Cycle helmet ownership and use; a cluster randomised controlled trial in primary school children in deprived areas

Aims: To assess the effectiveness of two different educational interventions plus free cycle helmets, in increasing cycle helmet ownership and use. Methods: A cluster randomised controlled trial was carried out in 28 primary schools in deprived areas of Nottingham, involving 1213 year 5 schoolchildren (age 9 and 10). Children received either a helmet + educational pack (educational pack and order form for free cycle helmet) or a helmet + multifaceted intervention (educational pack, order form for free cycle helmet, school assembly, lesson devoted to cycle helmet education, and an invitation to a school based cycling event). Results: The helmet + educational pack was as effective as the helmet + multifaceted intervention in terms of helmet ownership (OR 1.51, 95% CI 0.50 to 4.58) and wearing (OR 0.98, 95% CI 0.57 to 1.68). Helmet ownership significantly increased from baseline with both interventions, and wearing significantly increased from baseline with the helmet + educational pack. The interventions reduced the inequality in helmet ownership between children residing in deprived and non-deprived areas that had been present prior to the study. Conclusions: An educational pack plus a form to order a free cycle helmet is an effective way of increasing bicycle helmet ownership and use and reduces inequalities in helmet ownership among children in deprived areas. Further work is needed to determine the length of the effect of such interventions.

[1]  A. Ogilvy-Stuart,et al.  Key topics in neonatology, 2nd edition , 2005, Archives of Disease in Childhood.

[2]  T. Chambers.  An open letter to Doctors Mather and Bannon , 2005, Archives of Disease in Childhood.

[3]  V. Marrian.  The 72nd Annual General Meeting of the Scottish Paediatric Society , 1995, European Journal of Pediatrics.

[4]  M. Rudolf.  The obese child , 2004, Archives of disease in childhood - Education & practice edition.

[5]  B. Metcalf,et al.  Parents' awareness of overweight in themselves and their children: cross sectional study within a cohort (EarlyBird 21) , 2004, BMJ : British Medical Journal.

[6]  P. Sloper,et al.  Facilitators and barriers for co-ordinated multi-agency services. , 2004, Child: care, health and development.

[7]  R. Appleton,et al.  Systematic review of melatonin treatment in children with neurodevelopmental disabilities and sleep impairment. , 2004, Developmental medicine and child neurology.

[8]  E Dykes,et al.  Patterns and risks in spinal trauma , 2004, Archives of Disease in Childhood.

[9]  Zoë Lawrence,et al.  Building on the best – choice, responsiveness and equity in the NHS , 2004, Health expectations : an international journal of public participation in health care and health policy.

[10]  F. Petty,et al.  Inert Medication Ingredients Causing Nonadherence Due to Religious Beliefs , 2004, The Annals of pharmacotherapy.

[11]  M. Machala,et al.  Evaluation of a Pilot Program in Rural Schools to Increase Bicycle and Motor Vehicle Safety , 2000, Journal of Community Health.

[12]  J. L. Williams,et al.  Comparison of a long spinal board and vacuum mattress for spinal immobilisation , 2003, Emergency medicine journal : EMJ.

[13]  S. Dosani.  Caring for Jewish Patients , 2003, BMJ : British Medical Journal.

[14]  Denise Kendrick,et al.  Cross sectional survey of socioeconomic variations in severity and mechanism of childhood injuries in Trent 1992-7 , 2002, BMJ : British Medical Journal.

[15]  C. Ni Bhrolchain,et al.  Case mix presenting to paediatricians in a UK district (1998). , 2002, Public health.

[16]  Tor D Tosteson,et al.  A pediatric, practice-based, randomized trial of drinking and smoking prevention and bicycle helmet, gun, and seatbelt safety promotion. , 2002, Pediatrics.

[17]  P Berg,et al.  Bicycle helmet use among schoolchildren—the influence of parental involvement and children's attitudes , 2001, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[18]  F P Rivara,et al.  Risk compensation theory should be subject to systematic reviews of the scientific evidence , 2001, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[19]  M Hillman,et al.  The risk compensation theory and bicycle helmets , 2001, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[20]  J. Sacks,et al.  Measuring Community Bicycle Helmet Use among Children , 2001, Public health reports.

[21]  D. Thompson,et al.  Cochrane Review : Helmets for preventing head and facial injuries in bicyclists , 2017 .

[22]  K. D. Luc.  Developing Care Pathways: The Handbook , 2000 .

[23]  A. Cook,et al.  Trends in serious head injuries among cyclists in England: analysis of routinely collected data , 2000, BMJ : British Medical Journal.

[24]  T. Miller,et al.  Cost-outcome analysis in injury prevention and control: eighty-four recent estimates for the United States. , 2000, Medical care.

[25]  A. J. Lee,et al.  A hospital led promotion campaign aimed to increase bicycle helmet wearing among children aged 11–15 living in West Berkshire 1992–98 , 2000, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[26]  F. Saulsbury.  Henoch-Schönlein purpura in children. Report of 100 patients and review of the literature. , 1999, Medicine.

[27]  Lynne Warda,et al.  Urban and rural patterns of bicycle helmet use: factors predicting usage , 1999, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[28]  J. Sterne,et al.  Methods for evaluating area-wide and organisation-based interventions in health and health care: a systematic review. , 1999, Health technology assessment.

[29]  F P Rivara,et al.  Bicycle helmet promotion among low income preschool children , 1998, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[30]  B. Tonge,et al.  An investigation into sleep characteristics of children with autism and Asperger’s Disorder , 1998, Journal of paediatrics and child health.

[31]  K. Liller,et al.  Middle school students and bicycle helmet use: knowledge, attitudes, beliefs, and behaviors. , 1998, The Journal of school health.

[32]  P. Parkin,et al.  Evaluation of a bicycle skills training program for young children: a randomized controlled trial , 1998, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[33]  P C Cryer,et al.  Rates of, and the factors affecting, cycle helmet use among secondary schoolchildren in East Sussex and Kent , 1998, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[34]  S G Hendrickson,et al.  Impact of a theory based intervention to increase bicycle helmet use in low income children , 1998, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[35]  S. Wardle,et al.  Cycle helmet ownership and wearing; results of a survey in South Staffordshire. , 1998, Journal of public health medicine.

[36]  D. Watts,et al.  Effect of a bicycle safety program and free bicycle helmet distribution on the use of bicycle helmets by elementary school children. , 1997, Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.

[37]  T. Chambers.  Death of the general paediatrician? , 1997, Archives of disease in childhood.

[38]  I. Roberts,et al.  Cause specific social class mortality differentials for child injury and poisoning in England and Wales. , 1997, Journal of epidemiology and community health.

[39]  G. Ramelli,et al.  Dapsone in cutaneous Henoch‐Schönlein syndrome—worth a trial , 1997, Acta paediatrica.

[40]  T. Koepsell,et al.  Does sharing the cost of a bicycle helmet help promote helmet use? , 1997, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[41]  H. Ni,et al.  Evaluation of a statewide bicycle helmet law via multiple measures of helmet use. , 1997, Archives of pediatrics & adolescent medicine.

[42]  J E Jan,et al.  Use of melatonin in the treatment of paediatric sleep disorders , 1996, Journal of pineal research.

[43]  C F Finch,et al.  Teenagers' attitudes towards bicycle helmets three years after the introduction of mandatory wearing. , 1996, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[44]  B Brown,et al.  The effects of a 4-year program promoting bicycle helmet use among children in Quebec. , 1996, American journal of public health.

[45]  P C Parkin,et al.  Evaluation of a subsidy program to increase bicycle helmet use by children of low-income families. , 1995, Pediatrics.

[46]  R J McDermott,et al.  The MORE HEALTH bicycle safety project. , 1995, The Journal of school health.

[47]  M. Labrecque,et al.  [Can physicians efficaciously promote the purchase of bicycle helmets?]. , 1994, Canadian family physician Medecin de famille canadien.

[48]  P. Sarma.  Dapsone in Henoch-Schönlein purpura. , 1994, Postgraduate medical journal.

[49]  P C Parkin,et al.  Current bicycle helmet ownership, use and related factors among school-aged children in metropolitan Toronto. , 1994, Canadian journal of public health = Revue canadienne de sante publique.

[50]  P C Parkin,et al.  Evaluation of a promotional strategy to increase bicycle helmet use by children. , 1993, Pediatrics.

[51]  J. Zone,et al.  Inhibition of neutrophil adherence to antibody by dapsone: a possible therapeutic mechanism of dapsone in the treatment of IgA dermatoses. , 1993, The Journal of investigative dermatology.

[52]  R. Durant,et al.  Correlates of Children's Bicycle Helmet Use and Short-term Failure of School-level Interventions , 1992, Pediatrics.

[53]  R A Pendergrast,et al.  Correlates of children's bicycle helmet use and short-term failure of school-level interventions. , 1992, Pediatrics.

[54]  A. Dannenberg,et al.  Bicycle helmet use among Maryland children: effect of legislation and education. , 1992, Pediatrics.

[55]  M. Marvel,et al.  A school-based intervention to increase the use of bicycle helmets. , 1992, Family medicine.

[56]  W James,et al.  Physicians promoting bicycle helmets for children: a randomized trial. , 1991, American journal of public health.

[57]  J. Down,et al.  Helmet promotion in the emergency room following a bicycle injury: a randomized trial. , 1991, Pediatrics.

[58]  Morris Ba,et al.  Promotion of bicycle helmet use among schoolchildren: a randomized clinical trial. , 1991 .

[59]  B. Morris,et al.  Promotion of bicycle helmet use among schoolchildren: a randomized clinical trial. , 1991, Canadian journal of public health = Revue canadienne de sante publique.

[60]  P. Lautala.  [The obese child]. , 1990, Duodecim; laaketieteellinen aikakauskirja.

[61]  T. Koepsell,et al.  Bicycle helmet use by children. Evaluation of a community-wide helmet campaign. , 1989, JAMA.

[62]  N. Rosenblum,et al.  Steroid effects on the course of abdominal pain in children with Henoch-Schonlein purpura. , 1987, Pediatrics.

[63]  S. Spedding,et al.  NOCTURNAL DIFFICULTIES IN A POPULATION OF MENTALLY HANDICAPPED CHILDREN , 1985 .

[64]  J. Ledermann,et al.  Dapsone in Allergic Vasculitis: Its Use in Henoch-Schönlein Disease following Vaccination 1 , 1983, Journal of the Royal Society of Medicine.