Implementation of the Child Housing Assessment for a Safe Environment

NCT05886270 | Completed

• 2 other identifiers: MDHHU0059-20IRB00018899
• Study Type: interventional
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

This implementation study uses a multi-method quantitative and qualitative, non-experimental design to estimate the magnitude of home injury risks, identify strategies for addressing those risks and sustaining those interventions, and to calculate the costs of housing-related modifications to prevent childhood home injuries. The study objectives are to: Aim 1. Implement injury prevention measures based on safety hazards identified using the CHASE Tool within 300 low-income households (at or below 80% AMI) in Baltimore City or County; Aim 2. Determine the costs of the injury prevention measures completed by residents and/or professional providers; Aim 3. Conduct a formative evaluation using mixed methods to 3a. determine feasibility of incorporating injury prevention into residential programs from the perspective of installers and residents, including identifying barriers and facilitators, and 3b. understand the consistency of implementing and maintaining the injury prevention measures across referral sources, by residents and staff.

Conditions

Accident Injury; Home Injury

Outcome Measures

Primary Outcomes (15)

• Change in number of Poison Storage hazards

  Poison storage injury hazards will be identified using the CHASE Tool. Fail criteria include: "Your medicine is not locked up" and "Your household products are not locked up."

  Baseline, 1 month, 3 months

• Change in number of Smoke Alarms hazards

  Smoke alarm injury hazards will be identified using the CHASE Tool. Fail criteria include: "You do not have a smoke alarm on every level of your home."

  Baseline, 1 month, 3 months

• Change in number of Fire Escape Safety hazards

  Fire escape safety injury hazards will be identified using the CHASE Tool. Fail criteria include: "You do not have at least two exits in all sleeping areas", "Your fire escape exit (door/window) is not working", and "Your fire escape exit(s) are blocked."

  Baseline, 1 month, 3 months

• Change in number of Sprinkler System hazards

  Sprinkler system injury hazards will be identified using the CHASE Tool. Fail criteria include: "Your sprinkler system is leaking."

  Baseline, 1 month, 3 months

• Change in number of Carbon Monoxide Alarm hazards

  Carbon monoxide alarm injury hazards will be identified using the CHASE Tool. Fail criteria include: "You do not have at least one carbon monoxide alarm on each level of the home."

  Baseline, 1 month, 3 months

• Change in number of Electrical Fire and Shock hazards

  Electrical fire and shock injury hazards will be identified using the CHASE Tool. Fail criteria include: "You have a dangerous power strip", "You have a dangerous electrical cord", "You have wires sticking out", "Your electrical receptacle does not have a cover", "Your electrical receptacle is broken", and "Your electrical breaker is broken."

  Baseline, 1 month, 3 months

• Change in number of Electrical Tripping Risk hazards

  Electrical tripping injury hazards will be identified using the CHASE Tool. Fail criteria include: "You have electrical extension cords that pose a trip and fall hazard."

  Baseline, 1 month, 3 months

• Change in number of Hot Water Burn hazards

  Hot water burn injury hazards will be identified using the CHASE Tool. Fail criteria include: "You need to retest the hot water temperature to make sure it is a safe temperature", and "You need a new water heater tank installed."

  Baseline, 1 month, 3 months

• Change in number of Window Fall hazards

  Window fall injury hazards will be identified using the CHASE Tool. Fail criteria include: "Not all of your windows at or above the second level of the home have window stops or guards."

  Baseline, 1 month, 3 months

• Change in number of Accidental Strangulation hazards

  Accidental strangulation injury hazards will be identified using the CHASE Tool. Fail criteria include: "Your blinds pose a hazard (you do not have cord protectors or cordless blinds/shades)", and "Your blinds/curtains are not cordless, cord protected, or cord unprotected but inaccessible to the child."

  Baseline, 1 month, 3 months

• Change in number of Stair Fall hazards

  Stair fall injury hazards will be identified using the CHASE Tool. Fail criteria include: "Your interior stairs are unsafe", "Your carpet is loose", "Your handrails are defective", and "Your railings are defective."

  Baseline, 1 month, 3 months .

• Change in number of Bathroom Fall hazards

  Bathroom fall injury hazards will be identified using the CHASE Tool. Fail criteria include: "Your shower or tub floor surface needs to be deep cleaned before non-slip decals can be applied", "Your shower or tub floor surface needs to be cleaned before non-slip decals can be applied", "You do not have grab bars in your bath tub(s)/shower(s)", and "You do not have a secured, structurally sound shower door."

  Baseline, 1 month, 3 months

• Change in number of Protruding Nail hazards

  Protruding nails will be identified using the CHASE Tool. Fail criteria include: "You have nails or screws that stick out of the walls and floors that could hurt someone."

  Baseline, 1 month, 3 months

• Change in number of Falling Furniture hazards

  Falling furniture injury hazards will be identified using the CHASE Tool. Fail criteria include: "You have an entertainment center(s) \> 3 ft. above the ground that is not secured to the wall", "You have a book case in the room that is not secured to the wall", "You have a flat screen TV in the room that is not secured to the wall", "You have a traditional TV in the room that is not secured to the wall", and "You have a stove that is not secured to the wall or cabinet/counter."

  Baseline, 1 month, 3 months

• Change in number of Stair Gate hazards

  Stair gate injury hazards will be identified using the CHASE Tool. Fail criteria include: "You do not have a stair gate installed at the top or bottom of the stairs on the 2nd, and if applicable, 3rd floor", "Not all the stair gates at the top of the stairs are hardware mounted", and "The basement does not have a stair gate at the bottom of the stairs and the top of the stairs, if there is no door at the top of the stairs."

  Baseline, 1 month, 3 months

Secondary Outcomes (3)

• Cost of installing injury prevention measures

  1 month, 3 months

• Change in participants' self-reported rates of experienced barriers and facilitators to incorporating injury prevention tools in their home.

  Baseline, 1 month, 3 months

• Change in qualitative descriptions of participants' confidence to make and maintain injury prevention measures in their home.

  1 month, 3 months

Study Arms (1)

Participants

EXPERIMENTAL

This arm consists of 300 homes of low-income families with children \< 7 years of age who are referred from two of GHHI's currently active programs, DSS Foster Care Homes Program, and Amerigroup Maryland Asthma Program.

Other: Housing Assessment/Safety Modifications

Interventions

Housing Assessment/Safety Modifications OTHER

A GHHI Assessor will complete three home visits to assess home injury hazards and provide a scope of work that includes home modifications that directly address each of the identified home injury hazards. The Assessor will also provide do-it-yourself education materials and injury prevention supplies to assist them in completing the modifications.

Participants

Eligibility Criteria

• Age: Up to 7 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Households with at least one child under 7 years of age, or foster care families planning to host a child under 7
• The child under 7 years of age lives with the parent or legal guardian most of the time
• Income at or below 80% AMI as defined by US Department of Housing and Urban Development (HUD)
• A home address in Baltimore City or Baltimore County

You may not qualify if:

• Parent or guardian whose household is participating is not in either the GHHI DSS Foster Care Homes Program (FCHP) OR GHHI Amerigroup Maryland Asthma Program (AMAP)
• Household does not have at least one child under 7 years of age, or foster care families are not planning to host a child under 7
• The child under 7 years of age does not live with the parent or legal guardian most of the time
• Income is not at or below 80% AMI as defined by HUD
• The home address is not in Baltimore City or Baltimore County

Sponsors & Collaborators

• Johns Hopkins Bloomberg School of Public Health: lead
• Green and Healthy Homes Initiative: collaborator
• US Department of Housing and Urban Development: collaborator

Study Sites (1)

Johns Hopkins Center for Injury Research & Policy

Baltimore, Maryland, 21205, United States

Location

MeSH Terms

Conditions

Accidental Injuries

Condition Hierarchy (Ancestors)

Wounds and Injuries

Study Officials

• Wendy Shields, PhD

  Johns Hopkins Center for Injury Research and Policy

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: A total of 300 homes in Baltimore City and Baltimore County will be studied, which will be referred from two of GHHI's currently active programs, DSS Foster Care Homes Program (FCHP, n=200 homes) and Amerigroup Maryland Asthma Program (AMAP, n=100 homes), which are Medicaid eligible children referred from Amerigroup-Maryland into GHHI's asthma home-visiting program. The investigators selected families in FCHP and AMAP because they are a representative and generalizable population of low-income children known to have a greater risk of home injuries.

Study Record Dates

• First Submitted: August 4, 2022
• First Posted: June 2, 2023
• Study Start: June 24, 2022
• Primary Completion: December 5, 2025
• Study Completion: December 5, 2025
• Last Updated: December 22, 2025

Record last verified: 2025-12

Locations

US (1)