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Table 1 Characteristics of included studies and assessed variables for their potential correlations with helmet-wearing behavior

From: Effective factors of improved helmet use in motorcyclists: a systematic review

First author

Year of conduction

Location

Design

Sample size and characteristics

Assessed factors

Associated factors

STROBE

Ackaah [12]

2010

Tamale metropolis, Ghana

Cross-sectional (observational)

3115 drivers and 1058 passengers

Age (estimated), sex, driving status, riding location

Age (estimated), driving status, riding location

17

Merali [13]

2010–2014

Cambodia

Cross-sectional (observational)

62,039 child passengers 12 years of age and younger (apparent age)

Helmet wearing by the driver, province, day of the week, time of the day, no of passengers, no of children

Helmet wearing by the driver, province, day of the week, time of the day, no of passengers

20

Mirkazemi [14]

2008–2009

Pune city, India

Cross-sectional (questionnaire)

2259

Helmet ownership, sex, age, marital status, education, socioeconomic class, type of family, and type of residence

sex, marital status, type of family, and type of residence

19

Adnan [15]

2017

Karachi, Pakistan

Repeated cross-sectional (questionnaire)

246 and 277

Age, license possession, number of daily trips, education riding experience, history of severe crashes, the experience of a stolen helmet, marital status, monthly income, length of trips, time of the day, mean fuel consumption, enforcement campaign

Age, license possession, number of daily trips, monthly income, riding experience, history of crashes, the experience of a stolen helmet, marital status, license possession, number of daily trips, and age in the CART model

18

Aghamolaei [16]

Not mentioned

Bandar-Abbas, Iran

Cross-sectional (questionnaire)

221

TBP and HBM constitutes

Perceived behavioral control, perceived barriers, self-efficacy, and cues to action

20

Akaateba [17]

Not mentioned

Wa, Ghana

Cross-sectional (observational)

11,360 drivers and 3107 passengers

Sex, time of the day, day of the week, riding location, driving status

Sex, time of the day, time of the week, riding location, driving status

19

Akaateba [18]

2013

Wa, Ghana

Cross-sectional (observational and questionnaire)

271

Sex, age, marital status, occupation, education, license possession, helmet ownership, knowledge, attitude, and beliefs

Sex, age, marital status, occupation, attitude, and belief

19

Aidoo [19]

2017

Kumasi, Ghana

Cross-sectional (survey)

503

Sex, age, marital status, education, occupation, frequency of driving, law awareness, helmet ownership, history of crashes, license possession, riding experience, length of trips

Sex, marital status, education, helmet ownership, license possession

16

Babio [20]

1999

Spain

Cross-sectional (survey)

1029

Age, sex, education, income, marital status, community size, type of roads, occupation, social class

Age, income, community size, type of roads, education

17

Ranney [21]

2006–2008

USA

Cross-sectional (web-based survey)

445 newly licensed motorcyclists

Age sex, education, marital status, history of previous injuries, license possession, type of motorcycle, attitudes, and beliefs

Sex, education, history of previous injuries, attitudes, and beliefs

20

Bachani [22]

2010–2011

Cambodia

Cross-sectional (observational and questionnaire)

68,894 observations and 304 interviews

Time of the day, driving status, attitude, helmet ownership

Time of the day, driving status, attitude

18

Bao [23]

2011–2014

Vietnam

Cross-sectional (observational and questionnaire)

301,981 observations and 2730 interviews

KAP and reasons for using helmets

KAP and reasons for using helmets

13

Skalkidou [24]

1998

Greater Athens, Greece

Cross-sectional (questionnaire)

982 riders and 349 passengers

Sex, age, driving status, day of the week, time of the day, type of roads, type of motorcycle, riding experience, license possession, attitude

Sex, driving status, day of the week, time of the day, type of roads, type of motorcycle, attitude

15

Ghasemzadeh [25]

2014

Charoymag (rural areas), Iran

Cross-sectional (observational and questionnaire)

150

TPB, subjective norms, attitude, age, economic status, license possession, education, occupation, history of crashes, driving status

TPB, subjective norms, attitude, economic status, education, occupation, driving status

19

Wadhwaniya [26]

2011–2013

Hyderabad, India

Cross-sectional (observational and questionnaire)

4774 drivers and 97 passengers

Sex, age, education, driving status, type of motorcycle, motorcycle ownership, the purpose of the trip, helmet ownership

Sex, age, education, driving status, type of motorcycle, the purpose of the trip, helmet ownership

20

Hernández [27]

2013

Colombia

Cross-sectional (observational and questionnaire)

3980

Sex, age, climate condition, type of roads, socioeconomic status

Sex, type of roads, socioeconomic status

18

Hung [28]

2005–2006

Hai Duong Province, Vietnam

Cross-sectional (questionnaire)

716 drivers and 92 passengers

Sex, age, education, income, driving status, type of roads, type of motorcycle, type of residence, driving frequency, driving experience, driving distance, license possession, occupation, alcohol consumption, attitudes

Age, education, income, driving status, type of roads, driving distance, attitudes

20

Jiwattanakulpaisarn [29]

2009

Thailand

Cross-sectional (questionnaire)

2429 drivers and 1328 passengers

Sex, age, driving frequency, attitudes

Sex, age, driving frequency, attitudes

15

Khan [30]

Not mentioned

Karachi, Pakistan

Cross-sectional (questionnaire)

300 male drivers

Age, education, marital status, knowledge about enforcement laws

Education

18

Kumphong [31]

Not mentioned

Khon Kaen, Thailand

Cross-sectional (observational)

27,977 drivers and 6,947 passengers

Age (apparent age), sex, driving status, type of motorcycle, time of the day, day of the week, no of passengers, presence of police, red-light running behavior

Age (apparent age), sex, driving status, type of motorcycle, time of the day, day of the week, no of passengers, presence of police, red-light running behavior

17

Sreedharan [2]

2007

Kerala state, India

Cross-sectional (questionnaire)

309

Sex, age, education, marital status, religion, alcohol consumption, attitudes

Sex, age, marital status, alcohol consumption, attitudes

17

Shults [32]

2011

USA

Cross-sectional (survey and interview)

211 youths (aged 12–17 years)

Sex, driving frequency, location of residence

Driving frequency

19

Xuequn [33]

2009

Zhongshan, Guangdong Province, China

Cross-sectional (observational)

13,410 drivers and 4498 passengers

Sex, driving status, type of roads, no of passengers, the registration status of motorcycle, time of the day, day of the week, climate condition

Sex, driving status, type of roads, no of passengers, the registration status of motorcycle, climate conditions (only for passengers)

19

Ledesma [34]

2006

Mar del Plata, Argentina

Cross-sectional (observational)

451

Sex, type of motorcycle, climate condition, type of roads, time of the day

Sex, type of motorcycle, climate condition, type of roads

17

Ledesma [35]

2012

Mar del Plata, Argentina

Cross-sectional (observational)

2542 drivers and 664 passengers

Sex, driving status, type of motorcycle, climate condition, time of the day, day of the week, the registration status of the motorcycle, season

Sex, driving status, type of motorcycle, climate condition, time of the day, day of the week, the registration status of the motorcycle

18

Saeed [36]

Not mentioned

Karachi, Pakistan

Cross-sectional (survey)

400 female passengers

Education, opinions on helmet laws

Education

19

Roehler [37]

2011

Cambodia

Cross-sectional (questionnaire)

510 drivers, 410 passengers, and 99 proxied child passengers

Sex, driving status, reasons for using the helmet

Driving status

18

Grummon [38]

2010

Ohio, USA

Cross-sectional (questionnaire)

248 youth aged 9–15 years

Age, risky behavior, the parental reminder of helmet wearing, parental supervision, and perceived severity

The parental reminder of helmet-wearing, parental supervision, and perceived severity

20

Li [39]

2005

Shantou and Chaozhou, China

Cross-sectional (observational and questionnaire)

2325 interviews

Type of roads, time of the day, day of the week, KAP

Type of roads, time of the day, day of the week, KAP

17

Trejo [40]

2009

Mexico

Cross-sectional (observational)

26,046 drivers and 3971 passengers

Diving status, no of passengers, purpose of the trip, time of the day, day of the week, socioeconomic status of municipalities

Diving status, no of passengers, purpose of riding, socioeconomic status of municipalities

19

Grimm [41]

2011

Delhi, India

Two-stage cross-sectional (questionnaire)

1502

Age, sex, marital status, education, religion, helmet ownership, no of children, type of roads, type of motorcycle, history of crashes, length of trips, insurance possession

sex, education, religion, no of children, insurance possession, length of trips

15

Siviroj [5]

2007

Thailand

Cross-sectional (questionnaire)

18,998

Age, sex, engine size, time of the day, history of crashes, type of roads

Age, time of the day, history of crashes, type of roads

17

Kulanthayan [42]

1998

Kajang, Malaysia

Cross-sectional (observational and questionnaire)

500 (comparison between helmeted and non-helmeted or inappropriate helmeted riders

Age, sex, educational level, driving location, the length of the trips, driving experience

Age, sex, driving location, the length of the trips

20

Conrad [43]

1989

Indonesia

Cross-sectional (observational and questionnaire)

9242 drivers and 3541 passengers; 150 interviews

Sex, driving status, time of the day

Driving status, time of the day

19

Papadakaki [44]

Not mentioned

Greece

Cross-sectional (questionnaire)

405

Age, sex, education, time of the day, alcohol consumption, the purpose of the trip, history of crashes, attitudes, season

Sex, education, time of the day, alcohol consumption, the purpose of the trip, history of crashes, attitudes

20

Dandona [45]

2009

Hyderabad, India

Cross-sectional (questionnaire)

4183 drivers

Age, sex, education, type of motorcycle, motorcycle ownership, reasons for using helmets

Age, sex, education, type of motorcycle, motorcycle ownership, reasons for using helmets

16

Gkritza [46]

2000–2006

Iowa, USA

Cross-sectional (observational)

27,521

Climate conditions, type of roads, time of the day, month of the year, helmet sage by passenger/driver

Climate conditions, type of roads, time of the day, month of the year, helmet sage by passenger/driver

19

Zamani-Alavijeh [47]

2008–2009

Tehran, Iran

Cross-sectional (observational and questionnaire)

6010 drivers, 2215 passengers, and 31 (in-depth interviews)

Driving status, season, reasons for helmet use, history of crashes

-

15

Pileggi [48]

2004

Catanzaro, Italy

Cross-sectional (questionnaire)

898 youths (14–20 years of age)

Sex, alcohol consumption, a close friend who always uses helmets, driving status, history of crashes, performing sports activities, or riding over the speed limits

Sex, alcohol consumption, a close friend who always uses helmets, driving status

19

Jomnonkwao [49]

Not mentioned

Thailand

Cross-sectional (questionnaire)

401 urban and 400 rural drivers

Constitutes of HBM

Health motivation (i.e., importance of health; for urban areas), perceived severity (mortalities of not-wearing helmets), cue to action (advertisements), and perceived benefits (feeling safe; for rural areas)

21

Devagappanavar [50]

2017

Bangalore, India

Cross-sectional (observational)

1471 drivers and 920 passengers

Sex, driving status, driving location, time of the day, day of the week

Driving status, driving location, day of the week

11

Satiennam [51]

2012–2016

Khon Kaen Province, Thailand

Cross-sectional (observational, using an automatic helmet-use detection system)

42,821 drivers and 6,307 passengers

Age, driving status, number of passengers, time of the day, day of the week, type of motorcycle

Age (adults > children), driving status, number of passengers, time of the day, day of the week, type of motorcycle

18

Olewinski [52]

Not mentioned

USA

Cross-sectional (questionnaire)

125 athletes (scooter or moped drivers)

Reasons for helmet usage

The coach’s mandate has been the strongest predictor of helmet usage

19

Siebert [53]

2018

Nepal

Cross-sectional (observational and questionnaire)

1885 drivers and 663 passengers (observations); and 183 drivers and 36 passengers (interview)

Driving status, attitudes regarding fatalism, risk-personality, and helmet usefulness

Driving status, believing in fate as the cause of accidents, and presenting themselves as risk-taking persons have been higher among non-helmeted riders

20

Fletcher [54]

2016–2018

Jamaica

Cross-sectional (questionnaire)

155 hospital-admitted riders (139 drivers and 14 passengers)

Age, driving status, occupation status, type of motorcycle, license possession, insurance possession, riding training course

Age, driving status (only bivariate), type of motorcycle, license possession (only bivariate), insurance possession (only bivariate), riding training course

16

Fathollahi [55]

2016

Iran

Cross-sectional (questionnaire)

30,548

Age, sex, education, income, marital status, type of residence, alcohol consumption

Age, sex, education, income, marital status, type of residence (urban > rural)

18

Sankaran [56]

2015 and 2016

Mumbai, India

Cross-sectional (observational)

28,209 and 37,245

Age, sex, time of the day, day of the week, presence of passengers

Age, sex, time of the day, day of the week, presence of passengers

16

Merali [57]

2011–2016

Bangkok, Thailand

Cross-sectional (observational)

462 drivers

Type of roads, motorcycle use as taxi or non-taxi

Motorcycle use as taxi > non-taxi, type of roads (non-residential > residential)

19

Adewoye [58]

Not mentioned

Nigeria

Cross-sectional (questionnaire)

306 commercial drivers

Age, education, marital status, religion, the reason for using helmets

Age, education, marital status

20

Babazadeh [59]

2014–2016

Charuymaq, Iran

Cross-sectional (questionnaire)

150 rural drivers

Age, education, income, occupation, license possession, history of crashes, history of police fines

Education, income, history of police fines

18

  1. STROBE Strengthening the Reporting of Observational Studies in Epidemiology, No number, TPB theory of planned behavior, HBM health belief model, KAP knowledge, attitude, and practice