Home Safety Program Research Articles

Cost-effectiveness of the ‘Stay One Step Ahead’ Home Safety programme for the prevention of injuries among children under 5 years

BackgroundUnintentional injuries are a common cause of morbidity and mortality in the under-5s, but undertaking home safety practices can reduce injury risk. Stay One Step Ahead (SOSA) is an evidence-based...

Evaluation of the effectiveness, implementation and cost-effectiveness of the Stay One Step Ahead home safety promotion intervention for pre-school children: a study protocol

BackgroundUnintentional injuries in children under the age of 5 years commonly occur in the home and disproportionately affect those living in disadvantaged circumstances. Targeted home safety promotion should be offered...

A systematic review and meta-analysis of exercise-based falls prevention strategies in adults aged 50+ years with visual impairment.

To determine the impact of exercise or physical training on falls or physical function in people aged 50+ years with visual impairment, compared with control (no intervention or usual care). An updated systematic review of randomised controlled trials, investigating the effect of exercise or physical activity on falls prevention or physical function in adults aged 50+ with visual impairment. Searches of CINAHL, the Cochrane Register of Controlled Trials (CENTRAL), Embase, and Medline were undertaken. Three trials were identified for the period February 2013 to July 2017 and added to the four in the original review. New trials evaluated yoga, the Otago Exercise Programme in combination with a home safety programme and the Alexander Technique. Meta-analysis of data from two trials (n = 163) indicated a non-statistically significant positive impact of exercise on the Chair Stand Test (WMD -1.85 s, 95% CI -4.65 to 0.96, p = 0.20, I2 22%). In this update, two new trials measured falls so meta-analysis was possible for three trials (n = 539) and revealed no impact on falls (RR 1.05, 95% CI 0.73 to 1.50, p = 0.81, I2 30%). Although exercise or physical training can improve physical function in older adults with visual impairment, and diverse strategies are being evaluated, there are no proven falls prevention strategies. In the few studies available, falls are not consistently reported and more work is required to investigate falls prevention in older adults with visual impairment.

Preventing Unintentional Injuries to Young Children in the Home: Understanding and Influencing Parents’ Safety Practices

AbstractUnintentional injuries are the leading cause of preventable deaths for children in most industrialized countries. In this article, I consider research on how parents prevent home injuries to children under 6 years and discuss an intervention aimed at improving parents’ home‐safety practices. Parents of young children use three types of home‐safety practices: teaching about safety, modifying the environment, and supervising. Relying predominantly on teaching increases young children's risk of injury, whereas modifying the environment and supervising protect children and predict fewer injuries. Drawing on evidence about factors that motivate parents’ safety practices, an intervention was developed to improve supervision: The Supervising for Home Safety program positively changed parents’ appraisals about injury and supervision practices. Developing evidence‐based injury‐prevention programs is an effective way to address this national public‐health issue.

Supervising for Home SafetyProgram: A Randomized Controlled Trial (RCT) Testing Community-Based Group Delivery

The individually delivered Supervising for Home Safety (SHS) program improves caregivers' injury-related beliefs and supervision practices. The current randomized controlled trial used a group delivery in a community setting and assessed program impact, feasibility, and acceptance. Caregivers of 2-5-year-olds were randomized to receive either the SHS or an attention-matched control program. In the SHS group only, there were increases from baseline to postintervention in the following: beliefs about children's vulnerability to injury, caregiver preventability of injuries, and self-efficacy to do so; readiness for change in supervision; and watchful supervision. Face-to-face recruitment by staff at community organizations proved most successful. Caregivers' satisfaction ratings were high, as was caregiver engagement (95% completed at least seven of the nine sessions). The SHS program can be delivered to groups of caregivers in community settings, is positively received by caregivers, and produces desirable changes that can be expected to improve caregivers' home safety practices.

A feasibility study to prevent falls in older people who are sight impaired: the VIP2UK randomised controlled trial

BackgroundPublished evaluations of successful interventions to prevent falls in people with sight impairment (SI) are limited. The aim of this feasibility study is to optimise the design and investigation of home safety (HS) and home exercise (HE) programmes to prevent falls in older people with SI.MethodsA community-based feasibility study in north-west England comprising a three-arm randomised controlled trial (RCT) allocated participants to (1) a control group receiving usual care and social visits, (2) an experimental group receiving the HS programme and (3) an experimental group receiving the HS + HE programme. Participants were community-dwelling, aged 65 years and older and sight impaired. Primary outcome data on falls were collected continuously over 6 months. Secondary outcomes on physical activity (self-report and instrumented) and adherence were collected at baseline and 3 and 6 months for HE and at 6 months for the HS programme. Costs for the HS and HS + HE groups were calculated from logs of time spent on home visits, telephone calls and travel. The research assistant and statistician were blinded to group allocation.ResultsAltogether, 49 people were recruited over a 9-month period (randomised: 16 to control, 16 to HS, 17 to HS + HE). The interventions were implemented over 6 months by an occupational therapist at a cost per person (pounds sterling, 2011) of £249 (HS) and £674 (HS + HE). Eighty-eight percent (43/49) completed the trial and 6-month follow-up. At 6-month follow-up, 100 % reported partially or completely adhering to HS recommendations but evidence for adherence to HE was equivocal. Although self-reported physical activity increased, instrumented monitoring showed a decrease in walking activity. There were no statistically significant differences in falls between the groups; however, the study was not powered to detect a difference.ConclusionIt is feasible and acceptable for an occupational therapist to deliver HS and HE falls prevention programmes to people with SI living independently in the community. Future studies could access Local Authority Registers of people with SI to improve recruitment rates. Further research is required to identify how to improve adherence to HE and to measure changes in physical activity before conducting a definitive RCT.Trial registrationISRCTN53433311, registered on 8 May 2014.

Home safe home

The London Health Sciences Centre Home Safety Program (HSP) provides safety devices, education, a safety video, and home safety checklist to all first-time parents for the reduction of childhood home injuries. The objective of this study was to evaluate the HSP for the prevention of home injuries in children up to 2 years of age. A program evaluation was performed with follow-up survey, along with an interrupted time series analysis of emergency department (ED) visits for home injuries 5 years before (2007-2013) and 2 years after (2013-2015) implementation. Spatial analysis of ED visits was undertaken to assess differences in home injury rates by dissemination areas controlling differences in socioeconomic status (i.e., income, education, and lone-parent status) at the neighborhood level. A total of 3,458 first-time parents participated in the HSP (a 74% compliance rate). Of these, 20% (n = 696) of parents responded to our questionnaire, with 94% reporting the program to be useful (median, 6; interquartile range, 2 on a 7-point Likert scale) and 81% learning new strategies for preventing home injuries. The median age of the respondent's babies were 12 months (interquartile range, 1). The home safety check list was used by 87% of respondents to identify hazards in their home, with 95% taking action to minimize the risk. The time series analysis demonstrated a significant decline in ED visits for home injuries in toddlers younger than2 years of age after HSP implementation. The declines in ED visits for home injuries remained significant over and above each socioeconomic status covariate. Removing hazards, supervision, and installing safety devices are key facilitators in the reduction of home injuries. Parents found the HSP useful to identify hazards, learn new strategies, build confidence, and provide safety products. Initial finding suggests that the program is effective in reducing home injuries in children up to 2 years of age. Therapeutic/care management study, level V.

Reducing safety risk among underserved caregivers with an Alzheimer's home safety program

ABSTRACTObjectives: Older adults living with Alzheimer's disease (AD) experience more of the types of accidents and injuries prevalent among older adults. Relatively few studies specifically on safety risks have included older adults of color and tested interventions. This pilot study tested the feasibility and evaluability of educating Hispanic and African American caregivers of patients living with AD about reducing safety risks in their homes.Methods: This outpatient memory clinic-based intervention study included a pre-/post-test survey design with two nonequivalent groups and predominately serves Hispanic and African Americans. Of 60 eligible caregivers, 67% participated in a tailored, safety training class with an optional follow-up call.Results: The results indicate a reduction in some safety risks compared to baseline and/or a no intervention group, respectively, including leaving patients at home alone part-time (p < .01 and p < .01), getting lost (p < .05 and p < .05), going outdoors alone less often (p < .05 and p < .01), and giving themselves medicine (p < .05 and p < .01). At post-test, 47 clinically significant instances occurred, in which caregivers who participated in the intervention self-reported patients living with AD to be ‘completely safe’ in one or more of the safety risk items compared to 8 instances among those who did not.Conclusions: This pilot pre/post design with non-equivalent groups study needs refinement in a future randomized control trial. Despite limitations, this pilot study demonstrates the first feasible and evaluable intervention with both statistically and clinically significant results that suggest potential for reducing safety risks among at-risk minority patients living with AD in future research.

Victims of domestic injuries and suicide among women of reproductive age in Iran

BackgroundAs a part of a national home safety programme in Iran, a surveillance system was designed and implemented in the whole country (especially in rural areas) to register those injuries...

Results of a randomized controlled trial assessing the efficacy of the Supervising for Home Safety program: Impact on mothers’ supervision practices

Unintentional injury constitutes a major health risk for young children, with many injuries occurring in the home. Although active supervision by parents has been shown to be effective to prevent injuries, evidence indicates that parents do not consistently apply this strategy. To address this issue, a randomized controlled trial was conducted to evaluate the impact of the Supervising for Home Safety program on parent supervision practices in the home and when unobtrusively observed in a naturalistic laboratory setting. Using a participant-event monitoring procedure, parents of children aged 2 through 5 years completed supervision recording sheets weekly both before and after exposure to the intervention program; Control parents completed the same measures but received a program focusing on child nutrition and active lifestyles. Unobtrusive video recordings of parent supervision of their child in a room containing contrived hazards also were taken pre- and post-intervention. Results indicated that groups did not differ in demographic characteristics. Comparisons of post- with pre-intervention diary reported home supervision practices revealed a significant decrease in time that children were unsupervised, an increase in in-view supervision, and an increase in level of supervision when children were out of view, with all changes found only for the Intervention group. Similarly, only parents in the Intervention group showed a significant increase in attention to the child in the contrived hazards context, with these differences evident immediately after and 3 months after exposure to the intervention. These results provide the first evidence that an intervention program can positively impact caregiver supervision.

A randomized controlled trial evaluating the impact of the Supervising for Home Safety program on parent appraisals of injury risk and need to actively supervise.

A video to promote parents' appreciation of young children's risk of injury and need for active supervision was recently developed (Morrongiello, Zdzieborski, Sandomierski, & Lasenby-Lessard, 2009). Integrating this video with tailored activities resulted in the Supervising for Home Safety program. The current randomized, controlled trial evaluated the efficacy of this program for increasing parental appraisals of child-injury risk and the need to actively supervise 2- through 5-year-old children. Parents were recruited throughout the community and randomly assigned to either intervention (content focused on child-injury risks and supervision needs) or control (content focused on child nutrition and exercise) groups, with these balanced for child sex and age. Pre- and postintervention measures of parental appraisals of child-injury risk (vulnerability for injury, potential injury severity, preventability of injury) and supervision (value of active supervision, self-efficacy for actively supervising) were taken. Following exposure to the intervention, appraisals of children's injury risk and parents' need to actively supervise significantly increased in the intervention group but not the control group, and all effects, except change in vulnerability appraisal, persisted for 12 months after exposure to the intervention program. Additional analyses were conducted to explore barriers that parents identified to closely supervising and solutions they suggested to address barriers. The Supervising for Home Safety program produced the desired effects on parental appraisals. It holds promise as a program that may improve parents' supervision practices.

Senior Lifestyles and Injury Prevention

The purpose of this multicenter, before-and-after observational study was to determine whether a short educational intervention was associated with improvement in self-reported safety behavior in older adults. We developed 4 original injury prevention presentations with companion testing materials: Motor Vehicle Safety, Fall Prevention, Pedestrian Safety, and Home Safety. Participants also completed pre-post Short Form Health Survey Instrument (SF-12) quality-of-life surveys. Of 414 participants, 226 completed follow-up testing and SF-12 surveys, for a 54.6% response rate. Those who completed either Pedestrian or Home Safety program showed no significant changes (P > .05) in either test scores or SF-12, and they comprised 61.9% of the final sample. Participants in the Motor Vehicle Safety and Fall Prevention programs accounted for 38.1% of the final sample and did show significant improvements between pre-post test scores. Only Fall Prevention participants showed significant differences in pre-post SF-12 scores. In the Fall Prevention group, numerous SF-12 subscores from the initial survey were significantly inversely correlated with pretest scores, and improvements in some SF-12 subscores correlated with improvements in test scores. Findings from the Fall Prevention group suggest that seniors with quality-of-life limitations may be aware of their increased risk and more willing to make changes to enhance safety. Further study is needed because many questions regarding optimal approaches to injury prevention in the aging demographic remain unanswered.

A randomized trial to assess the effectiveness of an infant home safety programme

The aim of this study was to test an intervention aimed at addressing the risk of injury in infants 2 – 12 months of age. A non-blinded, randomized controlled trial was conducted, whereby parents were randomly assigned to either a control or one of two intervention groups. Parents completed questionnaires regarding safety behaviours and injuries at the 2 (baseline), 6 and 12 month immunization visit at the community health unit. During the 2 month visit to the health unit, the two intervention groups received a home safety kit containing nine items, an instructional brochure and a risk assessment checklist. Subjects randomized to the safety kit plus home visit group also received a standardized home visit from a community health nurse. Two of the 14 parental safety behaviours showed a significant increase in use among parents in the intervention groups. Neither of the interventions was associated with a reduction in parent-reported injuries among children. It was concluded that home visitation may provide a beneficial adjunct to the provision of safety devices and may increase use by parents.

Reducing hazard related falls in people 75 years and older with significant visual impairment: how did a successful program work?

Background: In a randomized controlled trial testing a home safety program designed to prevent falls in older people with severe visual impairment, it was shown that the program, delivered by...

A preventative home safety programme for community-dwelling older people with low vision reduced falls and was more cost-effective than an exercise programme

Australian Occupational Therapy JournalVolume 53, Issue 3 p. 243-244 A preventative home safety programme for community-dwelling older people with low vision reduced falls and was more cost-effective than an exercise programme Esther Steultjens, Esther Steultjens CAPs Advisory Advisory Member e.steultjens@ergologie.nlSearch for more papers by this authorLindy Clemson, Lindy Clemson The University of Sydney l.clemson@fhs.usyd.edu.auSearch for more papers by this author Esther Steultjens, Esther Steultjens CAPs Advisory Advisory Member e.steultjens@ergologie.nlSearch for more papers by this authorLindy Clemson, Lindy Clemson The University of Sydney l.clemson@fhs.usyd.edu.auSearch for more papers by this author First published: 10 August 2006 https://doi.org/10.1111/j.1440-1630.2006.00603.xCitations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume53, Issue3September 2006Pages 243-244 RelatedInformation

The impact of home safety promotion on different social strata in a WHO safe community

Few studies have investigated the impact of home safety promotion programmes on different social strata. The aim of this study was to investigate the distribution of effects of a community-based home safety programme on home injury rates among families with different connections to the labour market. A quasi-experimental design was used, with pre- and post-implementation registrations covering the total populations below 65 years of age in the programme implementation area (population 41,000) and in a neighbouring comparison municipality (population 26,000) in Ostergötland County, Sweden. In the intervention and comparison areas, households in which the adults were not vocationally active displayed the highest rates of home injury. After 6 years of programme activity, the home injury rates for males and females in all social status categories displayed a decreasing trend in the intervention area. The opposite was true for the comparison area, i.e. the incidence of injury increased, with the exception of females in non-vocationally active households. The decline in injury rates in the intervention area was statistically significant for males and females in the employed category and for males in the non-vocationally active category. Changes in injury rates in the comparison area were not statistically significant. The programme was partially successful in that it reduced the injury rate in non-vocationally active households, but it did not influence the injury rate in the employed households. The study design did not allow for conclusions regarding why the post-intervention injury rates remained higher in non-vocationally active households. Further research on the association between the incidence of home injury and socio-economic factors is warranted.

Randomised controlled trial of prevention of falls in people aged ≥75 with severe visual impairment: the VIP trial

Objectives To assess the efficacy and cost effectiveness of a home safety programme and a home exercise programme to reduce falls and injuries in older people with low vision.Design Randomised...

Developing and Implementing a Senior Community Based Fall Prevention and Home Safety Program

Occupational therapists are primary candidates in taking a proactive role in meeting the community dwelling senior citizen's safety, environmental, and cognitive needs through the development of community based programs in conjunction with aging organizations. The purpose of this paper is to provide recommendations to occupational therapists in developing, implementing, and marketing a senior community based fall prevention and home safety program in conjunction with a Council on Aging and occupational therapy outpatient private practice.

Developing and Implementing a Senior Community Based Fall Prevention and Home Safety Program

Occupational therapists are primary candidates in taking a proactive role in meeting the community dwelling senior citizen's safety, environmental, and cognitive needs through the development of community based programs in conjunction with aging organizations. The purpose of this paper is to provide recommendations to occupational therapists in developing, implementing, and marketing a senior community based fall prevention and home safety program in conjunction with a Council on Aging and occupational therapy outpatient private practice.

Evaluation of a first aid and home safety program for hispanic migrant adolescents

Background: Unintentional injuries are the major cause of death among children, adolescents, and young adults. This article presents an evaluation of an injury-prevention program for 11- to 16-year-old, Hispanic migrant youth. Design: Randomized controlled trial with two conditions: first aid and home safety training and tobacco and alcohol prevention. Participants were assessed at baseline, at immediate post-intervention, and at 1-year follow-up. Participants: A total of 660 Hispanic adolescent and parent pairs participated in a program entitled Sembrando Salud (sowing the seeds of health). Intervention: The intervention consisted of two conditions: first aid and home safety training and tobacco and alcohol prevention. Both groups were exposed to an eight-session, multimedia program presented by bilingual, bicultural college students. The sessions consisted of lectures, discussions, and skills development and practice. Outcome Measures: To examine the efficacy of the first aid and home safety intervention, adolescents were assessed for changes in first aid confidence, knowledge of items in a first aid kit, knowledge of how to respond in an emergency situation, acquisition of a first aid kit, and behavioral skills testing in response to two emergency scenarios. Results: Similar changes in confidence were observed in both groups after the intervention. Participants in the first aid and home safety program were better able to identify items to include in a first aid kit, how to respond in an emergency situation, and reported fewer erroneous victim-caring procedures than the tobacco and alcohol prevention group. Conclusions: Sembrando Salud was successful at achieving and maintaining change in confidence and knowledge of first aid and emergency response skills over a yearlong period.