title: The Impact of Mandatory Helmet-Use Legislation on the Frequency of Cycling to School and Helmet Use Among Adolescents.
abstract: This paper analyzes changes in the frequency of cycling to school and helmet wearing after the introduction of a mandatory helmet law, and attempts to identify factors associated with the acceptance of helmet use.
  
  
  
  A mixed-method study was designed with a 7-month follow-up period (April 2014 to November 2014). The initial sample included 262 students (aged 12 to 16 years) from Valencia, Spain. The data were collected by questionnaire and 2 focus-group interviews were conducted.
  
  
  
  No significant changes in cycling-to- school behavior were found during the study period. Cycle helmet use improved, especially among boys, those who used their own bike, and among adolescents who lived within 2 km of school (P < .05 in all cases). The most common reasons given for not using a helmet were social factors. Peer-group pressure had a negative influence on helmet use among adolescents. Participants also indicated that helmet use is inconvenient, in particular among students who used the public bicycle-sharing program.
  
  
  
  The implementation of the helmet-use law did not have a negative impact on the frequency of cycling to school. Our findings provide an empirical basis for designing educational interventions and programs to increase helmet use among adolescents.
authors.affiliation: Dept of Teaching of Musical, Visual, and Corporal Expression. University of Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Molina-García
authors.forename: Ana
authors.initials: A
authors.lastname: Queralt
mesh_terms: D000293:Adolescent; D001642:Bicycling / Q000331:legislation & jurisprudence*; D002648:Child; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012574:Schools; D013334:Students; D011795:Surveys and Questionnaires