Academic journal article International Journal of Child Health and Human Development

Bicycle and Helmet Use of Young Adults and Adolescents: A Meta-Analysis

Academic journal article International Journal of Child Health and Human Development

Bicycle and Helmet Use of Young Adults and Adolescents: A Meta-Analysis

Article excerpt

Introduction

Head injuries comprise one-third of bicycle injuries treated in emergency departments in the United States (1-5). This comes as no surprise as rates of helmet use have been reported to be low (5). Children, in particular, are more prone to these types of injuries because they are much more likely to be involved in a bicycle-related injury (1) and as a result are commonly treated cohorts, (3).

Multiple studies (6-7) have been recently published, determined to scientifically document bicycle and helmet use in the adolescent and young adult population. The first of the bunch, published by Chow et al. (6) reported a negative correlation between age and helmet use among adolescent males in Toronto, Ontario, Canada; helmet use decreased from 96% to 76% to 59% for Grade 7 to 12 students. Borean et al. also noted a similar trend, with helmet use falling from 88% to 58% for adolescent cyclists in Toronto, Ontario, Canada (7).

Since then, many studies have been carried out (8-11). Many have been published, and the Bicycle Safety & Awareness Club also has some unpublished data; these studies have not been systematically compared against each other though. The aim of this meta-analysis is to compile all the data from recent literature and compare the helmet use rates of adolescents and young adults in different regions.

Methods

A literature search was conducted in many databases, such as Ovid MEDLINE and OLDMEDLINE, Embase Classic and Embase, PsycINFO. Relevant studies were screened to determine whether it reported bicycle and helmet use in adolescent and young adult populations. Additional data from three unpublished studies of the Bicycle Safety & Awareness Club - an independent all-girls school Mississauga, Canada; a school in Singapore; young adults in Vancouver, British Columbia, Canada - was also collected.

The extracted endpoints were: bicycle use when commuting to school; duration of school commute; frequency of school commute; frequency of helmet use during school commute; knowledge of legislation/safety; bicycle use during recreational time; and frequency of helmet use during recreational time. These endpoints were compiled into a table and summed to produce a weighted average for each endpoint. The endpoints were produced for six age cohorts - three cohorts of adolescents (Grade 7 and 8 students, Grade 9 and 10 students, Grade 11 and 12 students) and three cohorts of young adults (aged 19 years and below, between 20 years old and 22 years old, and 23 years old and above).

For the studies conducted in the adolescent population, weighted averages were produced for independent-school studies in Canada, public high school studies in Canada, and a Singapore high school study. The studies conducted in the young adult population yielded weighted averages for each endpoint for: the Canadian Province of Ontario, Province of Quebec, Province of Saskatchewan, Province of Nova Scotia, Province of British Columbia, State of New York in the United States, State of California in the United States, and Outside of North America. These numerous weighted averages ultimately yielded three averages based on region - Canada, United States, and Outside of North America.

Singapore lacks bicycle legislation; the question in the Singapore questionnaire for the adolescents was a True/False question regarding whether it is safer or not as safe for helmet use. The data was merged with the data for Canadian adolescents regarding bicycle legislation. In two studies (12-13), they only had two age cohorts for young adults - 19 years and below, and 20 years and above. The data for the oldest cohort was added to the middle cohort of this meta-analysis; the authors remarked that they had no responses from young adults older than 22 years old.

Results

A total of seventeen published studies (6-22) were included in the meta-analysis, as well as data from three unpublished studies conducted by the Bicycle Safety and Awareness Club. …

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