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Child Housing Assessment for a Safe Environment (CHASE): a new tool for injury prevention inside the home
  1. Wendy C Shields1,2,3,
  2. Andrea C Gielen2,4,
  3. Shannon Frattaroli1,2,
  4. Rashelle J Musci5,
  5. Eileen M McDonald2,4,
  6. E F Van Beeck3,
  7. David M Bishai2,6
  1. 1Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  3. 3Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
  4. 4Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  6. 6Health Economics, Johns Hopkins Center for Injury Research and Policy, Baltimore, Maryland, USA
  1. Correspondence to Ms Wendy C Shields, Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21215, USA; wshield1{at}jhu.edu

Abstract

Objective To develop a tool to assess the safety of the home environment that could produce valid measures of a child’s risk of suffering an injury.

Methods Tool development: A four-step process was used to develop the CHASE (Child Housing Assessment for a Safe Environment) tool, including (1) a literature scan, (2) reviewing of existing housing inspection tools, (3) key informants interviews, and (4) reviewing the National Electronic Injury Surveillance System to determine the leading housing elements associated with paediatric injury. Retrospective case–control study to validate the CHASE tool: Recruitment included case (injured) and control (sick but not injured) children and their families from a large, urban paediatric emergency department in Baltimore, Maryland in 2012. Trained inspectors applied both the well-known Home Quality Standard (HQS) and the CHASE tool to each enrollee’s home, and we compared scores on individual and summary items between cases and controls.

Results Twenty-five items organised around 12 subdomains were included on the CHASE tool. 71 matched pairs were enrolled and included in the analytic sample. Comparisons between cases and controls revealed statistically significant differences in scores on individual items of the CHASE tool as well as on the overall score, with the cases systematically having worse scores. No differences were found between groups on the HQS measures.

Conclusion Programmes conducting housing inspections in the homes of children should consider including the CHASE tool as part of their inspection measures. Future study of the CHASE inspection tool in a prospective trial would help assess its efficacy in preventing injuries and reducing medical costs.

  • environmental modification
  • case-control study
  • mixed methods
  • health disparities
  • home
  • child
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Footnotes

  • Funding This study was funded by National Center for Injury Prevention and Control, CDC (1R49CE002466).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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