{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T03:35:11Z","timestamp":1784432111381,"version":"3.55.0"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,8,1]]},"abstract":"<jats:p>Background. Improper bicycle helmet fit increases the risk of head injury.1 Information on the rate of proper use of bicycle helmets is lacking. Promotion of helmet use is recommended at well-child and adolescent visits.2 Actual helmet assessment during such visits has not been reported.<\/jats:p>\n               <jats:p>Objectives. The primary goal of this study is to measure the proportion of children whose helmets are in proper condition and can be made to fit properly by the child and\/or parent. The secondary goal is to begin to assess the value and practicality of helmet inspection during well-child and adolescent visits.<\/jats:p>\n               <jats:p>Methods. The study took place at a private pediatric office in Falmouth, Massachusetts, from June 1 through August 31, 2001. Eligible children and adolescents were those aged 4 to 18 years presenting for well examination, along with siblings present at the visit. Eligible families completed a questionnaire, then had a timed attempt to fit a helmet, followed by an assessment of helmet fit and condition against a predetermined standard.<\/jats:p>\n               <jats:p>Results. Eighty-four percent (395\/473) of eligible families participated. A total of 479 participants were assessed. Eighty-eight percent of participants (419\/478) owned a helmet. Reported helmet use \u201calways\u201d or \u201calmost always\u201d was 73% for bicycling (317\/434), 69% for in-line skating (193\/279), 58% for scootering (179\/310), and 50% for skateboarding (79\/158). Compared with younger children, teenagers were less likely to wear helmets for all activities. Complete pass rate for every aspect of condition and fit was 4% (20\/478, 95% confidence interval: 3\u20136). The pass rate when the parent alone fit the helmet was 0% (0\/52). Three individual aspects of fit were most problematic: 1) helmet \u2018resting position\u2019 too high on the forehead (pass rate 249\/479; 52%), 2) improper strap position (pass rate 157\/476; 33%), and 3) excessive movement of the helmet from front to back of the head (pass rate 247\/479; 52%). Mean time for questionnaire completion was 4 (standard deviation: \u00b11) minutes, and 7 (standard deviation: \u00b13) minutes for helmet assessment.<\/jats:p>\n               <jats:p>Conclusions. Ninety-six percent of children and adolescents wore helmets in inadequate condition and\/or with inadequate fit. This occurred despite a high acceptance of helmet use by this population. Initial evidence suggests that helmet assessment during well visits may be practical and valuable.<\/jats:p>","DOI":"10.1542\/peds.112.2.320","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"320-323","source":"Crossref","is-referenced-by-count":27,"title":["Bicycle Helmet Assessment During Well Visits Reveals Severe Shortcomings in Condition and Fit"],"prefix":"10.1542","volume":"112","author":[{"given":"Gregory W.","family":"Parkinson","sequence":"first","affiliation":[{"name":"From Falmouth Pediatric Associates, Falmouth, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly E.","family":"Hike","sequence":"additional","affiliation":[{"name":"From Falmouth Pediatric Associates, Falmouth, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,8,1]]},"reference":[{"key":"2021121003372663800_R1","doi-asserted-by":"crossref","unstructured":"Rivara FP, Astley SJ, Clarren SK, Thompson DC, Thompson RS. Fit of bicycle safety helmets and risk of head injuries in children. Inj Prev.1999;5:194\u2013197","DOI":"10.1136\/ip.5.3.194"},{"key":"2021121003372663800_R2","unstructured":"American Academy of Pediatrics, Committee on Injury and Poison Prevention. Bicycle helmets. Pediatrics.1995;95:609\u2013610"},{"key":"2021121003372663800_R3","unstructured":"Thompson DC, Rivara FP, Thompson R. Helmets for preventing head and facial injuries in bicyclists (Cochrane Review). In: The Cochrane Library, Issue 2. Oxford, United Kingdom: Update Software; 2001"},{"key":"2021121003372663800_R4","doi-asserted-by":"crossref","unstructured":"Beirness DJ, Foss RD, Desmond KJ. Use of protective equipment by inline skaters: an observational study. Inj Prev.2001;7:51\u201359","DOI":"10.1136\/ip.7.1.51"},{"key":"2021121003372663800_R5","unstructured":"Unpowered scooter-related injuries\u2014United States, 1998\u20132000. 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Bron, France: IRCOBI; 1992:51\u201360"},{"key":"2021121003372663800_R14","unstructured":"Smith TA, Tees D, Thom DR, Hurt HH. Evaluation and Replication of Impact damage to bicycle accidents. In: Proceedings of the 37th Annual Conference, Association for the Advancement of Automotive Medicine. Barrington, IL: Association for the Advancement of Automotive Medicine; 1993"},{"key":"2021121003372663800_R15","unstructured":"US Consumer Product Safety Commission. National Bike Helmet Use Survey. Washington, DC: US Consumer Product Safety Commission; 1999:1\u20137"},{"key":"2021121003372663800_R16","doi-asserted-by":"crossref","unstructured":"DiGueseppi CG, Rivara FP, Koepsell TD, Polissar L. Bicycle helmet use by children. Evaluation of a community-wide campaign. JAMA.1989;262:2256\u20132261","DOI":"10.1001\/jama.262.16.2256"},{"key":"2021121003372663800_R17","unstructured":"Morris BA, Trimble NE, Fendley SJ. Increasing bicycle helmet use in the community. 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