Developing and consumer testing fire and burn and cold injury prevention education with people who are unhoused: EQUIP Toolkit

Abstract

Fifteen percent of people receiving care for major burn injuries in urban burn centers across North America were homeless pre-injury. The number and risk of such injuries are increasing due to greater numbers of people experiencing homelessness (PEH) and frequency of extreme climate events. Prevention education, along with passive and active fire and cold weather protections are critical for preventing these injuries. To increase acceptability, understandability, and actionability, prevention education needs to be in plain language, contextualized, and consumer-tested. We aimed to test newly developed fire and burn and cold injury prevention education materials with PEH and gain insights for preferred prevention strategies to address and mitigate related risks and hazards. Forty cognitive interviews with PEH were conducted. The Model System Knowledge Translation Center's consumer-testing toolkit was used to evaluate understandability and actionability of the education materials. Transcripts were analyzed using a harm reduction framework and deductive and inductive thematic coding. Themes were: 1) engage - being approachable and accessible, 2) use context-specific design to enhance relatability - reflect the lived experiences of PEH and their environments, 3) reduce harm - focus on mitigating rather than eliminating hazards, 4) empower - incorporate prevention guidance, guided by PEH in combination with conventional prevention strategies, and 5) integrate - disseminate prevention education and PEH preferred safety equipment within services and locations utilized by PEH. The process of consumer-testing with PEH generated acceptable fire, burn and cold injury prevention and mitigation strategies. These strategies were used to develop actionable prevention education materials.

Keywords: burn injury; cold injury; injury prevention; prevention education; unhoused.