Preventing bicycle-related head trauma in children.

Although the majority of bicycle-related injuries and deaths could be prevented by the use of bicycle helmets, rates of helmet use in the United States remain well below Healthy People 2000's goal of 50% usage. Educational efforts to improve usage rates often fail to produce significant changes, in part because a child's understanding of risk plays only a small role in his or her decision to wear a helmet. To address the need for more effective injury prevention techniques, the authors propose a modification of the Health Belief Model, which is used by injury control experts to explain the various cognitive, social, and environmental factors that influence preventative health behavior. By incorporating the behavioral theory of self-efficacy in the structure of the Health Belief Model, trauma care providers and injury prevention specialists will be better able to design successful injury prevention programs that address key variables in health-related decision making.