Prevention
Drowning prevention, programmes, and strategies.
- The safety actions of surfers in Victoria, Australia: Assessing the impact of water safety and first aid training, opens in a new tab, Buly A Cardak, Kiera Staley, Alex Donaldson, et al., Safety Science, Volume 190, (October 2025). Recreational surfers in Victoria, Australia were surveyed every four weeks for 128 weeks about their beach safety actions when surfing. While previous studies have explored rescues performed by surfers over their surfing career/lifetime, this study is the first to provide data on safety action that incorporates a ‘per event’ denominator of exposure (safety action per 100 surfs). Victorian surfers reported giving safety advice, first aid and assistance in the water at average rates of 11.6, 0.4 and 1.1 times per 100 surfs respectively. We found that surfers with a board rescue qualification provided beach safety advice on average 3.1 more times per 100 surfs (29 % more often) and first aid 0.4 more times per 100 surfs than (or 3 times the rate of) surfers without this qualification. The difference between the rate of assistance provided by surfers with and without board rescue and first aid qualifications were not statistically significant. We estimate that surfers may provide safety advice up to 739,209 times, first aid 25,490 times and assistance 70,097 times per year in Victoria. The economic value of lives saved by survey respondents through surfer assistance in the water is estimated to be $848 million (2023 AUD). Extrapolating this economic value to the impact of all surfers in Victoria, the potential value of lives saved is $3.8 billion (2023 AUD). Results confirm the importance of the safety actions of surfers to other beachgoers and point to the positive impact of board rescue training and qualifications on surfer beach safety actions.
- Multicultural Communities Water Safety Workshop Statement, opens in a new tab, Australian Water Safety Council, (July 2024). The Workshop objectives were to: Bring together multi-sectoral policy makers, senior leaders at a local, state and federal level and community leaders, along with drowning prevention advocates, researchers and practitioners. Review the key activities outlined in the Australian Water Safety Strategy 2030 (page 50-51). Identify and prioritise 2-5 actions required to reduce drowning among multicultural communities Develop a workshop action statement for collective commitment to this issue.
- Drowning prevention challenges and opportunities: An exploratory study of perspectives of delegates from ASEAN nations, opens in a new tab, Amy E. Peden, Justin Scarr, Trung Doan Minh, et al., PLOS One, (June 2024). The South East Asian region has the world’s second highest fatal drowning burden. This study reports analysis of survey data from representatives from nations within the Association of South East Asian Nations regarding current efforts, challenges and future opportunities for drowning prevention. Twenty-two responses were received from respondents from all ASEAN nations excepting Cambodia and Myanmar. Drowning prevention initiatives varied across ASEAN nations, with most efforts focused on public education and raising awareness, including the provision of drowning data to the media. The lack of comprehensive, national level data collection was identified as a challenge, necessitating strengthened data collection capacity. Governmental involvement spanned one to six different ministries, highlighting the multi-sectoral nature of drowning prevention. However, a lead ministry could be identified in only two countries. Despite the challenges identified, there remain many opportunities to strengthen drowning prevention across ASEAN nations, addressing a significant regional public health threat.
- Conceptual definition for drowning prevention: a Delphi study, opens in a new tab, Scarr J, Jagnoor J, Injury Prevention, Volume 30(2), pp.145-152, (2024). The Delphi method enabled the codevelopment of our conceptual definition for drowning prevention. Agreement on the definition forms the basis for strengthened multisectoral action, and partnerships with health and sustainable development agendas. Defining drowning prevention in terms of vulnerability and exposure might increase focus on social determinants and other upstream factors critical to prevention efforts.
- Definition: "Drowning prevention is defined as a multidisciplinary approach that reduces drowning risk and builds resilience by implementing evidence-informed measures that address hazards, exposures, and vulnerabilities to protect an individual, community or population against fatal and non-fatal drowning."
- Enhancing cultural connection to water for Aboriginal and Torres Strait Islander peoples,, opens in a new tab Porykali, B., Jaceck, A., B, Barnier, J., et al., Guunu-Maana (Heal), The George Institute for Global Health for Royal Life Saving Australia, (2023). This report conducted two scoping reviews in parallel. It was considered necessary for the systematic scoping review on water safety programs to be complemented by a second parallel desktop scoping review exploring the meanings and connections to water. Key recommendations were:
- Reinforce how current programs, initiatives and services can connect to Aboriginal and Torres Strait Islander knowledge systems (meanings and connections).
- Assess community programs and initiatives for Aboriginal and Torres Strait Islander cultural connection, safety and worldview.
- Advocate for cultural responsiveness training to be included into the workforce in Australian water safety organisations, including holding a roundtable forum with key stakeholders and partners.
- Utilise cultural interest to engage children, youth, adults and communities with water safety programs and initiatives.
- Lessons learned through the 20-year development of a national fatal drowning database in Australia,, opens in a new tab Amy E Peden, Stacey Willcox-Pidgeon, Justin-Paul Scarr, et al., BMC Public Health, Volume 23, Article 1499, (August 2023). Co-ordinated, evidence-based policy and programmatic efforts are needed to respond to complex drowning prevention problems. Comprehensive, current, and robust data are vital for agenda setting, burden and risk factor identification, intervention design and evaluation, as well as setting policy. We aim to record methods used in, and identify impacts of, the development of a national fatal drowning database (NFDD) in Australia, including lessons learned across research, policy, and practice.
- Engaging beachgoers for drowning prevention: the spillover effects on non-participants, opens in a new tab, Peter Kamstra, Brian R. Cook, Jasmin C. Lawes, et al., Environmental Hazards, Volume 22(5), pp.437-455, (2023). Despite reduced drowning incidence at lifeguard patrolled beaches, 71 drowning fatalities occurred on Australian beaches last year (2021–2022). Prevailing drowning prevention practices on beaches include patrolling lifeguards positioning safety flags in less hazardous locations and encouraging beachgoers to swim between them. Such methods represent a ‘deficit based’ approach to community engagement, in which experts determine acceptable behaviours and encourage adherence using a one-way transfer of information. Deficit based approaches can be useful, but participatory forms of community engagement are hypothesised to support learning that can transfer to other locations and through non-participants’ social networks. Using a lifeguard patrolled beach in Gerroa, Australia as a case study, we employed a ‘relationship building’ methodology to explore whether engagements on the beach can prompt transformational learning and whether such learning spills over to non-participants or to unpatrolled locations. Findings from 49 survey-interview engagements and 15 follow-up interviews suggest that building relationships with researchers is an enjoyable form of community engagement that contributes to learning about risk; simultaneously, findings suggest that learning can transform beachgoers’ intentions and practices at unpatrolled beaches. This paper provides a broadened theoretical and empirical model of community engagement aimed at beach drowning risk prevention via relationship building.
- Evaluating the impact of skill development for drowning prevention: a relationship-building approach to community engagement, opens in a new tab, Peter Kamstra, Brian R Cook, Robert Brander, et al., Injury Prevention, Volume 29(5), pp.425-430, (2023). Evaluate the impact of a broadened theoretical and empirical model of community engagement aimed at coastal drowning prevention via relationship building between lifeguards and beachgoers through the delivery of skill development sessions on the beach. A lifeguard-patrolled beach in Lorne, Victoria, Australia, during the 2023 peak summer holiday season. In total, 12 skill development sessions were delivered by teams of lifeguards and risk researchers to beachgoers. Sessions were codesigned by the research team and shared with lifeguards beforehand to review and include lifeguards’ interpretations of localised risk during delivery. In total, 85 survey interviews were conducted with self-selecting beachgoers post participation. In total, 79 participants (93%) enjoyed participating in the session(s) and 77 participants (91%) reported learning something new. Learning how to identify rip current (n=59) and escape a rip current (n=40) were the two most commonly learnt skills. Participants’ intended changes in future beachgoing behaviours (n=46) include asking lifeguards at patrolled beaches how to identify site-specific (rip current) risk (n=11) and attempting to identify a rip current before entering the water (n=10). The spillover effects of participation include sharing what participants had learnt with family and friends.
- Awareness without learning: A preliminary study exploring the effects of beachgoer's experiences on risk taking behaviours, opens in a new tab, Peter Kamstra, Brian R. Cook, Robert W. Brander, et al., Heliyon, Volume 8(12), (December 2022). Most drowning deaths on Australian beaches occur in locations not patrolled by lifeguards. At patrolled locations, where lifeguards supervise flagged areas in which beachgoers are encouraged to swim between, the incidence of drowning is reduced. To date, risk prevention practices on coasts focus on patrolled beaches, deploying warning signs at unpatrolled locations with the aim of raising public awareness of risk. What remains unexplored is the potential for learning and behaviour change that can transfer from patrolled to unpatrolled beaches through beachgoer's experiences and interactions with lifeguards. The aim of this preliminary study is to explore the risk perceptions of beachgoers at a patrolled beach to establish if and how their experiences of beach risk and interactions with lifeguards affect their behaviours. Data was collected in Gerroa, Australia by engaging 49 beachgoers using a mixed survey-interview methodology. Results show that beachgoers are aware that they should ‘swim between the flags’, but many did not know the basis for the positioning of safety flags. A key finding is that beachgoer's express a clear desire for a skills-based model of community engagement that enables learning with lifeguards. This demonstrates a reflective public that desires skill-development, which may transfer from patrolled to unpatrolled beaches to affect broader risk reduction on the Australian coast. Learning how to avoid site-specific rip hazards with lifeguards at the beach presents a promising, and previously unexplored model for beach drowning risk prevention that has the potential to affect behaviour at unpatrolled beaches, providing an empirically-supported alternative to prevailing deficit-based awareness raising methods.
- An evaluation of a video-based intervention targeting alcohol consumption during aquatic activities, opens in a new tab, Kyra Hamilton, Jacob J. Keech, Stacey Willcox - Pidgeon, et al., Australian Journal of Psychology, Volume 74(1), (2022). Alcohol consumption and being male are drowning risk factors. Changing beliefs and intentions to undertake risky aquatic-related behaviours, such as consuming alcohol, is key to reducing loss of life and injury. We evaluated the impact of a video encouraging change in young males’ social cognitions and intentions to discourage their mates as well as their own alcohol consumption around the water. The video has the potential to influence young males’ social cognitions regarding their mates’ and their own risky drinking behaviour around water in the short term, although sustained interventions are required. Messaging delivered on-site at popular aquatic locations in the lead-up to traditionally risky periods for alcohol-related drowning should be considered. Provision of strategies to combat social pressures among young males to act on their intentions to engage in drinking and swimming are needed.
- ‘Keep watch’ around water: short-term impact of a Western Australian population-wide television commercial,, opens in a new tab Michael Casten, Gemma Crawford, Jonine Jancey, et al., Journal of Public Health, Volume 30, pp.151-157, (2022). This study is one of few water safety media campaigns to provide insights into awareness, comprehension, intention and acceptability of mass-media campaigns to prevent drowning. Findings suggest traditional media continue to play a role in reinforcing drowning prevention messages to parents particularly in increasing awareness of how to keep children safe in and around water.
- Bush Nippers: Evaluating the effectiveness of the Nipper education program in regional inland Victoria, Australia,, opens in a new tab Hannah L. M. Calverley, Rhiannon Birch, Grace Strugnell, et al., Health Promotion Journal of Australia, Volume 33(3), pp.852-860, (2022). ‘Nippers’ programs provide coastal lifesaving and water safety knowledge and skills to children aged 5-14 years in Australia. However, a 49% increase in Victorian inland waterway drowning compared with the 10-year average, necessitated adapting the Nippers water safety program to inland regions: Bush Nippers. Overall, 105 participants from two age groups (under 9 and under 12) were involved across three Bush Nippers programs delivered at river and/or pool locations in regional Victoria, Australia. Significant increases in knowledge from pre to immediate post-test were recorded and water competencies were high post-test. Communities were grateful for the regional program delivery and understood the necessity of learning lifesaving skills, particularly in open water environments. Costs were akin to other similar programs indicating program replicability and enhancing likelihood of uptake.
- Bush Nippers: An evaluation of the effectiveness of the Nippers program in a regional setting, opens in a new tab [year 2 report], Victorian Government/Life Saving Victoria, (2021).
- Characteristics and beach safety knowledge of beachgoers on unpatrolled surf beaches in Australia, opens in a new tab, Lea Uebelhoer, William Koon, Mitchell D. Harley, et al., Natural Hazards and Earth System Sciences, Volume 22, pp.909-926, (2022). The majority of drowning deaths on Australian beaches occur significant distances away from lifeguard services. This study uses results of 459 surveys of beachgoers at five beaches unpatrolled by lifeguards in New South Wales, Australia, to improve understanding of who visits these beaches and why, and to identify risk factors associated with their beach safety knowledge and behaviour. Many unpatrolled beach users were infrequent beachgoers (64.9 %) with poor rip current hazard identification skills, who did not observe safety signage that was present, and yet intended to enter the water to swim (85.6 %) despite being aware that no lifeguards were present. The survey found that the main reasons why beachgoers visited unpatrolled beaches were because they were conveniently close to their holiday accommodation, or they represented a quieter location away from crowds. Future beach safety interventions in Australia need to extend beyond the standard “swim between the flags” message in recognition that many Australian beaches will remain unpatrolled, yet still frequented, for the foreseeable future. Future beach safety interventions for unpatrolled beaches should be tailored towards the varied demographic groups of beach users.
- Missing masculinities: The need for gender transformative approaches in water safety promotion for men, opens in a new tab, Jake Quinton, Audrey R. Giles, Kyle Rich, Health Promotion Journal of Australia, Volume 33(1), pp.148-150), (2022). Globally, men are more prone to engage in high-risk behaviours, which can shorten their life expectancy compared with women. Furthermore, men die by drowning at twice the rate of women. As such, drowning prevention campaigns have often focused on finding ways to change men's attitudes towards water safety and particularly the use of lifejackets, personal protective equipment that play key roles in preventing drowning. Specifically, water safety education campaign designers in Western nations have often attempted to appeal to men's masculinity (eg, Ref.4, and especially their roles as fathers and providers, in efforts to decrease men's drowning rates by encouraging lifejacket use (eg, Ref.5,6. Such campaigns have focused almost exclusively on the traditional, heterosexual ideals of masculinity, also referred to as hegemonic masculinity. In this commentary, we argue that if high rates of fatal drowning among males are to be reduced, it will be important for water safety education campaigns to engage with a gender transformative approach to include a broader range of masculinities.
- Correspondence of Beach User Perception, Lifesaving Strategies and Rip Currents: Implications for Beach Management,, opens in a new tab Summer Locknick, Chris Houser, Coastal Management, Volume 49(6), pp.598-616, (2021). The potential for drowning or rescue depends on a combination of physical and social factors, and this is the first study to examine the relationship amongst the presence and location of rips, beach user intentions and behavior, and the hazard level identified by the lifeguards. Results of a survey administered in the summer of 2019 at Cavendish Beach and Brackley Beaches along the north shore of Prince Edward Island (PEI), Canada, suggests that beach user intention and perception of the rip current hazard may not accurately reflect their actions. Despite being aware of beach hazards, most beach users and in particular the tourists to the area, did not observe beach warnings. Their activity on the beach also appears to be influenced by the design of the beach access and the presence of other beach users. Respondents who could not recall the hazard level defined by beach flags and signs on the boardwalk tended to sit further away from the access point and lifeguards. Most of the respondents were tourists who were at a higher risk of needing rescue or drowning caused by rip currents due to their lack of rip knowledge and familiarity with those beaches. It is argued that the potential for drownings and rescues can be mitigated through changes in the design of the beach access and the distribution of lifeguard resources, but further research into the correspondence of beach user perception, lifesaving strategies and rip currents is required.
- Exploring the impact of a student-centred survival swimming programme for primary school students in Australia: the perceptions of parents, children and teachers,, opens in a new tab Lauren Petrass, Kate Simpson, Jenny Blitvich, European Physical Education Review, Volume 27(3), pp.684-702, (2021). This study used a self-report questionnaire and practical testing procedures to examine the effectiveness of a 10-week student-centred aquatic programme designed for children aged 10–12 years. The study also determined whether the non-traditional swimming programme was accepted by swim teachers, school teachers and principals, and parents from a range of schools from different geographical regions in Victoria, Australia. A total of 204 students were enrolled in the programme. The pre-programme results indicated a good level of swimming, water safety and aquatic knowledge, but low swimming ability. Swimming ability significantly improved from pre-programme to post-programme, with no significant post-programme ability differences between male and female children or for participants from different programmes. Qualitative feedback collected through questionnaires, interviews and/or focus groups from students (n = 73) and parents (n = 69), school teachers and principals (n = 14), swim teachers and swim school managers (n = 21) indicated strong support from principals and swim teachers for the student-centred pedagogy, and all stakeholders valued the focus on survival swimming competencies. This research highlights the importance of including stakeholders when designing and implementing aquatics programmes. The study has resulted in a well-founded, effective programme with tailored resources and instructional materials that are available for swim centres and schools that would enable schools globally to adopt and implement this programme.
- Can child drowning be eradicated? A compelling case for continued investment in prevention,, opens in a new tab Amy Peden, Richard Franklin, Tessa Clemens, ACTA Paediatrica, Volume 110(7), pp.2126-2133, (2021). A total population analysis of unintentional fatal drownings among 0- to 19-year-olds in Australia, Canada and New Zealand from 2005 to 2014 was undertaken. A total of 1454 children drowned. Rates ranged from 0.92 (Canada) to 1.35 (New Zealand) per 100 000. Linear trends of crude drowning rates show both Australia (y = −0.041) and Canada (y = −0.048) reduced, with New Zealand (y = 0.005) reporting a slight rise, driven by increased drowning among females aged 15-19 years (+200.4%). Reductions of 48.8% in Australia, 51.1% in Canada and 30.4% in New Zealand were seen in drowning rates of 0- to 4-year-olds. First Nations children drowned in significantly higher proportions in New Zealand (X2 = 31.7; P < .001). Continual investment in drowning prevention, particularly among 0- to 4-year-olds, is contributing to a reduction in drowning deaths; however, greater attention is needed on adolescents (particularly females) and First Nation's children. Lessons can be learned from each country's approach; however, further investment and evolution of prevention strategies will be needed to fully eradicate child drowning deaths.
- Exploring children’s participation in commercial swimming lessons through the social determinants of health,, opens in a new tab Stacey Willcox-Pidgeon, Amy Peden, Justin Scarr, Health Promotion Journal of Australia, Volume 32(2), pp.172-181, ( 2021). Swimming and water safety lessons, in part, have reduced drowning in children, while also enabling healthy aquatic participation. Research suggests that some Australian children receive insufficient swimming and water safety education and are not achieving essential skills. Swim schools were more likely to teach freestyle (87%) and backstroke (83%); and less likely to teach water safety skills like treading water (53%), and survival backstroke (46%). Overall, 40% of 12-year-old children failed to achieve the National Benchmark of 50 metres freestyle, fewer were achieving minimum water safety skills. Children from low socio-economic areas and regional locations were less likely to be achieving 50 metres freestyle. Children in this study were commonly from major cities (94%) and of high socio-economic areas (53%). The authors conclude that stakeholders must prioritise holistic drowning prevention education strategies, ensuring all children can access swimming and water safety programs regardless of their socio-economic status or geographical location.
- Reducing inequities among adult female migrants at higher risk for drowning in Australia: The value of swimming and water safety programs,, opens in a new tab Stacey Willcox-Pidgeon, Richard Franklin, Sue Devine, et al., Health Promotion Journal of Australia, Volume 32(S1), pp.49-60, (2021). This paper presents findings from a community-based qualitative evaluation of swimming and water safety (SWS) programs delivered to adults from migrant backgrounds in Sydney, Australia. Study participants were ≥25 years, first generation and most had lived in Australia for ≥10 years. Most were non-swimmers and were fearful of water prior to the program. Key themes were: direct SWS program outcomes, health and well-being; enablers and barriers to participation including: motivation, a program coordinator, fear and settlement priorities. Findings suggest that in order to increase SWS participation among migrant communities, the broader determinants of health need to be considered. Culturally appropriate strategies are required to enable both men and women equal opportunities to access SWS programs.
- Coastal drowning: A scoping review of burden, risk factors, and prevention strategies,, opens in a new tab William Koon, Amy Peden, Jasmin Lawes, PLOS One, (2021). Of the 146 included studies, the majority (76.7%) were from high income countries, 87 (59.6%) reported coastal drowning deaths, 61 (41.8%) reported risk factors, and 88 (60.3%) reported prevention strategies. Populations, data sources and coastal water site terminology in the studies varied widely; as did reported risk factors, which most frequently related to demographics such as gender and age. Prevention strategies were commonly based on survey data or expert opinion and primarily focused on education, lifeguards and signage. Few studies (n = 10) evaluated coastal drowning prevention strategies.
- Next steps for drowning prevention in rural and remote Australia: A systematic review of the literature,, opens in a new tab Danielle Taylor, Amy Peden, Richard Franklin, Australian Journal of Rural Health, Volume 28(5), pp.530-542, (2020). Thirty-two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control.
- Identifying a gap in drowning prevention: high-risk populations,, opens in a new tab Stacey Willcox-Pidgeon, Richard Charles Franklin, Peter Leggat, et al., Injury Prevention, Volume 26(3), pp.279-288, (2020). In total, 35 articles were included. High-risk populations identified were: ethnic minorities, First Nations/Aboriginal people, migrants and rural residents. Over half (51%) focused on children (0–18 years). Risk factors included social determinants, swimming ability and knowledge, attitudes and behaviour. Four intervention studies were found; two focused on upskilling adults from high-risk populations to increase employment opportunities within the aquatic industry; an evaluation of a 10-year rock fishing safety education project and a learn-to-swim programme for minority children. Proposed prevention strategies included education, practical skills, research, policy and engagement.
- Alcohol_Focused Drowning Prevention Campaigns: What Do We Know and What Should We Do Now?, opens in a new tab Hannah Calverley, Lauren Petrass, Jennifer Blitvich, International Journal of Aquatic Research and Education, Volume 12(2), (2020). This project aimed to: (i) review and assess all alcohol themed drowning prevention campaigns within high income countries (HICs); (ii) determine whether the campaign had undergone evaluation for effectiveness; and (iii) provide recommendations to improve the effectiveness of future interventions. For each of the eighty-one HICs identified for the 2019 fiscal year, searches of peer-reviewed literature (through academic databases) and grey literature (through webpages and emails to organisations) were conducted. Twelve alcohol focused campaigns were identified, with only two providing limited information about program evaluation. For most campaigns identified, there was a dearth of information available and therefore assessment of campaign quality was unfeasible. This brief report highlights a lack of alcohol themed drowning prevention campaigns in HIC, and an absence of evaluations on their effectiveness.
- Behavioural Water Safety and Autism: a Systematic Review of Interventions,, opens in a new tab Catriona Martin and Karola Dillenburger, Review Journal of Autism and Developmental Disorders, Volume 6, pp.356–366, (2019). People with autism are approximately twice as likely to die from drowning than members of the general population. Drowning can take place in quite small bodies of water. Therefore, acquiring good water safety skills is of the utmost importance. A systematic review of research into effective behavioural interventions for water safety and swim skills was conducted. In total, 11 studies were identified. Findings suggest that behaviourally based interventions can improve a range of water safety and swim skills in individuals with autism.
- Cardiopulmonary resuscitation and first-aid training of river users in Australia: A strategy for reducing drowning,, opens in a new tab Amy E. Peden, Richard C. Franklin, Peter Leggat, Health Promotion Journal of Australia, Volume 30(2), pp.258-262, (2019). Rivers are a leading location for fatal drowning worldwide, often geographically isolated from timely medical assistance. Cardiopulmonary resuscitation (CPR) benefits drowning victims and those who suffer cardiac arrests. This study explored CPR and first-aid training of river users in Australia. Current CPR qualifications are important, particularly among those visiting high-risk river drowning locations. System-level, upstream strategies that should be explored include compulsory CPR training in secondary schools and linking CPR updates to motor vehicle licence renewals.
- Epidemiology, risk factors and strategies for the prevention of global unintentional fatal drowning in people aged 50 years and older: a systematic review,, opens in a new tab Amy E Peden, Richard C Franklin, Ana Catarina Queiroga, Injury Prevention, Volume 24, pp.240-247, (2018). Drowning is a global public health issue and prevention poses an ongoing challenge for all countries. Many nations are experiencing ageing populations, and little is known about the epidemiology, risk factors and prevention of drowning deaths among older people. This paper reports on a systematic review of literature published on drowning among older people. Thirty-eight papers were deemed relevant to the study design, including 18 (47%) on epidemiology, 19 (50%) on risk factors and 9 (24%) on strategies for prevention. Risk factors identified included male gender, ethnicity, rurality and increasing age. Prevention strategies commonly proposed were education and wearing life jackets. Gaps identified in the published literature include a lack of consistency around age groupings used for epidemiological studies; a lack of consensus on risk factors; a lack of total population, country-level analysis; and the need for older age-specific prevention strategies that have been implemented and their effectiveness evaluated. This review identified drowning deaths among older people as a global issue. Further work is required to reduce drowning in this cohort. High-quality epidemiological studies identifying risk factors using standardised age groupings to allow for international comparisons are required, as are implementation and evaluation of older age-specific prevention strategies.
- Preventing river drowning deaths: Lessons from coronial recommendations,, opens in a new tab Amy Peden, Richard Franklin, Peter Leggat, Health Promotion Journal of Australia, Volume 29(2), pp.144-152, (2018). SMART coronial recommendations may be more successful in achieving the behavioural, social and societal change required to prevent future river drownings. The recommendations examined in this study can be used as a benchmark for what could be considered appropriate safety actions.
- Improving Pool Fencing Legislation in Queensland, Australia: Attitudes and Impact on Child Drowning Fatalities,, opens in a new tab Richard Franklin and Amy Peden, International Journal of Environmental Research and Public Health, Volume 14(12), (2017). Four-sided, non-climbable pool fencing is an effective strategy for preventing children from drowning in home swimming pools. In 2009, the Queensland Government introduced legislation to improve the effectiveness of pool fencing. This study explores community attitudes towards the effectiveness of these legislative changes and examines child (<5 years) drowning deaths in pools. Data from the 2011 Queensland Computer-Assisted Telephone Interviewing (CATI) Social Survey include results from questions related to pool ownership and pool fencing legislation. Fatal child drowning cases between 1 January 2005 and 31 December 2015 were sourced from coronial data. Of the 1263 respondents, 26/100 households had a pool. A total of 58% believed tightening legislation would be effective in reducing child drowning deaths. Pool owners were more likely to doubt the effectiveness of legislation when compared to non-pool owners. Perceptions of effectiveness did not differ by presence of children under the age of five. There were 46 children who drowned in Queensland home pools between 2005 and 2015. While pool owners were less likely to think that tightening the legislation would be effective, the number of children drowning in home swimming pools declined over the study period. Drowning prevention agencies have more work to do to ensure that the most vulnerable (young children in houses with swimming pools) are protected.
- A Review of Drowning Prevention Interventions for Children and Young People in High, Low and Middle Income Countries,, opens in a new tab Justine Leavy, Gemma Crawford, Francene Leaversuch, et al., Journal of Community Health, Volume 40, pp.424-441, (2016). This review aimed to identify, assess and analyse public health interventions to reduce child drowning and investigate the use of behavioural theories and evaluation frameworks to guide child drowning prevention. Thirteen databases were searched for relevant peer reviewed articles. The systematic review was guided by the PRISMA criteria and registered with PROSPERO. Fifteen articles were included in the final review. Studies were delivered in high, middle and low income countries. Intervention designs varied, one-third of studies targeted children under five. Almost half of the studies relied on education and information to reduce drowning deaths, only three studies used a multi-strategy approach. Minimal use of behavioural theories and/or frameworks was found and just one-third of the studies described formative evaluation. This review reveals an over reliance on education and information as a strategy to prevent drowning, despite evidence for comprehensive multi-strategy approaches. Accordingly, interventions must be supported that use a range of strategies, are shaped by theory and planning and evaluation frameworks, and are robust in intervention design, delivery and evaluation methodology. This approach will provide sound evidence that can be disseminated to inform future practice and policy for drowning prevention.
- Fatal river drowning: the identification of research gaps through a systematic literature review,, opens in a new tab Peden AE, Franklin RC, Leggat PA, Injury Prevention, Volume 22(3), pp.202-209, (2016). Drowning is a leading cause of unintentional death. Rivers are a common location for drowning. Unlike other location-specific prevention efforts (home swimming pools and beaches), little is known about prevention targeting river drowning deaths. Twenty-nine papers were deemed relevant to the study design including 21 (72.4%) on epidemiology, 18 (62.1%) on risk factors and 10 (34.5%) that proposed strategies for prevention. Risk factors identified included age, falls into water, swimming, using watercraft, sex and alcohol. Gaps were identified in the published literature. These included a lack of an agreed definition for rivers, rates for fatal river drowning (however, crude rates were calculated for 12 papers, ranging from 0.20 to 1.89 per 100 000 people per annum), and consensus around risk factors, especially age. There was only one paper that explored a prevention programme; the remaining nine outlined proposed prevention activities. There is a need for studies into exposure patterns for rivers and an agreed definition (with consistent coding).
- Interventions associated with drowning prevention in children and adolescents: systematic literature review,, opens in a new tab Belinda Wallis, Kerrianne Watt, Richard Franklin, et al., Injury Prevention, Volume 21(3), pp.195-204, (2015). Drowning remains a leading cause of preventable death in children across the world. This systematic review identifies and critically analyses studies of interventions designed to reduce fatal and non-fatal drowning events among children and adolescents or reduce the injury severity incurred by such incidents. Seven studies fulfilled the inclusion criteria. Interventions were categorised into three themes of Education, Swimming Lessons and Water Safety, and Pool Fencing. All are possible effective strategies to prevent children from drowning, particularly young children aged 2–4 years, but very little evidence exists for interventions to reduce drowning in older children and adolescents. There were methodological limitations associated with all studies, so results need to be interpreted in the context of these.
- Recreational Drowning Prevention Interventions for Adults, 1990–2012: A Review,, opens in a new tab Justine E. Leavy, Gemma Crawford, Linda Portsmouth, et al., Journal of Community Health, Volume 40, pp.725-735, (2015). The aim of this paper is to systematically identify and analyse the evidence for drowning interventions with an adult focus. A systematic search was undertaken for peer-reviewed articles which were published in English between 1990 and 2012, focused on adults and described a drowning intervention. After quality appraisal by expert reviewers using a purposively tailored checklist, a final total of six studies were included for review. The six studies were all conducted in high income countries. Four were drowning interventions, two were retrospective analyses. The drowning interventions duration ranged from 10 days to 5 years, the analysis studies from 6 to 21 years. Two of the studies reviewed used behaviour change theory to inform development, and two reported formative evaluation. Prevention strategies included education (n = 3), technology (n = 1) and environmental (n = 1). Positive short term effects and significant behaviour change in life jacket use was reported (n = 2). A mixed effect was observed in the six studies. The complexity of the issues surrounding drowning requires the collection of robust data and evaluation of preventative measures to support the development of targeted and tailored prevention interventions. This review reinforces the need for a genuine and sustained global approach to addressing adult drowning prevention. Drowning is a serious public health issue and should receive the same attention as other public health priorities.
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