Elsevier

The Journal of Pediatrics

Volume 145, Issue 3, September 2004, Pages 360-364
The Journal of Pediatrics

Original Articles
Predicting bicycle helmet stage-of-change among middle school, high school, and college cyclists from demographic, cognitive, and motivational variables

https://doi.org/10.1016/j.jpeds.2004.05.034Get rights and content

Abstract

Objectives

To apply Prochaska's Transtheoretical model of behavior change to bicycle helmet use among middle school, high school, and college students.

Study design

A battery of questionnaires was administered to cyclists in the seventh and ninth grades and to college students in Phoenix, Arizona (N = 797). The battery included: (1) a question to determine respondent's stage of behavior change in Prochaska's Transtheoretical model; (2) items assessing the perceived pros and cons of helmet use; (3) a bicycle safety knowledge test; and (4) demographic information.

Results

Forty-three percent of the students were in “Precontemplation,” 17% were in either “Contemplation” or “Preparation,” 16% were in either “Action” or “Maintenance,” and 24% were in the “Relapse” stage of change. Grade, Sex, Knowledge, Pros, and Cons, and the Grade by sex and the Grade by knowledge interactions were significant predictors of helmet use stages. Compared with students in Precontemplation, students in the Contemplation stage were disproportionately younger and had higher Pro scores, lower Con scores, and more knowledge (except in the ninth grade).

Conclusions

The Transtheoretical model of behavior change is a viable theoretical framework for designing interventions aimed at increasing bicycle helmet use in children and adolescents.

Section snippets

Participants

Participants were students who had ridden a bicycle in the past 6 months. We drew a convenience sample of seventh graders from a middle school and ninth graders from a high school that are part of the Paradise Valley Independent School District, which serves primarily a middle-class population in the suburbs of Phoenix. For our college sample, we recruited undergraduates from Arizona State University who participated in the study as a way of fulfilling a course requirement. This project was

Description of the sample and descriptive statistics

There were 988 respondents. After eliminating participants with missing data, our sample size was 797; 31% of the respondents were seventh graders, 28% were ninth graders, and the remaining 41% were college students (53% male). Of the students, 83% were White, non-Hispanic; 11% were Hispanic; 4% were Asian; 2% were African American; and the remaining 1% of the students were Native American. A bicycle was owned by 91% of the students, and 43% reported that they owned a helmet. The modal category

Discussion

Maibach and Cotton17 have described the most appropriate messages for people in each stage of the Prochaska model. For people in Precontemplation, interventions should: (1) enhance knowledge about the consequences of the risky behavior; (2) personalize the risk; (3) emphasize the benefits of the healthy behavior; and (4) encourage the patient to reevaluate the pros and cons of the healthy behavior. In contrast, interventions for people in the Contemplation stage should: (1) encourage actual

Acknowledgements

We thank Susan Bookspan for her valuable research assistance.

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