Injury Prevention at Work

	HIPRC Overview Overview Injury Prevention at Work Acute Care Biomechanics Epidemiology Rehabilitation Collaborative Efforts

Bicycle Helmet Campaign Demonstrates a Successful Effort

It's no coincidence that more bicyclists in Seattle wear helmets than bicyclists in any other major city in the country where laws do not require it. The Harborview Injury Prevention and Research Center (HIPRC) is behind this impressive injury-control achievement.

Ten years ago, physicians at Harborview Medical Center and Children's Hospital and Medical Center in Seattle were treating nearly 200 children each year with bicycle-related head injuries. Alarmed by this number, the physicians -- members of the HIPRC faculty -- launched the Washington Children's Bicycle Helmet Campaign in 1986. It became one of the HIPRC's greatest successes, serving as a primer in the design, implementation and evaluation of injury-prevention programs for field professionals. Today it remains an international model for helmet- promotion efforts.

HIPRC physicians first conducted a study to put bicycle-related head injuries in context. Although bicycle helmets were available 15 years ago, just one child in 100 wore one. Why didn't parents buy bike helmets for their children, and what factors influenced whether children actually wore them? The results, from a survey of more than 2,500 fourth-graders and their parents, shaped the eventual campaign. More than two-thirds of the parents said they had never thought of providing a helmet, and another third cited cost as a factor. The few students who owned helmets tended not to wear them because their friends didn't.

Another vital piece of information was missing: The effectiveness of bike helmets in preventing head injury. The HIPRC's ensuing study, in conjunction with Group Health Cooperative of Puget Sound, showed that helmets reduce the risk of serious head injury by 85 percent and brain injury by 88 percent. Armed with this knowledge, the HIPRC designed a campaign around four key objectives: increasing public awareness of the importance of helmets, educating parents about helmet use, overcoming peer pressure among children against wearing helmets, and lowering helmet prices.

The HIPRC formed a coalition of health, bicycling, helmet industry and community organizations to design and manage a variety of promotions. As a result, parents and children heard about helmets on television, on the radio, in the newspapers, in their doctor's office, at school and at youth groups. These sources also advertised discount coupons that cut helmet prices by half to approximately $20. Nearly 5,000 helmets were distributed at no or low cost to needy families.

These efforts produced the hoped-for results. By September 1993, helmet use had jumped from 1 percent to 57 percent among children in the greater Seattle area, and adult use likewise increased to 70 percent as parents learned the benefits of helmets. Five years into the campaign, an HIPRC evaluation revealed its ultimate effectiveness: admissions at five Seattle-area hospitals for bicycle-related head injuries dropped by approximately two-thirds for children 5 to 14 years old.

Several national entities -- among them the American Academy of Pediatrics and the National SAFE KIDS Campaign -- followed the HIPRC model in developing their own helmet promotion programs. The HIPRC has advised statewide campaigns in four states and community efforts in dozens of locales nationwide, including more than 20 communities in Washington state alone.

Research continues as the HIPRC investigators examine the correlation between helmet fit and injury risk, the effectiveness of hard-shell vs. soft-shell helmets, and the effectiveness of helmet protection for young children compared to older riders.

As the HIPRC moves through its second decade, the helmet campaign is taking on a more legislative and regulatory emphasis. Recent evaluations show that helmet-use rates have stabilized, a possible sign that the campaign has done all that an extensive educational effort can do. HIPRC officials continue to publicize the fact that communities with helmet laws achieve higher usage rates than Seattle in less time.

"In my mind, the next step is statewide legislation," said Dr. Abraham Bergman, HIPRC head of prevention and founder of the bike helmet campaign. "We have shown that an increase in helmet use leads to fewer head injuries among children, and a substantial financial savings to families and our community. It's only logical to ensure their use."

^ Back to Top