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The effect of the 100% Motorcycle Helmet Use campaign on motorcyclist head injuries in Thailand
ABSTRACT ONLY: In 2011, the Thai government introduced the 100% Motorcycle Helmet Use campaign in an effort to increase helmet wearing among motorcyclists. A nationwide mass media campaign (television, radio, internet, and social media) provided information on the advantages of helmet wearing, disadvantages of non-helmet wearing, instructions for proper helmet usage and choosing a good quality helmet. The aim of this study was to assess the impact of this campaign on motorcycle head injury. Motorcycle injury data was extracted from twenty-seven hospitals that voluntarily participate in the Thai Injury Surveillance (IS) system for years 2009-2012 and helmet use estimates were taken from roadside surveys. Helmet use among motorcyclists changed very little with the onset of the helmet use campaign; however, motorcyclists wearing helmets were associated with a 52% reduction in the odds of a head injury (OR=0.48, 95% CI: 0.47-0.49). The immediate impact of the campaign on head injury rates was assessed for each hospital using an interrupted time series generalized linear autoregressive moving average (GLARMA) model. The results from each hospital were synthesized using a meta-analytic approach. We estimated no significant reduction in motorcycle head injuries (IRR=0.99, 95% CI: 0.92-1.06) following the onset of the helmet use campaign; however, the results by hospital were highly heterogeneous (I^2=65%). There is little evidence to suggest the helmet use campaign had any causal impact on motorcycle-related head injury during this period, although helmet use was associated with a significant reduction in head injury.