Article Text

Ice cleat distribution programmes and ice cleat use among older adults: repeated cross-sectional evidence from 63 municipal interventions in Sweden


Introduction Ice cleats may help prevent ice-related falls in places with icy roads, but there is limited evidence about the association between ice cleat distribution and ice cleat use. Our study examined the association between Swedish municipal distribution programmes and ice cleat use among older adults (65+ years).

Methods We combined data on municipal ice cleat distribution programmes (n=63) with repeated cross-sectional self-reports of ice cleat use in Sweden from 2007, 2010, 2014 and 2018. Respondents (n=63 234) were classified as exposed if they lived in a municipality with a programme, belonged to an eligible age group and responded after distribution (n=2507). Dose-response was assessed using distributed ice cleat pairs per capita (mean: 0.38). Linear probability models were used to estimate probability differences in ice cleat use between exposed and unexposed respondents, adjusting for age, sex, country of birth, education, survey wave and municipality. Ineligible age groups living in programme municipalities, who should be unaffected by ice cleat distribution, were used for bias assessment.

Results Exposure to ice cleat distribution programmes was associated with 7.5 percentage points (95% CI 4.2 to 10.9) higher self-reported ice cleat use after confounding adjustment. The association was larger in municipalities that distributed one pair of ice cleats per capita (17.3 percentage points (95% CI 11.2 to 23.4)). No association was found among the ineligible age groups (−2.3 (95% CI −5.5 to 1.0)).

Conclusion Distributing ice cleats to older adults may help increase their use of ice cleats in settings with icy road conditions.

  • behavior change
  • uptake/adherence
  • fall
  • process/impact evaluation
  • cross sectional study
  • older people

Data availability statement

Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. This study used data from two sources. Our programme survey data are non-sensitive and will be shared with anyone upon reasonable request. The national survey data are protected by a confidentiality agreement with the Swedish Civil Contingencies Agency and therefore cannot be shared publicly. Researchers interested in obtaining these data can contact the Swedish Civil Contingencies Agency.

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