Factors associated with bicycle-helmet use among 8–16 years aged Turkish children: a questionnaire survey

Abstract

The purpose of this cross-sectional, descriptive study was to assess the rates of helmet and to examine variables related to bicycle helmet use in a sample of 8–16 year old Turkish children. Data were collected from a purposive sample of 1180 students who self-identified as cyclists and 1128 parents or guardians in two state primary schools in two urban municipalities in the northern part of Istanbul, Turkey. Results showed that self-reported helmet use was found prevalent in 4.4% of the children. The most cited reasons for not wearing a helmet were: ‘don't own one’, ‘helmets are uncool’, and ‘uncomfortable’. Significant differences between helmet users and non-users correlated to gender, age, owning a bicycle helmet, wearing a friend's bicycle helmet and parents or guardian's bicycle helmet use while riding. Only three variables – helmet ownership (OR = 10.028, 95% CI 5.08, 19.79), parents’ helmet use (OR = 2.62, 95% CI 1.22, 5.66) and friends’ helmet use (OR = 0.16, 95% CI 0.07, 0.37) emerged as significant predictors of the likelihood of helmet use. The relatively low helmet use prevalence points to an urgent need for a multipronged campaign, including strategies such as raising awareness, educating primarly parents and friends, and distributing bicycle helmets for free or at a reduced cost.

Keywords:

• associated factors
• barriers
• bicycle
• helmet use
• Turkish children

Acknowledgements

The authors gratefully acknowledge John D. Kraemer, Department of Health Systems Administration, Georgetown University School of Nursing and Health Studies and O’Neill Institute for National and Global Health Law, Georgetown University Law Center for editing this article; the students and their parents and guardians who participated in the study.