Evaluation of a Community Bicycle Helmet Promotion Campaign: What Works and Why

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Abstract
Purpose.: This study identifies effective components of a bicycle helmet promotion campaign, and mechanisms by which these components affect child helmet ownership. Design.: A random telephone survey identified parents whose children did not own helmets prior to an educational campaign. A follow-up survey was conducted six months later. Regression analysis estimated the effects of four campaign components on child helmet ownership and tested for mediation by cognitive variables. Setting.: Study participants were residents of a suburban community which undertook a citywide educational campaign to increase child helmet ownership. Subjects.: Subjects were 210 parents with at least one school-aged child, none of whom owned helmets. Intervention.: A multicomponent campaign was implemented by a community coalition. In addition, random subsamples of the study participants received direct mail or direct telephone communications. Results.: Of the eligible respondents identified in the baseline sample, 39% completed the follow-up survey. Regression analysis showed that children whose parents received either helmet advice from a physician or direct telephone communications were 2.6 and 2.2 times more likely, respectively, to own helmets as children whose parents did not experience similar communication. Parental worry mediated the association, but parental beliefs about the effectiveness of helmets did not. Conclusions.: Future helmet campaigns should use interpersonal strategies to increase parental worry about their children being involved in a bicycle accident. Generalization of these findings is limited by the high socioeconomic status of the study participants, and by the outcome measure, which is helmet ownership, not helmet use.