PSYCHOSOCIAL FACTORS ASSOCIATED WITH THE USE OF BICYCLE HELMETS AMONGCHILDREN IN COUNTIES WITH AND WITHOUT HELMET USE LAWS

We examined the extent to which psychosocial factors, in addition to t he presence of a law, are associated with the use of bicycle helmets. A mailed questionnaire was completed by 3494 children in fourth, seven th, and ninth grades in three Maryland counties: Howard County, which had a law requiring child bicyclists to wear helmets and an educationa l campaign; Montgomery County, which had an educational campaign but n o law;and Baltimore County, which had neither. Overall, 19% of the res pondents reported having worn a bicycle helmet on their most recent ri de. In a multiple logistic regression, children's use of helmets in al l three counties was significantly associated with their beliefs about the social consequences of wearing helmets and the extent to which th eir friends wear helmets. Significant interactions were also found, su ggesting that in the presence of a law, an educational campaign, or bo th, children's use of helmets was associated more with social concerns than with parental influences or cognitive factors, such as beliefs a bout the need for helmets or perceptions of risk. To increase helmet u se, the issues of stylishness, comfort, and social acceptability of we aring helmets need to be addressed and more widespread adoption of bic ycle helmet laws should be encouraged.