The results of 10 years’ experience with the Skaraborg bicycle helmet program in Sweden

Abstract

The aim of the study was to utilize the Skaraborg Bicycle Helmet Program (SBIHP)to describe processes and methods contributing to attitudinal and behavioral change favorable to bicycle-helmet wearing. A subsidiary aim was to demonstrate how a helmet-wearing program can be built up. The background to the study lies in the fact that the SBIHP has been evaluated to have produced a significant average annual reduction, of 3·1%, in all bicycle-related injuries in Skaraborg County in Sweden over the period 1978–1993. Increased helmet use contributed to a 59% drop in head injuries in the same period. This reduction makes it interesting to examine factors relevant to the program at municipal and county level, and also the national and international factors that may have contributed to the outcome. The structure of the process is described in time sequence, by means of program documentation, campaigns, information meetings and newspaper articles. A county-wide injury-prevention program designed to utilize the child health care system to prevent childhood injuries was embarked upon in 1982 in the Swedish municipality of Lidköping. In 1987, the County Council's Executive Committee decided to introduce a several-year bicycle helmet program for four-year-olds. An evaluation conducted in 1991 justified the continuation of the SBIHP. A conclusion to be drawn from the current study is that political and intersectoral support, and also the distribution of information via the media, are important determinants of success. The participation of politicians reinforces the interventive process and, alongside the involvement of committed individuals, has been decisive in determining a favorable outcome.