Lessons Learned from Implementing a Programme of Home Modifications to Prevent Falls amongst the General Population

Home fall injuries amongst the general population are common and costly. In the Home Injury Prevention Intervention (HIPI) trial, we showed that 26% of medically treated home fall injuries could be prevented by a package of home modifications undertaken by qualified builders. This paper describes how we addressed unexpected safety issues associated with the implementation of the programme. Following the intervention, we ensured that participants could contact the builders. We monitored any problems or issues over a two-year period. We also held public meetings to explain the results of the study and record participants’ comments about the trial. Generally, people were satisfied with the modifications. However, there were clear safety issues with particular modifications and we revisited homes to address these. These findings highlight the need to allocate some resources for monitoring and remediation work to follow up interventions, and also a need for some regulation of the quality of safety products

Study Protocol of a Randomized Controlled Trial of Home Modification to Prevent Home Fall Injuries in Houses with Māori Occupants

Worldwide, injuries due to falls in the home impose a substantial burden and merit considerable effort to find effective prevention measures. The current study is one of very few randomized controlled trials that assess the effectiveness of home modification for preventing falls. It is the first carried out with a minority or indigenous community and focused on reducing inequities. Just over 250 households in Aotearoa, New Zealand, with Māori occupants were recruited in two strata, 150 from the Wellington region and 100 from the Taranaki region. These were randomly allocated to equally sized treatment and control groups within the respective regions, the treatment group receiving a package of home modifications designed to prevent falls at the start of the study, and the control group receiving the package at the end of the study. Injury data came from the Accident Compensation Corporation, a state-owned no-fault injury insurer. This provided coverage of virtually all unintentional injuries requiring medical treatment. Matched injury claims were made available for analysis once all identifying fields had been removed. These data will be pooled with data for Māori households from the already-conducted Home Injury Prevention Intervention (HIPI) study, which tested an identical intervention on the general population. In the analysis, the primary outcome measure will be fall injury rates over time, comparing treatment and control households, adjusting for the stratum and prior falls in the household. A secondary measure will be the rates of specific injuries, which are most likely to be prevented by the package of modifications tested. We anticipate that the findings will provide robust evidence for effective injury prevention measures that can reduce an important contributor to health inequities for indigenous populations such as the Māori

He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing

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