NEW YORK (Reuters Health) - Young bicycle riders are not the only ones who often disregard public health messages to wear helmets, researchers report. New study findings show that less than 14% of young bicycle and scooter riders, skateboarders or in-line skaters wear protective head gear.

"Helmet use promotion and tracking should not only focus on bike riding, but also on other childhood leisure activities like skating and scooter riding," study author Dr. Samuel N. Forjuoh of the Scott and White Santa Fe Center in Temple, Texas told Reuters Health.

Forjuoh and his colleagues observed 841 children in eight central Texas communities during an 8-week study period to determine their rates of helmet use while engaged in four activities--bicycle riding, scooter riding, skateboard riding and in-line skating.

Fewer than one out of every seven children used helmets while participating in the leisure activities, they report in the July issue of Archives of Pediatric and Adolescent Medicine. In addition, nine children either carried their helmets or had them hanging on their bicycle handlebars.

Helmet use was most common among in-line skaters, nearly 20% of whom used the protective gear, and least common among scooter riders, the researchers note. Also, about one third of children under 6 years old used helmets in comparison to about 10% of children aged 6 to 12.

Children were most likely to wear helmets if they were accompanied by adults while engaging in leisure activities, the report indicates.

For example, all of the children who went in-line skating with an adult wore helmets, and those riding bicycles were 10 times more likely to wear helmets if they were with an adult. Scooter riders were nearly 12 times more likely to wear helmets when adults were around.

"Parents must always model safety behaviors for their children to follow," Forjuoh said. "Helmet use is still low in many areas, particularly those without helmet laws; however, parents still remain the main advocates for helmet use promotion."

In other findings, slightly more than one quarter of the children who wore helmets did not wear them correctly--horizontally positioned on the head in a straight line and strapped under the chin. This was particularly true among scooter riders, 53% of whom wore their helmets tilted forwards or backwards or unstrapped.

"There should be increased use of parents and peers as advocates for child helmet use in leisure activities," Forjuoh said. In addition, "no one should forget to buy an approved helmet when buying a bike/skates/scooter for a child."

The Texas Department of Transportation funded the study.

SOURCE: Archives of Pediatric and Adolescent Medicine 2002;156:656-661.

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