A Heads-Up Idea

Dr. Driver's Brainchild Saves Little Heads

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Public Health Feature – December 2011

Tex Med.  2011;107(12):31-35.

By Crystal Conde
Associate Editor

A bicycle accident 17 years ago gave Larry Driver, MD, an idea that has since saved countless children from serious head injuries across Texas.  

Dr. Driver was practicing in San Angelo in 1994 when a neighbor girl fell off her bike. Because she wasn't wearing a helmet, she suffered a concussion and passed out. Although she recovered after spending a night in the hospital, the experience moved Dr. Driver. Knowing a bicycle helmet could have easily prevented her injury, he organized the Hard Hats for Little Heads program. He soon won Texas Medical Association House of Delegates backing, and since then the program has distributed helmets to more than 100,000 children in the state.  

"Hard Hats provides an opportunity for physicians to get out of the office and into the community to educate children and adults about injury prevention," said Dr. Driver, a member of the TMA Committee on Cancer. "The good folks in white coats are providing hard hats for kids, especially those who are disadvantaged and likely don't have helmets." 

Hard Hats encourages children to wear a properly fitted helmet every time they bike, skate, skateboard, or ride a scooter. The Centers for Disease Control and Prevention says proper helmet use can reduce head injuries, the most common cause of serious disability or death in bicycle crashes, by up to 85 percent.  

Hard Hats has support from physicians, medical students, TMA Alliance members, TMA Foundation donors, county and local medical societies, and specialty societies. The foundation provides funding, thanks to top donors – Blue Cross and Blue Shield of Texas, Prudential, and an anonymous foundation – and gifts from physicians and their families. The foundation has given Hard Hats more than $535,000 since the program's inception. 

The first Hard Hats event took place in San Angelo in 1994, where physicians and volunteers distributed about 500 helmets with the help of the San Angelo Police Department.  

Before moving from San Angelo to Houston in 1998, Dr. Driver secured a grant for $35,050. The San Angelo Health Foundation donated $32,500 to the TMA Foundation to buy and distribute 5,000 helmets. The additional money from the foundation paid for printing Hard Hats flyers and stickers.  

TMA honored Dr. Driver's efforts in 1995 with the Golden Apple Award for Service in Disease Prevention and Health Promotion. In 1998, the San Angelo City Council proclaimed May as Hard Hats for Little Heads Bicycle Safety Month.

"I am so very gratified and proud of this program, which continues to be a flagship program for the TMA Foundation," Dr. Driver said. 

A Milestone

TMA's Hard Hats program accomplished a major goal in May when it crossed the 100,000 helmet threshold, thanks to the efforts of TMA physicians, medical students, and TMA Alliance members. 

During the past five years, TMA increased the number of helmets given by more than 200 percent, from 8,390 in 2006 to 17,792 in 2010. This year, more than 15,000 helmets were given away at 116 events as of October. Low-income children in more than 100 of Texas' 254 counties received most of the helmets. 

TMA President C. Bruce Malone, MD, an Austin orthopedic surgeon, has seen children suffer because they weren't wearing a helmet during a crash.  

"When I stood over a child in the intensive care unit who was brain dead and had hardly a scratch on the rest of his body, I became frustrated with the lack of protection for kids. I pledged to myself then that I would do everything I could to get every child to wear a helmet, and I'm pleased to be part of an organization that is working so hard to protect our children.  

"The accomplishment of giving away 100,000 helmets is something to celebrate," Dr. Malone said. "More importantly, we're celebrating the children who have been protected from potential lifelong injury and possibly even death."  

To find out how you can give helmets in your community and help TMA reach 200,000 helmets, email the TMA outreach coordinator or call (800) 880-1300, ext. 1470, or (512) 370-1470. 

TMA Foundation President Russell W.H. Kridel, MD, a Houston facial plastic surgeon, says Hard Hats' success "depends on the synergy that is created when medicine, business, and community each contribute their expertise and resources to keeping kids safe." 

On top of teaching children and their families about how bike helmets prevent injury and death, he says, Hard Hats teaches them the value of taking greater responsibility for their health. 

"That is the vision that the foundation has going forward, so we want this program to grow by partnering with sports teams, hospital concussion centers, and others to stress the importance of preventing injury and how good health is essential to a full and productive life." (See "Legislature Takes on Helmet Safety, Concussions.")

Not only do Hard Hats bicycle helmet giveaways prevent injury and save lives, but they also save money. 

"The cost of providing lifetime health care to someone who suffered a traumatic brain injury from a bicycle accident is very high. Hard Hats has the potential to save Texas communities millions of dollars in long-term supportive care," Dr. Driver said. 

Dr. Driver has lofty dreams for the future of the Hard Hats program. He'd like to reach out to professional baseball and football teams in Texas to collaborate in the program. 

"If each team would donate 10,000 helmets, it could be a huge endeavor for them to promote a positive public health message," he said. 

Physicians Make a Difference

Adrian Billings, MD, PhD, an Alpine family physician and a member of the TMA Committee on Rural Health, is on the Hard Hats for Little Heads Advisory Panel. He has been involved in the program since 2007 when he started riding his bike to work. 

"I've always worn a helmet, but I noticed how rare it was to see children in Alpine wearing helmets. The nearest pediatric neurosurgeon is six hours away in Lubbock. In a rural area where access to specialists is remote, we need to educate children about the importance of wearing a helmet to prevent serious injury or even death," he said.  

He spearheaded a July 4 helmet giveaway that year and distributed helmets to 50 children. Two years later, he blanketed far West Texas by giving 1,400 bike helmets to all public school children from kindergarten through eighth grade in Valentine, Marfa, Presidio, Terlingua, Fort Davis, and Alpine. 

Plus, each year the Alpine elementary school rewards students for perfect attendance by giving them a bicycle. Dr. Billings' clinic gives winning students free bicycle helmets. Last year, he gave out 48 helmets.  

"The clinic staff and I go to the elementary school, size the helmets properly, and teach the children the importance of wearing them," Dr. Billings said. 

Dr. Billings now sees more Alpine children wearing helmets while riding their bikes. 

"I can identify the helmets I've given away through the Hard Hats program. It's rewarding to see more kids wearing helmets than before," he said. 

Dr. Billings is a member of the Texas Academy of Family Physicians (TAFP), which covers the cost of up to 50 helmets for any of its members who sponsor a helmet giveaway. TMA provides free helmets to match helmet purchases by any sponsor. With the free TMA match, TAFP members can get up to 100 helmets at no cost.  

He says TAFP and TMA support strengthens the Hard Hats program and benefits Texas' children. 

"I can buy more helmets with that subsidy from TAFP. So much of what I do as a medical professional is preventive. Hard Hats for Little Heads fits into my clinic, practice, and life," he said.  

Dr. Driver says Hard Hats events give medical students "a great opportunity in their formative stages to realize the impact they can have by promoting safe and healthy activities like bike riding and doing it in a safe way."  

All Hard Hats events must have a TMA physician sponsor. The events help showcase TMA's commitment to improving the health of all Texans. Physicians can sponsor a helmet giveaway in the office during appointments, at a health fair or other community event, or as part of a bike rodeo. They can even partner with a school or other community group to give away helmets. 

The physician's role at a Hard Hats event includes:   

  • Discussing the importance of wearing a helmet, 
  • Describing the benefits of exercise at every age and why it is so important, 
  • Demonstrating how to wear a helmet properly, 
  • Ensuring each helmet given to a child fits properly, 
  • Doing media interviews, and 
  • Visiting with community residents.   

For tips on finding a physician sponsor for Hard Hats events, visit the TMA website

The Hard Hats for Little Heads webpage also has resources physicians can use to plan and promote an event and to educate children and parents at events on the importance of wearing a helmet and getting sufficient exercise. 

For more information or to receive a Hard Hats event starter packet (including the grant agreement that must be signed for each event), contact TMA's outreach coordinator by calling (800) 880-1300, ext. 1470, or (512) 370-1470. Sign up to receive TMA Giving Back, a monthly e-newsletter with up-to-date information on TMA's outreach programs. To sign up, e-mail TMA's outreach coordinator

Crystal Conde can be reached by telephone at (800) 880-1300, ext. 1385, or (512) 370-1385; by fax at (512) 370-1629; or by email.  



Legislature Takes on Helmet Safety, Concussions   

A new law now sets standards for periodic inspection of football helmets and eliminating worn-out helmets. 

House Bill 675 by Rep. Eddie Lucio III (D-Brownsville) and Sen. Eddie Lucio Jr. (D-Brownsville) prohibits school districts from using football helmets 16 years or older. Under the new law, which took effect Sept. 1, school districts must recondition all helmets 10 years or older at least once every two years. 

School districts also must maintain and make available to parents documentation indicating the age and reconditioning date of each helmet. 

"Football helmets are the first line of defense in preventing head injuries among Texas high school athletes, and many of them are several years old, as they have been passed down from one year to the next," the legislators said. They added that the University Interscholastic League didn't have any rules on the age of a helmet or how often it had to be reconditioned.  

Additionally, Texas now has regulations governing the prevention, treatment, and oversight of concussions affecting student athletes. Before passage of House Bill 2038, written by Rep. Walter "Four" Price (R-Amarillo) and sponsored in the Senate by Sen. Bob Deuell, MD (R-Greenville), management of concussed student athletes varied widely throughout Texas.  

The legislation passed with physician input on the potentially long-lasting effects of concussions, especially multiple untreated concussions. 

TMA collaborated with Representative Price's office to create a frequently asked questions document on the new concussion management regulations. 

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