Modifying the environment: a community-based injury-reduction program for elderly residents

The Department of Public Health, City and County of San Francisco, established the Community and Home Injury Prevention Program for Seniors (CHIPPS) to reduce the rate of unintentional injuries among elderly residents. Through a collaboration between the CHIPPS program, the University of California at Berkeley School of Public Health and the University of California at San Francisco School of Medicine, we tested the hypothesis that providing minor home safety modifications would reduce rates of falls, scalds, and burns. A one-group, pretest-posttest design was used to compare self-reported falls, scalds, and burns for six-month periods before and after the intervention. The intervention used 10 person-hours of unskilled labor and $93 worth of materials on average and included home safety assessments and modifications such as removing clutter; installing hand rails, grab bars, nonskid strips; and securing rugs and electrical cords. Reported falls were reduced by 60% after the intervention, from 0.81 to 0.33 falls per person year (p < .01). Scalds were reduced from 9 to 0 (P < .01) and burns from 7 to 0 (P < .02) during the six-month periods before and after the intervention. Some of the apparent effect may be due to differential reporting. This community-based program to reduce hazards in the home environments of senior citizens was feasible, well accepted, and probably effective in preventing falls, burns, and scalds. Medical Subject Headings (MeSH): accidental falls/prevention and control, aged, safety.