title: Understanding reasons for non-compliance in motorcycle helmet use among adolescents in Greece.
abstract: OBJECTIVE
  To explore attitudes towards two-wheel motorized vehicle (TWMV) helmet use among adolescents in a country with poor legal compliance.
  
  
  METHODS
  Self-administered questionnaires were completed by 523 high school students to define the sample of a qualitative study; thereafter, the Health Belief Model (HBM) was applied in 12 focus groups comprising 70 students.
  
  
  METHODS
  Three randomly selected public secondary schools in middle-income areas of Athens, Greece.
  
  
  RESULTS
  Students reporting frequent helmet use were characterized by a high perceived threat of a TWMV-related injury, which seemed to be associated with both prior experience of an injury and receiving information on helmet wearing from "significant others." Students reporting helmet non-use were characterized by a low threat perception, possibly attributable to adolescent egocentrism and accompanying feelings of invulnerability or to lack of knowledge and experience in risk identification. A sharp contrast was noted regarding the most important perceived benefit of helmet use, expressed among users as "protection in the case of a road crash" and among non-users as "avoiding tickets from traffic police". Main barriers to helmet use, as identified by non-users, included: low perceived efficacy of helmets; peer pressure; lack of appropriate information on helmet use; high helmet cost; lack of convenience; vision and hearing disturbance; and style reasons.
  
  
  CONCLUSIONS
  When social norms of low compliance to safety laws prevail, qualitative research can assist in developing tailored educational interventions targeting behavior modification among adolescents.
authors.affiliation: Center for Research and Prevention of Injuries, Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Germeni
authors.forename: C
authors.initials: C
authors.lastname: Lionis
authors.forename: B
authors.initials: B
authors.lastname: Davou
authors.forename: E Th
authors.initials: ET
authors.lastname: Petridou
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology*; D000293:Adolescent; D001294:Attitude to Health; D005260:Female; D006115:Greece; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D008297:Male; D009049:Motorcycles; D010465:Perception