Promoting Helmets Without Laws: Can it be done?

Globally, especially in high-income countries, laws are often used to require the use of bicycle helmets, especially for children. Although the trend to pass bicycle helmet laws is increasing, many countries and jurisdictions still do not have helmet wearing laws. In these places helmet wearing is promoted by education and community-based programmes. Do these programmes work?

In a systematic review of programmes that promote helmet wearing in children using non-legislative means, Simon Royal and his colleagues from Nottingham, United Kingdom, found that they do. In fact, they double the amount of helmet wearing on the average, and some promotional strategies, tend to increase helmet wearing even more. Community-based programmes that provide free helmets to children may increase wearing by a factor of greater than four. Programmes that are school-based and provide subsidized, rather than free helmets, do not appear to be as effective.

With overall child helmet wearing rates varying from 46% in the United States of America to 14% in the United Kingdom and about 33% in Sweden, helmet promotional programmes are needed to increase wearing. The authors recommended that community leaders undertake them. This study – excerpted from a report that originally appeared in the Cochrane Database of Systemic Reviews – identifies additional research implications such as exploring the effectiveness of free versus subsidized helmet programmes, the impact that promotional programmes have in low- and middle- income countries, and whether or not promotional programmes can act to decrease bicycling.

Royal S, Kendrick D, Coleman T. Promoting bicycle helmet wearing by children using non-legislative interventions: systematic review and meta-analysis. Inj Prev 2007;13(3): 162-7.

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