Evolution of a successful community bicycle helmet campaign.

BACKGROUND Bicycling injuries claim more than 900 lives each year in the United States, and the major cause of deaths is head injuries. Bicycle helmets can prevent head and brain injuries, yet helmet use rate remains low. Helmets are expensive, and their cost can be prohibitive. This study asks the question, "If bicycle helmets are made affordable, will they be worn?" METHODS A multifaceted bicycle helmet campaign was begun in Grand Junction, Colorado, population 76,000, in 1992 and was evaluated after its first 2 years. The educational component involved presentations in local schools and at community functions, physician education, and media promotions. A discount helmet program was established through community donations, which allowed helmets to be sold to low-income families for $5 and to middle- and upper-income families for $15; approximately 2400 helmets were sold. One year later a local retailer sold helmets for $12.99; approximately 4000 helmets were sold. RESULTS Twenty-three locations were surveyed in 3 consecutive years by observers looking for bicycle riders and the presence or absence of helmets. The base-line overall use rate in 1992 was 9.9 percent, which increased to 20.9 percent in 1993 and to 37.1 percent in 1994. There were increases in helmet use in all age groups. CONCLUSIONS A community bicycle helmet campaign that combines affordable helmets with appropriate education can effect an increase in helmet use. A major key to a successful program is a local retailer willing to sacrifice profits to promote helmet sales and use.