Adolescents continue to report food and nutrient intake and physical activity levels that conflict with the U.S. Dietary Guidelines and the Year 2000 objectives. Some of the barriers to healthier eating and exercise are related to factors within the adolescent's environment, such as access to healthy food choices or availability of preventive nutritional guidance as part of routine health care. Many barriers, though, fit into the theoretical framework that attempts to describe determinants of other risky behaviors of adolescents. These include (1) adolescent and peer subgroup norms that devalue healthy eating behavior; (2) participation in other risky behaviors; (3) low competency (actual and perceived) in sports, food selection, and food preparation; and (4) familial and cultural expectations. Implications were discussed for intervention approaches and policy recommendations that help confront these barriers.

Objectives-To reduce fires and fire related injuries by increasing the prevalence of functioning smoke alarms in high risk households. Setting-The programme was delivered in an inner London area with above average material deprivation and below average smoke alarm ownership. The target population included low income and rental households and households with elderly persons or young children. Methods-Forty wards, averaging 4000 households each, were randomised to intervention or control status. Free smoke alarms and fire safety information were distributed in intervention wards by community groups and workers as part of routine activities and by paid workers who visited target neighbourhoods. Recipients provided data on household age distribution and housing tenure. Programme costs were documented from a societal perspective. Data are being collected on smoke alarm ownership and function, and on fires and related injuries and their costs. Results-Community and paid workers distributed 20 050 smoke alarms, potentially suYcient to increase smoke alarm ownership by 50% in intervention wards. Compared with the total study population, recipients included greater proportions of low income and rental households and households including children under 5 years or adults aged 65 and older. Total programme costs were £145 087. Conclusions-It is possible to implement a large scale smoke alarm giveaway programme targeted to high risk households in a densely populated, multicultural, materially deprived community. The programme's eVects on the prevalence of installed and functioning alarms and the incidence of fires and fire related injuries, and its cost eVectiveness, are being evaluated as a randomised controlled trial. (Injury Prevention 1999;5:177-182)

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