A comparison of parent and child perspectives about barriers to and facilitators of bicycle helmet and booster seat use (original) (raw)
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Child: Care, Health and Development, 2020
Background: Mandatory bicycle helmet and booster seat laws for children are now common across Canada and the United States. Previous research has found that despite legislation, child compliance is often low. Our objectives were to identify and compare children's perspectives on barriers to and facilitators of their use of bicycle helmets and booster seats. Methods: Eleven focus groups were conducted with a total of 76 children; five groups of children between the ages of 4 and 8 years discussed booster seats and bicycle helmets, and six groups of children between the ages of 9 and 13 years discussed bicycle helmets. Efforts were made to include diverse participants from a variety of ethno-cultural and socioeconomic backgrounds. Results: Poor fit and physical discomfort were most often described as barriers to bicycle helmet use. Helmet appearance was a barrier for some children but acted as a facilitator for others. Booster seat facilitators included convenient features such as drink cup holders and being able to sit higher up in order to have a better view, while barriers included fear of being teased, and wanting to feel and be seen as more mature by wearing a seatbelt only. Conclusions: The main barriers to usage of bicycle helmets and booster seats identified by young people were modifiable and fit within a theory of planned behaviour framework that includes subjective norms, child attitudes towards safety equipment and perceived behavioural control of its usage. Recommendations were made regarding how these elements can be utilized in future injury prevention campaigns. K E Y W O R D S bicycle helmets, booster seats, children, focus groups, injury prevention 1 | INTRODUCTION Road traffic injuries involving cyclists, motor vehicle occupants, and pedestrians are the leading cause of serious injuries and injury death for children over one year of age (Public Health Agency of Canada, 2011). Laws governing mandatory bicycle helmet and booster seat usage for children are now in place in many jurisdictions across the United States and Canada. Most research has shown that legislation is responsible for substantial declines in child injuries and deaths, in both Canada and elsewhere (Dellinger & Kresnow, 2010; Mannix et al., 2012). While legislation is a worthwhile and effective health promotion strategy (MacPherson & Spinks, 2008), significant barriers still remain that reduce children's bicycle helmet (Jewett,
The promotion of bicycle helmet use in children and youth: an overview of reviews
Evidence-Based Child Health: A Cochrane Review Journal, 2011
Background: Bicycle-related head injuries are a common reason for paediatric emergency department visits. Helmets have been designed to reduce head injuries, and helmet use has been encouraged through mandatory helmet legislation and nonlegislation helmet promotion activities.
The Journal of Pediatrics, 1994
Studies have demonstrated that bicycle-related head injuries are a serious threat to children and that bicycle helmets are a readily available, effective preventive measure. 14 In the absence of specific promotional campaigns, estimates of helmet use range from 0% to 13% by self-report 5-8 and 0% to 19% by observational studies. 9"12 A community-wide bicycle helmet campaign in Seattle, Wash., 9 documented an increase in helmet use from 5% before the campaign to 16% afterward (compared with an increase from 1% to 3% in a comparison community). A helmet use law in Howard County, Md. s, lO, 15 resulted in increases in observed helmet use from 4% before passage of the law to 47% afterward 1°
Neighbourhood Sociocultural Demographics and their Association with Helmet Use in Children
Background - Wheeled sport (bicycle, scooter, and in-line skate) head and facial injuries can be prevented through use of a properly worn helmet. Given the evidence for the effectiveness of bicycle helmets, it is important to examine factors related to their use among children. The objective of this study was to examine neighbourhood sociocultural demographics and their association with observed helmet use among school-aged children riding in defined urban communities. Methods - Children were observed at fifty-five pre-selected sites in twenty defined neighbourhoods in Toronto, Ontario between June and September of 2005. Trained volunteer observers recorded information on helmet use. Neighbourhood level data was adapted from Statistics Canada, and socio-economic and demographic variables for the year 2000-2001 were obtained for each of the twenty neighbourhoods included in the study. Logistic regression was preformed to examine the relationship between neighbourhood sociocultural demographics and helmet use. Results - Of the 306 riders, 174 children were observed riding without a helmet. Neighbourhood socio economic and demographic variables were significantly associated with observed helmet use. Helmet use was lowest among children observed riding in neighbourhoods with a high percent of families with an incidence of low income; a high percent of the population aged fifteen and over with less than high school education; high percent of the population with no knowledge of English or French; and low childhood immunization rates. Conclusion - Results from this study indicate that neighbourhood sociocultural demographics are significantly associated with observed helmet use among children. These results offer a unique opportunity to target specific neighbourhoods according to their sociocultural demographics for helmet-promotion programs and interventions.
Barriers to Bicycle Helmet Use
Pediatrics, 2001
Objective. To determine why people do or do not wear helmets while bicycling. Methods. A survey was conducted from August through October 1999. Two survey areas were chosen for this study: local public schools and paved bicycle trails. For the school arm of the study, 3 public elementary, middle, and high schools were selected from 3 different regions of Rochester, Minnesota, for participation in the study. For the bicycle arm of the study, 3 paved trails located in southeastern Minnesota were selected. A total of 2970 surveys were distributed to the public school system, and 463 surveys were collected from bicyclists on the paved bicycle trails. The survey population was split into 3 age categories for analysis: child (7–10), adolescent (11–19), and adult (older than 19). Results. Of the 2970 surveys distributed to Rochester public schools, 2039 (69%) were returned for analysis. Seventy-eight of the surveys that were completed in the public school system were discarded for the foll...
Impact of a theory based intervention to increase bicycle helmet use in low income children
Injury Prevention, 1998
Objective-While community interventions to increase bicycle helmet use have increased markedly, few of these studies are theoretically based. The purpose of this study was to determine relationships among PRECEDE model predictors and self reported helmet use among 407 fourth graders from nine low income, non-urban schools. Setting-Low income schools, with high minority populations in eight nonmetropolitan Central Texas counties were chosen. Methods-Schools were randomly assigned in a repeated measures design to either classroom only, parent-child, or control groups. School nurses were educated by the researchers to present a head injury prevention program in all but the experimental schools. Researchers made contact by phone with the parents of children in the parent-child group. Results and conclusions-Participation in either of the educational interventions, followed by belief that helmets protect your head (a predisposing factor), and participation in the parent intervention condition, added significant unique variance to the prediction of helmet use after helmet ownership is accounted. These four variables, taken together, account for 72% of the variance in predicting bicycle helmet use.
American Journal of Public Health, 1993
OBJECTIVES. The passage of a mandatory bicycle helmet law for children in Howard County, Maryland, provided an opportunity to compare legislation and education as strategies to increase helmet use. METHODS. In 1991, a survey was mailed to fourth-, seventh-, and ninth-grade students attending a stratified sample of public schools in Howard County and in two similar suburban/rural counties without helmet laws. RESULTS. Of 7217 students surveyed, 3494 responded (48.4%). Self-reported helmet use in Howard County rose from 11% to 37% after the law and accompanying educational campaign went into effect. Helmet use changed from 8% to 13% in Montgomery County, where educational efforts were undertaken, and from 7% to 11% in Baltimore County, where helmet promotion activities were minimal. Predictors of helmet use included having friends who wore helmets, believing helmet laws are good, being in fourth grade, living in Howard County, and using seatbelts regularly. CONCLUSIONS. Legislation co...
Evaluation of a community bicycle helmet promotion campaign: what works and why
American Journal of Health Promotion, 1993
Purpose. This study identifies effective components of a bicycle helmet promotion campaign, and mechanisms by which these components affect child helmet ownership. Design. A random telephone survey identified parents whose children did not own helmets prior to an educational campaign. A follow-up survey was conducted six months later. Regression analysis estimated the effects of four campaign components on child helmet ownership and tested for mediation by cognitive variables. Setting. Study participants ...