title: Trends in motorcycle helmet use in Vietnam: results from a four-year study.
abstract: OBJECTIVE
  Helmet use is a major risk factor for road traffic injuries and fatalities. This study sought to determine the state of helmet use in Ha Nam and Ninh Binh provinces in Vietnam, and ascertain knowledge, attitudes, and practices of helmet use over time.
  
  
  METHODS
  Observational helmet use studies, and roadside knowledge, attitudes, and practice surveys.
  
  
  METHODS
  Data were collected through observational helmet use studies at multiple sites in Ha Nam and Ninh Binh provinces over 14 rounds between June 2011 and December 2014. Six rounds of knowledge, attitude, and practice surveys were administered at gas stations between December 2011 and July 2014. Trend analysis and negative binomial regressions were used to analyze trend data.
  
  
  RESULTS
  Between June 2011 and December 2014, 301,981 helmet-use observations were conducted in Ha Nam and Ninh Binh. Correct helmet use increased significantly (P < 0.01) in Ha Nam from 34.3% to 76.9% (P < 0.01), while use in Ninh Binh increased from 68.9% to 72.2% (P > 0.05).
  
  
  CONCLUSIONS
  Helmet use has improved statistically significantly in Ha Nam but not in Ninh Binh. Ceiling effects may have limited the scope of improvements in Ninh Binh province.
authors.affiliation: Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: J
authors.initials: J
authors.lastname: Bao
authors.affiliation: Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: abachani@jhu.edu.
authors.forename: A M
authors.initials: AM
authors.lastname: Bachani
authors.affiliation: Center for Injury Policy and Prevention Research, Hanoi School of Public Health, Hanoi, Vietnam.
authors.forename: C P
authors.initials: CP
authors.lastname: Viet
authors.affiliation: Center for Injury Policy and Prevention Research, Hanoi School of Public Health, Hanoi, Vietnam.
authors.forename: La N
authors.initials: N
authors.lastname: Quang
authors.affiliation: World Health Organization, Vietnam Country Office, Hanoi, Vietnam.
authors.forename: N
authors.initials: N
authors.lastname: Nguyen
authors.affiliation: Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Hyder
mesh_terms: D000056:Accident Prevention / Q000379:methods / Q000639:trends; D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data / Q000639:trends; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D006259:Craniocerebral Trauma / Q000517:prevention & control*; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data* / Q000639:trends; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009049:Motorcycles; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014744:Vietnam / Q000453:epidemiology
keywords: Drink driving; Helmets; Road injury; Vietnam