BICYCLE HELMET LAWS AND EDUCATIONAL CAMPAIGNS - AN EVALUATION OF STRATEGIES TO INCREASE CHILDRENS HELMET USE

Objectives. The passage of a mandatory bicycle helmet law for children in Howard County, Maryland, provided an opportunity to compare legisl ation and education as strategies to increase helmet use. Methods. In 1991, a survey was mailed to fourth-, seventh-, and ninth-grade studen ts attending a stratified sample of public schools in Howard County an d in two similar suburban/rural counties without helmet laws. Results. Of 7217 students surveyed, 3494 responded (48.4%). Self-reported helm et use in Howard County rose from 11% to 37% after the law and accompa nying educational campaign went into effect. Helmet use changed from 8 % to 13% in Montgomery County, where educational efforts were undertak en, and from 7% to 11% in Baltimore county, where helmet promotion act ivities were minimal. Predictors of helmet use included having friends who wore helmets, believing helmet laws are good, being in fourth gra de, living in Howard County, and using seat-belts regularly. Conclusio ns. Legislation combined with education appears to increase bicycle he lmet use substantially more than does education alone. The Howard Coun ty law may be considered a successful model of a strategy to increase children's helmet use.