Modification of the home environment for the reduction of injuries

Abstract

Background Injury in the home is common, accounting for approximately a third of all injuries. The majority of injuries to children under five and people aged 75 and older occur at home. Multifactorial injury prevention interventions have been shown to reduce injuries in the home. However, few studies have focused specifically on the impact of physical adaptations to the home environment and the e ectiveness of such interventions needs to be ascertained. Objectives To determine the e ect of modifications to the home environment on the reduction of injuries due to environmental hazards. Search methods We searched The Cochrane Library, MEDLINE, EMBASE and other specialised databases. We also scanned conference proceedings and reference lists. We contacted the first author of all included randomised controlled trials. The searches were last updated to the end of December 2009, and were not restricted by language or publication status. Selection criteria Randomised controlled trials. Data collection and analysis Two authors screened all abstracts for relevance, outcome and design. Two authors independently assessed methodological quality and extracted data from each eligible study. We performed meta-analysis to combine e ect measures, using a random-e ects model. We assessed heterogeneity using an I 2 statistic and a Chi 2 test. Main results We found 28 published studies and one unpublished study. Only two studies were su iciently similar to allow pooling of data for statistical analyses. Studies were divided into three groups; children, older people and the general population/mixed age group. None of the studies focusing on children or older people demonstrated a reduction in injuries that were a direct result of environmental modification in the home. One study in older people demonstrated a reduction in falls and one a reduction in falls and injurious falls that may have been due to hazard reduction. One meta-analysis was performed which examined the e ects on falls of multifactorial interventions consisting of home hazard assessment and modification, medication review, health and bone assessment and exercise (RR 1.09, 95% CI 0.97 to 1.23). Modification of the home environment for the reduction of injuries (Review)

There is more to life than risk avoidance – elderly people’s experiences of falls, fall-injuries and compliant flooring

“…For example, participation in programs for physical activity is generally low (Franco et al, 2015), few elderly people want to make home modifications when these are proposed by health care personal (Turner et al, 2011) and despite evidence of hip protectors having an injury reducing effect, compliance is low (Santesso, Carrasco‐Labra, & Brignardello‐Petersen, 2014). Even if evidence points towards a lack of interest in prevention, the participants in this study do take precautions.…”

Effectiveness of a home hazard modification program for reducing falls in urban community‐dwelling older adults: A randomized controlled trial

“…The presences of certain home hazards were more important in predicting falls at home among vigorous rather than the frail older adults (Northridge, Nevitt, Kelsey, & Bruce, 1995). Nevertheless, a metaanalysis provided insufficient evidence to show that interventions focused on the residential environment, including home hazard assessment and modification, medication reviews, health and bone assessment, and exercise decreases injuries in older adults (Turner et al, 2011). Thus, evidence for the effectiveness of home hazard self-assessment and self-modification for preventing falls is insufficient.…”

Everyday outdoor mobility in old age: Focus group interviews with active senior citizens

“…The causes are often aspects related to the physical environment and human impact, e.g., dizziness and lack of own responsibility [14]. Despite these factors, outdoor fall prevention has been neglected since most research has focused on falls occurring in the home or hospital environment [15,16]. Risk factors differ between outdoor and indoor falls, e.g.…”