Objectives: To evaluate an Oregon law requiring bicyclists younger than 16 year to wear a helmet and to compare methods of measuring helmet use.
Design: Four prelaw and postlaw statewide helmet use surveys: (1) statewide observations, (2) middle school observations, (3) classroom self-report surveys, and (4) a statewide adult telephone survey.
Setting: Oregon.
Subjects: Statewide observations, 3313 child bicyclists at 13 sites; middle school observations, 995 child bicyclists at 33 randomly selected middle schools; classroom self-report surveys, fourth, sixth, and eighth graders in 448 classrooms (ie, 8955 students) before the law was effected and 456 classrooms (ie, 9811 students) after the law was effected in 66 randomly selected schools; and statewide telephone survey, 1219 randomly called parents of 1437 children younger than 16 years.
Main outcome measures: Prelaw and postlaw helmet use and ownership and knowledge and opinion about the law.
Results: Observed helmet use among youth was 24.5% before the law was effected and 49.3% after the law was effected. School-observed use increased from 20.4% to 56.1%. Classroom survey self-reported "always" use of helmets increased from 14.7% to 39.4%; reported use on the day of the survey increased from 25.8% to 76.0%. Telephone survey-reported "always" helmet use increased from 36.8% to 65.7%. Younger children and girls were more likely to use helmets. Most students (ie, 87.8%) and parents (ie, 95.4%) knew about the law; however, only 42.6% of children thought the law was a good idea.
Conclusions: We conclude that (1) the law increased helmet use; (2) although use estimates differ, all helmet surveys showed similar degrees of prelaw and postlaw change; and (3) half of child bicyclists are still not wearing helmets, indicating a need for additional promotion of helmet wearing. Laws seem to be an effective way to increase helmet use.