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Objectives: Assess the association of helmet use with motorcycle crash mortality and identify characteristics of riders who do not wear helmets in Connecticut crashes. Methods: Police crash data for Connecticut motorcycle crashes 2001-2007 were analyzed. Bivariate analysis and multivariable logistic regressions were performed including age, gender, seating position, road type, season, time of day, and recklessness. Results: Of the 9,214 crashes with helmet use data available, helmets were worn in 4,072 (44.2%). Non-helmeted riders, age ≥ 18, riding interstate or state roads, in the evening or at night, and who were riding recklessly were associated with higher odds of fatality. Predictors of nonhelmet use included males, passengers, age <18 or 30 to 59, and riding in the summer, evening or at night, and on US, state, and local roads. Conclusion: Current crash data affirm that helmets reduce fatal crashes in Connecticut. A set of factors help predict nonhelmeted riders to whom safety training could be targeted. [ABSTRACT FROM AUTHOR]

Background: As the United States embraces electronic health records (EHRs), improved emergency medical services (EMS) information systems are also a priority; however, little is known about the experiences of EMS agencies as they adopt and implement electronic patient care report (e-PCR) systems. We sought to characterize motivations for adoption of e-PCR systems, challenges associated with adoption and implementation, and emerging implementation strategies. Methods: We conducted a qualitative study using semi-structured in-depth interviews with EMS agency leaders. Participants were recruited through a web-based survey of National Association of EMS Physicians (NAEMSP) members, a didactic session at the 2010 NAEMSP Annual Meeting, and snowball sampling. Interviews lasted approximately 30 minutes, were recorded and professionally transcribed. Analysis was conducted by a five-person team, employing the constant comparative method to identify recurrent themes. Results: Twenty-three interviewees represented 20 EMS agencies from the United States and Canada; 14 EMS agencies were currently using e-PCR systems. The primary reason for adoption was the potential for e-PCR systems to support quality assurance efforts. Challenges to e-PCR system adoption included those common to any health information technology project, as well as challenges unique to the prehospital setting, including: fear of increased ambulance run times leading to decreased ambulance availability, difficulty integrating with existing hospital information systems, and unfunded mandates requiring adoption of e-PCR systems. Three recurring strategies emerged to improve e-PCR system adoption and implementation: 1) identify creative funding sources; 2) leverage regional health information organizations; and 3) build internal information technology capacity. Conclusion: EMS agencies are highly motivated to adopt e-PCR systems to support quality assurance efforts; however, adoption and implementation of e-PCR systems has been challenging for many. Emerging strategies from EMS agencies and others that have successfully implemented EHRs may be useful in expanding e-PCR system use and facilitating this transition for other EMS agencies.