Barriers to bicycle helmet use in young children in an urban elementary school.

PURPOSE: Traumatic brain injury is a leading cause of death in bicycle crashes. The factors associated with bicycle helmet use in young children with diverse ethnic and socioeconomic backgrounds have not been studied. The purpose of this study was to identify barriers to helmet use in young children in an urban elementary school. DESIGN: Qualitative content analysis with semistructured interviews, observational field notes, and artifacts. SETTING: Urban elementary school. PARTICIPANTS: Seventeen students whose age ranged from 5 to 7 years and whose ethnic background was identified as African American (14) or Caucasian (3). METHOD: Children participated in a brain safety fair that included presentations and activities. Semistructured, pre- and postexperience interviews were completed. Observations of the students participating in the activities and reflective art projects from the students were collected. RESULTS: The analysis found the following barriers to helmet use: (a) lack of access to a helmet, (b) poor fit of helmets due to hairstyles, and (c) lack of knowledge regarding helmet use. CONCLUSION: The present study suggests that the issue of helmet design and comfort for younger children with variable hairstyles needs to be addressed in order to increase helmet use in this population.