Prevalence of helmet use in skateboarders: A systematic review and narrative synthesis

Abstract

Introduction: Helmet adoption remains low among skateboarders, but the specific prevalence remains unclear. The purpose of this study was to summarize available evidence on helmet-use prevalence among skateboarders. Methods: A systematic search of PubMed and Web of Science was conducted using the search terms: skateboard, skateboarding, protective gear, protective equipment, pads, or helmet. Articles were included if they were in English with specific data on helmet use among skateboarders. Articles excluded were those representing reviews or conference abstracts/presentations; or if helmet use prevalence for skateboarders could not be ascertained. Data extraction and quality assessment were performed independently by two reviewers, with a third resolving disagreements. Study quality was assessed using the Newcastle Ottawa Quality Assessment Scale. Results: A total of 228 articles were identified, of which only 17 studies (7.5%) met inclusion criteria. Included studies spanned four decades (1992–2023) and covered populations across North America, Australia, and Europe. Helmet use prevalence was consistently low, ranging from 0% to 41.7%, with variations by age, sex, and region. Most studies were of moderate quality (n = 10). Samples were male dominant, with many studies not reporting additional demographics. Barriers to helmet use included comfort and perceived inconvenience. Findings also highlighted worse outcomes for skateboarders without helmets compared to those with helmets. Conclusions: Findings demonstrated a consistently low prevalence of helmet use among skateboarders, despite its established role in reducing head injuries. These findings underscore the need for targeted public health initiatives to promote helmet use and address barriers to adherence. Practical Applications: Public health campaigns and educational programs should focus on increasing awareness of helmet effectiveness while addressing common barriers such as comfort and social norms. Additionally, improvements in helmet design and partnerships with influential skateboarders could help normalize helmet use and encourage adoption within the skateboarding community.