Varying Effect of a Randomized Toddler Home Safety Promotion Intervention Trial by Initial Home Safety Problems

Objectives: Toddlers are vulnerable to unintentional injuries. A safety intervention targeting low-income families of toddlers, was effective at improving home safety. The current study examined whether the effect varies by initial home safety problems. Methods: 277 mother-toddler dyads recruited in the Mid-Atlantic region of the United States during 2007–2010 were randomized into safety promotion (n = 91) or attention-control groups (n = 186). Observers rated participants’ homes with a 9-item safety problem checklist at baseline, and at 6- and 12-months follow-up. Initial home safety problems were categorized as multiple (≥ 4 problems) and none/few (< 4). Linear mixed models assessed the moderating effect with a three-way interaction (time, intervention, and initial safety problems). Results: At 12 months, the intervention effect was stronger among families with multiple initial problems than no/few initial problems, with a reduction of 1.55 more problems among the families with multiple problems, compared to the families with no/few problems (b = − 1.55, SE = 0.62, p = 0.013). Conclusions: Interventions targeting families with multiple safety problems may be more effective than universal programming.