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Children’s helmet usage may increase through proper intervention
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BOSTON — A combination of safety interventions proved successful in getting underserved minority children to wear helmets for wheeled sports, according to recent study results.
Presenting here at the 2012 Pediatric Academic Societies Annual Meeting, Kristy L. Putnam, MD, explained how she and her colleagues from the Maricopa Medical Center in Phoenix implemented a comprehensive wheeled sports safety education program from 2008 to 2010 to determine whether underserved children ages 0 to 17 years would retain helmet use for wheeled sports.
“While only educating children and their families about helmet use has met with mixed results, our study found that actually distributing helmets to these families significantly improved their likelihood of use,” Putnam told Infectious Diseases in Children.
The program included bilingual trained coordinators who provided safety education at hospital outpatient clinics, schools, health fairs and the emergency department. Helmets were distributed free of charge to children who reported not owning one. Researchers followed up by phone to determine if the children continued helmet use.
A total of 2,168 children received free helmets and safety education; 60% (1,294) received helmets and safety education at the hospital; 23% (496) at the health fair; and 17% (378) at a school. The mean age of the children was 7.2 years. Most participants (73%) were Hispanic, 5% were African American, 3% white and 1% Asian and Native American. Fifty-eight percent of participants spoke Spanish as their primary language.
Results showed that of the children who received a helmet, 81% wore it all or most of the time; gender or ethnicity did not affect the frequency with which children wore their helmets.
Researchers concluded that it “is possible to achieve high levels of helmet usage 30 days after intervention, particularly when the importance of wheeled sports safety education is exemplified by provision of a free helmet to lower socioeconomic level families.”
According to Putnam, “While the inherent limitation of this study was that there was a reporting bias, our results also demonstrated — which we did not expect — that patients from primarily Spanish-speaking households, as well as those of Spanish or Latino descent, reported using the helmets more often. This finding was statistically significant, and the next step in our study will be to determine the reason behind this.”
For more information:
- Putnam, K. #1501.86. Presented at: the 2012 PAS Annual Meeting. April 28–May 1, 2012; Boston.
Disclosure: Dr. Putnam reports no relevant financial disclosures.
Perspective
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William T. Gerson, MD
Helmet use to prevent sport-related head trauma has been the focus of public health initiatives for a great many years. The effectiveness of helmet use to prevent serious head injuries in adult and child bicyclists has been well documented. The impact of bicycle injuries and deaths disproportionally impacts children.
The abstract presented by Putnam and colleagues is important on several levels. The first is that Dr. Putnam is a house officer, bringing the importance of advocacy projects during residency to the forefront. Secondly, the abstract describes an intervention aimed at all wheeled sports activities in an urban underserved minority population. By combining a comprehensive wheeled sports (bike, scooter, skate, skate board) bilingual safety education program with community outreach (performing the program at hospital outpatient clinics, school and community health fairs, and the emergency department) in addition to providing free and fitted helmets to those in need — a high level of helmet usage was demonstrated at one month after intervention.
We have known since the 1990s that providing helmet subsidies is cost-effective and increases helmet use. We also know that usage rates are influenced by parental involvement, sibling and peer use and that unfortunately rates drop as children reach adolescence. Clearly socioeconomic forces play a role in helmet use. Emphasis on wheeled sports is important as the frequency of injury in this arena dwarfs all other sports-related causes. However, the necessity of helmet use for multiple other activities, and the lack of a universal, adaptable helmet make cost and access an even more complex an issue.
As with many health safety issues, changing the culture is at the root of improved outcomes. Here in Vermont, such a program for ski helmet use (PHAT – Protect Head at All Times) has specifically targeted the ski resort culture in a successful approach to increased helmet use among skiers and riders on our slopes. The members of this partnership between the Vermont Children’s Hospital and regional ski resorts, ski organizations, and the Vermont Department of Health also went out of its way to enlist office practices to popularize the intervention.
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