Date Published: May 20, 2019
Publisher: Public Library of Science
Author(s): Maya Senthilkumaran, Goris Nazari, Joy C. MacDermid, Karen Roche, Kim Sopko, Wisit Cheungpasitporn.
To assess the effectiveness of Home Fire Safety (HFS) interventions versus other interventions/no interventions/controls on HFS knowledge and behaviour at short-, intermediate- and long-term follow ups.
Systematic review and meta-analysis of randomized controlled trials.
MEDLINE, EMBASE and PubMed databases were searched from January 1998 to July 2018, and studies retrieved.
Toddlers, children (primary or secondary school), teenagers or adults.
HFS interventions compared to other interventions / no interventions / controls.
HFS knowledge and behaviour.
10 studies were identified (8 RCTs and 2 prospective cohort). Two studies assessed the effects of HFS interventions vs no interventions on HFS knowledge at up to 4 months follow up in school children and demonstrated significant difference between groups (very low quality, 2 RCTs, 535 participants, SMD 0.38, 95% CI: 0.21 to 0.55, p < 0.001). One study examined the effects of different modes of HFS interventions (computer-based vs instructor-led) on HFS knowledge and behaviour immediately post-intervention in adults and displayed no significant difference between groups (HFS knowledge; very low quality, 1 RCT, 68 participants, SMD -0.02, 95% CI: -0.50 to 0.45, p = 0.92) and (HFS behaviour; very low quality, 1 RCT, 68 participants, SMD 0.06, 95% CI: -0.41 to 0.54, p = 0.79) respectively. The limited evidence supports the use of HFS interventions to improve HFS knowledge and behaviour in children, families with children and adults.
Every day, 7 people die from home fires in the United States (US) . Residential fires remain a major public health burden [2–4]. Between 2011 and 2015, U.S. fire departments responded to an average of 358,500 home structure fires per year, which resulted in an average of 2,510 fatalities annually . In 2016, the rate at which U.S. home structure fires were reported was 1.1 per thousand population . In United Kingdom, it was estimated that at least 500 deaths and 15,000 injuries were due to residential fires in 1998 [5–6].
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane collaboration guidelines [28–29] (S1 Checklist) PROSPERO registration number: CRD42018106866.
This review identified and synthesized the most rigorously designed intervention studies, finding that there is a small number of studies examining diverse HFS interventions on knowledge and behaviour. In fire prevention research a major challenge is how researchers can ascertain whether a fire was prevented. Hence, they rely on test of knowledge of fire prevention strategies. The limitation, which is substantial, is that this may not insure these strategies are implemented. However, promising results were found in the small pool of studies in that statistically and clinically important improvements in HFS knowledge were found when different interventions were compared to the control or no intervention groups, in primary school children and families with children at up to 4 months follow up. We also found that there was no immediate difference in HFS knowledge and behavioural improvements between two ways of delivering HFS programs (instructor-led vs. computer-based).
The limited evidence supports the use of HFS interventions to improve HFS knowledge and behaviour in children, families with children and adults. Large-scale well-designed randomized controlled trials that consider the unique nature of prevention research and look at behavioural or fire rates as outcomes in larger scale implementation are needed to further assess the effectiveness of HFS interventions.