This study assessed whether use of the Home Safety Self Assessment Tool (HSSAT) in a community health education program would increase knowledge of home safety, ability to recognize activities that can pose home safety problems, and ability to safely perform home activities and promote plans to reduce fall hazards. It was hypothesized that older adult participants would increase: Knowledge of home safety and ways to reduce falls risks at home, ability to safely perform routine activities at home, ability to recognize activities that can pose safety problems and fall risks, and likelihood of developing a plan to reduce home hazards.

More than 70 million Americans are expected to be age 65 yr or older by 2030; most want to age in their homes and communities. Falls are a major public health problem and cause of unintentional injury for older adults. One out of three older adults falls each year. Although falls often result from multifactorial causes, environmental factors often independently contribute to falls. Safe home environments support older adults’ independence and can reduce falls. Occupational therapists play key roles in fall prevention to support home safety and community living.

This study examined whether an occupational therapy community health education program using the HSSAT enables diverse, urban older adults to improve home safety and reduce fall risks.

The study used a quasi-experimental pretest and posttest design as well as a qualitative component using focus groups. Participants were English-speaking adults ≥60 yr old who attended senior centers. They were recruited through informational flyers. Inclusion criteria required the ability to read and speak English, participate in discussions, use a telephone, ambulate independently with or without ambulatory aids, and participate in 4 weekly sessions. Exclusion criteria included vision, hearing, or cognitive impairments limiting reading or communication, inability to use a telephone, and need for full-time help at home. Licensed community agency social workers were recruited using informational flyers.

Quantitative data were obtained from pre- and posttest questionnaires. Focus group data were obtained from audiotape transcripts and field notes. SPSS Version 22 was used for quantitative statistical analysis.

Descriptive statistics were used to analyze demographic information. The Wilcoxon signed-rank test, a nonparametric test, was used to determine if there were significant differences between pre- and posttest responses on questionnaires. Focus group data were analyzed using content analysis. Significant differences pre and post were found for older adults’ ability to recognize activities that pose safety problems (p = .013) and to establish a plan to improve home safety (p = .02), supporting two of four hypotheses. Focus group data found consensus that home safety is a major problem for community-living older adults; the HSSAT was seen as a promising tool for community practice.

Findings support the benefit of providing occupational therapy community-based home safety programs using the HSSAT to increase older adults’ abilities to (1) recognize activities that can pose safety problems and fall risks and (2) design plans to increase safety at home. Focus group data analysis supports using the HSSAT in community practice with elders with opportunities for interdisciplinary home safety programs.

IMPACT STATEMENT: This study supports occupational therapy home safety programs using the HSSAT. The 2016 American Occupational Therapy Association Centennial Vision priorities list a need for evidence-based practice and participation in prevention. This program provides one such example with opportunities for interdisciplinary collaboration.