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Promoting bicycle helmet wearing by children using nonlegislative interventions: systematic review and meta‐analysis
Author(s) -
Reading Richard
Publication year - 2008
Publication title -
child: care, health and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.832
H-Index - 82
eISSN - 1365-2214
pISSN - 0305-1862
DOI - 10.1111/j.1365-2214.2007.00818_3.x
Subject(s) - psychological intervention , medicine , meta analysis , randomized controlled trial , subgroup analysis , poison control , injury prevention , odds ratio , physical therapy , environmental health , psychiatry , surgery
Promoting bicycle helmet wearing by children using nonlegislative interventions: systematic review and meta‐analysis.
Royal S. , Kendrick D. & Coleman T.(2007)Injury Prevention,13,162–167.
DOI: 10.1136/ip.2006.013441.Objectives To assess the effectiveness of nonlegislative interventions in increasing bicycle helmet use among children and young people, and to identify possible reasons for differential effectiveness of interventions. Design Systematic review and meta‐analysis. Data sources 10 electronic databases were searched up to October 2006. Several other sources of potentially relevant information were identified and examined. Review methods We included randomized controlled trials, nonrandomized controlled trials and controlled before‐and‐after studies of interventions to promote bicycle helmet use, which did not require the enactment of legislation. Participants were aged between 0 and 18 years. Main outcome measure Observed helmet wearing. Results 13 studies were included in the review and 11 in the meta‐analysis. The odds of observed helmet wearing were significantly greater among children and young people in the intervention groups (OR 2.13, 95% CI 1.35–3.35). Subgroup analysis indicated that the effect might be greater for community‐based studies (4.57, 2.37–8.81) and those providing free helmets (4.60, 2.25–9.43) than for those providing subsidized helmets (2.11, 1.09–4.06) and those set in schools (1.73, 1.04–2.89). Evidence for the effectiveness of the interventions was stronger in studies with follow‐up periods of ≥6 months (2.23, 1.27–3.90) than in those with longer‐term follow‐up (1.63, 0.91–2.91). Conclusions Non‐legislative interventions are effective in increasing bicycle helmet use among children and young people. Community‐based helmet promotion programmes that include the provision of free helmets may increase observed helmet wearing to a greater extent than those set in schools or those providing subsidized helmets.