Bicycle Helmet Promotion in Children: What's the Evidence?

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Health Evidence - lead by Dr. Maureen Dobbins - hosted a webinar, funded by the Canadian Institutes of Health Research (KTB-112487), on bicycle helmet promotion interventions in children, presenting key messages, and implications for practice on Thursday October 25, 2012 at 1:00 pm EST.

This webinar interpreted the evidence in the following review:

Owen, R., Kendrick, D., Mulvaney, C., Coleman, T., Royal, S. (2011). Non-legislative interventions for the promotion of cycle helmet wearing by children. Cochrane Database of Systematic Reviews, 2011(11): Art. No.: CD003985.

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Bicycle Helmet Promotion in Children: What's the Evidence?

  1. 1. This webinar has been made possible with support from the Canadian Institutes of Health Research Welcome! Bicycle Helmet Promotion in Children:What’s the evidence? You will be placed on hold until the webinar begins.The webinar will begin shortly, please remain on the line.
  2. 2. What’s the evidence? Owen, R., Kendrick, D., Mulvaney, C., Coleman, T., & Royal, S. (2011). Non-legislative interventions for the promotion of cycle helmet wearing by children. Cochrane Database of Systematic Reviews. (11) Art. No.: CD003985. http://health-evidence.ca/articles/show/16356
  3. 3. Participant Side PanelHousekeeping in WebEx Use Q&A to post comments/questions during the webinar  ‘Send’ questions to All (not privately to ‘Host’) Connection issues  Recommend using a wired Internet connection (vs. wireless), to help Q&A prevent connection challenges WebEx 24/7 help line: 1-866-229-3239
  4. 4. This webinar has been made possible with support from the Canadian Institutes of Health Research Welcome! Bicycle Helmet Promotion in Children:What’s the evidence?
  5. 5. The Health Evidence Team Kara DeCorby Heather Husson Jennifer Yost Managing Director Project Manager Guest PresenterMaureen DobbinsScientific DirectorTel: 905 525-9140 ext 22481E-mail: dobbinsm@mcmaster.ca Lori Greco Robyn Traynor Lyndsey McRae Knowledge Broker Research Coordinator Research Assistant
  6. 6. What is www.health-evidence.ca? Evidence inform Decision Making
  7. 7. Why use www.health-evidence.ca? 1. Saves you time 2. Relevant & current evidence 3. Transparent process 4. Supports for EIDM available 5. Easy to use
  8. 8. Knowledge Translation Supplement Project CIHR-funded KTB-112487
  9. 9. Review Owen, R., Kendrick, D., Mulvaney, C., Coleman, T., & Royal, S. (2011). Non-legislative interventions for the promotion of cycle helmet wearing by children. Cochrane Database of Systematic Reviews. (11) Art. No.: CD003985.
  10. 10. Questions?
  11. 11. Summary Statement:Owens (2011) P children & adolescents 0-18 years I interventions to promote bicycle helmet use that did not require the enactment of legislation C usual care/no intervention O primary outcomes: Observed bicycle helmet wearing and self reported bicycle helmet ownership and bicycle helmet wearingQuality Rating 9 (strong)
  12. 12. Overall Considerations non-legislative interventions (community-based, school-based and the provision of free helmets) led to increased odds, of observed helmet wearing and self- reported helmet wearing findings must be interpreted cautiously given the significant differences across study findings, moderate to high risk of bias of the included studies, and the bias associated with self-reported outcomes
  13. 13. General ImplicationsPublic health should promote/support/implement: Community- or school-based interventions to improve observed and self-reported helmet wearing Interventions focused on those <12 years of age to improve observed helmet wearing Provision of free helmets (with inclusion of education) to improve odds of observed OR self-reported helmet wearing Provision of interventions delivered in a healthcare setting to increase observed helmet wearing For some outcomes a small number of studies was available (i.e. n=2), and studies were at moderate to high risk of bias, meaning reported positive effect was likely overestimated
  14. 14. General ImplicationsPublic health should consider that: long-term effectiveness remains unknown, and most sub-analyses (e.g. community-based interventions vs. control) were based on studies at high risk of bias. this review did not evaluate whether non-legislative interventions promoting the wearing of helmets resulted in fewer head injuries sustained by children.
  15. 15. What’s the evidence -Outcomes reported in the review * Observed helmet wearing Self-reported helmet ownership Self-reported helmet wearing *summary includes outcomes for which data are reported in the review
  16. 16. What’s the evidence?Observed Helmet Wearing Overall, interventions increased the odds of observed helmet wearing (OR 2.08, 95%CI 1.29 to 3.34).  Specifically, community-based (OR 4.30, 95%CI 2.24 to 8.25, four studies); school-based (OR 1.73, 95%CI 1.03 to 2.91, eight studies); provision of free helmets (OR 4.35, 95%CI 2.13 to 8.89, two studies); population 12 years of age and under (OR 2.50, 95%CI 1.17 to 5.37, five studies) No impact with interventions providing subsidized helmets (with education).
  17. 17. What’s the evidence?Self-reported Helmet Ownership No impact (OR 2.67, 95%CI 0.89 to 8.03), overall, with interventions on self-reported helmet ownership compared to no intervention, except in studies providing free helmets (OR 11.63, 95%CI 2.14 to 63.16, 3 studies).
  18. 18. What’s the evidence?Self-reported Helmet Wearing Overall, the odds of self-reported helmet wearing were greater among those receiving interventions (OR 3.27, 95%CI 1.56 to 6.87).  Specifically, school-based (OR 4.21, 95%CI 1.06 to 16.74, six studies); healthcare setting (OR 2.78, 95%CI 1.38 to 5.61, two studies); provision of free helmets (OR 7.27, 95%CI 1.28 to 41.44, three studies); provision of education-only (OR 1.93, 95%CI 1.03 to 3.63, seven studies); and, age >11 years (OR 4.99, 95%CI 1.68 to 14.83, three studies) No impact on those < 12 years of age
  19. 19. Excluded Studies Studies not included in the meta-analysis (8 studies) found mixed effects on both self-reported helmet ownership, and observed helmet wearing, across a variety of intervention settings
  20. 20. General ImplicationsPublic health should promote/support/implement: Community- or school-based interventions to improve observed and self-reported helmet wearing Interventions focused on those <12 years of age to improve observed helmet wearing Provision of free helmets (with inclusion of education) to improve odds of observed OR self-reported helmet wearing Provision of interventions delivered in a healthcare setting to increase observed helmet wearing For some outcomes a small number of studies was available (i.e. n=2), and studies were at moderate to high risk of bias, meaning reported positive effect was likely overestimated
  21. 21. General ImplicationsBased on limited evidence of effectiveness, publichealth should not promote/support/implement: Provision of subsidized helmets (with education) Non-legislative interventions if the goal is to increase odds of self-reported helmet ownership
  22. 22. Questions?
  23. 23. Posting BoardFor a copy of the presentation please visit our posting board: http://forum.health-evidence.ca/Login with your health-evidence username and password or register if you aren’t a member yet.
  24. 24. Canadian Institutes of Health ResearchInstitute of Population and Public Health Funding Opportunities• Population Health Intervention Research to Promote Health and Health Equity• Knowledge Translation Awards• Institute Community Support Grants and Awards• CIHR’s Open Operating Grants Program 27
  25. 25. Population Health Intervention Research ExampleEvaluation of traffic safety interventions in B.C.Jeffrey Brubacher, et. al (UBC)Looking at whether number of vehicle crashes changed afterchanges to the province’s Motor Vehicle Act.Findings will influence B.C.’s road safety strategy and will be ofinterest to traffic safety lawmakers from other Canadianprovinces and territories. 28
  26. 26. • Visit ResearchNet for current CIHR funding opportunities: http://www.researchnet- recherchenet.ca/• For further information please contact us ipph-ispp@uottawa.ca 29

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