmet promotion program for low income children attending preschool enrichment programs throughout Washington State.
  
  
  METHODS
  Preschool Head Start programs that conducted routine home visits among their enrolled families at least five times during the school year were eligible. Eighteen sites and 880 children met this criterion and were able and willing to carry out evaluation activities. Two hundred children were from control sites where no helmet promotion activities were carried out.
  
  
  METHODS
  Classroom activities with children, education of parents during school meetings and home visits, fitting and distribution of helmets, a bicycle skills and safety "rodeo" event, and requiring children to wear helmets while riding on school grounds.
  
  
  METHODS
  Regularly scheduled home visits were used to observe helmet use of enrolled preschool children before and after the promotion program. Home visitors requested parental permission for enrolled children to ride, and then noted whether the child wore a helmet.
  
  
  RESULTS
  Helmet use in the intervention group more than doubled, from 43% to 89%, while use in the control group increased from 42% to 60% (p < 0.05 for intervention group changes v control group changes).
  
  
  CONCLUSIONS
  This multifaceted helmet promotion program successfully increased helmet use. Similar home visit protocols may be useful to evaluate the impact of other injury intervention programs.
authors.affiliation: Harborview Injury Prevention and Research Center, Seattle, WA 98104-2499, USA.
authors.forename: J
authors.initials: J
authors.lastname: Britt
authors.forename: I
authors.initials: I
authors.lastname: Silver
authors.forename: F P
authors.initials: FP
authors.lastname: Rivara
mesh_terms: D001642:Bicycling / Q000293:injuries*; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000517:prevention & control*; D018479:Early Intervention, Educational; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D011203:Poverty; D015397:Program Evaluation; D014861:Washington