Helmet Use Among E-Bike, Pedal Bike, and E-Scooter Riders in Canberra: A Cross-sectional Survey Study (Phase 4)

BackgroundHelmet use is a proven safety measure that reduces the risk of head injury among cyclists and e-scooter riders. Despite legal requirements for pedal bikes and e-bikes in Australia, compliance varies, particularly among users of electric vehicles. The growing popularity of e-bikes and e-scooters in urban areas presents new public health challenges, yet observational data on helmet use, behavioural determinants, and the effectiveness of safety interventions remain limited. AimPhase 4 of the Helmet Use in Canberra study aims to identify demographic and behavioural predictors of unsafe riding and to explore perceived barriers and facilitators to helmet use, including compliance with existing regulations. MethodsA cross-sectional survey will be administered to Canberra residents aged 18 years or older, both online and in-person. The survey will assess attitudes toward helmet use, perceptions of head injury risk, and the deterrent effect of fines. Data will capture demographic characteristics, vehicle type, riding behaviours under varying conditions, and opinions regarding mandatory helmet laws and signage interventions. Survey responses will be de-identified, securely stored, and analysed using descriptive statistics and ordinal logistic regression to evaluate factors influencing compliance. Survey findings will be triangulated with observational and hospital data from earlier study phases. Expected ResultsThe survey is anticipated to provide insights into public attitudes toward helmet use, the perceived effectiveness of fines as behavioural deterrents, and the acceptability of policy interventions. These findings will inform evidence-based strategies to improve helmet compliance and reduce head injuries among urban riders. Trial RegistrationAustralian and New Zealand Clinical Trials Registry (ANZCTR) [ACTRN12626000245392].