title: Barriers to bicycle helmet use among Dutch paediatricians.
abstract: BACKGROUND
  In the Netherlands, bicycle helmet wearing rates are very low and perceived social barriers to helmet use are important. We aimed to determine why Dutch paediatricians do or do not wear helmets while bicycling and whether their personal behaviour is influencing their position about the promotion of helmet use.
  
  
  METHODS
  Attendants to the annual meeting of the Dutch Paediatric Society (7-9 November 2006) were surveyed about bicycle riding frequency, helmet use, reasons for not wearing a helmet, helmet use among their own children and personal position about the promotion and legislation of bicycle helmet use.
  
  
  RESULTS
  Of the 1110 paediatricians who are active in the Netherlands, 258 answered the survey. Ninety-six per cent of the respondents ride a bicycle (68% more than once a week). Bicycle was used as a mean of transport (32%), as a recreation/sport (11%) or with both purposes (57%). When cycling for transportation, 94% never wear a helmet and 2% always wear it. When cycling for recreation, 70% never wear a helmet and 18% always wear it. The most common reasons given for not wearing a helmet were: 'I never thought about that' (43%), 'Poor appearance' (31%), 'Nobody uses it in the Netherlands' (27%) and 'Uncomfortable' (25%). A majority (91%) of the respondents agreed that bicycle helmets are effective in reducing the rate of head injury to bicyclists and that they should be advised to children (82%) and adolescents (54%).
  
  
  CONCLUSIONS
  Our results indicate that among Dutch paediatricians, cycling rate is high and helmet wearing rate is very low and that they experience numerous personal barriers to bicycle helmet use. This might explain why bicycle helmet promotion campaigns are scarcely supported by Dutch paediatricians.
authors.affiliation: Department of Pediatrics, Research Institute Growth and Development, Maastricht University Medical Centre, Maastricht, The Netherlands. eiv@paed.azm.nl
authors.forename: E
authors.initials: E
authors.lastname: Villamor
authors.forename: S
authors.initials: S
authors.lastname: Hammer
authors.forename: A
authors.initials: A
authors.lastname: Martinez-Olaizola
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001642:Bicycling; D002648:Child; D006259:Craniocerebral Trauma / Q000517:prevention & control*; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010372:Pediatrics / Q000706:statistics & numerical data*; D012449:Safety; D011795:Surveys and Questionnaires; D055815:Young Adult