title: Increasing smoke alarm operability through theory-based health education: a randomised trial.
abstract: BACKGROUND
  Although working smoke alarms halve deaths in residential fires, many households do not keep alarms operational. We tested whether theory-based education increases alarm operability.
  
  
  METHODS
  Randomised multiarm trial, with a single arm randomly selected for use each day, in low-income neighbourhoods in Maryland, USA. Intervention arms: (1) Full Education combining a health belief module with a social-cognitive theory module that provided hands-on practice installing alarm batteries and using the alarm's hush button; (2) Hands-on Practice social-cognitive module supplemented by typical fire department education; (3) Current Norm receiving typical fire department education only. Four hundred and thirty-six homes recruited through churches or by knocking on doors in 2005-2008. Follow-up visits checked alarm operability in 370 homes (85%) 1-3.5 years after installation.
  
  
  METHODS
  number of homes with working alarms defined as alarms with working batteries or hard-wired and number of working alarms per home. Regressions controlled for alarm status preintervention; demographics and beliefs about fire risks and alarm effectiveness.
  
  
  RESULTS
  Homes in the Full Education and Practice arms were more likely to have a functioning smoke alarm at follow-up (OR=2.77, 95% CI 1.09 to 7.03) and had an average of 0.32 more working alarms per home (95% CI 0.09 to 0.56). Working alarms per home rose 16%. Full Education and Practice had similar effectiveness (p=0.97 on both outcome measures).
  
  
  CONCLUSIONS
  Without exceeding typical fire department installation time, installers can achieve greater smoke alarm operability. Hands-on practice is key. Two years after installation, for every three homes that received hands-on practice, one had an additional working alarm.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov number NCT00139126.
authors.affiliation: Pacific Institute for Research and Evaluation, Calverton, Maryland, USA Faculty of Health Sciences, Centre for Population Health Research, Curtin University, Perth, Australia.
authors.forename: Ted R
authors.identifier: http://orcid.org/0000-0002-0958-2639
authors.initials: TR
authors.lastname: Miller
authors.affiliation: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA.
authors.forename: Gwen
authors.initials: G
authors.lastname: Bergen
authors.affiliation: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Ballesteros
authors.affiliation: Pacific Institute for Research and Evaluation, Calverton, Maryland, USA.
authors.forename: Soma
authors.initials: S
authors.lastname: Bhattacharya
authors.affiliation: Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Andrea Carlson
authors.initials: AC
authors.lastname: Gielen
authors.affiliation: Econometrica, Inc., Bethesda, Maryland, USA.
authors.forename: Monique S
authors.initials: MS
authors.lastname: Sheppard
mesh_terms: D002028:Building Codes; D005191:Family Characteristics; D005260:Female; D006266:Health Education; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008396:Maryland; D008875:Middle Aged; D008962:Models, Theoretical; D011482:Protective Devices / Q000592:standards*; D036301:Qualitative Research; D012449:Safety; D012906:Smoke
chemical_list: D012906:Smoke
keywords: Accidents; Health Education Sa; Housing; Injuries; Randomised Trials