Cross Fertilising ‘Injury Prevention’ journal (IP) and BJSM                           

Protective sports equipment can prevent serious injury (McIntosh et al, BJSM, 2011). Why then doesn’t everyone use it?

Behaviour change theory tells us that, first, attitudes need to be right. But if people do not support protective equipment they will not use it.

A paper by Ruedl et al in the June 2012, Volume 18 (3) issue of Injury Prevention has categorized differences in why some people do and do not wear ski helmets. What differentiated the two groups most was a “subjective disadvantage” attitude in which users had much more positive opinions about helmet design factors such as their stylishness, ability to keep the head warm, non-restriction of vision, non-effect on hairstyles, cost and weight. In contrast, there was a negative association between helmet use and “safety awareness” attitudes, with the more safety conscious skiers being more likely to wear helmets.

As I read this paper, I was struck by the similarity of these ski helmet findings to those we found for protective eye-wear use in squash a decade ago (Eime et al, Sports Medicine, 2004). An additional observation from our work was that the non-users who were so critical of the design and wearability features of protective eye wear were also those who were more likely to have never tried it.  So preconceived opinions about protective equipment are a barrier to even trying it in the first place. By framing the issue within the socio-ecological framework for behavior change, we were able to successfully design and implement a promotion campaign aimed at addressing this particular belief, as well as others (Eime et al, BJSM, 2005).

Many sports have challenges towards maximising protective equipment use, especially (but not exclusively) when they do not introduce regulation mandating it.  We’d like more people to use it but that means convincing those with negative attitudes about it to change their behaviours.  In other words, we need to improve how we market protective equipment to those most likely to benefit from its use.

We argued in a very recent BJSM editorial, the way forward must be for injury prevention experts to learn from our social marketing colleagues (Newton et al, BJSM, 2012).  Imagine the power of a truly viral safety campaign that leads to demonstrably higher rates of appropriate protective equipment. What a dint that would make on injury rates!

**************************************************************************

Caroline Finch is an injury prevention researcher from the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP) within the Monash Injury Research Centre, Monash University, Australia.  She specializes in both injury surveillance and implementation and dissemination science applications for sports injury prevention.  She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group.  Caroline can be followed on Twitter @CarolineFinch