Associations between adult and child bicycle helmet use

To observe the incidence of proper and improper use or non-use of bicycle helmets by children and adults when riding bicycles in groups. An observational survey of bicycle riders on a recreational bicycle path. In eight half-day sessions, two observers independently rated all riders in groups that consisted of adults and children either wearing or not wearing helmets. Those who wore helmets were then rated as wearing them properly or improperly. Two-thirds of children wore helmets, but less than one-half wore them properly. One third of the adults wore helmets, and one-half of those wore them properly. Adult helmet use affected child helmet negatively. The strongest correlations were between adult helmet use or non-use and improper or no helmet use in accompanying children. Primary care nurses who work with healthy populations should collaborate with other groups involved with families to not only exhort them to wear helmets when riding bicycles but also to instruct those riders how to wear their helmets properly.