Background
Methods
Identification of relevant articles
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(Fall OR accident OR accidental fall)
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AND (home adj3 hazard* OR environment* adj3 hazard*)
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AND (housing OR public housing OR Housing for the elderly OR home OR dwelling)
Inclusion and exclusion criteria
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Assess environmental hazards for falls in one or more of the following settings: personal homes or apartments, public housing, and housing for older persons including retirement residences, even if the checklist was not entirely described.
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Include an assessment of environmental hazards in bathrooms and/or on stairs/steps by lay and/or professional raters (e.g. nurses providing home healthcare services).
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Involve a population aged 65 years of age or older.
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Primary research study or research protocols for primary studies.
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Focus exclusively on hospital or long-term care settings.
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Focus exclusively on a population aged less than 65 years of age (e.g. children).
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Not written in English or French.
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Conference and poster abstracts; letters, commentaries, editorials, reviews (e.g. narrative reviews, systematic reviews, meta-analysis studies), and practice guideline papers.
Study selection
Data extraction
Stage and Fields | Description (and response options where applicable) |
---|---|
Stage 1 | |
Definition of environmental hazards | The definition of environmental hazards |
Definition of falls | The definition of falls |
Study objective | The objective of the study |
Year | Year of the article publication; if more than one article originating from the same study, the year of the first article was selected |
Country(ies) | Country(ies) where the study was conducted |
Population | Specific characteristics of the study population |
Assessors | Who assessed environmental hazards (occupational therapist; physiotherapist, nurse; researcher or research assistant; other professional; participants or family members) |
Training or experience | Whether assessors were trained to use the checklist or experienced with home assessment (yes or no) |
Quality of the training | Details about the training provided to assessors |
Checklist name | The name of the specific checklist used |
Psychometric properties | Validity or reliability of the checklist reported for the current study or another study using the same checklist. |
Stage 2 | |
Environmental hazards analyzed/reported | All information provided about what and how hazards were evaluated in bathrooms and on stairs/steps (indoor and/or outdoor), and if and how the person-environment fit was assessed |
Number of items | How many fall-related items were in the checklist (in total; in bathrooms; on indoor stairs/steps; and on outdoor stairs/steps) |
Data coding and analysis
Stage 1
Stage 2
Results
Stage 1
Definitions of environmental hazards
Geographic location and objectives of studies
Checklist used
Checklist | Author | Year | Countries where checklists have been used | Total #of fall-related items in checklist | Psychometric data reported (Y/N) | Bathrooms | Indoor stairs/steps | Outdoor stairs/steps | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
#of fall-related items in bathrooms | > 50% of items are subjective (Y/N) | > 50 of items are non-structural hazards (Y/N) | Assessed grab bars (Y/N) | #of fall-related items on indoor stairs/steps | > 50% of items are subjective (Y/N) | > 50 of items are non-structural hazards (Y/N) | Assessed handrails (Y/N) | #of fall-related items on outdoor stairs/steps | > 50% of items are subjective (Y/N) | > 50 of items are non-structural hazards (Y/N) | Assessed handrails (Y/N) | ||||||
Carter et al. | Carter et al. [51] | 1997 | Australia | 99 | Y | 24 | N | Y | Y | 16 | Y | N | Y | 2 | Y | Y | N |
CDC Home checklist | CDC [148] | 2005 | USA, Singapore | 25 | N | 6 | Y | Y | N | 7 | N | N | Y | 7 | N | N | Y |
Cougar1 | Fisher et al. [71] | 2006 | USA | 56 | Y | 5 | Y | Y | Y | 5 | Y | N | Y | 1 | Y | Y | N |
Edwards & Jones | Edwards & Jones [66] | 1998 | South Wales | 14 | N | 5 | N | Y | Y | 1 | N | N | Y | 0 | a | a | a |
Environmental Safety Checklist | Huang et al. [16] | 2005 | China | 31 | Y | 5 | Y | Y | Y | 4 | Y | Y | Y | 1 | a | a | a |
Evci et al. | Evci et al. [69] | 2006 | Turkey | 15 | N | 6 | N | N | Y | 5 | N | N | Y | 0 | a | a | a |
Greene et al. | Greene et al. [79] | 2009 | USA | 15 | N | 2 | N | N | Y | 4 | N | N | Y | 4 | N | N | N |
Healthy housing index | Keall et al. [90] | 2008 | New Zealand | 26 | N | 3 | Y | N | 12 | Y | Y | 9 | Y | Y | |||
HEAP | Gitlin et al. [15] | 2002 | USA | 69 | Y | 10 | N | Y | Y | 6 | Y | Y | Y | 6 | Y | N | Y |
HEAVI | Yonge et al. [22] | 2017 | USA | 127 | Y | 15 | N | Y | Y | 17 | N | N | Y | 19 | N | N | Y |
HEROS Environmental Safety Check | Sadasivam et al. [124] | 2014 | USA | 5 | Y | 6 | Y | Y | Y | 0 | a | a | a | 0 | a | a | a |
Home Environment Survey | Rodriguez et al. [121] | 1995 | USA | 17 | Y | 4 | N | N | Y | Can’t tell | a | a | a | Can’t tell | a | a | a |
HOME FAST | Mackenzie et al. [102] | 2000 | Australia, Scotland, Malaysia, England | 25 | Y | 6 | Y | Y | Y | 4 | Y | N | N | 1 | Y | N | Y |
HOME FAST – Self-Report Assessment | Mehraban et al. [110] | 2011 | Australia | 87 | Y | 7 | Y | Y | Y | 11 | Y | N | Y | 3 | Y | N | Y |
Home fall hazard assessment | You et al. (2004) [23] | 2004 | China | 60 | Y | 16 | Y | Y | 10 | Y | Y | 0 | a | a | |||
Home-screen safe | Johnson et al. [86] | 2001 | Australia | 10 | N | 2 | Y | Y | N | Can’t tell | a | a | a | Can’t tell | a | a | a |
Housing Enabler2 | Iwarsson & Björn [149] | 2010 | Sweden | 188 | Y | 13 | N | N | Y | 11 | N | N | Y | 11 | N | N | Y |
Housing Enabler screening tool | Carlsson et al. [49] | 2009 | Sweden, Germany, Latvia, Hungary, Denmark, Finland, Iceland, England | 61 | Y | 10 | Y | Y | Y | 6 | Y | N | Y | 6 | Y | N | Y |
Isbener et al. | Isbener et al. [82] | 1998 | USA | 21 | N | 0 | a | a | a | 10 | Y | N | Y | 2 | N | N | N |
Kamei et al. | Kamei et al. [87] | 2015 | 33 | N | 7 | Y | Y | Y | Can’t tell | Y | N | Y | Can’t tell | a | a | a | |
Kellogg international work group | Kellogg international work group [139] | 1987 | Canada, USA | 40 | N | 4 | Y | Y | Y | 6 | Y | N | Y | 0 | a | a | a |
Lan et al. | Lan et al. [17] | 2009 | 6 | N | 3 | Y | Y | Y | 0 | a | a | a | 1 | Y | N | Y | |
Lim & Sung | Lim & Sung [126] | 2012 | Korea | 3 | N | 1 | N | Y | N | 0 | a | a | a | 0 | a | a | a |
MAHC-10 Fall Checklist | Bamgbade & Dearmon [44] | 2016 | USA | 1 | N | < 1 | a | a | N | Can’t tell | a | a | a | Can’t tell | a | a | a |
Marshall et al. | Marshall et al. [108] | 2005 | USA | 10 | N | 2 | N | N | Y | 1.5 | N | N | Y | 1.5 | N | N | Y |
McLean & Lord | McLean & Lord [34] | 1996 | Australia | 15 | N | 4 | N | Y | Y | 0 | a | a | a | 2 | N | N | Y |
MDS-HC | Morris et al. [112] | 1997 | Canada, Hong Kong, USA, Korea, Italy, Australia, Czech Republic, Japan | 8 | Y | 1 | Y | Y | Y | 1 | Y | N | N | 1 | Y | Y | N |
Morgan et al. | Morgan et al. [111] | 2005 | 73 | Y | 13 | Y | Y | Y | 2 | Y | N | Y | 4 | N | N | Y | |
Nevit et al. | 1898 | USA | 22 | Y | 8 | Y | Y | Y | 0 | a | a | a | 0 | a | a | a | |
Safe living guide | Public Health Agency of Canada [151] | 2015 | Canada | 34 | Y | 9 | Y | Y | Y | 6 | Y | Y | Y | 2 | Y | N | Y |
SAFER-HOME | Chiu & Oliver [53] | 2006 | Canada, USA | 17 | Y | 7 | Y | Y | Y | 2 | Y | N | Y | 0 | a | a | N |
SAFER Tool | Letts et al. [98] | 1998 | Canada | 17 | Y | 5 | Y | Y | Y | 2 | Y | N | Y | 0 | a | a | N |
Sattin et al. | Sattin et al. [8] | 1998 | USA | 10 | Y | 3 | N | Y | Y | 0 | a | a | a | 0 | a | a | a |
Sophonratanapokin et al. | Sophonratanapokin et al. [132] | 2012 | Thailand | 9 | N | 4 | N | N | Y | 2 | N | N | Y | 1 | N | N | N |
Stalenhoef et al. | Stalenhoef et al. [135] | 1998 | Netherlands | 116 | Y | 17 | Y | Y | Y | 11 | Y | N | Y | 0 | a | a | a |
Stevens et al. | Stevens et al. [137] | 2001 | Australia | 14 | N | 8 | Y | Y | N | 2 | N | N | N | 0 | a | a | a |
Tanner | Tanner [20] | 2003 | USA | 20 | N | 2 | N | N | Y | Can’t tell | Y | N | Y | Can’t tell | a | a | a |
Tideiksaar et al. | Tideiksaar et al. [140] | 1987 | Canada, England, USA | 37 | Y | 6 | Y | N | Y | 4 | Y | N | Y | 5 | Y | N | Y |
Vladutiu et al. | Vladutiu et al. [144] | 2012 | USA | 6 | N | 2 | N | N | Y | 3 | N | N | Y | 1 | N | N | N |
WeSHA | Clemson et al. [58] | 1992 | Australia, England, New Zealand, USA | 72 | Y | 10 | Y | Y | Y | 7 | Y | N | Y | 5 | Y | N | Y |
Wyman et al. | Wyman et al. [21] | 2007 | USA | 37 | Y | 12 | Y | Y | Y | 7 | Y | N | Y | 0 | a | a | a |
Zhang et al. | Zhang et al. [152] | 2016 | China | 30 | Y | 8 | Y | Y | Y | 6 | Y | N | Y | 1 | Y | N | N |
Psychometric properties of checklists
Study populations
Who completed the assessment
Report developing a checklist or testing its validity or reliability | |||
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Report training assessors | Yes (n = 67) | No (n = 53) | p* |
Yes | 56.7% | 20.8% | < 0.0001 |
No | 43.3% | 79.2% |
Stage 2
Location of assessment items | Checklists including ≥1 items n (%) | Range for number of items | Average (SD) number of items |
---|---|---|---|
Bathrooms | 39 (92.9%) | 1–24 | 7.2 (5.1) |
Indoor stairs/steps | 33 (78.5%) | 1–17 | 6.0 (4.2) |
Outdoor stairs/steps | 23 (54.7%) | 1–19 | 4.2 (4.2) |
All locations | 42 (100%) | 1–188 | 38.1 (38.8) |
Person-environment fit
Summary of key findings related to bathrooms
Characteristics of items assessed on checklists | n (%) |
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Overall | |
> 50% of items are subjective | 25 (63%) |
> 50% of items are non-structural hazards | 30 (77%) |
Frequently assessed hazards | |
Assessed the presence of throw rugs and/or if they were well anchored to the floor (non-structural hazards) | 20 (51%) |
Assessed the lack of a non-skid mat or strips in the tub and/or shower (non-structural hazards) | 22 (56%) |
Assessed the absence of grab bars (structural hazards) | 35 (90%) |
Summary of key findings related to stairs/steps
Characteristics of items assessed on checklists | n (%) |
---|---|
Indoor stairs/steps (n = 33 checklists) | |
> 50% of items are subjective | 23 (70%) |
> 50% of items are non-structural hazards | 3 (9%) |
Assessed handrails absence or features (structural hazard) | 30 (91%) |
Outdoor stairs/steps (n = 23 checklists) | |
> 50% of items are subjective | 13 (57%) |
> 50% of items are non-structural hazards | 3 (13%) |
Assessed handrails absence or features (structural hazard) | 15 (65%) |