Background

As with many Indigenous populations internationally, Māori in New Zealand suffer health inequity. We aimed to assess the rate of fall injuries at home with and without home modifications in houses with Māori occupants.

Methods

We did a single-blind randomised controlled trial in the Wellington and Taranaki regions of New Zealand and enrolled owner-occupied households with at least one Māori occupant. Only households who stated they intended to live at that address for the subsequent 3 years were eligible for participation. We randomly assigned (1:1) households to either the intervention group, who received home modifications (handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, repairs to window catches, high-visibility and slip-resistant edging for outside steps, fixing of lifted edges of carpets and mats, non-slip bath mats, and slip-resistant surfacing for outside areas such as decks) immediately, or the control group, who received the modifications 3 years later. Data on home injuries were obtained from the Accident Compensation Corporation and coded by study team members, who were masked to study group allocation. The primary outcome was the rate of medically treated fall injuries at home per household per year, analysed according to intention to treat. This Māori Home Injury Prevention Intervention (MHIPI) trial is now completed, and is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12613000148774.

Findings

Between Sept 3, 2013, and Oct 1, 2014, 824 households were assessed for eligibility and 254 were enrolled, of which 126 (50%) were assigned to the intervention group and 128 (50%) were assigned to the control group. After adjustment for previous falls and geographical region, there was an estimated 31% reduction in the rate of fall injuries at home per year exposed to the intervention compared with households in the control group (adjusted relative rate 0·69 [95% CI 0·47–1·00]).

Interpretation

Low-cost home modifications and repairs can be an effective means to reduce injury disparities. The high prevalence of modifiable safety issues in Māori homes merits considerable policy and community effort.

Funding

Health Research Council of New Zealand.

中文翻译：

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房屋改造以防止毛利人住家 (MHIPI) 的房屋坠落伤害：一项随机对照试验

背景

与国际上的许多原住民人口一样，新西兰的毛利人遭受健康不平等。我们的目的是评估在有毛利人居住的房屋中进行和不进行房屋改造的家中跌倒伤害率。

方法

我们在新西兰的惠灵顿和塔拉纳基地区进行了一项单盲随机对照试验，并招募了至少一名毛利人居住的自住家庭。只有表示打算在接下来的 3 年内住在该地址的家庭才有资格参与。我们将 (1:1) 的家庭随机分配到干预组中，他们接受了家庭改造（外部台阶和内部楼梯的扶手、浴室的扶手、外部照明、窗钩的修理、高能见度和防滑边缘）外台阶，固定地毯和垫子的提升边缘，防滑浴垫，以及室外区域（如甲板）的防滑表面），或控制组，他们在 3 年后接受修改。关于家庭伤害的数据来自事故赔偿公司，并由研究小组成员编码，他们对研究组分配不知情。主要结果是每个家庭每年在家中接受医疗治疗的跌倒伤害率，根据意向治疗进行分析。这项毛利家庭伤害预防干预 (MHIPI) 试验现已完成，并已在澳大利亚新西兰临床试验登记处注册，ACTRN12613000148774。

发现

2013 年 9 月 3 日至 2014 年 10 月 1 日期间，824 户家庭接受了资格评估，254 户被纳入，其中 126 户（50%）被分配到干预组，128 户（50%）被分配到对照组。在调整以前的跌倒和地理区域后，与对照组的家庭相比，每年在家中接受干预的跌倒伤害率估计降低了 31%（调整后的相对率 0·69 [95% CI 0· 47–1·00]）。

解释

低成本的房屋改造和维修可以成为减少伤害差异的有效手段。毛利人家庭中可修改的安全问题的高发率值得政策和社区做出大量努力。

资金

新西兰健康研究委员会。