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R. Cushman, W. James, H. Waclawik (1991)
Physicians promoting bicycle helmets for children: a randomized trial.American journal of public health, 81 8
D. Nakayama, M. Gardner, K. Rogers (1990)
Disability from bicycle-related injuries in children.The Journal of trauma, 30 11
Rivara FP DiGuiseppi CG (1990)
Attitudes toward bicycle helmet ownership and use by school-age childrenAJDC, 144
C. DiGuiseppi, F. Rivara, T. Koepsell (1990)
Attitudes toward bicycle helmet ownership and use by school-age children.American journal of diseases of children, 144 1
Cameron MH Vulcan AP (1993)
Mandatory bicycle helmet use: Victoria, AustraliaMMWR Morb Mortal Wkly Rep, 42
Timothy Coté, Jeffrey Sacks, M. Kresnow, Deborah Lambert-Huber, E. Schmidt, Andrew Dannenberg, C. Lipsitz (1992)
Bicycle helmet use among Maryland children: effect of legislation and education.Pediatrics, 89 6 Pt 2
Division of State Government Affairs American Academy of Pediatrics (1995)
Review of Bicycle Helmet Laws
B. Weiss (1992)
Trends in bicycle helmet use by children: 1985 to 1990.Pediatrics, 89 1
Robert Thompson, F. Rivara, D. Thompson (1989)
A case-control study of the effectiveness of bicycle safety helmets.The New England journal of medicine, 320 21
J. Sacks, P. Holmgreen, Suzanne Smith, D. Sosin (1991)
Bicycle-associated head injuries and deaths in the United States from 1984 through 1988. How many are preventable?JAMA, 266 21
Holmgreen P Sacks JJ (1991)
Bicycle-related head injuries and deaths: how many are preventable?JAMA, 266
A. Vulcan, M. Cameron, L. Heiman (1993)
Mandatory bicycle helmet use--Victoria, Australia.MMWR. Morbidity and mortality weekly report, 42 18
M. Macknin, S. Medendorp (1994)
Association between bicycle helmet legislation, bicycle safety education, and use of bicycle helmets in children.Archives of pediatrics & adolescent medicine, 148 3
B. Weiss (1986)
Bicycle helmet use by children.Pediatrics, 77 5
Andrew Dannenberg, A. Gielen, Peter Beilenson, Mark Wilson, Alain Joffe (1993)
Bicycle helmet laws and educational campaigns: an evaluation of strategies to increase children's helmet use.American journal of public health, 83 5
K. Christoffel, Helen Binns, James Stockman, Patricia McGuire, J. Poncher, S. Unti, B. Typlin, G. Lasin, W. Seigel (1988)
Practice-based research: opportunities and obstacles.Pediatrics, 82 3 Pt 2
R. Cushman, J. Down, N. Macmillan, H. Waclawik (1991)
Helmet promotion in the emergency room following a bicycle injury: a randomized trial.Pediatrics, 88 1
Abstract 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.Arch Pediatr Adolesc Med. 1996;150:1259-1264 References 1. Sacks JJ, Holmgreen P, Smith SM, Sosin DM. Bicycle-related head injuries and deaths: how many are preventable? JAMA . 1991;266:3016-3018.Crossref 2. Nakayama DK, Gardner MJ, Rogers KD. Disability from bicycle-related injuries in children . J Trauma . 1990;30:1390-1394.Crossref 3. Thompson RS, Rivara FP, Thompson DC. A case-control study of the effectiveness of bicycle safety helmets . N Engl J Med . 1989;320:1361-1367.Crossref 4. American Academy of Pediatrics, Division of State Government Affairs. Review of Bicycle Helmet Laws . Elk Grove Village, III: American Academy of Pediatrics: 1995. 5. Weiss BD. Trends in bicycle helmet use by children: 1985-1990 . Pediatrics . 1992;89:78-80. 6. Cote TR, Sacks JJ, Lambert-Huber DA, et al. Bicycle helmet use among Maryland children: effect of legislation and education . Pediatrics . 1992;89:1216-1220. 7. Vulcan AP, Cameron MH, Heiman L. Mandatory bicycle helmet use: Victoria, Australia . MMWR Morb Mortal Wkly Rep . 1993;42:359-363. 8. Dannenberg AL, Gielen AC, Beilenson PL, et al. Bicycle helmet laws and educational campaigns: an evaluation of strategies to increase children's helmet use . Am J Public Health . 1993;83:667-674.Crossref 9. Macknin ML, VanderBrug Medendorp S. Association between bicycle helmet legislation, bicycle safety education, and use of bicycle helmets in children . Arch Pediatr Adolesc Med . 1994;148:255-259.Crossref 10. Weiss BD. Bicycle helmet use by children . Pediatrics . 1986;77:677-679. 11. DiGuiseppi CG, Rivara FP, Koepsell TD. Attitudes toward bicycle helmet ownership and use by school-age children . AJDC . 1990;144:83-86. 12. Kaufer Christoffel K, Binns HJ, Stockman JA III, et al. Practice-based research: opportunities and obstacles . Pediatrics . 1988;82:399-406. 13. Cushman R, Down J, MacMillan N, Waclawik H. Helmet promotion in the emergency room following a bicycle injury: a randomized trial . Pediatrics . 1991; 88:43-47. 14. Cushman R, James W, Waclawik H. Physicians promoting bicycle helmets for children: a randomized trial . Am J Public Health . 1991;81:1044-1046.Crossref
Archives of Pediatrics & Adolescent Medicine – American Medical Association
Published: Dec 1, 1996
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