abstract: 'Background Helmet use among bike-share users is low. We sought to

  characterize helmet-use patterns, barriers to helmet use, and cycling

  safety practices among bike-share users in Toronto.

  Methods A standardized survey of public bike-share program (PBSP) users

  at semi-random distribution of PBSP stations was undertaken. By

  maintaining a ratio of one helmet-wearer (HW): two non-helmet-wearers

  (NHW) per survey period, we controlled for location, day, time, and

  weather.

  Results Surveys were completed on 545 (180 HW, 365 NHW) unique users at

  48/80 PBSP locations, from November 2012 to August 2013. More females

  wore helmets (F: 41.1\%, M: 30.9\%, p=0.0423). NHWs were slightly

  younger than HWs (NHW mean age 34.4 years vs HW 37.3, p=0.0018). The

  groups did not differ by employment status, education, or income. Helmet

  ownership was lower among NHWs (NHW: 62.4\% vs HW: 99.4\%, p<0.0001), as

  was personal bike ownership (NHW: 65.8\%, vs HW: 78.3\%, p=0.0026). NHWs

  were less likely to always wear a helmet on personal bikes (NHW: 22.2\%

  vs HW: 66.7\%, p<0.0001), and less likely to wear a helmet always or

  most of the time on PBSP (NHW: 5.8\% vs HW: 92.3\%, p<0.0001). Both

  groups, but more HWs, had planned to use PBSP when leaving their houses

  (HW: 97.2\% vs NHW: 85.2\%, p<0.0001), primarily to get to work (HW:

  88.3\% vs NHW: 84.1\%, p=0.19). NHWs were more likely to report that

  they would wear a helmet more (NHW: 61.4\% vs HW: 13.9\%, p<0.0001),

  and/or cycle less (NHW: 22.5\% vs HW: 4.4\%) if helmet use was

  mandatory.

  Conclusions PBSP users surveyed appear to make deliberate decisions

  regarding helmet use. NHWs tended to be male, slightly younger, and less

  likely to use helmets on their personal bikes. As Toronto cyclists who

  do not wear helmets on PBSP generally do not wear helmets on their

  personal bikes, interventions to increase helmet use should target both

  personal and bike-share users. Legislating helmet use and provision of

  rental helmets could improve helmet use among bike-share users, but our

  results suggest some risk of reduced cycling with legislation.

  Resume

  Contexte Peu d''usagers des services de partage de velos portent le

  casque. Aussi les auteurs ont-ils cherche a caracteriser les habitudes

  du port du casque, les obstacles a son utilisation et les pratiques en

  matiere de securite parmi les usagers du service de partage de velos a

  Toronto.

  Methode Une enquete normalisee a ete menee parmi les usagers du

  programme public de partage de velos (PPPV), a differentes stations,

  choisies selon une repartition semi-aleatoire. Les auteurs, en

  maintenant constant le rapport de un porteur de casque (PC)/deux

  non-porteurs de casques (NPC) par periode d''enquete, ont neutralise les

  variables relatives au lieu, au jour, a l''heure et au temps (conditions

  meteorologiques).

  Resultats L''enquete a porte sur 545 (180 PC; 365 NPC) usagers

  differents, a 48/80 stations, de novembre 2012 a aout 2013. Les femmes

  (F) etaient plus nombreuses que les hommes (H) a porter le casque (F:

  41,1 \%; H: 30,9 \%; p=0,0423). Les NPC etaient un peu plus jeunes que

  les PC (NPC: 34,4 ans en moyenne contre {[}c.] PC: 37,3 ans en moyenne;

  p=0,0018). Par contre, il n''y avait pas de difference entre les groupes

  quant a la situation de l''emploi, aux etudes ou au revenu. Le fait de

  posseder son propre casque etait plus faible parmi les NPC (NPC: 62,4 \%

  c. PC: 99,4 \%; p<0,0001) que parmi les PC, tout comme le fait de

  posseder sa propre bicyclette (NPC: 65,8 \% c. PC: 78,3 \%; p=0,0026).

  Les NPC avaient moins tendance a toujours porter un casque sur leur

  bicyclette personnelle (NPC: 22,2 \% c. PC: 66,7 \%; p<0,0001) et a

  toujours ou presque toujours porter un casque sur les bicyclettes du

  PPPV (NPC: 5,8 \% c. PC: 92,3 \%; p<0,0001). Dans les deux groupes, mais

  davantage dans celui des PC, les cyclistes avaient prevu recourir au

  PPPV au depart de la maison (PC: 97,2 \% c. NPC: 85,2 \%; p<0,0001),

  surtout pour se rendre au travail (PC: 88,3 \% c. NPC: 84,1 \%; p=0,19).

  Les NPC etaient plus nombreux que les PC a indiquer qu''ils porteraient

  le casque plus souvent (NPC: 61,4 \% c. PC: 13,9 \%, p<0,0001) et/ou

  qu''ils feraient moins de bicyclette (NPC: 22,5 \% c. PC: 4,4 \%) si le

  port du casque devenait obligatoire.

  Conclusions Les usagers du PPPV ayant participe a l''enquete semblent

  avoir fait un choix delibere quant au port du casque. Les NPC etaient en

  general des hommes, un peu plus jeunes que les PC et les premiers

  avaient moins tendance que les seconds a porter un casque sur leur

  bicyclette personnelle. Comme les cyclistes qui ne portent pas de casque

  sur les bicyclettes du PPPV n''en portent generalement pas sur leur

  bicyclette personnelle a Toronto, les interventions visant a accroitre

  le port du casque devraient viser autant les proprietaires de bicyclette

  personnelle que les usagers du service de partage de velos. Toutefois,

  le fait d''imposer le port du casque et la fourniture de casques de

  location par voie legislative pourrait certes ameliorer le port du

  casque parmi les usagers du service de partage de velos, mais, d''apres

  les resultats de l''enquete, cela pourrait aussi avoir pour consequence

  de diminuer l''usage de la bicyclette.'
affiliation: 'Friedman, SM (Corresponding Author), Univ Hlth Network, Dept Emergency
  Med, RFE G S434,200 Elizabeth St, Toronto, ON M5G 2C4, Canada.

  Friedman, Steven Marc; Cleiman, Paula, Univ Hlth Network, Dept Emergency Med, RFE
  G S434,200 Elizabeth St, Toronto, ON M5G 2C4, Canada.

  Friedman, Steven Marc; Adamson, Matthew; Arenovich, Tamara, Univ Toronto, Fac Med,
  Toronto, ON, Canada.

  Oleksak, Karolina; Mohabir, Ishmael Michael, Univ Toronto, Fac Sci, Toronto, ON,
  Canada.

  Ta, Robert, Univ Dublin Trinity Coll, Sch Med, Dublin, Ireland.

  Reiter, Kimberley, Univ Ottawa, Fac Med, Ottawa, ON K1N 6N5, Canada.'
author: Friedman, Steven Marc and Adamson, Matthew and Cleiman, Paula and Arenovich,
  Tamara and Oleksak, Karolina and Mohabir, Ishmael Michael and Ta, Robert and Reiter,
  Kimberley
author-email: steven.friedman@uhn.ca
author_list:
- family: Friedman
  given: Steven Marc
- family: Adamson
  given: Matthew
- family: Cleiman
  given: Paula
- family: Arenovich
  given: Tamara
- family: Oleksak
  given: Karolina
- family: Mohabir
  given: Ishmael Michael
- family: Ta
  given: Robert
- family: Reiter
  given: Kimberley
da: '2023-09-28'
doi: 10.1017/cem.2015.22
eissn: 1481-8043
files: []
issn: 1481-8035
journal: CANADIAN JOURNAL OF EMERGENCY MEDICINE
keywords: bicycle helmets; bicycling Injuries; bike lanes; bike share
keywords-plus: BICYCLE SAFETY; LEGISLATION; PREVALENCE; VICTORIA; MONTREAL
language: English
month: JAN
number: '1'
number-of-cited-references: '42'
orcid-numbers: Ta, Robert/0000-0002-2204-1810
pages: 28-36
papis_id: 4b57fb5b7471491e11594979cfe1bf83
ref: Friedman2016helmetwearingpractic
times-cited: '12'
title: 'Helmet-Wearing Practices and Barriers in Toronto Bike-Share Users: a Case-Control
  Study'
type: Article
unique-id: WOS:000368765600004
usage-count-last-180-days: '0'
usage-count-since-2013: '28'
volume: '18'
web-of-science-categories: Emergency Medicine
year: '2016'