Citation

Parkin PC, Hu X, Spence LJ, Kranz KE, Shortt LG, Wesson DE. Pediatrics 1995; 96(2 Pt 1): 283-287.

Affiliation

Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

Copyright

(Copyright © 1995, American Academy of Pediatrics)

DOI

unavailable

PMID

7630685

Abstract

OBJECTIVE. We have previously shown that an educational program was not effective in increasing bicycle helmet use in children of low-income families. The objective of this study was to evaluate a combined educational and helmet subsidy program in the same population, while controlling for secular trends. The secondary objective was to complete a third year of surveying children's bicycle helmet use throughout the study community. DESIGN. A prospective, controlled, before-and-after study. SUBJECTS. Bicycling children 5 to 14 years of age from areas of low average family income. SETTING. A defined geographic community within a large urban Canadian city. INTERVENTION. In April 1992, students in three schools located in the area of lowest average family income were offered $10 helmets and an educational program; three other low-income areas served as control areas. MAIN OUTCOME MEASURE. Helmet use was determined by direct observation of more than 1800 bicycling children. RESULTS. Nine hundred ten helmets were sold to a school population of 1415 (64%). Reported helmet ownership increased from 10% to 47%. However, observed helmet use in the low-income intervention area was no different from the rate in the three low-income control areas (18% versus 19%). There was no difference in the trend in helmet use during the period of 1990 through 1992 in the intervention area (4% to 18%) compared with the control areas (3% to 19%). Helmet use rates from all income areas have increased from 3.4% in 1990, to 16% in 1991, to 28% in 1992. In 1992, helmet use in the high-income areas was 48% and in the low-income areas was 20%. CONCLUSIONS. There has been a trend toward increasing helmet use in all income areas during the 3-year period. Despite encouraging helmet sales and increases in reported helmet ownership, the results of the observational study do not support the efficacy of a helmet subsidy program in increasing helmet use in children residing in areas of low average family income. Strategies to increase helmet use in children of low average family income remain a priority.