The perspectives of young people on barriers to and facilitators of bicycle helmet and booster seat use.

BACKGROUND: Mandatory bicycle helmet and booster seat laws for children are now common across Canada and the United States. Previous research has found that despite legislation, child compliance is often low. Our objectives were to identify and compare children's perspectives on barriers to and facilitators of their use of bicycle helmets and booster seats. METHODS: Eleven focus groups were conducted with a total of 76 children; five groups of children between the ages of 4 and 8 years discussed booster seats and bicycle helmets, and six groups of children between the ages of 9 and 13 years discussed bicycle helmets. Efforts were made to include diverse participants from a variety of ethno-cultural and socioeconomic backgrounds. RESULTS: Poor fit and physical discomfort were most often described as barriers to bicycle helmet use. Helmet appearance was a barrier for some children but acted as a facilitator for others. Booster seat facilitators included convenient features such as drink cup holders and being able to sit higher up in order to have a better view, while barriers included fear of being teased, and wanting to feel and be seen as more mature by wearing a seatbelt only. CONCLUSIONS: The main barriers to usage of bicycle helmets and booster seats identified by young people were modifiable and fit within a theory of planned behaviour framework that includes subjective norms, child attitudes towards safety equipment and perceived behavioural control of its usage. Recommendations were made regarding how these elements can be utilized in future injury prevention campaigns.

A comparison of parent and child perspectives about barriers to and facilitators of bicycle helmet and booster seat use.

To date, little work has compared similarities and differences between parent and young people's perceptions of barriers to and facilitators of bicycle helmet and booster seat usage. Our goal was to conduct such a comparison in order to inform future safety campaigns. Eleven focus groups with a total of 68 parents and 11 focus groups with a total of 76 young people were conducted. Recruitment was conducted and focus groups were held in diverse neighbourhoods to facilitate participation by families from a variety of cultural, linguistic, and socioeconomic backgrounds. Overall, parents and their children agreed on 50% of the barriers identified for bicycle helmet use and approximately 40% of the barriers for booster seats. Barriers common to both types of equipment for parents and children included comfort, style and design, and fear of teasing. Common facilitators included perceived safety, and comfort. While there was considerable overlap between the perspectives of parents and young people, there were also differences, underscoring the importance of addressing both perspectives. The barriers and facilitators identified were modifiable to a large extent; based on these, recommendations for future injury prevention campaigns were outlined.

Impact of the decision-making environment on policy responses to road worker fatality in Manitoba and Saskatchewan.

OBJECTIVES: Fatal accidents often lead to policy changes. However, the existing decision-making environment is critical to policy responses. This study compares the policy responses to similar events in Manitoba and Saskatchewan. The key question explores the extent to which the policy decisions in each province differ despite the similarity of the events. METHODS: Key documents were examined. Provincial court rulings, workplace health & safety incident investigation reports, court transcripts and police reports were used to compare resulting policy changes as well as the socio-political and economic decision-making context. Relevant clauses in resulting legislation were also compared to assess the specific changes that were made in each province. RESULTS: In each province, a young, female highway construction worker was killed. However, the provinces responded in very different ways. In Saskatchewan, the Premier called for recommendations to improve worker safety, initiating an in-depth governmental study and the development of a broad safety strategy. In Manitoba, political and social pressures shifted the decision-making environment and contributed to the rushed passing of a bill focused on traffic fine increases that resulted in record-breaking traffic fine revenue while failing to include broader safety measures. CONCLUSION: Different decision-making contexts can lead to vastly different policy outcomes even when responding to very similar events. Key differences included time constraints, access to information and the nature of the political process invoked.

Challenges in the Accurate Surveillance of Booster Seat and Bicycle Helmet Usage by Children: Lessons from the Field.

Motor vehicle collisions and bicycle collisions and falls are a leading cause of death by preventable injury for children. In order to design, implement and evaluate campaigns and programs aimed at improving child safety, accurate surveillance is needed. This paper examined the challenges that confront efforts to collect surveillance data relevant to child traffic safety, including observation, interview, and focus group methods. Strategies to address key challenges in order to improve the efficiency and accuracy of surveillance methods were recommended. The potential for new technology to enhance existing surveillance methods was also explored.