Vol.:(0123456789) 1 3 Journal of Community Health https://doi.org/10.1007/s10900-019-00663-4 ORIGINAL PAPER The Role of a Community‑Based Intervention in Promoting Helmet Use in a Non‑probability Sample of Rural Motorcyclists in Iran Towhid Babazadeh 1  · Kamiar Kouzekanani 2  · Sadegh Ghasemzadeh 3  · Hossein Matlabi 4  · Hamid Allahverdipour 5 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Although the use of helmets is known to prevent the majority of mortalities by head injuries, it is ignored by a large number of motorcyclists. The present study was conducted to promote helmet use in an attempt to reduce injuries among motorcyclists in a rural area by adopting a community-based participation approach. The one-group pretest–posttest pre-experimental design was conducted in northwest Iran. The study was conducted in three phases: (1) baseline measurement, (2) implementation of the intervention, and (3) assessment of the outcomes. The intervention included the distribution of learning tools, education of various community groups, tightening of driving laws for ofending motorcyclists, promotional programs at community level, and utilizing all opportunities to discuss the benefts of helmets. Due to the non-experimental nature of the study, no causal inferences were drawn. After the intervention, the percentage of the awareness of the benefts of helmet use was increased by 28%, positive attitudes towards benefts of helmet use was increased by 32.6%, and supporting helmet use was increased by 58.6%. Moreover, helmet sale and use increased by 147.0% and 32.0%, respectively. Additionally, motorcycle accidents, head injuries, and mortalities were decreased by 71.8, 55.5, and 60.0%, respectively. Community-based participa- tion approach may positively infuence health promoting behaviors and motorcyclists’ decisions to wear helmet in rural areas. Keywords Helmet · Interventional study · Community-based participation · Motorcyclists Background Injuries caused by road accidents have not only increased mortality and disability, but also become a great challenge in public health, particularly in the developing countries, by imposing heavy economical-social costs on individu- als, families, society, and public health services [1–3]. In road accidents, deaths caused by motorcycle accidents have turned into an alarming issue in some countries like Malaysia (58%) and Thailand (90%) [4–8]. Furthermore, the highest accident-related mortality rate pertains to the motorcyclists [1, 4], with head and neck injuries being the primary cause [9, 10]. Helmets can reduce severity of head injuries up to 70%, and death risk of the motorcyclists by 40% [1, 4, 9]. A study by Dongo et al. [11] indicated that not wearing helmets contributed to 6.3% of the deaths among motorcyclists [11]. Published research shows that helmet use by motorcy- clists is afected by several factors. Considering it unneces- sary when riding short distances, feeling of heat and discom- fort, spoiled hairstyle, disturbed sight and hearing [12–15], high costs, lack of appropriate information [16], lack of * Hamid Allahverdipour allahverdipourh@tbzmed.ac.ir Towhid Babazadeh Towhid.babazadeh@gmail.com Kamiar Kouzekanani kamiar.kouzekanani@tamucc.edu Sadegh Ghasemzadeh sghasemzade@yahoo.com Hossein Matlabi hm1349@gmail.com 1 Department of Public Health, Sarab Faculty of Medical Sciences, Sarab, Iran 2 College of Education & Human Development, TAMUCC, 6300 Ocean Dr., Unit 5818, FC 223, Corpus Christi, TX 78412-5818, USA 3 Department of Health Education & Promotion, Tabriz University of Medical Sciences, 14711 Tabriz, Iran 4 Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran 5 Research Center of Psychiatry and Behavioral Sciences, Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran