Barriers and Challenges of a Home Safety Intervention Program in a High Risk Community

Background: Greater than 4.5 million U.S. children are injured in the home annually, and socioeconomically challenged children are over-represented in this population.

Objectives: To implement a home safety intervention program using home visitors for at risk families, and to identify the barriers and challenges of such an intervention.

Methods: A home safety intervention program using home visitors was implemented for at risk families identified in a hospital-based primary care clinic. Research eligibility was determined by zip code of residence and age of child less than five years in the household. A baseline home visit was conducted where knowledge and behavior about home safety was recorded. Then home safety education and a home safety kit were provided. A follow-up home visit was conducted two months after the initial visit to observe changes in home safety behavior and knowledge. Statistical analysis will be done between intake and follow-up visit to gauge the effectiveness of the intervention.

Results: As of February 2009 forty-seven baseline home visits have been completed and follow-up visits are being conducted. There are multiple barriers and challenges in implementing this intervention. Examples include lack of permanent housing in this population, instability of phone numbers to arrange follow up visits and concern for the safety of the home visitors during some of the home visits.

Conclusion: Implementing a home safety intervention program using hospital-based home visitors for a hospital-based primary care clinic has revealed multiple barriers and challenges.