Healthy Homes Healthy Children (H3C)
Condition: Injury in the Home
Study type: Interventional

Summary: 
      Aim

      To evaluate the efficacy of a CCHMC Human Resources Benefits program to reduce exposure to
      injury hazards and subsequent injury-related medical claims for their children.

      Hypothesis

      H1: The investigators anticipate, based on our recently completed trial, that the
      installation of multiple, passive safety devices in the homes of children 6- to 36-month old
      children of CCHMC non-contract employees randomized to the intervention group will reduce
      childhood injuries and medical claims by 50% compared to children of CCHMC non-contract
      employees who do not receive the home safety program.

      H2: Cincinnati Children's Hospital Medical Center Employees whose children are randomized to
      the intervention will have 30% less lost work days compared to employees whose children are
      assigned control group.
    

Detailed description: 
      Injury is the leading cause of morbidity and mortality for US children; the home is the
      leading location of injury for younger US children. Unintentional injuries in the home
      environment account for more than 4 million visits to emergency departments, with over 74,000
      hospitalizations and 2,800 deaths each year in US children at a cost in excess of $3 billion
      annually and $800 per emergency visit. Ambulatory visit rates for injury in US Children are
      more than 3-fold higher than emergency visit rates and account for more than 13 million
      visits to offices and clinics each year in the U.S.

      There is increasing interest in developing systems to improve the health of populations of
      children residing in the Cincinnati Children's Hospital Medical Center (CCHMC) primary
      service area. Emerging payment models are fostering programs that can improve proactive
      population health management including preventive measures to reduce morbidity and improve
      the value of health services provided by insurers and accountable care organizations. This
      project will test the efficacy of an intervention to reduce exposure to injury hazards in the
      home and subsequent preventable and medically attended injury in young children.

      Experimental Group: In homes of children randomized to the intervention arm of the trial, a
      comprehensive observational survey of living spaces will be undertaken. The study will
      examine living spaces to which a child may be exposed including 5 high-exposure, high-risk
      areas (main activity room, kitchen, child's bedroom and bathrooms, and stairways). In
      addition to quantifying hazards, the area of rooms will be obtained allowing for
      determination of both the number and density of injury hazards.

      The hazards identified by the intervention team will be reviewed with the parent and the
      proposed interventions will be presented. Intervention options are designed and prioritized
      so that the most passive and durable interventions are recommended first and progressively
      less 'passive' and less durable options last. After consent is obtained, passive measures
      will be installed across the living space as indicated.

      Control Group: Participants who are assigned to the control group will have their medical
      claims examined related to injury in the home. Households in this control condition will also
      be provided with information sheets on child safety developed by the American Academy of
      Pediatrics, The Injury Prevention Program (TIPP). These age-based recommendations for child
      safety are provided as standard of care at many pediatric offices.
    

Intervention name(s): Injury Prevention Measures
Intervention type(s): Other
Intervention description(s): The hazards identified in the home will be reviewed with the parent and the proposed interventions will be presented. Intervention options are designed and prioritized so that the most passive and durable interventions are recommended first (e.g. self-closing, self-locking stair gate) and progressively less 'passive' and less durable options last (e.g. area gate, pressure mounted gate, or refusal of intervention).
Other intervention name(s): Injury in the Home; Injury; Injury Prevention; Cincinnati Home Injury Prevention; Injury Hazards; Modifiable Injury Hazards
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Injury; Injury Prevention; Cincinnati Home Injury Prevention; Injury Hazards; Modifiable Injury Hazards