Facilitators and barriers to bicycle helmet use: A qualitative evidence synthesis

Abstract

Background: Bicycles are environment-friendly and is an effective physical activity intervention to decrease risk of non-communicable diseases. Family physicians and primary care workers play a key role in promoting its usage, including addressing safety concerns through the use of bicycle helmet use. The uptake of bicycle helmets is low in many settings. We aimed to understand facilitators and barriers to bicycle helmet use. Method: We searched five major electronic databases, screened references and manually searched conference abstracts for qualitative studies that focused on facilitators and barriers to bicycle helmet use. We critically appraised the studies using the Critical Appraisal Skills Programme (CASP) checklist and used PROGRESS-Plus tool for an equity-focused analysis. We conducted a thematic synthesis for analysis and used GRADE-CERQual to report confidence in findings. Results: We included 15 studies from high-income countries. We identified 4 themes: 1. Perceptions on helmet design, it’s quality and cost together with experiences influencing helmet use (10 studies, low confidence); 2. Perceived risk and benefits of helmet use through a gender lens (10 studies, moderate confidence); 3. Parental strategies influencing children’s behavior regarding helmet use (6 studies, moderate confidence); 4. Adoption and enforcement of laws that shape perception and usage of bicycle helmets (8 studies, very low confidence). Conclusion: Our study identified facilitators and barriers and can be considered for developing programs and strategies to influence bicycle helmet use, but the confidence in findings is not high. Family physicians and primary care workers should consider these factors when promoting bicycle helmet for injury prevention. There is a need for more qualitative studies in different contexts to develop more robust evidence.

Bicycle-related traumatic injuries: a retrospective study during COVID-19 pandemic

“…Qualitative analysis of the barriers and attitudes towards helmet use specifically may be useful to target these efforts in our Asian context. [23,24] Our study highlights that a majority of the injuries occurred on roads and in public areas and between 7 pm and 7 am. Further efforts to improve road user safety in these areas include clear, bright signage and dedicated lanes.…”

Community health workers for health systems resilience during COVID-19: protocol for qualitative evidence synthesis

“…The protocol for the review will be registered a priori. We follow the principles laid down by the Cochrane Qualitative and Implementation Methods29–33 and those used previously in other studies 34–36. The protocol was drafted and written according to the Cochrane Effective Practice and Organisation of Care: Qualitative Evidence Synthesis 37.…”

“…We follow the principles laid down by the Cochrane Qualitative and Implementation Methods [29][30][31][32][33] and those used previously in other studies. [34][35][36] The protocol was drafted and written according to the Cochrane Effective Practice and Organisation of Care: Qualitative Evidence Synthesis. 37 The planned (tentative) start and end dates for conducting the full review are 1 November 2023 and 31 March 2024.…”