P3.133: Changing Practice and Promoting Helmet Use through a Pediatric Bike Helmet Distribution Program

Background: Bicycle helmets reduce fatalities by 73% and traumatic brain injuries by 58%, yet helmet use in pediatric patients remains low, with many children involved in accidents not wearing helmets. Among children who do wear helmets, proper fitting is inconsistent. A major barrier to helmet compliance is limited access, as many children lack helmets. Studies show that discussing helmet safety during pediatrics office visits increases helmet use.

Project Description: We educated pediatric providers at an academic medical institution on helmet counseling and proper fitting techniques and implemented a program to distribute free bicycle helmets in both general and subspecialty pediatrics clinics, as well as at local community events. Over 9 months, more than 500 helmets were provided to pediatric patients-350 in clinic visits and approximately 150 at community events. The project was supported through a combination of helmet donations, grant funding, and hospital community outreach funding.

Residents and attendings were surveyed before and after the helmet program’s implementation to assess changes in their practices and comfort with counseling on helmet usage and proper fitting techniques. Pre-surveys, which included Likert scale and self-efficacy questions, were distributed via an anonymous Qualtrics survey link prior to a fifteen-minute in-person training session that demonstrated proper helmet fitting and discussed helmet safety counseling. Post-surveys were administered 8-12 months later to evaluate change in practices and perceptions.

Discussion: A total of 35 pre-surveys (32 residents, 3 attendings) and 30 post-surveys (27 residents, 3 attendings) were collected and analyzed. 90% of post-survey respondents reported that helmets were a “very useful” resource for their patients. Comparing pre- and post-survey data revealed many improvements and changes in practice since the start of the helmet program: the percentage of respondents who knew how to properly fit a helmet on a patient increased from 23% to 70%, provider comfort with counseling on strategies to increase helmet usage rose from 37% to 73%, and comfort with educating parents on fitting helmets rose from 26% to 77%. Additionally, we observed a shift in practice, with the percentage of providers reporting that they provide helmet-specific counseling in “most” or “every” well-child visit increasing from 20% to 37%. Also notably, the percentage of providers who reported that they never discussed helmets dropped from 26% to 0%.

Conclusion: Implementing pediatric provider education on helmet safety, in conjunction with a free helmet distribution program, has improved self-reported provider practices and increased helmet access for patients. While these results show positive changes in provider reports, further efforts are needed to ensure sustained changes and promote provider-initiated discussions on proper helmet usage and fitting. Our survey highlights the continued need to engage pediatricians in these ongoing efforts.