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96 Examining the effectiveness of China’s helmet promotion campaign: a before-and-after study
  1. Peishan Ning1,
  2. Huiying Zong1,
  3. Li Li1,
  4. Peixia Cheng1,
  5. David Schwebel2,
  6. Yang Yang3,
  7. Lei Yang1,
  8. Youyou Wu1,
  9. Min Zhao1,
  10. Guoqing Hu1,4
  1. 1Department of Epidemiology and Health Statistics; Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
  2. 2Department of Psychology, University of Alabama at Birmingham, Birmingham, USA
  3. 3Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogens Institute, University of Florida, Gainesville, USA
  4. 4National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China


Background Helmet use is an effective intervention to reduce road traffic injuries among cyclists and motorcyclists.

Aims Using a video-based before-and-after study, we evaluated the effectiveness of China’s helmet promotion campaign initiated on June 1, 2020.

Methods Helmet wearing rate and correct helmet wearing rate, 95% confidence interval, and adjusted odds ratio were calculated to compare rate changes before and after the national campaign. Subgroup analyses were performed by sex, age group, weekday vs. weekend, time period, type of road user, shared vs. non-shared vehicle, and occupation.

Results A total of 11,536 cyclists and motorcyclists were videotaped, 5256 (45.6%) during pre-campaign observations and 6280 (54.4%) post-campaign. The overall helmet wearing rate rose from 8.8% to 62.0% after implementation of the national campaign. The helmet wearing rate increased substantially for all subgroups following the campaign. In contrast, the overall and most subgroup rates of correct helmet use decreased significantly after implementing the campaign. Large differences existed across subgroups for helmet wearing rate and correct helmet wearing rate in both pre- and post-campaign observations. After implementing the campaign, the helmet wearing rate was highest among takeaway and express deliveryman (88.8%) and lowest among traditional bicyclists (3.8%); three-wheeled motorcyclists had the lowest rate of correct helmet use (58.8%).

Conclusion China’s helmet promotion campaign was associated with a substantial increase in helmet wearing rate but didn’t improve correct helmet wearing rates.

Learning outcomes Policymakers might consider amending the campaign somewhat to improve both the helmet wearing rate and the rate of correct helmet use.

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