Objective: To determine whether a wide-scale, long-term community promotional effort would increase the use of bicycle helmets among children.
Design: Over 2 years, a non-profit group coordinated a range of activities to promote helmet use. On one date before the intervention began and three dates during the intervention, observers surveyed students riding bicycles.
Setting: Cyclists were observed at 5 elementary schools, three secondary schools, and two community college entrances.
Participants: A total of 851 cyclists were observed, 536 of them at elementary schools in a convenience sample.
Interventions: Print, radio, and television advertising; posters; pamphlets; bicycle rodeos; and a play were used in a public awareness campaign. Health promotion activities included education, social marketing, community development, and legislative action.
Main outcome measures: Number of cyclists and whether they wore helmets.
Results: Combining the two observation dates for each year, helmet use increased from 5.4% in 1990 to 15.4% in 1991. The greatest increase was observed among elementary school students, the group most at risk of serious head injury or death. Overall, girls were twice as likely to wear helmets as boys.
Conclusions: Wide-scale, long-term community promotion appears to be effective in increasing the use of bicycle helmets.