Helmet use among cyclists and motorcyclists involved in media-reported road traffic crashes after implementation of the national 'One Helmet, One Belt' campaign in China.

BACKGROUND

China implemented the 'One Helmet, One Belt' road safety campaign in April 2020 to improve helmet use among cyclists and motorcyclists. We evaluated its long-term effect.

METHODS

We analysed crash data from 379 media sources that reported at least one road traffic crash per quarter between January 2019 and September 2024, as indexed by the Automated Road Traffic Crash Data Platform. The proportion of media-reported crashes involving helmeted motorcyclists and cyclists was compared before and after implementation of the national campaign. We calculated adjusted (aORs) using logistic regression, controlling for season and the COVID-19 pandemic period and fitted Joinpoint regression models to identify periods with significant changes.

RESULTS

Among 20 546 media-reported crashes involving motorcyclists and cyclists, the overall proportion of riders wearing helmets increased significantly following the campaign's implementation (aOR: 2.37; 95% CI: 2.08 to 2.72). However, this increase emerged only in the first 8 months of the campaign (April-December 2020), after which proportions plateaued. Subgroup analyses detected distinct temporal patterns for motorcyclists (an initial increase followed by decline), professional delivery riders (no significant trends) and publicly shared vehicle riders (consistently increasing trends).

CONCLUSIONS

Our study documents an initial increase followed by stabilisation in proportion of media-reported crashes involving helmeted motorcyclists and cyclists following the national injury prevention campaign. The intervention's effectiveness varied across rider subgroups. These findings underscore the importance of sustaining and enhancing the national campaign while developing targeted interventions for distinct user groups in China, also suggesting similar initiatives might be effective in other international contexts.