Background Nearly 25% of people with major burn injuries in urban North American burn centers are experiencing homelessness at time of injury. Education, a critical component for the prevention of burn and cold injuries, must be delivered along-side passive and active fire and cold weather protection, especially for populations living unhoused. Prevention education that is written in plain language, depicted in relatable ways, and consumer tested, especially for populations with low health literacy, increases a material’s acceptability, understandability and actionability.

Objective We aimed to consumer test newly developed fire and burn and cold injury prevention education materials with people experiencing homelessness (PEH) in Seattle, Washington. We also aimed to identify PEH preferred prevention strategies to address and mitigate fire and cold weather risks and hazards.

Methods 40 cognitive interviews with people experiencing homelessness were conducted. The Patient Education Materials Assessment Tool (PEMAT-P) and the Model System Knowledge Translation Center (MSKTC) consumer testing toolkit were used to evaluate the understandability and actionability of the newly developed education materials. Transcripts were analyzed with Dedoose using a combination of deductive and inductive thematic coding.

Results Participants provided valuable feedback on the understandability and actionability of newly developed educational materials. Feedback themes were categorized into the domains of 1) engage and relate – being relatable to the diverse experiences and literacy levels of PEH, 2) reduce harm – focus on mitigating rather than eliminating hazards, 3) use context-specific design – reflect PEH and their environments in the materials, 4) empower – incorporate prevention guidance, tips and tricks from PEH in addition to conventional prevention strategies, and 5) prioritize both equipment and education – combine education with dissemination of safety equipment (e.g., fire blankets, cookstove adaptations, clothing).

Conclusions The process of consumer testing with PEH generated strategies for acceptable and actionable prevention education materials. Additionally, consumer testing increases collective support and trust from PEH and the organizations that work with them. By developing and implementing targeted burn and cold injury prevention education in conjunction with PEH preferred prevention strategies, public health initiatives will be strengthened and may be more effective.