title: Correlation between parental perception and actual childhood patterns of bicycle helmet use and riding practices: implications for designing injury prevention strategies.
abstract: OBJECTIVE
  Bicycle injuries account for 10% of all pediatric traumatic deaths. Bicycle helmets have proven to decrease morbidity and mortality, yet trauma data show low helmet use among injured children. However, owning a bicycle helmet does not universally result in a child wearing a helmet. Furthermore, we hypothesize that parental perception of their children's use of the bicycle helmet may not reflect accurately true utilization by their child. To investigate this hypothesis the authors examined both parents' and their children's reports of bicycle ownership, supervision, riding patterns, and helmet use.
  
  
  METHODS
  A random sample of grade 5 and 6 students (ages 8 to 12) and their parents were surveyed about bicycle ownership, riding patterns, supervision, and helmet use. The children and their guardians responded independently to the questionnaire. Statistical analysis was performed using the chi(2) test when indicated.
  
  
  RESULTS
  Eighty-eight of 102 children (86%) responded. This represented 56% girls and 44% boys aged 8 to 12 years. Sixty-nine of 90 (77%) of the parents returned the survey. Ninety-six percent of the children owned a bicycle. A total of 87.5% of children owned a bicycle helmet. Eighty percent of the time children ride their bicycles on the road or sidewalk, with less then 20% on marked trails or parks. Parents reported that their children wear a helmet 90% of the time. In contrast, children report no helmet use in up to 61% of riding instances (P <.05). Parents themselves do not wear a helmet in greater then 60% when riding, which is correlated by their children. Seventy-one percent of the children report that they ride unsupervised the majority of the time.
  
  
  CONCLUSIONS
  Bicycle and bicycle helmet ownership is high among this study group. There is a significant possibility that children will ride unsupervised, in at-risk situations, without wearing a helmet. Parental perceptions about bicycle helmet use by their children may not accurately reflect true utilization. In this study group parents appear as poor role models for their children. Injury prevention strategies need to focus on children and adults to improve effectiveness.
authors.affiliation: Division of Pediatric Surgery, Departments of Surgery and Pediatrics, West Virginia Children's Hospital, Jon Michael Moore Trauma Center, West Virginia University, Morgantown West Virginia, USA.
authors.forename: P F
authors.initials: PF
authors.lastname: Ehrlich
authors.forename: J
authors.initials: J
authors.lastname: Longhi
authors.forename: R
authors.initials: R
authors.lastname: Vaughan
authors.forename: S
authors.initials: S
authors.lastname: Rockwell
mesh_terms: D000056:Accident Prevention; D000328:Adult; D000704:Analysis of Variance; D001294:Attitude to Health; D001642:Bicycling / Q000293:injuries* / Q000331:legislation & jurisprudence / Q000523:psychology*; D002648:Child; D002669:Child Welfare; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006266:Health Education / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009017:Morbidity; D020380:Needs Assessment; D010067:Ownership / Q000706:statistics & numerical data; D016487:Parenting / Q000523:psychology; D010290:Parents / Q000193:education / Q000523:psychology*; D002666:Psychology, Child; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014903:West Virginia / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control