Effect of Education and Legislation on Bicycle Helmet Use in a Multiracial Population

Abularrage, Joseph J.; DeLuca, Arthur J.; Abularrage, Christopher J.

doi:10.1001/archpedi.1997.02170380045007

Cited by 40 publications

(23 citation statements)

References 19 publications

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“…29 Of the studies that have used observational survey methods, the duration of prelegislation data collection has been limited to 1 to 9 months before legislation, and postlegislation data collection has been as short as 1 to 10 months. 9,14,15 In addition, sample sizes have been small (50 -300 children); thus, the CIs around the point estimates of helmet use have been wide. 9,12,14 In our study, we collected data for 6 years before legislation and for 2 years after legislation.…”

Section: Discussionmentioning

confidence: 99%

“…9,14,15 In addition, sample sizes have been small (50 -300 children); thus, the CIs around the point estimates of helmet use have been wide. 9,12,14 In our study, we collected data for 6 years before legislation and for 2 years after legislation. A total of 9768 observations were made, and for each year of observation, the sample size ranged from 914 to 1879.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Socioeconomic Status on the Effectiveness of Bicycle Helmet Legislation for Children: A Prospective Observational Study

et al. 2003

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ABSTRACT. Objective. To evaluate the influence of average family income in a geographic area on the effectiveness of helmet legislation on observed helmet use by children (5-14 years).Methods. The study was conducted in East York, a health district of Metropolitan Toronto, in collaboration with the East York Health Unit. In 1996, the total population was 107 822, 11 340 of which were children 5 to 14 years. Census data were used to group the 21 census tracts in East York into 7 geographically distinct areas. The boundaries of these areas are natural barriers to travel, such as expressways, ravines, railway tracks, and hydroelectric power lines. The areas were also ranked according to average family income (based on Statistics Canada data). For analytical purposes, areas were defined as low-, mid-, and high-income areas. Census data profiles of the areas have been previously described. For each consecutive year from 1990 to 1997 inclusive, direct observations of children riding bicycles in East York during the months of April through October were made. In 1995, observations were completed before the introduction of the law on October 1, 1995. Only children who were between 5 and 14 years of age and riding a 2-wheeled bicycle were included in the study. In total, 111 sites across all 7 areas were selected for observation. Observational sites included school yards of all elementary and middle schools (kindergarten to grade 8) and all parks in East York. In addition, 5 major intersections and 5 residential streets from each area were randomly selected. Observers were trained and used a standardized data collection form. A pilot study showed that the data collected by observers were reliable and valid. Observers remained at each site for 1 hour and collected data on helmet use and sex. Ethical approval for the study was obtained from the Hospital for Sick Children Research Ethics Board, the East York Board of Education, and the Metropolitan Separate School Board. The proportion of children who were wearing a bicycle helmet was estimated by year (1990 -1997, inclusive), sex (male, female), location (school, park, major intersection, residential street), and income area (low, mid, high). For estimating the effect of legislation on helmet use, data from the year immediately after legislation (1996) were compared with data from the year preceding legislation (1995). The relative risk (RR) of helmet use (after vs before legislation) was calculated along with a 95% confidence interval (CI). Logistic regression analysis was used to adjust for potential confounding variables (sex and location).Results Conclusions. This study showed that bicycle helmet use by children increased significantly after helmet legislation. In this urban area with socioeconomic diversity and in the context of prelegislation promotion and educational activities, the legislative effect was most powerful among children who resided in low-income areas. Pediatrics 2003;112:e192-e196. URL: http://www. pediatrics.org/cgi/content/full/112/3/e192; socioecono...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of Socioeconomic Status on the Effectiveness of Bicycle Helmet Legislation for Children: A Prospective Observational Study

et al. 2003

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“…For example, legislation requiring bicycle helmet use should be accompanied by an educational campaign for children and parents, police enforcement in the community, and discounted sales of helmets by local merchants (1,41). Programs addressing the safety of employees can also be extended to focus on the safety of other family members such as adolescents on and off the job.…”

Section: Ecological Approachesmentioning

confidence: 99%

A Review of Unintentional Injuries in Adolescents

Sleet

Ballesteros

Borse

2010

Annu. Rev. Public Health

115

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Unintentional injuries are the largest source of premature morbidity and mortality and the leading cause of death among adolescents 10-19 years of age. Fatal injury rates of males are twice those of females, and racial disparities in injury are pronounced. Transportation is the largest source of these injuries, principally as drivers and passengers, but also as cyclists and pedestrians. Other major causes involve drowning, poisonings, fires, sports and recreation, and work-related injuries. Implementing known and effective prevention strategies such as using seat belts and bicycle and motorcycle helmets, installing residential smoke alarms, reducing misuse of alcohol, strengthening graduated driver licensing laws, promoting policy change, using safety equipment in sports and leisure, and protecting adolescents at work will all contribute to reducing injuries. The frequency, severity, potential for death and disability, and costs of these injuries, together with the high success potential of prevention strategies, make injury prevention a key public health goal to improve adolescent health in the future.

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“…2,5,7,8,10,13,14,28 -33 Studies have determined that educational campaigns that promote bicycle helmet use and legislation that mandates bicycle helmet use can increase the prevalence of bicycle helmet use. 14,18,28,[33][34][35][36][37][38][39][40][41][42][43][44][45] Head injuries sustained from bicycle accidents have decreased after the implementation of educational campaigns 46,47 and legislation. 33 Although educational campaigns significantly increase the use of bicycle helmets, they seem to plateau when helmet use reaches between 50% and 60%.…”

mentioning

confidence: 99%

Barriers to Bicycle Helmet Use

Finnoff¹,

Laskowski²,

Altman

et al. 2001

Pediatrics

115

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ABSTRACT. 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 following reasons: age <10 years (35), insufficient completion (24), and selection of every reason for not wearing a bicycle helmet (19). A total of 463 surveys were completed on the 3 paved bicycle trails. One survey from the paved bicycle trail arm of the study was discarded because of insufficient completion. The total number of surveys used for statistical analysis was 2424. The distribution of male (52.7%) and female (47.3%) participants was similar. No significant difference in bicycle helmet use was found between genders.The age groups with the highest rate of bicycle helmet use were 50 to 59 years (62%) and older than 59 years (70%). The age groups with the lowest rate of bicycle helmet use were 11 to 19 years (31%) and 30 to 39 years (30%). The most common reasons given for not wearing a bicycle helmet were "uncomfortable," "annoying," "it's hot," "don't need it," and "don't own one." Bicycle helmet use was significantly influenced by peer helmet use in all 3 age groups. Children also were more likely to wear a bicycle helmet when their parents wore bicycle helmets.A majority of respondents in all 3 age groups indicated that bicycle helmets provided either "moderate" or "great" protection from head injury, although significantly more adults (65.9%) than adolescents (43.9%) believed that the protection afforded by bicycle helmets was "great." Despite this belief, a majority of adolescents and adults indicated that there was only a "slight risk" of head injury when bicycling without a helmet. Participants in all 3 categories were more likely to wear a bicycle helmet when they indicated either that there was a "great risk" of head injury when bicycling without a helmet or that helmets provided "great protection" from head injury. Adolescents and adults who believed that bicycling without a helmet put one at "great risk" for head injury also were more likely to indicate that helmets provided "great protection" from head injury.Conclusions. The prevalence of bicycle helmet use remains low despite research indicating the high l...

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Effect of Education and Legislation on Bicycle Helmet Use in a Multiracial Population

Cited by 40 publications

References 19 publications

Influence of Socioeconomic Status on the Effectiveness of Bicycle Helmet Legislation for Children: A Prospective Observational Study

Influence of Socioeconomic Status on the Effectiveness of Bicycle Helmet Legislation for Children: A Prospective Observational Study

A Review of Unintentional Injuries in Adolescents

Barriers to Bicycle Helmet Use

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