Preventable head and facial injuries by providing free bicycle helmets and education to preschool children in a head start program

Thein Hlaing Zhu,Mary O Aaland,Heather Henry,Lisa Hollister,Connie Kerrigan,Renee Schiebel

doi:10.4236/health.2011.311116

Abstract

The objectives of the study were to determine helmet use rates, incidence rates (IRs) of head and facial injuries for population attributable fraction (PAF) estimation, and to elucidate the magnitude of and changes in PAFs as the result of helmet use changes among preschool children. A study consisting of cross-sectional (survey) and longitudinal (follow-up) component was designed by including a randomly selected group of participants (n = 322) from 10 Head Start sites provided with free bicycle helmets along with a subgroup of prior helmet owners (n = 68) from the other random group (n = 285). All participants received bicycle helmet education. Helmet use surveys were conducted in May (1st Survey) and November 2008 (2nd Survey). The helmet owners were followed up to determine IRs, and incidence rate ratios (IRRs) for head and facial injuries. PAFs were computed using IRs as well as helmet use rates and IRRs. Helmet use rates increased significantly from the 1st to the 2nd Survey. The mean follow-up person-time was 5 months. The IRs for head, face (all portions), and face (upper/mid portions) injuries were higher in non-helmeted than helmeted riders. By using IRs, PAFs for the 3 injuries among the riders in both groups of helmet owners were 77%, 22%, and 32% respectively. The PAFs for each of the above injuries decreased by about 10% as helmet use rates increased. The magnitude of and changes in preventable head and facial injuries following free bicycle helmet distribution and education among helmeted riders was elucidated in this Head Start preschool children population.

Highlights

Head Start Programs exist in every state in the United States, and 908,412 children were enrolled in 2007 nationwide; of these, about 90% were preschool age [1]
The Community Action of Northeast Indiana (CANI) Head Start Program in Fort Wayne, Indiana serves over 800 preschool children
One research question that intrigued the research personnel before implementing the program was, “to what extent could head and facial injuries be prevented if this population is provided free bicycle helmets and education?” In other words, could we measure the population attributable fractions for head and facial injuries among helmeted riders?

Summary

Introduction

Head Start Programs exist in every state in the United States, and 908,412 children were enrolled in 2007 nationwide; of these, about 90% were preschool age [1]. Head Start is a federally funded preschool program that provides health, education and social services to children from low-income families that are at or below the federal poverty level. The Community Action of Northeast Indiana (CANI) Head Start Program in Fort Wayne, Indiana serves over 800 preschool children. The trauma program of the Parkview Hospital Level II Trauma Center in Fort Wayne, Indiana planned to distribute 800 free helmets to preschool children ages 3-5 years at the CANI Head Start sites in 2007-2008 to encourage helmet use both at school and home. One research question that intrigued the research personnel before implementing the program was, “to what extent could head and facial injuries be prevented if this population is provided free bicycle helmets and education?” In other words, could we measure the population attributable fractions for head and facial injuries among helmeted riders?

Objectives

Methods

Findings

Conclusion