Association Between Bicycle Helmet Legislation, Bicycle Safety Education, and Use of Bicycle Helmets in Children

doi:10.1001/archpedi.1994.02170030025005

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Vol. 148 No. 3, March 1994

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Association Between Bicycle Helmet Legislation, Bicycle Safety Education, and Use of Bicycle Helmets in Children

Michael L. Macknin, MD; Sharon VanderBrug Medendorp, MPH

Arch Pediatr Adolesc Med. 1994;148(3):255-259.

Abstract

Objective
To determine the association between bicycle helmet legislationand bicycle safety education and the use of bicycle helmetsby children under age 16 years.

Design
Anonymous questionnaire and direct observations of bicycle helmetuse.

Setting
Four predominantly white, upper-middle class suburbs of Cleveland,Ohio.

Participants
All students in grades 1 through 7 attending public school onthe day of the survey and children riding bicycles in a directobservational study.

Interventions
Beachwood had bicycle helmet legislation and safety education.Orange had only bicycle helmet legislation. Pepper Pike andMoreland Hills did not have bicycle helmet legislation or safetyeducation.

Results
In Beachwood, 416(67.6%) of 615 children who owned a bicyclereported always wearing their helmets, and 72 (85%) of 85 childrendirectly observed were wearing bicycle helmets. In Orange, 103(37.2%) of 277 children who owned bicycles reported always wearinghelmets, whereas 41 (17.9%) of 229 children in Moreland Hillsand 78(21.5%) of 362 children in Pepper Pike reported alwayswearing helmets. Helmet use was significantly (P<.001) higherin Beachwood, with legislation and education, than in the othercommunities; helmet use was significantly (P<.001) higherin Orange, with legislation alone, than in Moreland Hills andPepper Pike, with no programs.

Conclusions
There was a dramatic association between reports of increasedhelmet use and bicycle helmet legislation plus education; theassociation was stronger than that found with legislation only.

(Arch Pediatr Adolesc Med. 1994;148:255-259)

Author Affiliations

From the Departments of Pediatrics and Adolescent Medicine (Dr Macknin) and Biostatistics and Epidemiology (Ms Medendorp), The Cleveland (Ohio) Clinic Foundation.

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