Table 2

Summary of non-randomised controlled evaluations of interventions to promote smoke alarms

Study, year (country) Intervention (I) and control (C) populations Intervention Assessment Smoke alarms intervention Smoke alarms control Other outcomes: intervention Other outcomes: control
Project Burn Prevention, 1979,38 198234 39 (USA)I: 3 cities in east of stateI1: Mass media.
I2: I1 + school programme.
I3: I1+ community outreach
Population surveillance for ER injury visits, 4 y before to 12 mth after; telephone surveysNot reportedNot reportedAdjusted burn incidence rate ratio, during v before: I1: 1.4 (1.1, 1.6);
I2: 0.8 (0.5, 1.1);
I3: 1.2 (0.8, 1.7)
Adjusted burn incidence rate ratio, duringv before: 1.0 (0.6, 1.5)
C: 2 cities in west of state (with lower baseline burn incidence)C: No intervention
Miller et al, 198240 (USA)I: 120 consecutive parents of children seen for well care in middle class suburban practiceI: Pamphlet, brief education, discount alarms in office; usual well child careHome inspection 4–6 weeks after intervention. Response rate:
I: 108/120 (90%)
Owned: 79/108 (73%). Installed: 72/108 (67%). Functioning: 61/108 (56%)Owned: 64/105 (61%). Installed: 64/105 (61%). Functioning: 46/105 (44%)Not reportedNot reported
C: Preceding 120 consecutive, similar parentsC: Usual well child careC: 105/120 (88%)
LeBailly et al, 199049(USA)407 families with children <5 y seen for well child care in suburban practice or urban clinic, allocated sequentially in groups of ∼100 (differed on home ownership, socioeconomic status)I1: Free alarm and other safety devices
I2: Free alarm and other safety devices, injury prevention counselling
I3: Injury prevention counselling
Non-blinded home interviews and inspections 9 mth after intervention. Response rate: ∼75%Owned: I1: 100%;
I2: 99%;
I3: 92% (numerators, denominators not reported)
Owned: 96% (numerators, denominators not reported)Not collectedNot collected
C: Usual well child care
SCIPP, 198932; Basset al, 199129 (USA)2-150 I: 9 communities (total pop. 139 807)I: Injury prevention programme in communities, schools, homes, and clinical settingsPopulation injury surveillance 1 y before to 2 mth after. Phone survey response: pre, 59%, post, 85% (similar in 2 groups)Owned: 418/508 (82.3%). Change: +9.4%Owned: 339/409 (83.9%). Change: +14.9%Adjusted odds ratio for burns (duringv before), in interventionv control communities: OR = 0.8 (0.5, 1.2)
C: 5 demographically similar communities (total pop. 146 866)C: No intervention
Ozanne-Smithet al, 199442 (Australia)I: MunicipalityI: 3 y community injury prevention programme: mass media, education, training, promotion, and action for hazard reduction and environmental changePopulation injury surveillance; telephone survey post-intervention of 250 randomly selected households each group Installed: 166/248 (67%).
Installed since programme began: 158/248 (64%)
Installed: 166/250 (66%).
Installed since programme began: 156/248 (63%)
Data unavailableData unavailable
C: Demographically similar municipality (with higher baseline injury hospitalisation rate)C: No intervention
Schwarz et al, 199343 (USA)2-150 I: 5 contiguous census tracts (3004 households (51%) participated)I: Free alarms and installation; home inspection, education, modification; community educationInjury surveillance 2 y before to 1 y after; 1 y post-intervention inspection. Response rate:
I: 902/1250 (72%)
Functioning: 866/902 (96%)
Adjusted odds ratio: 0.14 (0.1, 0.2)
Functioning: 816/1060 (77%)Fire related injuries/1000: before: 1.83; during: 1.14; after: 0.86Fire related injuries/1000: before: 1.34; during: 2.68; after: 1.11
C: 4 bordering, contiguous census tracts (similar sociodemographics, baseline injury rates)C: No interventionC: 1060/1472 (72%)Incidence change (afterv before): 0.5 (0.4, 0.6)Incidence change (after v before): 0.8 (0.6, 1.1)
Mallonee et al, 199635(USA)I: City area with highest risk of fire related hospitalisations and deathsI: Door to door alarm give away, fire prevention brochures, limited alarm installationPopulation fire and fire related injury surveillance 2.5 y before to 4 y after programmeFunctioning at 4 y: 45%Not collectedAfter v before:
Fire related injuries/100k: 0.2 (0.1, 0.4). Fire related injuries/100 fires: 0.3 (0.1, 0.6). Fires/1000 homes: 0.75 (0.5, 1.1)
Afterv before:
Fire related injuries/100k: 1.1 (0.7, 1.7). Fire related injuries/100 fires: 1.3 (0.9, 2.0). Fires/1000 homes: 0.8 (0.5, 1.3)
C: Rest of cityC: No intervention
McConnell et al, 199637 (USA)I: All 2350 new residents of subsidised housingI: 35 min mandatory lecture and video on fire safety and prevention; reminder cardPopulation fire surveillance during 15 mth study periodNot collectedNot collected278 fires/100k person years. Relative risk (interventionv control): 0.18 (0.16, 0.21)1538 fires/100k person years
C: All existing residents (lower baseline fire risk, similar sociodemographics)C: No intervention
Centers for Disease Control (USA) (in progress) (n = 5)(5 separate state projects):
I: Within city block groups, town, or city
I: Installation of free smoke alarms in high risk householdsInjury and fire surveillance; smoke alarm ownership and functionIn progressIn progressIn progressIn progress
C: Comparison block groups, town, or cityC: Vouchers to redeem free smoke alarms for high risk households; installation on request
  • 2-150 Unpublished data provided by investigators.