Mobilizing Evidence Into Action - “How hot is your tap water?” Health Communication Campaign Joanne Kaashoek Toronto Public Health January 16, 2006.

Mobilizing Evidence Into Action -

“How hot is your tap water?” Health Communication Campaign

Joanne Kaashoek Toronto Public Health

January 16, 2006

Presentation Overview

Why This Issue? NACCARS data

The Campaign Components & duration

Preliminary Evaluation Data

Next Steps – Advocacy Policy Network

Flash / flame (12.5%) Electrical (6.8%) Chemical (4.0%) Contact (30.8%) Scalds (43.5%)

CHIRPP, 1999 Database

% types of burns

Spilled tea or coffee (34.7%) Hot food (28%) Cooking (15.5%) Tap water (7.1%)

CHIRPP, 1999 Database

% types of scalds

Tap Water Scalds Data

In Canada: 300 children, elderly

people and people with disabilities are treated in hospital with tap water injuries every year.

Safe Kids Canada, 2003

Children 1- 4 years of age:

Fire / Burn / Scald (ICD9 E890-899, 924)37.9/100,000 (Toronto)28.3/100,000 (Ontario excluding Toronto)

Hospital Inpatient Data 1998-2000

Provincial Health Planning Database

Local data on burns

Hot Tap Water Burns Children > 6 Six Years

In Ontario: 158 visited

emergency rooms

17 hospitalized

2003 Ambulatory Visits & Hospital Inpatient Data, MOHLTC.

Who is scalded most frequently?

Children under two years of age

59.6% treated with follow-up

27.2% admitted to hospital

CHIRPP, 1999 Database

Required hospitalization (28% vs 12%)

Prolonged hospitalization (21-35 days) for pain control, fluid balance, and multiple surgeries.

Over $ 5 million annually initial treatment costs

Hospitalization & costs

Safe Kids Canada, 2003

Rationale: Why focus on this issue?

Support Ontario Building Code

Serious InjuryPreventable -

Passive Interventions

Developing a Campaign Position

Parents’ knowledge and awareness

Legislative & education initiatives

Hot water heaters & risk of legionellosis

A common cause of serious burn injuries to

children is tap water scalds.

Health Canada Focus Groups

Safe Kids Canada, 2001

Toronto Public Health Focus Groups, 2004

Parental knowledge and awareness

Water heaters in Canada are set at 60C (140F).

Legislation

Water temperature <49C

Built in anti-scald device

Anti-scald device at outlet of water heater

Point of use anti-scald devices

Ontario Building Code September, 2004

Health Canada’s preferred option Store high, deliver low

Oil and gas fired water heaters No evidence to show risk in healthy population

Electric water heaters Maintain at 60C

Hot Water Heaters & Risk of Legionellosis

Campaign PositionHot Water Heater

Recommend anti-scald devices as first option.

Turn gas or oil water heaters down only: Single dwelling home Not at risk for Legionnaires’ disease

Campaign Components

Key Messages:“How hot is your tap water?”

Hot tap water is a common cause of serious burns to children.

Protect your child from a serious injury by controlling the temperature of your hot water.

Key Messages:“How hot is your tap water?”

Test the temperature of your hot water.

Reduce the temperature of your water to 49C with simple one-time only changes to plumbing systems.

Secondary Messages:“How hot is your tap water?”

Do not alter the temperature of your hot water heater if:

Electric Certain health

conditions

Safety tips for bathing children

Campaign Launch

Phase 1

November 2004

139 TTC Bus Shelter 385 Internal Subway

Ads Brochure Poster 8 Newspaper Ads

Phase 2

Sept 2005 – March 2006

470,000 Water bill insert 221 TTC bus shelter 660 Internal subway ads Brochure & poster Retail strategy

Campaign Pre-test

Item:

Measured hot watertemperatures

Reduced hot watertemperatures

%Yes % No %DK 22.4 77.6 -

33.8 56.9 9.3

How did you reduce the temperature of hot water in your home?

Item:

Temperature controls at base

of water heater

Temperature controls in

bathroom or kitchen

Turned down the water heater

%Yes % No % NA

1.5 32.3 66.2

2.6 31.3 66.2

31.5 2.4 66.2

Campaign Pre-test

Have you ever:

Used tap guards to block your

child’s access to the hot water

tap?

Heard of the “How hot is your

tap water?” campaign

%Yes % No %DK

10.6 88.1 1.3

7.5 89.4 3.0

Process Evaluation

November – Dec. 2004 311 visits to hot tap

water page

291 PDFs downloaded

4,500 brochures

3 requests to reproduce materials

Jan - September 2005

28,320 brochures

5,136 posters

470,000 water bills

Requests for 6,593 brochures, 187 posters

RRFSS Post Campaign Evaluation

Have you heard about the “How hot is your tap

water?” campaign?

Heard - 31.7 + 3.7%

Not heard - 63.7 + 3.9%

How helpful was the information? RRFSS Post Campaign Evaluation

010

2030

405060

7080

90100

%Very helpful %Somewhathelpful

%Not helpful

Pe

rce

nt Children 0-6 in home:

always/often/sometimes

Children 0-6 in home: rarely/never

Have you used the information?RRFSS Post Campaign Evaluation

0

10

20

30

40

50

60

70

80

90

100

%Yes - Used Information %No - Did not use

Pe

rce

nt Children 0-6 in home:

always/often/sometimes

Children 0-6 in home:rarely/never

How have you used this information? RRFSS Post Campaign Evaluation

  Count Percent ±95% CI

Made changes in my home (e.g. turned down water heater, child-proofed) 34 46.6 11.4

Supervised/watched children more carefully 17 23.3 9.7

Changed how I do things (e.g. use

back burners, spill-proof mugs) 11 15.1 8.2

Next Steps -

Targeted Dissemination Pre-kindergarten packages Day cares Retail strategy

Evaluation of the Campaign RRFSS Internet Panel

Next Steps -

Advocacy and Policy Building Codes Cost benefit analysis Enforcement of the Ontario Building Code

Childhood IP Policy Network

Draft terms of reference

Outreach to ECD-IP contacts

Policy development support Identification of other Priority IP issues and policy

strategies

Provincial body to support