Rural Adolescent Attitudes and Use of Helmets While Riding Dirt Bikes: A National Study

John Drey, BS
Parker Sternhagen, BS
Sarah Nichols, BS
Brianna Iverson, MD
Kareem Shoukih, BS
Taeuk Kang, MBiotech, MSc
Kristel Wetjen, RN, BSN
Brenda Vergara
Pam Hoogerwerf, BA
Charles Jennissen, MD

Dirt bikes are common in rural areas, especially on farms and ranches. Mishaps can result in serious injury with head injuries being the most common cause of death. Helmet use can significantly reduce the risk. Our objective was to determine rural adolescents’ attitudes regarding helmets, their frequency of helmet use while riding dirt bikes, and to identify demographic and other factors affecting helmet use and the support of helmet laws.

A convenience sample of 2025 National FFA (formerly Future Farmers of America) Convention & Expo attendees in Indianapolis, Indiana, completed an anonymous survey. After compilation, data were imported into SAS version 9.4. Descriptive, bivariate (Chi-square, Fisher’s exact test) and logistic regression analyses were performed. The Wilcoxon rank sum or Kruskal-Wallis test was used to determine differences in helmet importance score distributions.

2,516 adolescents (13-18 years) participated. Almost two-fifths (38%) lived on a farm, 38% lived in the country/not on a farm, and 24% were from towns. Nearly one-third (31%) stated their family owned a dirt bike with those from farms having a higher ownership percentage (39%) than those living elsewhere, p<0.0001. Over one-third (36%) had ridden dirt bikes in the past year. Males, dirt bike owners, those from farms or from the country/not a farm, and individuals from rural Rural Urban Commuting Area (RUCA) codes all had higher proportions having ridden dirt bikes. Respondents from the Northeast and West census regions had higher proportions having ridden a dirt bike in the past year versus the Midwest and South. Average helmet importance rating (1-10, 10 high) was 8.9 (SD1.9). Those with lower median helmet importance included males, those from farms, and those that had ridden dirt bikes, all p<0.0001. Helmet use was: Always 51%, Mostly 21%, Sometimes 11%, Rarely 8%, Never 10%. Midwesterners had about twice the odds of wearing helmet always/mostly as compared to those from the South and West. Overall, 70% supported laws requiring dirt bike helmet use with those from farms with lower endorsement percentages, p<0.0001. Those living in states with universal helmet laws had odds 2.7x higher, and those in states with helmet laws covering younger drivers had odds 1.8x higher of supporting helmet laws than those without laws. Over three-fifths (61%) reported their family had a “no helmet, no riding” rule; these respondents had a 10.6x higher odds of always/mostly wearing a helmet compared to those without a rule.

Dirt bike ownership and use by study adolescents was common, especially those from farms. Respondents rated wearing a helmet while riding dirt bikes as being very important, but much lower by farm residents. Farm youth also had lower proportions wearing helmets. The safety culture surrounding dirt bike helmet use is poor among farm adolescents and deserves targeted interventions. However, families with “no helmet, no riding” rules had a much higher likelihood of supporting helmet laws and always/mostly wearing helmets.

Attendees will be able to:
1. List at least three youth demographic factors associated with higher proportions having ridden dirt bikes in the past year.
2. Describe rural youth’s attitudes related to dirt bike helmet use and how it differs among motorized vehicles.
3. State which rural adolescents might be at greater risk for lack of helmet use on dirt bikes.