Bicycle helmets...to wear or not to wear them? Parental perceptions and attitudes concerning helmet use by children, in Figueira da Foz municipality, 2015 (Portugal)

Authors

  • Ricardo Eufrásio Unidade de Saúde Pública - ACES Baixo Vouga - ARS Centro
  • Fernando Lopes Public Health Unit - ACES Baixo Mondego - ARS Centro
  • Fernanda Vitória Unidade de Saúde Pública - ACES Baixo Mondego - ARS Centro
  • Manuela Branco Unidade de Saúde Pública - ACES Baixo Mondego - ARS Centro
  • Manuela Cardoso Unidade de Cuidados de Saúde Personalizados Figueira da Foz Sul - ACES Baixo Mondego - ARS Centro https://orcid.org/0009-0009-3907-7201

DOI:

https://doi.org/10.14195/1647-7723_32-1_8

Keywords:

Bicycle, helmet, accident, prevention, traumatic brain injury, parents and guardians (carers).

Abstract

There is growing concern about the impact of traumatic brain injuries in bicycle accidents. In recognition of the crucial importance of parents and guardians (carers) in the adoption of safety behaviours, we carried out a study to understand their perceptions and attitudes about helmet use by their children, in Figueira da Foz. A sample of 149 parents/guardians of children who rode a bicycle was enrolled, registered with and users of the child and adolescent health clinic (5-6 years old) in Figueira da Foz’s Health Centre, in 2015. A questionnaire was used to measure motivation for using bicycles and helmets. In order to identify predictors to helmet use the independent variables were included in a multiple logistic regression analysis model and the adjusted Odds Ratios were calculated. Most parents/guardians (90.5 %) considered the helmet the most important item of equipment for their child to wear when cycling. However, the reasons for not having a helmet were ‘only rides a bicycle few times’, ‘I’ve never thought about that’, and ‘it’s not necessary’. The overall rate of helmet use by the children is 57.7 %. Helmet use by parents/guardians (carers) was identified as the main determining factor for its use by the child (aOr:12.8; IC95 %:3.87-42.34; p<0.05). The positive influence of parents/guardians on children's use of helmets is clear, and they play a fundamental role in encouraging it. Family health teams could have significant influence on parents while counselling them about injury prevention and helmet use.

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References

Berg, P., & Westerling, R. (2001). Bicycle helmet use among schoolchildren--the influence of parental involvement and children’s attitudes. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 7(3), 218–222. DOI: https://doi.org/10.1136/ip.7.3.218

Bernstein, J. D., Harper, M. A., Pardi, L. A., & Christopher, N. C. (2003). Parental knowledge and children’s use of bicycle helmets. Clinical pediatrics, 42(8), 673–677. DOI: https://doi.org/10.1177/000992280304200802

Clements, J. L. (2005). Promoting the use of bicycle helmets during primary care visits. Journal of the American Academy of Nurse Practitioners, 17(9), 350–354. DOI: https://doi.org/10.1111/j.1745-7599.2005.00062.x

Costa, C. K., Dagher, J. H., Lamoureux, J., de Guise, E., & Feyz, M. (2015). Societal cost of traumatic brain injury: A comparison of cost-of-injuries related to biking with and without helmet use. Brain injury, 29(7-8), 843–847. DOI: https://doi.org/10.3109/02699052.2015.1004758

Davison, C. M., Torunian, M., Walsh, P., Thompson, W., McFaull, S., & Pickett, W. (2013). Bicycle helmet use and bicycling-related injury among young Canadians: an equity analysis. International Journal for Equity in Health, 12, 48. DOI: https://doi.org/10.1186/1475-9276-12-48

Dagher, J. H., Costa, C., Lamoureux, J., de Guise, E., & Feyz, M. (2016). Comparative Outcomes of Traumatic Brain Injury from Biking Accidents With or Without Helmet Use. The Canadian Journal of Neurological Sciences, 43(1), 56–64.DOI: https://doi.org/10.1017/cjn.2015.281

DiGuiseppi, C. G., Rivara, F. P., Koepsell, T. D., & Polissar, L. (1989). Bicycle helmet use by children. Evaluation of a community-wide helmet campaign. JAMA, 262(16), 2256–2261.

DGS - Direção Geral de Sáude (2010). “Programa Nacional de Prevenção de Acidentes, 2010-2016”. Divisão de Saúde Ambiental e Ocupacional. DGS, Lisboa, 2010.

DGS - Direção Geral de Sáude (2013). “Programa Nacional de Saúde Infantil e Juvenil”. Divisão de Saúde Sexual, Reprodutiva, Infantil e Juvenil. DGS, Lisboa, 2013.

Dinh, M. M., Kastelein, C., Hopkins, R., Royle, T. J., Bein, K. J., Chalkley, D. R., & Ivers, R. (2015). Mechanisms, injuries and helmet use in cyclists presenting to an inner city emergency. Emergency medicine Australasia: EMA, 27(4), 323–327. DOI: https://doi.org/10.1111/1742-6723.12407

Ehrlich, P. F., Longhi, J., Vaughan, R., & Rockwell, S. (2001). Correlation between parental perception and actual childhood patterns of bicycle helmet use and riding practices: implications for designing injury prevention strategies. Journal of Pediatric Surgery, 36(5), 763–766. DOI: https://doi.org/10.1053/jpsu.2001.22955

Ehrlich, P. F., Helmkamp, J. C., Williams, J. M., Haque, A., & Furbee, P. M. (2004). Matched analysis of parent’s and children’s attitudes and practices towards motor vehicle and bicycle safety: an important information gap. Injury control and safety promotion, 11(1), 23–28. DOI: https://doi.org/10.1076/icsp.11.1.23.26307

Elvik, R. (2013). Corrigendum to: “Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: a re-analysis of Attewell, Glase and McFadden, 2001” [Accid. Anal. Prev. 43 (2011) 1245–1251]. Accident; analysis and prevention, 60, 245–253. DOI: https://doi.org/10.1016/j.aap.2012.12.003

EURO SAFE (2012). “How safety conscious are European Countries towards children?”. European Child Safety Alliance, Child Safety Report Card 2012, Eurosafe.

EURO SAFE (2013). “Injuries in the European Union, Report on injury statistics 2008-2010”. Amsterdam, 2013. Disponível em http://ec.europa.eu/health/data_collection/docs/idb_report_2013_en.pdf

Forjuoh, S. N., Schuchmann, J. A., Fiesinger, T., & Mason, S. (2003). Parent-child concordance on reported barriers to helmet use by children. Medical science monitor: international medical journal of experimental and clinical research, 9(10), CR436–CR441.

Howland, J., Sargent, J., Weitzman, M., Mangione, T., Ebert, R., Mauceri, M., & Bond, M. (1989). Barriers to bicycle helmet use among children. Results of focus groups with fourth, fifth, and sixth graders. American journal of diseases of children (1960), 143(6), 741–744. DOI: https://doi.org/10.1001/archpedi.1989.02150180123033

Jewett, A., Beck, L. F., Taylor, C., & Baldwin, G. (2016). Bicycle helmet use among persons 5years and older in the United States, 2012. Journal of Safety Research, 59, 1–7. DOI: https://doi.org/10.1016/j.jsr.2016.09.001

Joseph, B., Pandit, V., Zangbar, B., Amman, M., Khalil, M., O’Keeffe, T., Orouji, T., Asif, A., Katta, A., Judkins, D., Friese, R. S., & Rhee, P. (2014). Rethinking bicycle helmets as a preventive tool: a 4-year review of bicycle injuries. European journal of trauma and emergency surgery: official publication of the European Trauma Society, 40(6), 729–732. DOI: https://doi.org/10.1007/s00068-014-0453-0

Klein, K. S., Thompson, D., Scheidt, P. C., Overpeck, M. D., Gross, L. A., & HBSC International Investigators (2005). Factors associated with bicycle helmet use among young adolescents in a multinational sample. Injury prevention: journal of the International Society for Child and Adolescent Injury Prevention, 11(5), 288–293. DOI: https://doi.org/10.1136/ip.2004.007013

Kotler, D. H., Babu, A. N. & Robidoux, G. (2016). Prevention, Evaluation, and Rehabilitation of Cycling-Related Injury. Curr Sports Med Rep. 2016 May-Jun;15(3): 199-206. DOI: https://doi.org/10.1249/JSR.0000000000000262

Liller, K. D., Nearns, J., Cabrera, M., Joly, B., Noland, V., & McDermott, R. (2003). Children’s bicycle helmet use and injuries in Hillsborough County, Florida before and after helmet legislation. Injury prevention: journal of the International Society for Child and Adolescent Injury Prevention, 9(2), 177–179. DOI: https://doi.org/10.1136/ip.9.2.177

Lindsay, H., & Brussoni, M. (2014). Injuries and helmet use related to non-motorized wheeled activities among pediatric patients. Chronic diseases and injuries in Canada, 34(2-3), 74–81.

Lohse, J. L. (2003). A bicycle safety education program for parents of young children. The Journal of school nursing : the official publication of the National Association of School Nurses, 19(2), 100–110. DOI: https://doi.org/10.1177/10598405030190020701

McDonald’s Corporation, US Consumer Product Safety Commission (1999). “National Bike Helmet Use Survey”. Yankelovich Partners Survey, 1999. Disponível em https://www.cpsc.gov/Newsroom/News-Releases/1999/CPSC-McDonalds-Release-National-Survey-on-Bike-Helmet-Usage-Helmet-Use-on-the-Rise-But-Half-of-All-Riders-Still-Not-Wearing-Helmets/

MacKay M, Vincent J. (2012). “Child Safety Report Card 2012: Europe Summary for 31 Countries”. Birmingham: European Child Safety Alliance, Eurosafe; 2012. Disponível em http://www.childsafetyeurope.org/publications/info/child-safety-report-cards-europe-summary-2012.pdf

Monclús, J. (2013). “Casco de ciclistas”. Fundación MAPFRE, February 2013. Available in http://archive.etsc.eu/documents/MAPFRE_Bicycle_helmets_2013.pdf

Ortega, H. W., Shields, B. J., & Smith, G. A. (2004). Bicycle-related injuries to children and parental attitudes regarding bicycle safety. Clinical pediatrics, 43(3), 251–259. DOI: https://doi.org/10.1177/000992280404300306

Persaud, N., Coleman, E., Zwolakowski, D., Lauwers, B., & Cass, D. (2012). Nonuse of bicycle helmets and risk of fatal head injury: a proportional mortality, case-control study. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne, 184(17), E921–E923. DOI: https://doi.org/10.1503/cmaj.120988.

Ramiro, S., Lopes, F., Martins, R., Parreira, L., Valadares, J., & Cordeiro, M. (2009). O uso de capacete em crianças que andam de bicicleta da Área da Grande Lisboa. Acta Pediatr Port, 40(3), 105-10.

Rivara, F. P, Thompson, D. C. & Thompson, R. S. (2015). Epidemiology of bicycle injuries and risk factors for serious injuryInjury Prevention 2015;21:47-51.

Robertson, D. W., Lang, B. D., & Schaefer, J. M. (2014). Parental attitudes and behaviours concerning helmet use in childhood activities: rural focus group interviews. Accident; analysis and prevention, 70, 314–319. DOI: https://doi.org/10.1016/j.aap.2014.04.011

Romanow, N. R., Hagel, B. E., Williamson, J., & Rowe, B. H. (2014). Cyclist head and facial injury risk in relation to helmet fit: a case-control study. Chronic diseases and injuries in Canada, 34(1), 1–7.

ROSPA (2015). The Royal Society for the Prevention of Accidents - “Cycling Accidents”. Road Safety Information Fact sheet, November, 2015. Available in http://www.rospa.com/rospaweb/docs/advice-services/road-safety/cyclists/cycling-accidents-factsheet.pdf

Ross, L. T., Brinson, M. K., & Ross, T. P. (2014). Parenting influences on bicycle helmet rules and estimations of children’s helmet use. The Journal of Psychology, 148(2), 197–213. DOI: https://doi.org/10.1080/00223980.2013.771131

Safe Kids (2009). “Raising Safe Kids: One Stage at a Time - a study of child development and unintentional injury”. Safe Kids, Washington DC, 2009. Disponível em

https://www.safekids.org/sites/default/files/documents/ResearchReports/Raising%20Safe%20Kids%20One%20Stage%20at%20a%20Time%20March%202009.pdf

Safe Kids Worldwide (2016). “Bicycle, Skate and Skateboard Safety Fact Sheet”, 2016. Available in http://www.safekids.org/sites/default/files/documents/skw_bike_fact_sheet_2016.pdf

Scholten, A. C., Polinder, S., Panneman, M. J., van Beeck, E. F., & Haagsma, J. A. (2015). Incidence and costs of bicycle-related traumatic brain injuries in the Netherlands. Accident; analysis and prevention, 81, 51–60. DOI: https://doi.org/10.1016/j.aap.2015.04.022

Sethi, M., Heidenberg, J., Wall, S. P., Ayoung-Chee, P., Slaughter, D., Levine, D. A., Jacko, S., Wilson, C., Marshall, G., Pachter, H. L., & Frangos, S. G. (2015). Bicycle helmets are highly protective against traumatic brain injury within a dense urban setting. Injury, 46(12), 2483–2490. DOI: https://doi.org/10.1016/j.injury.2015.07.030

Soori, H., & Bhopal, R. S. (2002). Parental permission for children’s independent outdoor activities. Implications for injury prevention. European Journal of Public Health, 12(2), 104–109. DOI: https://doi.org/10.1093/eurpub/12.2.104

Suelves, J. M., & Cabezas, C. (2013). Bicicleta y salud: el casco no es el problema, sino parte de la solución [Bicycle and health: helmets are not the problem, but a part of the solution]. Gaceta sanitaria, 27(6), 564. DOI: https://doi.org/10.1016/j.gaceta.2013.01.004

Svider, P. F., Chen, M., Burchhardt, D., O’Brien, P. S., Shkoukani, M. A., Zuliani, G. F., & Folbe, A. J. (2016). The Vicious Cycle: Pediatric Facial Trauma from Bicycling. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery, 154(2), 371–376. DOI: https://doi.org/10.1177/0194599815618932

SWOV - Institute for Road Safety Research. “Swov Fact sheet: Bicycle Helmets”. Swov, Leidschendam, the Netherlands, August 2013. Available in http://www.swov.nl/rapport/Factsheets/UK/FS_Cyclists.pdf

Teisch, L. F., Allen, C. J., Tashiro, J., Golpanian, S., Lasko, D., Namias, N., Neville, H. L., & Sola, J. E. (2015). Injury patterns and outcomes following pediatric bicycle accidents. Pediatric surgery international, 31(11), 1021–1025. DOI: https://doi.org/10.1007/s00383-015-3756-2

Vincenten, J. A., Sector, M. J., Rogmans, W., & Bouter, L. (2005). Parents’ perceptions, attitudes and behaviours towards child safety: a study in 14 European countries. International journal of injury control and safety promotion, 12(3), 183–189. DOI: https://doi.org/10.1080/17457300500136557

WHO (2008). “World Report on Child Injury Prevention 2008”. World Health Organization, Geneva, Switzerland, 2008. Available in http://www.who.int/violence_injury_prevention/child/injury/world_report/en/

Young, T. L., & Zimmerman, R. (1998). Clueless: parental knowledge of risk behaviors of middle school students. Archives of pediatrics & adolescent medicine, 152(11), 1137–1139. DOI: https://doi.org/10.1001/archpedi.152.11.1137

Zibung, E., Riddez, L., & Nordenvall, C. (2016). Impaired quality of life after bicycle trauma. Injury, 47(5), 1078–1082. DOI: https://doi.org/10.1016/j.injury.2015.11.015.

Zibung, E., Riddez, L., & Nordenvall, C. (2015). Helmet use in bicycle trauma patients: a population-based study. European journal of trauma and emergency surgery: official publication of the European Trauma Society, 41(5), 517–521. DOI: https://doi.org/10.1007/s00068-014-0471-y

Published

2025-02-13