title: Off-road vehicle ridership and associated helmet use in Canadian youth: an equity analysis.
abstract: OBJECTIVE
  In North America, the use of off-road vehicles by young people is increasing, as are related injuries and fatalities. We examined the prevalence of off-road ridership and off-road helmet use in different subgroups of Canadian youth in order to better understand possible inequities associated with these health risk behaviors.
  
  
  METHODS
  Data came from Cycle 6 (2009-2010) of the WHO Health Behavior in School-Aged Children Study (HBSC). Participants (n = 26,078) were young people from grades 6-10 in 436 Canadian schools. Students were asked, for a 12-mo recall period, how frequently they rode off-road vehicles and how often they wore a helmet while riding. Engagement in off-road ridership and helmet use were estimated by age group, gender, urban-rural geographic location, socioeconomic status, and how long participants had lived in Canada.
  
  
  RESULTS
  About half of the sample reported riding off-road vehicles (12,750; 52%). Among riders, 5,691 (45%) always wore helmets. Riders were more often older students, male and born in Canada. Students in rural areas and small towns were much more likely to ride off-road vehicles than their urban peers (RR, 95% CI: 1.28 [1.23-1.33]). Helmet use was less common among females, new immigrants, older students, and those in lower socioeconomic groups. There was little reported difference in helmet use by urban-rural location.
  
  
  CONCLUSIONS
  Risks associated with the use of off-road vehicles and with nonhelmet use are not equitably distributed across Canadian youth. Factors characterizing off-road ridership (notably urban-rural location) are distinct from factors for helmet use. Preventive interventions should target population subgroups.
authors.affiliation: Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada. colleen.davison@queensu.ca
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Davison
authors.forename: Wendy
authors.initials: W
authors.lastname: Thompson
authors.forename: Michael
authors.initials: M
authors.lastname: Torunian
authors.forename: Patricia
authors.initials: P
authors.lastname: Walsh
authors.forename: Steven
authors.initials: S
authors.lastname: McFaull
authors.forename: William
authors.initials: W
authors.lastname: Pickett
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D015541:Off-Road Motor Vehicles / Q000706:statistics & numerical data*; D015995:Prevalence; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D014505:Urban Population / Q000706:statistics & numerical data