Socio-demographic and experiential determinants of observed versus self-reported helmet use among motorcyclists in Northern Ghana: A comparative analysis

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OBJECTIVE: This study assessed the socio-demographic and experiential determinants of observed and self-reported helmet use among motorcyclists in northern Ghana. METHODS: A cross-sectional survey was conducted among 381 motorcyclists at twelve randomly selected fuel stations in Tamale in March-April, 2021. Motorcyclists were first observed on actual helmet use and then interviewed face-to-face. Modified Poisson regression was used to assess the factors associated with observed helmet use, self-reported helmet use, and over-reporting of helmet use. RESULTS: Observed helmet use was 21.3% while self-reported helmet use was 37.8% and rate of over-reporting was 31.0%. Multivariable analysis revealed the prevalence of helmet use among motorcyclists who had license was twice higher when observed (aPPR (adjusted prevalence rate ratio) =2.14, 95%CI = 1.28-2.59) and 55% higher when self-reported (aPPR = 1.55, 95%CI = 1.13-2.12). Prevalence among those who owned a helmet was twice higher when observed (aPPR = 2.24, 95%CI = 1.05-4.77) and 78% higher when self-reported (aPPR = 1.78, 95%CI = 1.17-2.70). Over-reporting of helmet use was 51% lower among respondents aged 30 to 39 years (aPPR = 0.49, 95%CI = 0.25-0.96) compared with those below 20 years, 54% lower among those who had tertiary education compared with those with no formal education (aPPR = 0.46, 95%CI = 0.23 - 0.93). Over-reporting was 53% higher if the motorcyclist had an additional helmet (aPPR = 1.53, 95%CI = 1.00-2.36). CONCLUSION: The study reveals a significant disparity between observed and self-reported helmet use; however, possession of rider's license and helmet ownership were significant determinants of both observed and self-reported helmet use. Interventions to promote increased licensing and helmet ownership are warranted.

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