Influence of adult role modeling on child/adolescent helmet use in recreational sledging: an observational study.

Background: During recreational sledging (tobogganing), the head represents the most frequent injured body region with approximately one-third of all sledging injuries among children and adolescents. Whether children are wearing a helmet or not might be influenced on parental encouragement and role modeling of helmet use. Therefore, the aim of this study was to evaluate the impact of adult helmet use on child/adolescent helmet use in recreational sledging.

Methods: More than 500 adults sitting together with another adult or child/adolescent on a two-seater sledge were interviewed during two winter seasons at the bottom of six sledging tracks on demographics, mean frequency of sledging per season, self-estimated skill level, risk-taking behavior, and the use of a helmet.

Results: Total helmet use of all observed persons was 41.0 %. Helmet use among interviewed adults significantly increased with increasing age up to 45 years, frequency of sledging, and skill level, respectively. Helmet use of interviewed adults was 46.5 % if a child/adolescent was sitting on the same sledge and 29.8 % (odds ratios (OR): 2.1, 95 % confidence intervals (CI): 1.4-2.9, p < 0.001) when sledging together with another adult. Helmet use was 71.3 % among children/adolescents and 26.7 % among adults (OR: 6.8, 95 % CI: 4.6-10.1, p < 0.001) sitting on the same sledge as the interviewed person, respectively.

Conclusion: Adults were wearing more often a helmet during recreational sledging when sitting together with a child/adolescent on the sledge. However, helmet use during sledging is clearly below 50 %. Thus, more intense educational campaigns on helmet use are urgently needed for tobogganists.