Background This study evaluates the impact of an enhanced fire department home visiting program on community participation and installation of smoke alarms and describes the rate of fire and burn hazards observed in homes. Methods Communities were randomly assigned to receive either a standard or enhanced home visiting program. Prior to implementing the program, 603 household surveys were completed to determine comparability between the communities. During a one year intervention period, 171 home visit events took place with 8,080 homes. Results At baseline, 60% of homes did not have working smoke alarms on every level; 44% had unsafe water temperatures; and 72% did not have CO alarms. Residents in the enhanced community relative to those in the standard community were significantly more likely to let the fire fighters into their homes (75% vs 62%). Among entered homes, those in the enhanced community were significantly more likely to agree to have smoke alarms installed (95% vs 92%), to be left with a working smoke alarm on every level of the home (84% vs 78%) and to have more smoke alarms installed per home visited (1.89 vs 1.74). Conclusions The high baseline rates of home hazards suggest that fire department home visiting programs should take an “all hazards” approach. CHWs and other community partnerships can be effective in promoting fire departments’ fire and life safety goals. Public health academic centers should partner with the fire service to help generate evidence on program effectiveness that can inform decision making about resource allocation for prevention.

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Objective Although water heater manufacturers adopted a voluntary standard in the 1980’s to pre-set thermostats on new water heaters to 120°F, tap water scald burns cause an estimated 1,500 hospital admissions and 100 deaths per year in the United States. This study reports on water temperatures in 976 urban homes and identifies water heater and household characteristics associated with having safe temperatures. Methods The temperature of the hot water, type and size of water heater, date of manufacture and the setting of the temperature gauge were recorded. Demographic data including number of people living in the home and home ownership were also recorded. Results Hot water temperature was unsafe in 41% of homes. Homeowners were more likely to have safer hot water temperature (≤ 120°F) than renters (63% vs. 54%; p<0.01). For 11% of gas water heaters, the water temperature was ≥ 130°F, although the gauge was set at less than 75% of its maximum setting. In a multivariate logistic regression, electric water heaters were more likely to have safe hot water temperatures than gas water heaters (OR=4.99; p<0.01). Water heaters with more gallons per person in the household were more likely to be at or below the recommended 120°F. Conclusions Our results suggest that hot water temperatures remain dangerously high for a substantial proportion of urban homes despite the adoption of voluntary standards to preset temperature settings by manufacturers. This research highlights the need for improved prevention strategies such as installing thermostatic mixing valves to ensure a safer temperature.

BackgroundDoor-to-door canvassing and installation of smoke alarms have been found to be effective at increasing the number of homes protected. This analysis reports on how smoke alarm coverage changes six months after a home visiting program in a large urban sample, and how this change varies by characteristics of the residents and characteristics of the services delivered during the home visit.MethodsFire department Standard and Enhanced home visiting programs were compared. During the home visit, fire fighters installed lithium battery smoke alarms. Residents in the Enhanced program received tailored education about fire safety. Six months after the home visit, participating residences were visited to complete a follow-up survey and to have the installed alarms checked.Results81% of the 672 homes that had a working smoke alarm on every level of the home at the end of the home visit remained safe at follow-up, and 87% of the residents found the home visit was very useful, and these rates did not differ between the Enhanced and Standard programs. The degree to which firefighters delivered their services varied, although households in which the resident’s engagement with the fire department team was rated as excellent were 3.96 times as likely to be safe at follow-up compared to those with poor or fair resident engagement (p=0.03).ConclusionsThere is a need to better understand how to maximize the time spent with residents during smoke alarm home visiting programs. This study helps with the development of methods needed for implementing and evaluating such programs in real-world settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s40621-014-0030-3) contains supplementary material, which is available to authorized users.