Features
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.

Commissioned by the National Indigenous Fire Safety Council – Funded by Indigenous Services Canada a project by the Aboriginal Firefighters Association of Canada (AFAC) – the article was produced by the British Columbia Injury Research and Prevention Unit and authored by Samar Al-Hajj, Len Garis, Colleen Pawliuk, Ediriweera Desapriya and Ian Pike.

“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. The researchers combed through a variety of electronic databases to find the studies, and categorized the results 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The search for eligible studies also included “grey literature” – non-academic but relevant published and unpublished literature from indigenous organizational websites and other sources. Two authors independently screened, selected and 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.

All in all, some 5,800 titles were considered, but after removing duplicates and conducting a comprehensive screening and assessment, 81 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 e, the selected studies broke down as follows:

• Education (30 per cent of interventions): Twenty-three studies adopted educational interventions, mainly related to smoke alarm installation and maintenance, fire escape plans and use of fire guards, and targeted to at-risk groups. Materials were disseminated through door-to-door campaigns and in a variety of settings, implemented by healthcare workers, 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 (8 per cent): Six studies assessed fire safety laws and regulations, including mandatory smoke alarm installation.
• Engagement (6 per cent): Five studies proposed interventions where participates interacted with community leaders, firefighters, health and social workers.
• Combined approaches: A number of studies combined interventions, including education and environmental (21 per cent), engagement and environmental (9 per cent) and education, engineering and enforcement (6 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 proved to be effective in enhancing household knowledge, fire safety decisions and practices.
• Effective outcomes were obtained when multi-faceted fire safety interventions were adopted, such as those combining environmental and educational interventions, which together markedly reduced fire incidents and associated injuries.
• Among adults and elderly people, educational interventions are only effective in reducing fire incidence and injuries if they are part of a program including 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 by community leaders, fire personnel or volunteers to install, check batteries and provide education information – but even these had a limited long-term effect without follow-up and reinforcement.
• 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, firefighters, social workers and other trusted personnel were successful in engaging targeted populations and improving knowledge, fire safety behaviour and fire injury rates.

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 proved to be critical to provide the researchers with a more complete picture of fire-prevention issues and 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 mass communications campaigns, education, clinician counseling, home visits or 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. “It’s a positive step toward addressing the disproportionate fire risk experienced by Indigenous communities across Canada.”

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 initiatives, 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 data sources, and targeted research questions.

The technical document and the Journal paper on which the article was based – similarly named “Interventions for Preventing Residential Fires in Vulnerable Neighbourhoods and Indigenous Communities: A Systematic Review of the Evidence” – can be found in the Resources section at: www.indigenousfiresafety.ca.

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Len Garis is director of research for the National Indigenous Fire Safety Council, Fire Chief (ret) for the City of Surrey, B.C., associate scientist emeritus with the B.C. Injury Research and Prevention Unit, adjunct professor in the School of Culture, Media, and Society at the University of the Fraser Valley (UFV), and a member of the Affiliated Research Faculty at John Jay College of Criminal Justice in New York. Contact him at lwgaris@outlook.com

Mandy Desautels is the director of strategic initiatives at the Aboriginal Firefighters Association of Canada (AFAC). She holds a B.Sc. in global resource systems from the University of British Columbia and a Master of Healthcare Administration from University of British Columbia. Prior to joining AFAC’s National Indigenous Fire Safety Council (NIFSC) project, she worked for BC Emergency Health Services and prominent NGOs. Contact her at MandyD@afac-apac.ca.  

Samar Al-Hajj is an Assistant Research Professor at the Faculty of Health Sciences at the American University of Beirut, Beirut, Lebanon; Founding Director for the Middle East and North Africa Program for Advanced Injury Research (MENA PAIR). Contact her at sh137@aub.edu.lb.

Ian Pike is a Professor with the Department of Pediatrics in the Faculty of Medicine at the University of British Columbia; Director of the British Columbia Injury Research and Prevention Unit, Investigator for the BC Children’s Hospital Research Institute, and Co-Executive Director for the Community Against Preventable Injuries. Contact him at ipike@bcchr.ca.