1. A municipal helmet policy for children is associated with increased helmet use Jacqueline Willmore, MPH Epidemiologist May 27, 2014

2. 2 Overview Background Objectives Methods Results Conclusions Implications

3. 3 Background Feasibility study 2009-2010 Children <10 have the highest rate of head injuries related to ice skating Only 6% of children were wearing a helmet when head injury occurred Helmet policies are effective 80% of children and 96% of parents of children said they would still participate

4. 4 January 2012 “…all customers aged 10 and under, as well as all weak or non-skaters of any age to wear a multi-impact CSA approved helmet during City of Ottawa public skating session.”

5. 5 Media launch with Mayor New policy signs in arenas Rink board banners Helmet discount coupons Training for staff Ongoing initiatives

6. 6 Objective Evaluate effects of the new helmet policy on: Helmet use Public skating attendance Attitudes toward helmet use

7. 7 Methods Pre- (2011) vs. post-policy (2013) design Observations of helmet use in 10 arenas Age group Sex Type of helmet Electronic attendance from 10 arenas Intercept surveys at 10 arenas

8. 8 Results Observations: Pre: 550 skaters at 10 arenas Post: 470 skaters at 11 arenas

9. 9 Skaters wearing a helmet by age group, 2011 vs. 2013 p<0.05

10. 10 Increases in both sexes p<0.05

11. 11 Appropriate type of helmet improved p<0.05

12. 12 Attendance did not change

13. 13 Conclusions A municipal helmet policy for children attending indoor recreational skating is associated with increased, appropriate helmet use

14. 14 Implications Indoor skating helmet policies are a feasible component of a comprehensive approach to injury prevention Opportunity for collaboration between public health, parks and recreation and others Continue normalization of helmets

15. 15 References 1. National Ambulatory Care Reporting System, ER Visits 2004-2008. Ontario Ministry of Health and Long-Term Care Provincial Health Planning Database, 2010. Available from: http://ophid.scholarsportal.info/details/view.html?q=bill&uri=/phirn/phpd b_PHIRN_e.xml (Accessed July 2010). http://ophid.scholarsportal.info/details/view.html?q=bill&uri=/phirn/phpd b_PHIRN_e.xml 2. Hospital Inpatient Data 2004-2008. Ontario Ministry of Health and Long- Term Care, 2010. Available from: https://www.intellihealth.moh.gov.on.ca/SASPortal/mainUnchallenged. do?unchallenged=yes (Accessed July 2010). https://www.intellihealth.moh.gov.on.ca/SASPortal/mainUnchallenged. do?unchallenged=yes 3. Canadian Hospitals Injury Reporting and Prevention Program database 2002-2007. CHEO. Public Health Agency of Ottawa, 2013. Available from: http://www.phac-aspc.gc.ca/injury-bles/chirpp/index-eng.php (Accessed July 2009).http://www.phac-aspc.gc.ca/injury-bles/chirpp/index-eng.php 4. Karkhaneh M, Kalenga JC, Hagel BE, Rowe BH. Effectiveness of bicycle helmet legislation to increase helmet use: a systematic review. Inj Prev. 2006 Apr; 12(2): 76-82. 5. Policy for Mandatory Helmet Use During Public Skates. Parks, Recreation and Cultural Services Department. City of Ottawa 2011. Available from: http://ottawa.ca/en/residents/parks-and- recreation/drop-activities/public-skating-descriptions (Accessed February 27, 2014).http://ottawa.ca/en/residents/parks-and- recreation/drop-activities/public-skating-descriptions

16. 16 Acknowledgements Colleen O’Mahony-Menton, Ottawa Public Health Staff from Parks, Recreation & Cultural Services Dr. Michael Vassilyadi, University of Ottawa, Children’s Hospital of Eastern Ontario, and ThinkFirst

17. 17 Thank you! Jacqueline.Willmore@ottawa.ca Questions?