The goal of this project is to better understand how older people interpret safety education materials and decide to make or not make safety related modifications to their home environments. Existing research on home hazard reductions indicates that there are significant hazards in the homes of a great many older people, even after safety education attempts to increase awareness of home hazards, relatively few people act to make home modifications to decrease risk. The discrepancies between professional assessments of home hazards and the assessments of the older person herself or himself and the gap between knowledge of risk and risk mitigation can be partially accounted for by understanding risk as social rather than just individual. We proposed to develop and test a culturally grounded social model of risk identification, evaluation and response. The social model includes an understanding of how past and present events interface with the contemporary context in older people's evaluation of home safety. The proposed study will conduct qualitative research as a """"""""natural experiment"""""""" using an already occurring public health effort to identify, describe and analyze: (a) the meanings that older people give to key concepts such as home safety risk and change, (b) the role of stories of other people and information passed among friends in decisions to make or not to make changes, (c) the place of variations in social boundedness and social hierarchies in responses to offers of home modification, and (d) the ways the safety education process contributes to older people's decisions to make home modifications. The study will be done in four economically and ethnically diverse neighborhoods in a large West Coast city, with the goal of identifying variation along lines of SES, age, gender, and ethnicity/cultural group with respect to interpretations of risk, safety, and willingness to undertake home modification.
