Motorcycle helmet attitudes, behaviours and beliefs among Cambodians

Roehler, Douglas R.; Sann, Socheata; Kim, Pagna; Bachani, Abdulgafoor M.; Campostrini, Stefano; Florian, M; Sidik, Mirjam; Blanchard, Claire; Sleet, David A.; Hyder, Adnan A.; Ballesteros, Michael F. · 2013 · OpenAlex-citations

DOI: 10.1080/17457300.2012.759594

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Summary

This study addresses the rising burden of motorcycle-related fatalities in Cambodia, a low- and middle-income country where road traffic injuries constitute a major health epidemic. Despite the proven protective benefits of helmets, usage rates remain low, particularly among passengers. The research aimed to identify specific barriers, motivators, and communication channels regarding helmet use among drivers, older passengers, and child passengers to inform targeted safety interventions. The researchers conducted brief, face-to-face roadside interviews in 2011 across Phnom Penh and four other provinces. The sample included 1,016 participants: 510 drivers, 410 older passengers (aged 16+), and 99 proxied child passengers (under 16). Drivers and older passengers were interviewed directly, while drivers served as proxies for children. Data collection focused on demographics, self-reported helmet ownership and usage frequency, perceived barriers and motivators, and sources of road safety information. Statistical analysis compared regular versus irregular helmet wearers to identify significant differences in attitudes and behaviors. The findings revealed a significant disparity in helmet usage: 50% of drivers reported consistent helmet use, compared to only 14% of older passengers and 6% of child passengers. While helmet ownership was high among drivers (95%) and older passengers (79%), it was significantly lower for children (57%). The primary motivator for wearing a helmet was life-saving protection in crashes, cited by 96% of drivers and 98% of older passengers. However, irregular wearers identified key barriers: situational dependence ("depends on where I drive"), forgetfulness, and discomfort. Notably, nearly one-third of drivers with child passengers believed children were "too young" to require helmets. Regarding communication, television was the dominant source of safety information, but irregular wearers, particularly older passengers, were significantly more influenced by family opinions than regular wearers. These results highlight critical gaps in Cambodia’s road safety landscape, specifically the lack of legislative enforcement for passenger helmet use and misconceptions regarding child safety. The study concludes that cost is not a primary barrier, as ownership is high, but behavioral and cultural factors are. Consequently, the findings directly shaped the Cambodian Helmet Vaccine Initiative, leading to a passenger-focused campaign utilizing television advertisements with strong family undertones to influence irregular wearers. Additionally, the data supported the expansion of school-based programs to address the low helmet usage among children, aiming to reduce the disproportionate mortality rate among young motorcyclists.

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