Nineteen studies (22 reports) were included in the review: nine randomised controlled trials, three cluster randomised controlled trials, three controlled before-and-after studies and four uncontrolled before-and-after studies. Ten reports were judged "++", eight as "+" and four "-" for study quality. The total number of participants was not reported.
Injury rates: Two studies reported that programmes in which smoke alarms were supplied and installed led to no significant reduction in child injury rates. One study reported that one programme that supplied and installed other home safety equipment (such as window locks and fire guards) in addition to smoke alarms did not show a significant reduction in child injury rates. The evidence of the impact of programmes that conducted a home risk assessment and supplied home safety equipment was mixed. One study reported a significant reduction in child injury rates at six to nine months follow-up for a programme in which home safety equipment (thermostatic valves) were supplied and installed.
Smoke alarms: Seven intervention comparisons showed that programmes on installation and functioning of smoke alarms were associated with a significant benefit in the correct installation and functioning of smoke alarms compared with controls. Four intervention comparisons showed a non-significant difference in this outcome between the two groups.
Other home safety equipment: Five intervention comparisons showed that programmes on installation of other home equipment (such as locks, fireguards and stair gates) were associated with a significant increase in the rate of installation and use of these items compared with controls. Most intervention comparisons showed no significant difference between the two groups.