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 Main results We found 28 published studies and one unpublished study.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)

Effectiveness of systematically delivered evidence-based home safety promotion to improve child home safety practices: a controlled before-and-after study

“…It is unsurprising that our complete case analysis found no significant effect of the intervention on injury rates as it was not powered to do so. This is consistent with findings of previous systematic reviews,9 40 which highlight the challenge of assessing intervention impact on injury rates because of the large sample sizes required.…”

Effectiveness of systematically delivered evidence-based home safety promotion to improve child home safety practices: a controlled before-and-after study

“…It is unsurprising that our complete case analysis found no significant effect of the intervention on injury rates as it was not powered to do so. This is consistent with findings of previous systematic reviews,9 40 which highlight the challenge of assessing intervention impact on injury rates because of the large sample sizes required.…”

Home Visits for Prevention of Impairment and Death in Older Adults: A Systematic Review

“…Including 64 randomised trials conducted over the last three decades , our results were not consistent with those of previous reviews that found beneficial effects for some groups of older adults on mortality and institutionalisation (Elkan et al, 2001;Huss et al, 2008;. Rather, our results corroborate previous reviews suggesting that home visit programmes do not appear to significantly differ in outcomes compared to usual care Turner et al, 2011;van Haastregt et al, 2000).…”

Percepção sobre queda e exposição de idosos a fatores de risco domiciliares

“…The way how the project was designed permitted the simultaneous identification of various household risk factors, which is important, given the synergistic character of many of the factors 2,3,[5][6][7] . Elevated frequencies were also regularly found in studies on changing a person's domestic environment with the objective of reducing the number of falls 14,15 . In the national specialist journals, the household risk factors are usually evaluated in emergency censuses related to the outcome of falls for one element 16 .…”

Effectiveness of systematically delivered evidence-based home safety promotion to improve child home safety practices: a controlled before-and-after study

“…It is unsurprising that our complete case analysis found no significant effect of the intervention on injury rates as it was not powered to do so. This is consistent with findings of previous systematic reviews,9 40 which highlight the challenge of assessing intervention impact on injury rates because of the large sample sizes required.…”

Home Visits for Prevention of Impairment and Death in Older Adults: A Systematic Review

“…Including 64 randomised trials conducted over the last three decades , our results were not consistent with those of previous reviews that found beneficial effects for some groups of older adults on mortality and institutionalisation (Elkan et al, 2001;Huss et al, 2008;. Rather, our results corroborate previous reviews suggesting that home visit programmes do not appear to significantly differ in outcomes compared to usual care Turner et al, 2011;van Haastregt et al, 2000).…”

Percepção sobre queda e exposição de idosos a fatores de risco domiciliares

“…The way how the project was designed permitted the simultaneous identification of various household risk factors, which is important, given the synergistic character of many of the factors 2,3,[5][6][7] . Elevated frequencies were also regularly found in studies on changing a person's domestic environment with the objective of reducing the number of falls 14,15 . In the national specialist journals, the household risk factors are usually evaluated in emergency censuses related to the outcome of falls for one element 16 .…”

Effectiveness of systematically delivered evidence-based home safety promotion to improve child home safety practices: a controlled before-and-after study

“…It is unsurprising that our complete case analysis found no significant effect of the intervention on injury rates as it was not powered to do so. This is consistent with findings of previous systematic reviews,9 40 which highlight the challenge of assessing intervention impact on injury rates because of the large sample sizes required.…”

Home Visits for Prevention of Impairment and Death in Older Adults: A Systematic Review

“…Including 64 randomised trials conducted over the last three decades , our results were not consistent with those of previous reviews that found beneficial effects for some groups of older adults on mortality and institutionalisation (Elkan et al, 2001;Huss et al, 2008;. Rather, our results corroborate previous reviews suggesting that home visit programmes do not appear to significantly differ in outcomes compared to usual care Turner et al, 2011;van Haastregt et al, 2000).…”

Percepção sobre queda e exposição de idosos a fatores de risco domiciliares

“…The way how the project was designed permitted the simultaneous identification of various household risk factors, which is important, given the synergistic character of many of the factors 2,3,[5][6][7] . Elevated frequencies were also regularly found in studies on changing a person's domestic environment with the objective of reducing the number of falls 14,15 . In the national specialist journals, the household risk factors are usually evaluated in emergency censuses related to the outcome of falls for one element 16 .…”