Attitudes toward Helmet Use Study

Thank you to everyone who helped out with the study!

Statelinetack has GREAT helmet deals today!!
So do Riding Warehouse and Schneiders!

Table of Contents

The sample (thank you!)
Sponsors
Some background
Details of who completed the research

• Professional or amateur status
• Experience with traumatic brain injury

Experimental Design

• Method
• Random Assignment (Stimuli and outcomes)

Results
More details
Just for fun
Poll: Do you use a helmet?

Thank you

First, I’d like to thank everyone who participated in this research, especially those who fully completed one or both of the Attitudes toward Helmet Use surveys. I appreciate each and every response. I’d like to give a special shout out to the endurance community: 507, or 37% of the participants who completed at least the initial section of Part 1, accessed the survey from a page or group dedicated to endurance. The groups included Facebook pages of the American Endurance Ride Conference, North America Endurance Green Beans, and several others.

Another large portion of the sample came from groups dedicated to trail riding or packing, such as Back Country Horsemen of America and Equine Trail Sports. 235 or 17% of the sample came from such sites.

I targeted endurance and trail riders, because wearing a helmet is neither frowned upon (as it may be in some Western-style sports) nor obligatory (as it is in many English-style disciplines). However, nearly half of the sample came from other sources.

Participants of the Chronicle of the Horse forum alone provided 186 responses, or 14%.

Other groups that helped out include Cowboy Dressage, breed pages (Morgans and Arabians), Your Western Horse Life, and World Wide Equine Chat.

Sponsors

I’d also like to thank everyone who donated items for the two end-of-survey drawings:
Trauma Void donated three helmets.
Riding Warehouse and Trafalgar Square Books donated gift certificates.
Debbie and Eitan Beth-Halachmy donated Cowboy Dressage books.

Thank you everyone!

Some background

I cannot report all the results of this study here, first because I haven’t done all the analyses, and second because the outcome of the experimental study will be submitted for publication in an academic journal. But I can share the purpose of the study, and some preliminary results, particularly the demographics of the sample, some descriptive statistics, and initial correlational findings. I will also tell you something about the method and stimuli.

The purpose of this research was two-fold. 

First, I explored the characteristics of those who use/do not use helmets when riding horses, including individual differences in personality and potentially related variables such as agency and socially desirable response bias. 

Of course, I expected the biggest determinant of helmet use to be discipline: most English-style disciplines and competitive sports, such as horse racing, require the use of helmets, at least in competition. Most Western-style disciplines, such as barrel racing and cutting, not only do not require helmets, but may frown upon them. The results of this study confirm what horse people already know in this regard. Of most interest to me was helmet use amongst those who trail ride and/or do endurance, where helmets are optional (if increasingly encouraged in endurance).

I measured overall attitudes towards helmets with a questionnaire presented after the questions about horse experience but before anything else. Participants indicated their (dis)agreement with 12 questions such as:

I was also interested in the effect of prior experience with traumatic brain injury (TBI): would people who had suffered a TBI, or known someone who had, be more likely to use a helmet? Would this possible effect depend on discipline? (Answers below! Keep reading for details on the experiment itself)

Sample details and correlational results

Who took the survey?

1,371 people (after discarding minors) completed at least the initial part of the survey (horse experience and attitudes towards helmets questionnaire); 1,194 finished the entire first study. 637 (53.4%) had either suffered a traumatic brain injury while riding a horse, or knew someone well who had.

Most participants were female (93%, mean age = 46.27, between 18-84 years old after discarding the minors).

Almost everyone (90%) currently owned a horse. More people said their main style of riding was primarily English (38%), followed by Western (32%), both (24%), and neither/no answer (6%).
See the Table below for primary and secondary disciplines.

Although the majority reported wearing a helmet all the time (69%), only 35% believe there should be laws or rules that require all people to wear helmets when riding.

Professional or amateur status?

Most respondents were not professionals, and amateurs were most likely to believe there should be rules (see Table below).

Whether or not people were usually required to wear helmets did make a difference in their support for laws/rules. This could be because places that require helmet use tend to be racetracks and jumping stables (where injury is more likely and tradition includes helmets).
It may also be that once people are accustomed to rules, they are less likely to object to them.

Experience with traumatic brain injury

Having suffered, or known someone who has suffered, a traumatic brain injury (TBI) was not related to support for rules regarding helmet use (χ² (df = 1) = 0.91, p = .340; 35.8% of sufferers believed there should be rules and 33.2% of nonsufferers did), but it did make people more likely to choose to wear a helmet all the time (see table below).

However, this was only true for Western-style riders. When you look at experience with TBI and current helmet use by main style, it doesn’t make any difference for those who chose English, Both, or Neither, but it did for Western riders (χ² (df = 4) = 14.79, p = .005 ). See Figure below.

Having experience with TBI also made a difference when it came to attitudes toward helmet use. In general, participants had a positive attitudes, with a mean of 3.63 overall (where the midpoint or neutral = 3.0 and higher scores = more positive attitudes).

Not surprisingly, Western riders had less positive attitudes compared with the rest, but still overall positive rather than negative. The interesting thing is that although having experience with TBI didn’t make a difference in attitudes for English and Both/Neither riders, it did for Western riders. They had much more positive attitudes if they had experience with TBI.

Of course, it is logical that experience matters, the interesting thing is that it didn’t for everyone.

I’ll add more tables at the end of this post, for those of you who want to know more!

Experimental Design

The second part of the study was experimental and had two parts (pictures and film). Only a subset of the sample completed Part 2 (film clip stimuli), and I haven’t yet analyzed the data from either experiment, so below is a summary of the method. I will tell you which image was preferred of the five included!
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I was interested in the ways in which advertising could be more or less effective in changing attitudes toward helmet use. Research in psychology and communication (Brehm, 1966; Dillard & Shen, 2005; Hong, & Faedda, 1996) has shown that people do not respond well to aggressive, threatening advertising. (e.g., “Brush your teeth or all your teeth will fall out!” “Wear your seat belt or you will be arrested!”).

Such messages are perceived as a threat to freedom of choice. The response can be negative emotions, anger, and the desire to do exactly the opposite: this is called psychological reactance. Some issues provoke reactance no matter how softly the message is phrased, particularly in certain people.

Think about gun control, for example, or being told by your significant other that you should get control of your emotions or “calm down.” Attitudes toward helmet is also a touchy subject. It could be that certain groups of riders would respond with reactance to the mere suggestion they should wear a helmet. It could also be that pairing the message with certain stimuli (in this case, pictures [Study 1] and videos [Study 2]).

As such, this study explored whether pairing different messages with photos or videos would make participants less likely to experience reactance to the message.

Method

First, participants answered questions about their prior experience with horses. They then completed questionnaires about their current attitudes towards helmet use and their personality traits. Then to test the hypotheses, they read a short threat-to-health message (on traumatic brain injury), along with instructions:

Equestrian sports are one of the greatest contributors to sports-related traumatic brain injury (TBI) in the United States. In one study that compared TBI in equestrian, roller, skiing/snowboarding, and aquatic sports, equestrian activities accounting for 45.2% of all such injuries in adults between 2003 and 2012 (Winkler et al. 2016).  Although other sports, such as American football, hockey, and basketball result in even more TBIs, riding horses still presents a major risk of head injury, especially for young riders.  Ability, experience, and equine discipline all affect risk of TBI, but anyone can get a concussion from a fall, kick, or low branch. Fortunately, many head injuries are preventable.

We are interested in how various strategies may encourage or discourage helmet use in people who differ in horse-related experience and personality. For this first part of the study, we are testing the relative appeal of different informative texts and pictures. 

You will now be asked to evaluate an informational message about helmet use.  Please read the message carefully. 

When rating the message, please answer honestly, independently of whether you personally use a helmet and/or advocate for helmet use.

Random assignment

After reading the above message, participants were randomly assigned to view a pro-helmet message paired with one of five pictures or to a control group (no picture, just message). They were also randomly assigned to message condition: high threat (aggressive, condescending language) vs. low threat. The message was adapted from prior research on psychological reactance (Dillard & Shen, 2005).

(In the real experiment, the background didn’t differ: it was all black type on white).

The control group saw only the text (either high or low threat); the experimental group saw a high or low threat message paired with one of the five photos below.

The top photo, of Jenna Kate Towner riding “Pagan” over Cougar Rock in Tevis, was the most popular choice in the control group.

I’d like to thank Jenna, Avalon Equine, Cairdeas Horsemanship, and my sons (bottom left and right, with horses belonging to WSG Morgans) for allowing me to use these pictures.

After reading the text (with the photo, for the experimental group), participants were asked to give their impressions of it. (“First, we would like to get your impressions of the message displayed above.  In the space below, please write whatever came to your mind as you read the text.”) The responses will be coded for cognitive reactance.

Emotional Reactance

They then assessed their emotional response to the message by indicating how much they were feeling a list of emotions (e.g., happy, angry, amused, aggravated, encouraged). This is a measure of emotional reactance.

Message Rating

They rated how they thought other people would react to the message by pulling a bar from 0 (not at all) to 100 (very much) in response to statements such as “The message is fun” and “The message would help convince people to wear a helmet.”

Post-test attitudes towards helmets

Finally, they gave their opinions on helmets and indicated how likely they were to use one in the future.

Manipulation Check

As a “manipulation check” (to verify that the high vs. low threat message worked as expected) they rated the message itself by telling us the extent to which they agreed with statements such as “The message tried to threaten my freedom to choose” and “The message tried to manipulate me.” Higher scores on the scale mean they thought the message was a threat and/or trying to manipulate.

The control group then chose which of the five pictures they thought would be most likely to encourage helmet use.

Results?

The full results of the manipulation on attitudes toward helmet use won’t be ready for some time. I share some preliminary findings below.

The first thing I had to do was verify that the threat manipulation worked. To do this, I compared scores on the Manipulation check across groups. As expected, people who had read the high threat message rated it as more manipulative. What was fascinating was that this was not true in the control group, probably because helmet use is a sensitive topic for horse people. Any message telling people to wear one is understood as a threat to freedom! But viewing the message paired with a picture made a huge difference in perceived threat:

You can see the reverse pattern for message rating (how much participants thought other people would like the message).

Change in attitudes or behavior?

Will the difference in perceived threat and rating carry over to post-test attitudes towards helmets and behavioral intentions? That remains to be seen. I will have to run complex statistical analyses. The group of interest are those that do not ride primarily English or Western, whose behavior will be harder to change. (English riders already use helmets).

In the meantime, you will find what the message + picture looked like below, along with more tables of descriptive statistics. If you have a question, feel free to leave it in a comment or contact me directly (jessica.black@ou.edu).

More Details:

The stimuli:

More on what the sample looked like

What about you? Please tell me about your helmet use in the two question poll below!

Just for fun:

The sample was pretty evenly balanced politically, with most people identifying as moderate, but (unsurprisingly) there were differences across disciplines. Trail/recreation & Western/ranch tended to be more conservative, English and Saddle Seat/Pleasure driving tended toward liberal, and Endurance was evenly split:

Side-benefit of helmets: Helmet cams!!
Watch the fun video below