{"id":140,"date":"2016-05-17T16:06:05","date_gmt":"2016-05-17T20:06:05","guid":{"rendered":"http:\/\/ctlsites.uga.edu\/hprb7010may2016\/?page_id=140"},"modified":"2016-06-07T16:18:43","modified_gmt":"2016-06-07T20:18:43","slug":"use-of-motorcycle-helmets","status":"publish","type":"page","link":"https:\/\/ctlsites.uga.edu\/hprb7010may2016\/use-of-motorcycle-helmets\/","title":{"rendered":"Effects of Universal Motorcycle Helmet Laws on Helmet Usage"},"content":{"rendered":"

Part I. Community Guide Update and Rationale for Intervention <\/u><\/p>\n\n\n\n\n\n\n
Author & Year<\/strong><\/td>\nIntervention Setting, Description, and Comparison Group(s)<\/strong><\/td>\nStudy Population Description and Sample Size<\/strong><\/td>\nEffect Measure (Variables)<\/strong><\/td>\nResults including Test Statistics and Significance<\/strong><\/td>\nFollow-up Time<\/strong><\/td>\n<\/tr>\n
\u00a0Naumann et al. (2015)<\/td>\nSince\u00a02008, all motorcyclists in North Carolina have been required to wear a helmet when operating their vehicles. This study is one of the first analyses of the effects of this state law. Hospital admissions for motorcyclists with traumatic brain injuries (TBI) and associated injuries were obtained for 2011, and compared with estimated admissions rates if NC had not enacted the helmet law. Economic effects were also estimated.<\/td>\nThe study population included all motorcyclists admitted to hospitals with TBIs as the result of a motorcycle crash in the state of North Carolina (n=275). The control population included the estimated number of motorcyclists that would\u00a0<\/em>have been admitted to hospitals with TBIs as the result of a motorcycle crash in North Carolina had the state’s helmet law not been implemented (n\u2248465-501).<\/td>\nThe measurements used were number of motorcyclists with TBIs and the estimated medical charges under the helmet law and a hypothetical non-helmet law situation.<\/td>\nImplementation of a helmet law in North Carolina prevented roughly 190-226 admissions of motorcyclists with TBIs. The law also prevented between $25.3 million and $31.0 million in hospital charges.<\/p>\n

No test statistics were provided.<\/td>\n

Technically, there was no follow-up time in this study because no time passed between the two measurements. All data was taken from the entire year of 2011.\u00a0<\/span><\/td>\n<\/tr>\n
\u00a0Usha et al. (2013)<\/td>\nKerala, India implemented a mandatory motorcycle helmet law in 2007. To display the effectiveness of this law in preventing injury amongst motorcyclists, researchers obtained data from people that\u00a0sustained facial injuries in nonfatal motorcycle accidents at one emergency department for the six months following enactment of the helmet law.<\/td>\nPatients included in this study were those that reported to the Emergency Department of Oral and Maxillofacial Surgery at Government Dental College in Calicut after sustaining facial injuries in a nonfatal motorcycle accident during the six months following the enactment of the helmet law (n=191). A control group was used, and it included the same type of people in a six month period two years prior to enactment of the helmet law (n=289).<\/td>\nThe most important variables in this study were percentage of patients using helmets at the time of their accidents both pre- and post-law, and amount\/type of injuries in helmeted and non-helmeted individuals.<\/td>\nHelmet usage increased by 32% in the six months after Kerala enacted the helmet law.<\/p>\n

Incidence of facial fractures:
\n<\/span>Helmeted: 14%
\nNon-helmeted:53%
\n(Chi square value = 21.930, P = 0.000)<\/p>\n

 <\/td>\n

Follow-up\u00a0time included the 6 months following enactment of the mandatory motorcycle helmet law – data was collected as patients presented to the hospital throughout that period of time.<\/span><\/td>\n<\/tr>\n
\u00a0Olsen et al. (2016)<\/td>\nLess than have of states in the US have universal helmet laws- just as many have partial helmet laws, where only certain members of the population (typically restricted by age) are required to wear helmets when operating a motorcycle. This study used data from 11 states (five with universal helmet laws and six with partial helmet laws) to determine the effectiveness of\u00a0both types of helmet laws on helmet usage, number of injuries resulting from motorcycle crashes, and medical charges resulting from these motorcycle crash-related injuries.<\/td>\nThis study included motorcycle crashes\u00a0in the 11 states (n=73,759).<\/p>\n

28,207 of these crashes were from partial law states, and the other 45,552 were from universal law states.<\/td>\n

\u00a0Variables included helmet use rates (one subcategory here included use rates in those under 21), emergency department and inpatient charges, fatality rates, and the rates of three types of injuries: head injuries, facial injuries, and traumatic brain injuries (TBIs).<\/td>\nHelmet Use (General):<\/span>
\nPartial states: 42%
\nUniversal states: 88%Helmet Use (Under 21):<\/span>
\nPartial states: 44%
\nUniversal states: 81%There were significantly less head, facial, and traumatic brain injuries in universal law states than partial law states [p-values all <0.01]. Mean and median hospital charges were lower in universal law states than partial law states [p<0.01].<\/td>\n		There were no specific follow-up points, as data\u00a0was collected continuously from 2005-2008.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

In 2013, the Community Preventative Services Task Force recommended<\/span> universal motorcycle helmet laws after a systematic review of the evidence available\u00a0at that time. \u00a0Universal helmet laws are explicitly recommended over both partial helmet laws and no helmet laws. In the time that has passed since this recommendation, there has been sufficient evidence to instead strongly recommend<\/span> universal helmet laws as a strategy that increases\u00a0helmet usage, thus lowering injuries and fatalities among motorcyclists.<\/p>\n

The new studies that were reviewed provided data from multiple states in the United States and one state in India. Though the findings were not exactly novel, this data indicated that the implementation of universal helmet laws increases helmet use rates amongst motorcyclists,\u00a0lowers injury rates in crashes, and decreases the financial burden that results from crash injuries. This not only applies to implementation in states with no existing helmet laws, but\u00a0also\u00a0states with existing partial helmet laws. These partial laws typically only require motorcyclists under the age of 18, 19, or 21 to wear helmets, and\u00a0currently exist in 28 states (Insurance Institute for Highway Safety, 2016). \u00a0As is evidenced in studies from 2013 onwards\u00a0and<\/em> previous studies that were involved in CPSTF’s 2013 recommendation, partial helmet laws do not adequately encourage helmet usage\u00a0and thus result in unnecessary injuries, fatalities, and costs amongst motorcyclists. In 2012, Michigan repealed its universal helmet law in favor of a partial helmet law. After this repeal, rates of helmet non-usage among motorcyclists increased from 7% to 29%. \u00a0This resulted in increased crash fatalities, longer hospital stays, and increased medical costs for injuries (Chapman et al. 2014). Though this article was not included in the above review because it was not a study of the implementation strategy but rather a review of a repeal of this strategy, it very clearly demonstrates how subpar helmet laws do not provide enough protection for motorcyclists.<\/p>\n

There is little to no evidence\u00a0that opposes the implementation of universal helmet laws. Now that it is very clearly known that universal laws are more protective than partial laws, and that repealing universal laws in favor of partial laws results in more fatalities and injuries amongst motorcyclists,\u00a0it should be\u00a0strongly recommended<\/span> that universal helmet laws are implemented nationwide<\/p>\n

 <\/p>\n

Part II. Theoretical Framework\/Model <\/u><\/p>\n

The Health Belief Model (HBM) is used to explain why people participate (or do not participate) in preventative measures against harm. The model\u00a0intends to motivate practices involved in good health and address the reasons why people might not follow these practices. In this model, six main constructs are thought to influence people’s behaviors: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action, and self-efficacy\u00a0(NCI, 2005). \u00a0Though the intervention here is creating a universal motorcycle helmet law, these constructs must also be addressed in order to\u00a0achieve a high rate of helmet usage.<\/p>\n

Constructs Used in Motorcycle Helmet Promotion<\/span><\/strong><\/p>\n