The effect of motorcycle safety campaign on helmet use: A systematic review and meta-analysis

Maryam Akbari, Kamran B. Lankarani, Reza Tabrizi, Mohebat Vali, Seyed Taghi Heydari, Seyed Abbas Motevalian, Mark J.M. Sullman

Research output: Contribution to journalReview articlepeer-review


Objective: This systematic review and meta-analysis was undertaken to estimate the effectiveness of motorcycle safety campaigns for increasing helmet use among motorcycle riders and passengers. Methods: PubMed, Scopus, EMBASE, and the Web of Science (WOS) databases were systematically searched up June 2020 for all relevant studies. The National Institute of Health (NIH) tool was used to assess the quality of all included studies. Inter-study heterogeneity was measured using the Chi-Squared and I2 statistics, with the odds ratio (OR) being used as a measure of the pooled effect size. Results: Out of the 561 records identified from the literature searches, eight articles (or 11 studies) were eligible for inclusion in the present meta-analysis. Using a random effects model, the results of the meta-analysis demonstrated statistically significant increases in helmet use among motorcycle riders (OR = 4.52, 95% CI: 1.01–20.14, I2 = 99.9%) and passengers (OR = 6.57, 95% CI: 1.41–30.56, I2 = 99.9%). The findings of sensitivity analyses, based on alternative levels of r for imputing the standard error (SE) of the ORs, showed the pooled OR of helmet use among motorcycle riders (r = 0.7; 3.49; 95% CI: 0.78, 16.44; r = 0.9; 3.49; 95% CI: 0.76, 16.11) was sensitive to different levels of r. However, no significant effect was detected on the pooled effect size for different correlation coefficients for motorcycle passengers (r = 0.7; 6.56; 95% CI: 1.59, 27.00; r = 0.9; 6.56; 95% CI: 2.25, 19.13). Increases in helmet use among motorcycle passengers were found in studies that: monitored pre and post campaign periods for longer than one year and were conducted in Thailand or Vietnam. However, the effect of motorcycle safety campaigns on helmet use among motorcycle riders remained significant for all of the different strata included. Conclusion: The present meta-analysis found that motorcycle safety campaigns can lead to a significant increase in helmet use among both motorcycle riders and passengers. Due to the high degree of inter study heterogeneity, these findings should be interpreted with some caution. Despite the apparent favourable influence of motorcycle safety campaigns, more robust research is required.

Original languageEnglish
JournalIATSS Research
Publication statusAccepted/In press - 2021


  • Helmet use
  • Meta-analysis
  • Motorcycle safety campaign


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