Academic journal article Journal of School Health

Middle School Students and Bicycle Helmet Use: Knowledge, Attitudes, Beliefs and Behaviors

Academic journal article Journal of School Health

Middle School Students and Bicycle Helmet Use: Knowledge, Attitudes, Beliefs and Behaviors

Article excerpt

Every year in the United States, approximately 900 bicyclists are killed.[1] Moreover, bicycle-related injuries account for 23,000 hospital admissions and more than 500,000 emergency room visits.[1] Most bicycle-related injuries treated in emergency rooms occur to children under age 15.[1] Head injury leads to most deaths and serious disabilities.[2] It has been determined that bicycle helmets, regardless of type, provide a protective effect for head and brain injury in the range of 69% to 74%.[3] Though the efficacy of helmets has been consistently demonstrated, a national study showed that only 25% of children reportedly always wear their helmet when cycling, and only 50% own a helmet.[4]

To encourage bicycle helmet use among children and adolescents, several state and local bicycle helmet promotion campaigns have been conducted. In Seattle, Wash., a comprehensive bicycle helmet campaign led to an increase in helmet use among children and youth from 5.5% to approximately 60%.[5] This campaign used broad-based community coalitions and organizations, extensive educational activities, mass media and public relations, and lower-priced helmets to promote children's bicycle helmet use. Bicycle helmet legislation has been important in increasing children's bicycle helmet use. Howard County, Md., increased bicycle helmet use among children from 4% to 47% after enacting legislation.[6] Studies from Georgia and Oregon also showed increases in children's bicycle helmet after legislation passed.[7, 8] In addition, various research has shown that making helmets more affordable and increasing awareness and reinforcement by parents, care givers, siblings, and peers promotes helmet use.[9-14]

A particularly difficult group to reach in bicycle helmet promotion efforts is older children and teen-agers. Studies indicate that older children are less likely to use helmets.[7, 15] A survey of 1,240 Australian adolescents, ages 13-17, showed that fewer than 25% reported always wearing a helmet, despite compulsory helmet legislation. Reasons for not wearing a helmet included appearance and comfort factors.[16]

Florida's 1996 bicyclist death rate was .81 per 100,000, a rate nearly three times the national rate of 0.32.[17] Consequently, several counties have conducted bicycle helmet promotion campaigns involving the community, media, and schools.

One successful campaign was implemented and evaluated in Hillsborough County, Fla. This effort, known as the "MORE HEALTH Bicycle Safety Project," was largely conducted in elementary school settings.[8] The bicycle safety program included education (grades K-2) and sales and distribution of high-quality bicycle helmets for all children enrolled in nine public elementary schools. Evaluation findings showed bicycle helmet use increased from 6% at baseline to approximately 61% after the program had been implemented for three years in the pilot school settings.

Effective January 1, 1997, Florida became the 15th state to enact bicycle helmet legislation. This legislation applies to children under age 16. During the first year of the law, only warnings were: issued to children riding bicycles without using helmets. Beginning January 1, 1998, a $15 fine was assessed for noncompliance. If the rider shows proof of having purchased a helmet, the fine is waived.

Observational surveys of children's (ages 5-13) bicycle helmet use in Hillsborough County have been conducted since 1993. Results of the most recent observational surveys showed helmet use has significantly increased from 3.6% in 1993 to 67% in 1998. Reasons for this increase in helmet use most likely include countywide, community-based education, education in the schools, media influence, and passage of the bicycle helmet law. However, it appears that most children wearing helmets are in elementary schools and riding bicycles in the highest income census tracts.

Many school-based bicycle helmet interventions described in the literature focus on elementary school children. …

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