Features Prevention
Fine-tuning fire prevention

Published in April 2022 in the International Journal of Environmental Research and Public Health, the article entitled “Interventions for Preventing Residential Fires in Vulnerable Neighbourhoods and Indigenous Communities: A Systematic Review of the Evidence” reviewed thousands of studies and research conducted since 1990 on residential fire prevention in order to identify the characteristics of interventions with success in mitigating fire incidents among vulnerable population groups.

The article was commissioned by the National Indigenous Fire Safety Council, and funded by Indigenous Services Canada, a project by the Aboriginal Firefighters Association of Canada (AFAC), and produced by the British Columbia Injury Research and Prevention Unit.

 “A significant body of research from around the world exists on fire-prevention interventions targeting vulnerable communities,” said Blaine Wiggins, executive director for AFAC, which represents regional Indigenous emergency and fire service organizations across the country. “Understanding not only what works, but what doesn’t, will help us create and deliver more effective fire-prevention programs and reduce the high toll of fires on Indigenous communities in Canada.”

A deep dive into the research
The article builds on the 2009 literature review “Proving that Fire Education Works” by TriData Corporation that considered 20 years of international fire prevention research and produced insights that led to the widespread deployment of successful fire-prevention efforts, such as targeted smoke alarm giveaways and public education in high-risk neighbourhoods.

The new review included reports published around the world after 1990 on any type of intervention designed to reduce the risk and frequency of residential fires and fire-related injuries. Researchers categorized studies through the lens of the 4Es of injury prevention approaches: education (intended to change behaviours), enforcement (legislation, policies, regulations and standards), engineering (products that create a safer environment), and engagement (engagement stakeholders in a process of systematic change and safety promotion).

The search for eligible studies also included “grey literature” – non-academic but relevant published and unpublished literature from Indigenous organizational websites and other sources. Authors extracted data from these sources in consultation with experts in the field.

Articles were included in the review if the fire intervention demonstrated an impact on the following five outcomes: Improvement of knowledge, attitudes and behaviours (KAB); reduction of residential fires risk, incidence and frequency; decline in injuries, hospitalizations and death rates; enhanced safety related to infrastructure damage and fire suppression; and lower costs for healthcare needs and response.

Eighty-one articles were chosen for the review. Of these selected titles, 42 originated in the United States, 14 from the United Kingdom, eight from Canada, seven from Australia, four from Sweden, two from New Zealand and one each from Japan, Germany, France and Iran.

When classified through the 4Es approach, the selected studies broke down as follows:

• Education (30 per cent of interventions): Twenty-three studies adopted educational interventions, mainly related to smoke alarms and fire escape plans, and targeted to at-risk groups. Materials were shared in a variety of settings, implemented by firefighters, community leaders and volunteers.
• Engineered/environmental (20 per cent): Sixteen of the studies modified the existing environment, including smoke alarm giveaway and installation programs, sprinkler inspections, and fire-resistant clothing and furniture.
• Enforcement (eight per cent): Six studies assessed fire safety laws and regulations, including mandatory smoke alarm installation.
• Engagement (six per cent): Five studies proposed interventions where participates interacted with community members.
• Combined approaches: A number of studies combined interventions, including education and environmental (21 per cent), engagement and environmental (nine per cent) and education, engineering and enforcement (six per cent).

Themes arising from successful interventions
At a high level, the review revealed the value of hands-on safety training and reinforcement, culturally-appropriate programming, and the combination of both environmental and educational approaches in reducing fire incidents and associated injuries and death.

Key insights included:

• Engaging household members in hands-on safety training was effective in enhancing household knowledge, fire safety practices.
• Effective outcomes were obtained when multi-faceted fire safety interventions were adopted. 
• Among adults and elderly people, educational interventions are only effective in reducing fire incidence and injuries if they include regular follow-ups and reinforcement of safety concepts.
• In vulnerable neighbourhoods, the most effective environmental modifications were smoke alarm giveaway programs that involved home visits to install, check batteries and provide information – but even these had a limited long-term effect without follow-up. 
• In terms of enforcement, mandatory smoke alarm installation was shown to reduce fire incidents and related injury and death, while fire-resistant clothing legislation showed some success in reducing child injury rates.
• Tailored, culturally appropriate intervention programs involving interaction with community leaders and other trusted personnel were successful in engaging targeted populations and improving knowledge and fire safety behaviour.

Overall, environmental modifications and education intervention programs proved to be the most cost-effective interventions and – with appropriate deployment and follow-up – may have strong relevance for Indigenous and other vulnerable communities in Canada.

Another outcome of the study was to highlight the lack of fire prevention evidence gathered from within Indigenous communities. The use of grey literature provided researchers with a more complete picture of fire-prevention challenges facing this population group.

Based on an assessment of the data, recommendations noted in the report included:

• Development of evidence-based programs, based on this new research, as a step toward reducing the greater risk of fires and fire-related injury and death among Indigenous people.
• Designing future fire interventions that include multiple approaches, including pub. ed. campaigns, inspections, fire alarm installation and timely battery change reminders, and legislation.
• Emphasize culture and context when developing interventions for a targeted population group.
• Incorporate long-term, multi-dimensional evaluations of inventions over subsequent months and years to accurately measure outcomes and create actionable next steps.

Looking ahead
The insights provide guidance for fire service professionals seeking to apply an evidence-based and culturally appropriate approach to fire prevention in Indigenous communities.

“Social determinants are built into this approach – it’s about the people, the places they live and the treatments that are going to solve the problem,” Wiggins noted.

As a result of the limited Indigenous-specific research available, it should be noted that the paper focuses on First Nations populations living on reserves. However, the authors believe that the fire prevention recommendations in the report have broad relevance to all Indigenous and vulnerable populations.

In future research, the AFAC aspires to expand beyond this population group to seek insights about Inuit and Metis people and First Nations off-reserve residents through new forms of data collection, different sources, and targeted research questions.

Len Garis is director of research for the National Indigenous Fire Safety Council and associate scientist emeritus with the B.C. Injury Research and Prevention Unit. 

Mandy Desautels is the director of strategic initiatives at the Aboriginal Firefighters Association of Canada (AFAC). 

Samar Al-Hajj is the founding director for the Middle East and North Africa Program for Advanced Injury Research.

Ian Pike is the director of the British Columbia Injury Research and Prevention Unit and co-executive director for the Community Against Preventable Injuries.