Bicycle helmet use and non-use - recently published research

Applying the health action process approach to bicycle helmet use and evaluating a social marketing campaign

BACKGROUND

Bicycle injuries are of concern in Canada. Since helmet use was mandated in 1996 in the province of British Columbia, Canada, use has increased and head injuries have decreased. Despite the law, many cyclists do not wear a helmet. Health action process approach (HAPA) model explains intention and behaviour with self-efficacy, risk perception, outcome expectancies and planning constructs. The present study examines the impact of a social marketing campaign on HAPA constructs in the context of bicycle helmet use.

METHOD

A questionnaire was administered to identify factors determining helmet use. Intention to obey the law, and perceived risk of being caught if not obeying the law were included as additional constructs. Path analysis was used to extract the strongest influences on intention and behaviour. The social marketing campaign was evaluated through t-test comparisons after propensity score matching and generalised linear modelling (GLM) were applied to adjust for the same covariates.

RESULTS

400 cyclists aged 25-54 years completed the questionnaire. Self-efficacy and Intention were most predictive of intention to wear a helmet, which, moderated by planning, strongly predicted behaviour. Perceived risk and outcome expectancies had no significant impact on intention. GLM showed that exposure to the campaign was significantly associated with higher values in self-efficacy, intention and bicycle helmet use.

CONCLUSION

Self-efficacy and planning are important points of action for promoting helmet use. Social marketing campaigns that remind people of appropriate preventive action have an impact on behaviour.

Bicycle accident-related head injuries in India

Objectives:

To describe the epidemiology of head injuries sustained due to bicycle accidents in India.

Materials and Methods:

Data were retrospectively collected over a period of six months (15 May 2011 to 15 November 2011). Demography of patients, Glasgow coma scale (GCS), clinical and imaging findings, and mortality and outcome using Glasgow outcome scale (GOS), Rivermead post-concussion symptom questionnaire (RPCSQ) and Rivermead head injury follow-up questionnaire (RHFUQ), were analyzed. Outcome was assessed by telephonic interview.

Results:

There were 108 patients (100 males) with mean age of 27.7 years. Seventy-four (68.5%) were from rural areas. Accidents due to vehicular collision accounted for 60 (55.6%) cases. None wore a helmet. The admission GCS was 14-15 in 68.5% cases, 13-3 in 31.5%. The risk of moderate to severe injuries was increased among working laborers (OR = 5), and patients with loss of consciousness (OR = 4). Sixty-three (49%) patients had abnormal computed tomography (CT) findings; most common finding was skull fracture 25 (23.1%). Four patients needed surgery. The GOS assessment at three to six months revealed favorable outcome in 66 patients (61.1%) and death in 8 (7.4%). The common post-concussion symptoms were headache, fatigue, and poor concentration.

Conclusion:

The majority of hospitalized cyclists were from a rural background and of the lower income group. After three months the majority of patients had good recovery with few persistent concussion symptoms.

Evolution of bicycle helmet use and its determinants in France: 2000-2010

This paper aims to analyse helmet use in France, as a voluntary behaviour rather than a legal requirement, promoted by public awareness campaigns. It aims to investigate the determinants of helmet wearing and to explore its evolution from 2000 to 2010. The analysis relies on data from a series of general population surveys called "Health Barometers": 2000 (n=13,163), 2005 (n=25,651) and 2010 (n=8573). Multivariate logistic regressions were used to identify factors associated with helmet use and time trends. Nearly half of the 15-75 year olds surveyed reported that they rode a bicycle, and among these cyclists, 22.0% reported that they wore a helmet on their last ride. Further analysis by gender reveals that twice as many men than women wore helmets. Over the last decade, helmet use among cyclists has clearly increased, from 7.3% in 2000 to 22.0% in 2010, whereas the influence of social and economic factors, such as unemployment and wage disparities, appears to have decreased. Several determinants of bicycle helmet use were highlighted. To improve the effectiveness of further public information campaigns on helmet use, the key target groups should include women, under 25 year olds and people living in urban areas. Promoting the wearing of helmets among families should also be enhanced, given the higher rate of helmet use by parents as well as children.