Factors Associated with Uptake of No-Cost Safety Modifications to Home Access Steps: Implications for Equity and Policy

Abstract

(1) Background: Fall injuries in the home present a major health burden internationally for all age groups. One effective intervention to prevent falls is home modification, but safety is only increased if opportunities to install safety modifications are taken up. This study sought to identify factors that may lead to a higher uptake of no-cost home modifications when these are offered to people living in the community. (2) Methods: We studied 1283 houses in the New Zealand cities of New Plymouth and Wellington. Using logistic regression, we modelled the odds of uptake according to the number of access steps, the provider who was undertaking the modifications, occupant ethnicity, prior fall injury history, and age group. (3) Results: Homes with older residents (age 65+) had higher uptake rates (35% vs. 27% for other homes). Larger numbers of access steps were associated with higher uptake rates. There was indicative evidence that homes with Indigenous Māori occupants had a higher uptake of the modifications for one of the two providers, but not the other. (4) Conclusions: No-cost home safety modifications offered via cold calling are likely to have relatively low uptake rates but the households that do consent to the modifications may be those who are more likely to benefit from the concomitant increased safety.