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  1. Coyle, Edward C. III BSPP
  2. Isett, Kimberley R. PhD
  3. Rondone, Joseph BSPP
  4. Harris, Rebecca BSPP
  5. Howell, M. Claire Batten BSPP
  6. Brandus, Katherine BSPP
  7. Hughes, Gwendolyn BSPP
  8. Kerfoot, Richard BSPP
  9. Hicks, Diana PhD


Context: Americans spend more than 90% of their time indoors, so it is important that homes are healthy environments. Yet many homes contribute to preventable illnesses via poor air quality, pests, safety hazards, and others. Efforts have been made to promote healthy housing through code changes, but results have been mixed. In support of such efforts, we analyzed International Code Council's (ICC) building code change process to uncover patterns of content and context that may contribute to successful adoptions of model codes.


Objective: Discover patterns of facilitators and barriers to code amendments proposals.


Design: Mixed methods study of ICC records of past code change proposals. N = 2660.


Setting: N/A.


Participants: N/A.


Main Outcome Measure(s): There were 4 possible outcomes for each code proposal studied: accepted as submitted, accepted as modified, accepted as modified by public comment, and denied.


Results: We found numerous correlates for final adoption of model codes proposed to the ICC. The number of proponents listed on a proposal was inversely correlated with success. Organizations that submitted more than 15 proposals had a higher chance of success than those that submitted fewer than 15. Proposals submitted by federal agencies correlated with a higher chance of success. Public comments in favor of a proposal correlated with an increased chance of success, while negative public comment had an even stronger negative correlation.


Conclusions: To increase the chance of success, public health officials should submit their code changes through internal ICC committees or a federal agency, limit the number of cosponsors of the proposal, work with (or become) an active proposal submitter, and encourage public comment in favor of passage through their broader coalition.