Children's bicycle helmet attitudes and use. Association with parental rules. The Pediatric Practice Research Group
P. A. Miller, H. J. Binns and K. K. Christoffel
Department of Pediatrics, Children's Memorial Hospital, Chicago, Ill., USA.
BACKGROUND: Previous studies have assessed the attitudes of parents and
children toward bicycle helmet ownership and use in various settings, but
they have not addressed the role of parental rules in promoting bicycle
helmet use by children. OBJECTIVES: To further explore the attitudes of
parents and children at pediatric practices toward bicycle helmet ownership
and use by children and to assess the role of parental rules in promoting
bicycle helmet use by children. DESIGN: One hundred sixty-nine 5- to
14-year-old children who owned bicycles and their parents were surveyed
during well-child visits at 5 general pediatric practices in the Chicago,
Ill, area. One hundred twenty-nine families were represented. Of the
children, 60% were aged 5 to 9 years, and 50% were girls. RESULTS:
Forty-eight children (28%) reported helmet ownership. Of the helmet owners,
21 (45%) reported helmet use; thus, the overall percentage of helmet use
was 12%. Helmet ownership by children was significantly (P < .05)
related to parental characteristics: educational level, race, perceived
effectiveness of bicycle helmets, seat belt use, and parental helmet
ownership. The most common reasons parents gave for lack of helmet
ownership by children were "never thought about purchasing" a helmet (35%),
"never got around to purchasing" a helmet (29%), "child wouldn't wear it
anyway" (26%), and the bicycle helmet was "too expensive" (16%). Only 33%
of the parents reported hearing about helmets from their children's
pediatrician, but 40% of these parents regarded pediatricians as their most
important information source. Of the children who did not own helmets, 64%
said they would wear a bicycle helmet if they had one, a more frequent
comment for 5- to 9-year-old children than 10- to 14-year-old children (76%
vs 49%, P < .01). The most common reasons for not wearing a helmet among
owners were as follows: forgot or lost it and not needed. The most common
reasons for not wearing a helmet among nonowners were as follows:
uncomfortable and appearance or perception of others. Children who owned
helmets and whose parents had a strict rule about wearing helmets were more
likely to always wear their helmets than helmet owners whose parents had a
partial rule or no rule (88% vs 19%, P < .001). CONCLUSIONS: Parental
rules are associated with bicycle helmet use by children. Pediatricians may
increase helmet use rates by promoting strict parental helmet rules as part
of their anticipatory guidance regarding bicycle safety. More research
about the effectiveness of this strategy is needed.
