Exploring the barriers and facilitators of helmet use among motorcyclists: A qualitative study

Road traffic injuries (RTIs) have been identified as a major public health problem worldwide. Motorcyclists are one of the most vulnerable groups in terms of injuries and fatalities in road traffic crashes. Not using a helmet and head and neck injuries are the main causes of death and disability among them. This study explores barriers and facilitators of helmet use among motorcyclists.

A qualitative approach to conventional content analysis was employed in this research. The purposive sampling method, with maximum diversity, was used to select participants among motorcyclists and traffic police officers in Qom City, Iran. To collect data and reach data saturation, 41 face-to-face semistructured interviews with 29 motorcyclists and 12 traffic police officers were conducted using the interview guide.

The mean and standard deviation of age were 32.6 ± 8.6 for the motorcyclist group and 34 ± 7.9 for the police group. Through qualitative data analysis, the codes were extracted from the collected data and categorized into 2 categories including barriers and facilitators. In the category of barriers 5 subcategories were identified including nonadherence to the helmet law, unpleasant feeling, psychological characteristics, economic factors, and helmet quality. In the category of facilitators, 3 subcategories were identified including education and information campaigns, encouragement and increase motivation, and policymaking and legislative measures.

Police supervision and law enforcement can be effective in improving the behavior of helmet use. Also, to create and increase the motorcyclists' motivation to use helmets, economic and cultural incentives and social participation can be used to facilitate acceptance of the law regarding helmet use. Furthermore, quality improvement of helmets to remove barriers and physical problems such as heat, visual and auditory restrictions, head movement restrictions, and weight can be very useful. The findings of this study can help to develop more appropriate and context-based interventions to increase helmet use and therefore to prevent RTIs in the community.