On Bike In Helmet Only
A Report of a 3-year Community Campaign Promoting Bicycle Helmets

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Contributed by M Sedlak, M Grivna, J Cihalova

Background
Bicycle-related head injuries are the main cause of hospitalization among young bikers in Europe. In the Czech Republic bicycle helmet use has been mandatory for children under 15 since 2001. In the city of Kromeriz, Czech Republic, a pilot study to increase helmet use among children was undertaken.

Methods
During 2003-5, an intersdisciplinary group developed and implemented a community-wide campaign focused on children and their parents. Using posters, art classes in schools and kindergartens, newspaper articles, and a web-site, the benefit of wearing helmets was introduced. Discount coupons for the purchase of helmets were distributed. About 3 500 children under 15 years in kindergartens, elementary schools and high schools were exposed to the campaign. Special training was organized for teachers, pediatricians, and police. Municipal leaders provided strong political support to the campaign. Children seen riding helmets were given rewards. Helmet use was observed in 8 different locations on three days in June. Hospitalizations caused by bicycle-related  injuries was monitored.

Results
From 2002 to 2005, oberved helmet use increased from 38% to 55% in children under 10 years and from 11% to 26% in 11-15 years olds. The incidence of hospitalizations for children with bicycle-related head injuries declined in each year of the campaign, compared to hospitalization rates for children who were not exposed to the campaign. 

Conclusion
Our data suggest that a community campaign was effective. It increased helmet use in support of our existing law. Interdisciplinary collaboration was crucial between the municipal council, schools, city police, pediatricians, epidemiologists, sponsors, insurance companies, and newspapers. In Kromeriz, the Safe Community program was a base for this cooperation. Other cities in the Czech Republic have started similar campaigns using our methods.

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