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Evaluating the effect of a social marketing campaign on bicycle helmet use in BC

Author(s): Jennifer Smith, Florian Karl, Ian Pike

Slidedeck Presentation Only (no paper submitted):

4C_2_Pike

Abstract:

Background

Bicycle helmets have been mandatory for cyclists of all ages in the province of British Columbia (BC) since 1996. Despite the law, many cyclists still do not wear a helmet, and so head injuries among this group represent a large human and economic burden. Preventable is a social marketing campaign focused on shifting public attitudes towards injury prevention, and has been active in the province of BC since 2009. Past campaign activity has focused on messaging to encourage safe cycling practices, including helmet use. The Health Action Process Approach (HAPA) is a behaviour change model that can be applied to explain the impact of the Preventable campaign on the transition between intention and action, in the context of bicycle helmet use.

Method

Four hundred cyclists across BC aged 25-54 years completed an online survey. Demographic information, cycling habits, injury attitudes, and recall of the Preventable campaign were collected and measured in the 36-item questionnaire. Path analysis was used to evaluate impact of each component of the HAPA model on both behavioural intentions and outcomes. The Preventable campaign was evaluated through t-test comparisons after Propensity Score Matching (PSM) and Generalized Linear Modelling (GLM) were applied as a sensitivity analysis. PSM and GLM matched/adjusted for the same covariates: age, sex, marital status, education, employment status, region of residence, frequency of bicycle use, type of cyclist, having children under 16 years of age, and injury history.

Results

Self-efficacy and legislational intention were most predictive of intention to wear a helmet, which itself strongly predicted behaviour, but was moderated by planning. Perceived risk of injuries, the perceived risk of being caught not wearing a helmet, and outcome expectancies had no significant impact on the intention to wear a helmet. GLM analysis showed that exposure to the Preventable campaign was significantly associated with higher values in self-efficacy, intention and bicycle helmet use.

Conclusion:

Self-efficacy and planning are important points of action for the promotion of helmet use. The approach of the Preventable campaign has demonstrated a positive impact on helmet use behaviour among adult cyclists in BC.