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Cited by 226Balance, Gait, and Falls PreventionInjury Epidemiology and PreventionOccupational Health and Safety Research

The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.

Home modifications to reduce injuries from falls in the Home Injury Prevention Intervention (HIPI) study: a cluster-randomised controlled trial

Keall, Michael D, Pierse, Nevil, Howden-Chapman, Philippa, Cunningham, Chris, Cunningham, Malcolm, Guria, Jagadish, Baker, Michael G·2015·The Lancet
DOI 10.1016/s0140-6736(14)61006-0
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Abstract

Background Despite the considerable injury burden attributable to falls at home among the general population, few effective safety interventions have been identified. We tested the safety benefits of home modifications, including handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, edging for outside steps, and slip-resistant surfacing for outside areas such as decks and porches.Methods We did a single-blind, cluster-randomised controlled trial of households from the Taranaki region of New Zealand. To be eligible, participants had to live in an owner-occupied dwelling constructed before 1980 and at least one member of every household had to be in receipt of state benefits or subsidies. We randomly assigned households by electronic coin toss to either immediate home modifications (treatment group) or a 3-year wait before modifications (control group). Household members in the treatment group could not be masked to their assigned status because modifications were made to their homes. The primary outcome was the rate of falls at home per person per year that needed medical treatment, which we derived from administrative data for insurance claims. Coders who were unaware of the random allocation analysed text descriptions of injuries and coded injuries as all falls and injuries most likely to be affected by the home modifications tested. To account for clustering at the household level, we analysed all injuries from falls at home per person-year with a negative binomial generalised linear model with generalised estimating equations. Analysis was by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12609000779279.Findings Of 842 households recruited, 436 (n=950 individual occupants) were randomly assigned to the treatment group and 406 (n=898 occupants) were allocated to the control group. After a median observation period of 1148 days (IQR 1085-1263), the crude rate of fall injuries per person per year was 0.061 in the treatment group and 0.072 in the control group (relative rate 0.86, 95% CI 0.66-1.12). The crude rate of injuries specific to the intervention per person per year was 0.018 in the treatment group and 0.028 in the control group (0.66, 0.43-1.00). A 26% reduction in the rate of injuries caused by falls at home per year exposed to the intervention was estimated in people allocated to the treatment group compared with those assigned to the control group, after adjustment for age, previous falls, sex, and ethnic origin (relative rate 0.74, 95% CI 0.58-0.94). Injuries specific to the home-modification intervention were cut by 39% per year exposed (0.61, 0.41-0.91).Interpretation Our findings suggest that low-cost home modifications and repairs can be a means to reduce injury in the general population. Further research is needed to identify the effectiveness of particular modifications from the package tested.Funding Health Research Council of New Zealand.

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Crossref · 10.1016/s0140-6736(14)61006-0

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  • The social benefits of injuries prevented by the HIPI intervention were estimated to be at least six times the costs of the intervention.

    “The social benefits of injuries prevented were estimated to be at least six times the costs of the intervention.”

    From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [86]

  • The HIPI benefit-cost ratio could be at least doubled for older people and increased by 60% for those with a prior history of fall injuries.

    “This benefit-cost ratio could be at least doubled for older people and increased by 60% for those with a prior history of fall injuries (irrespective of age).”

    From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [86]

  • An economic analysis of the HIPI intervention found that the costs of home fall injuries fell by 33%, indicating that more expensive/severe injuries were likely prevented to a greater extent than more minor injuries.

    “An economic analysis of this intervention found that the costs of home fall injuries fell by 33%, indicating that the more expensive/severe injuries were likely to have been prevented to a greater extent than more minor injuries.”

    From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [86]

  • In the HIPI RCT, injuries specific to the home-modification intervention were cut by 39%.

    “injuries specific to the home-modification intervention were cut by 39%.”

    From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [86]

  • The HIPI RCT found a 26% reduction in the rate of injuries caused by falls in the treatment group compared to controls.

    “There was a 26% reduction in the rate of injuries caused by falls in the treatment group compared to the controls”

    From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [86]

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Metadata

Authors
Keall, M. D., Pierse, N., Howden-Chapman, P., Cunningham, C., Cunningham, M., Guria, J., & Baker, M. G.
Affiliations
  • University of Otago (NZ)
  • Massey University (NZ)
  • Building Research Association of New Zealand (NZ)
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2015-01
Volume
385
Issue
9964
Pages
231-238
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(14)61006-0
OpenAlex
W2092907196
Cited by
226
References
22
Citations by year
2026: 11 · 2025: 20 · 2024: 15 · 2023: 20 · 2022: 23 · 2021: 25 · 2020: 15 · 2019: 14 · 2018: 20 · 2017: 26 · 2016: 20 · 2015: 15
FWCI
54.34
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Funders
Health Research Council of New Zealand
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
  • Social Sciences › Safety Research › Occupational Health and Safety Research
Keywords
home injury prevention, home modification, home safety, handrails, outdoor lighting, injury prevention interventions, older adults, low-income households, insurance claims, intention-to-treat analysis, generalized estimating equations, household clustering
MeSH terms
Accidental Falls, Accidents, Home, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Environment Design, Female, Household Articles, Humans, Infant, Infant, Newborn, Lighting, Male, Middle Aged, New Zealand, Wounds and Injuries, Single-Blind Method, Young Adult

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