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Although the likelihood of fire-related death in homes with smoke alarms is about one-half that in homes without alarms, alarm effectiveness is limited by behavior. Only 16% of residents of homes with alarms have developed and practiced plans for escape when the alarm sounds. We reviewed literature to identify behavioral constructs that influence smoke alarm use. We then convened experts in the behavioral aspects of smoke alarms who reviewed the constructs and determined that the appropriate areas for behavioral focus were formulating, practicing, and implementing escape plans should an alarm sound. They subsequently identified important behaviors to be addressed by burn-prevention programs and incorporated the constructs into a behavioral model for use in such programs. Finally, we organized the available literature to support this model and make programmatic recommendations. Many gaps remain in behavioral research to improve fire escape planning and practice. Future research must select the target behavior, apply behavioral theories, and distinguish between initiation and maintenance of behaviors associated with planning, practicing, and implementing home fire escape plans.

"Fishing for Burn Prevention" is an interactive educational burn and fire safety program designed to stimulate family involvement at health fairs, and it provides an alternative to handing out safety information. The program attracts preschoolers through preteens and is staffed by burn center personnel. The design consists of a small pool, a wooden fishing rod, several cutout fish, and hook-and-loop fasteners. Words that will stimulate interaction between the presenter and the participant are written on the fish; these can include "smoke detector," "cool the burn," "fire escape plan," "matches," "grease fire," and "120 degrees F." Providing an interactive, hands-on activity at health fairs can increase burn and fire safety awareness for the entire family.