Effect of education and legislation on bicycle helmet use in a multiracial population

Objective: To observe the effect of new legislation and a boroughwide bicycle helmet educational campaign on bicycle helmet use in a multiracial population. Design: A prospective observational study. Observations were made at randomly selected sites in Queens (study group) and Brooklyn (control group), NY, in May 1994, before a New York State law affecting both boroughs was enacted and before a bicycle helmet educational campaign was conducted in Queens. Variables observed included age, sex, race, and whether the child was wearing a bicycle helmet while riding. A bicycle helmet campaign was conducted in late May 1994. New York State bicycle helmet law was effected on June 1, 1994, requiring all children aged 1 to 14 years to wear helmets while riding their bicycles. Follow-up observations were made at the same sites in July or August 1994. Setting: Queens County, New York, which is the most racially diverse county in the United States, according to 1990 census data. Participants: Cross-sectional observations of children aged 1 to 14 years made at randomly selected sites. Interventions: A boroughwide bicycle helmet educational campaign conducted in May 1994 in Queens. Results: The overall use of helmets increased from 4.7% (13/276) to 13.9% (44/316) (P < .001) in the study group. Helmet use decreased from 5.6% (19/342) to 4.2% (13/312) (P = .10) in the control group during the same period. Conclusions: In a multiracial population, a statistically significant (P < .001) increase of helmet use was demonstrated after a campaign and distribution of educational material. Legislation alone is inadequate for ensuring increased bicycle helmet use.