title: Influence of adult role modeling on child/adolescent helmet use in recreational sledging: an observational study.
abstract: BACKGROUND
  During recreational sledging (tobogganing), the head represents the most frequent injured body region with approximately one-third of all sledging injuries among children and adolescents. Whether children are wearing a helmet or not might be influenced on parental encouragement and role modeling of helmet use. Therefore, the aim of this study was to evaluate the impact of adult helmet use on child/adolescent helmet use in recreational sledging.
  
  
  METHODS
  More than 500 adults sitting together with another adult or child/adolescent on a two-seater sledge were interviewed during two winter seasons at the bottom of six sledging tracks on demographics, mean frequency of sledging per season, self-estimated skill level, risk-taking behavior, and the use of a helmet.
  
  
  RESULTS
  Total helmet use of all observed persons was 41.0 %. Helmet use among interviewed adults significantly increased with increasing age up to 45 years, frequency of sledging, and skill level, respectively. Helmet use of interviewed adults was 46.5 % if a child/adolescent was sitting on the same sledge and 29.8 % (odds ratios (OR): 2.1, 95 % confidence intervals (CI): 1.4-2.9, p < 0.001) when sledging together with another adult. Helmet use was 71.3 % among children/adolescents and 26.7 % among adults (OR: 6.8, 95 % CI: 4.6-10.1, p < 0.001) sitting on the same sledge as the interviewed person, respectively.
  
  
  CONCLUSIONS
  Adults were wearing more often a helmet during recreational sledging when sitting together with a child/adolescent on the sledge. However, helmet use during sledging is clearly below 50 %. Thus, more intense educational campaigns on helmet use are urgently needed for tobogganists.
authors.affiliation: Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria. gerhard.ruedl@uibk.ac.at.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ruedl
authors.affiliation: Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria.
authors.forename: Elena
authors.initials: E
authors.lastname: Pocecco
authors.affiliation: Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Raas
authors.affiliation: Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Blauth
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
authors.forename: Peter U
authors.initials: PU
authors.lastname: Brucker
authors.affiliation: Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Burtscher
authors.affiliation: Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Kopp
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D001265:Athletic Injuries / Q000517:prevention & control*; D001317:Austria / Q000453:epidemiology; D002648:Child; D000067576:Child Health / Q000706:statistics & numerical data; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000517:prevention & control*; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010287:Parent-Child Relations; D011998:Recreation; D012309:Risk-Taking; D038161:Snow Sports / Q000293:injuries / Q000706:statistics & numerical data; D019876:Sports Equipment / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Injury prevention; Role modeling; Ski helmet; Sledding; Sledging; Tobogganing