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Bicycle helmet promotion among low income preschool children
  1. John Britt1,
  2. Ilene Silver2,
  3. Frederick P Rivara3
  1. 1Harborview Injury Prevention and Research Center, Seattle
  2. 2Injury Prevention Program, Department of Health, State of Washington
  3. 3Harborview Injury Prevention and Research Center and the Departments of Pediatrics and Epidemiology, University of Washington, Seattle
  1. Correspondence to: Professor Fred Rivara, Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Ave, Seattle, WA 98104–2499, USA.


Objective—To evaluate the effectiveness of a multifaceted bicycle helmet promotion program for low income children attending preschool enrichment programs throughout Washington State.

Study sample—Preschool Head Start programs that conducted routine home visits among their enrolled families at least five times during the school year were eligible. Eighteen sites and 880 children met this criterion and were able and willing to carry out evaluation activities. Two hundred children were from control sites where no helmet promotion activities were carried out.

Intervention—Classroom activities with children, education of parents during school meetings and home visits, fitting and distribution of helmets, a bicycle skills and safety “rodeo” event, and requiring children to wear helmets while riding on school grounds.

Evaluation methods—Regularly scheduled home visits were used to observe helmet use of enrolled preschool children before and after the promotion program. Home visitors requested parental permission for enrolled children to ride, and then noted whether the child wore a helmet.

Results—Helmet use in the intervention group more than doubled, from 43% to 89%, while use in the control group increased from 42% to 60% (p<0.05 for intervention group changes v control group changes).

Conclusions—This multifaceted helmet promotion program successfully increased helmet use. Similar home visit protocols may be useful to evaluate the impact of other injury intervention programs.

  • bicycle
  • helmet
  • evaluation

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