Rural Adolescent Attitudes and Use of Helmets While Riding ATVs, Motorcycles and Dirt Bikes

Sehansa Karunatilaka
Brianna Iverson, BS
Devin Spolsdoff, MS
Pam Hoogerwerf, BA
Kristel Wetjen, RN, MSN
Shannon Landers, BS
Charles Jennissen, MD

All-terrain vehicles (ATVs) are work and recreational vehicles common in rural areas and mishaps associated with them frequently cause death and serious injury. Head injuries are the most common cause of death in ATV-related events, and helmet use can significantly decrease the risk. Our objective was to determine rural adolescents’ attitudes regarding helmets while riding ATVs, motorcycles and dirt bikes, the frequency of helmet use on these vehicles, and how demographic factors may be associated.

A convenience sample of attendees of the 2022 Iowa FFA (formerly Future Farmers of America) Leadership Conference completed an anonymous survey at the University of Iowa Stead Family Children’s Hospital injury prevention booth. After compilation, data were imported into Stata 15.1 (StataCorp, College Station, TX). Descriptive and statistical analyses including bivariate (Chi-square, Fisher’s exact test) were performed.

A convenience sample of 1,331 adolescents between 13-18 years old participated in the study. One half lived on a farm, 21% lived in the country but not on a farm and 28% were from towns. Nearly two-thirds (65%) of subjects owned an ATV with 77% of all having ridden an ATV in the past year. Farm residents had the highest ATV ownership (78%) and having ridden (80%) proportions, both p<0.001. Overall, ownership and ridership for motorcycles (22% and 30%, respectively) and dirt bikes (29% and 39%, respectively) was significantly less than ATVs, all p<0.001. Of ATV riders, those living on farms or in the country but not on a farm rode them more frequently than those from towns, p<0.001. Higher percentages always/almost always wore helmets while riding dirt bikes (51%) and motorcycles (57%) than ATVs (21%), p<0.0001. Those from farms had significantly lower proportions wearing helmets as compared to those living elsewhere for all vehicles. Helmet use importance ratings (from 1-10, 10 high) were not different for motorcycles (mean 8.59) and dirt bikes (mean 8.30), but much lower for ATVs (mean 6.13). Females, non-owners, less frequent riders, and those supporting helmet laws all had higher helmet use importance ratings. Males, older adolescents, those from farms, and owners of the vehicle had lower proportions that supported helmet laws for ATVs, motorcycles and dirt bikes. Support for helmet laws was significantly lower for ATVs (30.7%) than dirt bikes (56.3%) or motorcycles (72.3%), both p<0.001.

ATV ownership and use by rural adolescents in the study was extremely common, especially those from farms. Study adolescents rated wearing a helmet while riding motorcycles and dirt bikes as being very important but much lower for ATVs. Farm youth had lower proportions wearing helmets for all vehicles and less support for laws mandating helmet use. Our study indicates that the safety culture surrounding helmet use is poor among rural adolescents and deserves targeted interventions. Increased helmet use would likely decrease the number of deaths and serious injuries associated with these motorized vehicles.

1. List at least three youth demographic factors associated with higher proportions having ridden ATVs, motorcycles and dirt bikes.
2. Describe rural youth’s attitudes related to helmet use and how it differs among motorized vehicles.
3. State which rural adolescents might be at greater risk for lack of helmet use on motorized vehicles including ATVs.