Negative prior aquatic experiences and children's aquatic competency: Do parent perceptions differ from reality?

ISSUE ADDRESSED: Achieving aquatic competence is recommended for preventing childhood drownings, yet many children in Victoria, Australia do not meet aquatic benchmarks despite participating in swimming and water safety programs. While few studies have explored factors influencing aquatic competency development, negative prior aquatic experiences (NPAE) have surfaced as a potential influence. Research on children's NPAE has primarily focused on parental perceptions rather than the child's actual experiences. METHODS: Parents and children (aged 10-12 years) completed reliable surveys for background information and NPAE-related data. Children also completed aquatic competency assessments against benchmark standards. Chi-square tests determined relationships between NPAE and aquatic competency, and thematic analysis categorised themes related to perceptions of the child's NPAE. RESULTS: Most parents (82.9%) indicated their child had not had NPAE, while only half (51.0%) of children did not report NPAE. Children reporting NPAE often perceived incidents as nearly drowning (41%), encompassing swimming pool environments and underwater submersion. Similarly, parents reported varied situations, noting NPAE involving open water and the child's loss of control. Parent-reported NPAE was associated with children less likely to achieve knowledge, continuous swimming, and survival competency benchmarks (p < .05). Children reporting NPAE were less likely to achieve underwater competencies (p < .05). CONCLUSIONS: The disparity between parent and child perspectives of NPAE demonstrates the importance of considering both perspectives. This should assist in providing appropriate support for children to develop aquatic competencies. SO WHAT?: Using NPAE data, practitioners can customise swim teaching approaches to address and prevent NPAE, particularly as many children associate their NPAE with pools, the common setting for aquatic education.

A systematic review of alcohol education programs for young people: do these programs change behavior?

Numerous education programs have addressed young peoples' alcohol use. To date, no peer-reviewed publication has evaluated the effectiveness of such programs delivered across a range of contexts to change alcohol-related behaviors, attitudes and/or knowledge. This systematic review aimed to identify alcohol education programs addressing young people, and determine whether they changed alcohol-related behavior, knowledge and attitudes; and, ascertain components of successful programs. Studies were identified, guided by the PRISMA review process, from the earliest records until June 2020. Included studies (N = 70) comprised an alcohol education program which focused on young people (15-24 years). Forty programs reported behavior changes, and these programs were the highest quality. Others impacted attitudes and/or knowledge only (n = 12); or reported no impacts (n = 17). Recent programs were more likely than older programs to feature online delivery and report behavior changes. To enhance alcohol education, future programs should include the identified quality criteria, alongside process and long-term outcome evaluations, to better monitor effectiveness. Findings indicated some education programs have capacity to positively change alcohol-related behavior; however, outcome consistency varied even in high-quality programs. Alcohol education programs should be designed alongside health education/promotion models and best-practice recommendations, to improve the likelihood of desirable behavior-related outcomes.

"They don't think it will ever happen to them": Exploring factors affecting participation in alcohol-influenced aquatic activity among young Australian adults.

ISSUE ADDRESSED: Young adults are over-represented in alcohol-related drownings in high-income countries; however, little research has investigated their behaviours and decision-making to inform prevention efforts. METHODS: Semi-structured interviews were conducted with 23 young Australian adults (aged 18-24 years). Questions, informed by previous research, inquired about behavioural practices in aquatic contexts and influences on involvement in alcohol-influenced aquatic activity. Interviews were transcribed verbatim. Thematic and interpretative phenomenological analysis followed. RESULTS: Two main themes: personal and contextual awareness, and the impact of other people affected perceptions and involvement in alcohol-influenced aquatic activity. Perceived control of situations and self-confidence affected how these influences impacted individuals' involvement. Participants acknowledged some young adults likely overestimate their aquatic abilities. This awareness was not discussed in relation to their own capabilities. CONCLUSION: Drowning prevention efforts should inform young adults of the dangers of combining alcohol and aquatic activities, and make risks appear more immediate and applicable. Consideration should be given to measuring both perceived and actual aquatic abilities within various aquatic environments, to determine whether self-reported perceived competence is an accurate proxy measure for actual aquatic ability. The influence of alcohol should also be highlighted. Steps are required for a positive shift in Australian norms of alcohol use in aquatic settings and the social and cultural attitudes towards this. SO WHAT?: This study provides new insight into young adults' perceptions and involvement in alcohol-influenced aquatic activity. It enhances the evidence base for drowning prevention and health promotion practitioners and should inform more focused campaigns to prevent alcohol-related drownings among young Australian adults.

Respecting alcohol, respecting the water: Young adult perspectives on how to reduce alcohol-influenced drownings in Australia.

ISSUE ADDRESSED: Alcohol-influenced drowning among young Australians (aged 18-24 years) is a prominent health concern. However, effectiveness of targeted prevention campaigns for this age group is unknown, as this information is not typically published in peer-reviewed or easily accessed grey literature. Accordingly, future campaigns cannot build on prior efforts to address this health problem. METHODS: Semi-structured interviews ascertained young Australian adults' perspectives on preventing alcohol consumption in aquatic settings, and their awareness of appropriate safety strategies and Australian national and state drowning prevention campaigns. Discussions were transcribed verbatim and thematically analysed using an interpretative phenomenological approach. RESULTS: Twenty-three individuals (mean age 20.65 years) participated in an interview. Participants had poor understanding of alcohol-focused drowning prevention campaigns and used logos and names to decipher key campaign messages. Education was recommended as the preferred method for prevention, and participants suggested preferences for delivery (eg social media, in schools, humour and shock tactics). The safety strategies discussed appeared to be transferred from strategies used in other contexts, rather than related to the specific risks of aquatic scenarios. CONCLUSIONS: Drowning prevention practitioners should ensure transparency and clarity of their campaign names and logos to enhance understanding of the messages. Practitioners should also consider using audience analysis during campaign design, delivery and evaluation, alongside best practice recommendations from literature, to enhance campaign suitability and effectiveness. SO WHAT?: Water safety practitioners and policy makers should acknowledge these findings when developing campaigns which address young adults' lack of awareness of safe aquatic behaviours to encourage a sustained behaviour change.

A Lack of Aquatic Rescue Competency: A Drowning Risk Factor for Young Adults Involved in Aquatic Emergencies.

Drowning is an important public health issue with major impacts on young adults aged 15-24 years, yet little is known about the causal factors for drowning for this group. As young adults recreate with peers in unpatrolled aquatic environments, the capacity to perform effective and efficient rescues seems pivotal. This study examined perceived ability of young adults to perform a rescue; determined the level of aquatic rescue knowledge; and measured the effect of an aquatic rescue intervention. In total, 135 participants completed pre- and post-intervention surveys and rescue practical testing. Wilcoxon matched pairs signed rank tests were used to assess significant differences pre- and post-intervention and Mann-Whitney tests used to compare groups. Pre-intervention, participants had a low level of rescue knowledge (Mdn = 50) and the relationship between perceived rescue ability and practical rescue testing was weak (rs = 0.33, p ≤ 0.001). Post-intervention, ability to perform a contact tow demonstrated significant improvement (z = - 9.09, p < 0.001, r = - 0.79) and rescue knowledge also improved significantly (Mdn = 100, z = - 9.42, p < 0.001, r = - 0.81). Many young adults lacked both the physical capacity and knowledge required to safely perform a rescue, a factor that may place them at increased drowning risk if they attempt an aquatic rescue. As a rescue based intervention can significantly improve competency of young adults regardless of previous experience and/or qualifications, research needs to consider how best these competencies can be promoted and/or developed with this high risk group.

Lack of caregiver supervision: a contributing factor in Australian unintentional child drowning deaths, 2000-2009.

OBJECTIVES: To establish how frequently supervision was explicitly identified as a factor in coroner-certified unintentional drowning deaths of children in Australia, and to determine the percentage of cases where failure of supervision may have been a contributing factor; also, to identify the proportion of cases with coroners' recommendations relating to supervision and unintentional child drownings. DESIGN AND SETTING: Retrospective case-series analysis of unintentional drowning deaths of children (aged 0-14 years) in Australia from 1 July 2000 to 30 June 2009, based on data from the National Coroners Information System (NCIS). MAIN OUTCOME MEASURES: Number of unintentional child drownings and the extent to which supervisory factors were formally reported by coroners as a contributing factor; proportion of cases with coroners' findings that also had coroners' recommendations. RESULTS: 339 relevant child drownings were identified within the 9-year period. Supervision (or lack thereof) was identified as a contributing factor in 71.7%. However, specific detail about the nature and extent of supervision varied across these cases. The availability of text documents describing the findings (police reports, coroners' findings, autopsy reports, toxicology reports), and the level of detail within these documents, also varied considerably across jurisdictions. Despite almost half (47.2%) of the closed cases having coroners' findings attached, only 15% of these also included specific coroners' recommendations. CONCLUSION: Lack of adequate supervision, or lack thereof, is a significant problem associated with fatal drownings of children in Australia. There is a need to improve the standard and consistency of information contained in text documents within the NCIS to provide more useful information for preventing child drowning deaths.

Observations of caregiver supervision of children at beaches: identification of factors associated with high supervision.

OBJECTIVE: To identify independent factors associated with caregiver supervision levels at beaches. METHODS: Children (aged 1-14 years) engaged in beach play and their caregivers were observed at Australian beaches during September-April, 2008/09. Caregiver, child, and environmental factor data were collected and recorded on a validated observation instrument. The main outcome of interest was a continuous measure of supervision. After adjusting for potential clustering by beach/state, multivariable linear regression was used to identify independent factors associated with caregiver supervision. RESULTS: Four independent predictors of supervision and one interaction effect (child age by the caregiver and child position on beach) were identified. Caregivers who were supervising from a different position to where the child was playing were less likely to provide high supervision, as were older caregivers (>35 years) compared to younger caregivers (≤34 years). Compared to children playing alone, children playing with one, or two or more others were less likely to receive high supervision, and children aged 1-4 years were likely to receive higher supervision than older children. CONCLUSION: This study provides new knowledge about underlying factors associated with the level of caregiver supervision in beach settings. Future studies should continue to explore independent predictors of supervision so that effective programmes, which focus on caregiver supervision, can be targeted to address poor supervision practices.

Abrasion injuries on artificial turf: A systematic review.

OBJECTIVES: To review the incidence of abrasion injuries sustained on artificial turf playing fields and the level of evidence existing on player perceptions of abrasion injuries on these surfaces. DESIGN: Systematic review. METHOD: A systematic search was performed using SPORTDiscus, Medline, Web of Science, Scopus and Science Direct databases. Inclusion criteria included: abrasion type injuries measured; conducted on artificial/synthetic turf; type of sport reported; peer-reviewed original research; English language search terms, but no language restrictions. A quality assessment was conducted using the Newcastle-Ottawa quality scale. RESULTS: The search yielded 76 potential articles, with 25 meeting all inclusion criteria. Twenty articles were injury-based and five were perception-based. The differences in injury definition and the lack of details of the playing surfaces produced varying results on the rate of injuries on artificial turf. Regardless of the condition of the surface, the level of play, or the sport, players perceived the fear of abrasion injuries as a major disadvantage of artificial turf surfaces. CONCLUSIONS: The review highlighted the current disparity that exists between players' perceptions of abrasion injuries and the level of evidence of abrasion injury risk on artificial turf playing surfaces. There is a need for the inclusion of greater detail of playing surfaces' specifications and condition, and an injury definition sufficiently sensitive to better measure abrasion injury incidence and severity. Without this more detailed information, it is likely that the strongly perceived risk of abrasion injuries will continue as a barrier to the adoption of artificial playing surfaces.

Drowning deaths among anglers: Are waders a contributing factor?

Recreational fishing has been a popular activity for Australians over at least the past two centuries. While the use of waders for recreational fishing is widely adopted by participants, there is considerable speculation as to whether waders are contributing to fishing-related drowning deaths. This study involved a comprehensive search of peer-reviewed and grey literature to identify relevant information and a pilot investigation in a swimming pool to understand the accuracy of the currently available information. Extensive searching indicated that there is no published peer-reviewed evidence on the contribution of waders to drowning deaths, although the grey literature and personal communication with fishers offer a range of opinions, some that aim to discredit the claim that waders contribute to drowning, and others that support it. Improved understanding of the actual effect of waders based on biomechanical buoyancy principles and a pilot study of submersion in controlled conditions contributes to enhanced safety of fishers who choose to wear waders, dispels current myths and informs future studies of fishers wearing waders.

Preventing adolescent drowning: understanding water safety knowledge, attitudes and swimming ability. The effect of a short water safety intervention.

Worldwide, epidemiological data indicate that children are a high-risk group for drowning and while progress has been made in understanding toddler drownings, there is a lack of empirical evidence regarding the drowning risk and protective factors inherent for adolescents and young adults. This study used a self-report questionnaire to establish swimming and water safety knowledge and attitudes of young adults and objectively measured their actual swimming ability using formal practical testing procedures. Participants then completed a short, 12-week intervention that encompassed swimming, survival and rescue skills, along with water safety knowledge applicable to a range of aquatic environments. Knowledge, attitudes and swimming ability were then re-measured following the intervention to evaluate its effectiveness. The Wilcoxon matched pairs signed ranks test was performed to detect whether there were significant differences between knowledge, attitude and swim ability scores pre-intervention and post-intervention. A total of 135 participants completed the baseline and follow up questionnaire and all practical testing. Results indicated that these young adults had a very low level of water safety knowledge pre-intervention, although the majority had sound swimming and water safety skills and attitudes. Overall, significant improvements were evident in knowledge (p<0.001) and swim ability (p<0.001) post-intervention, although no changes were observed in attitudes (p=0.079). Previous participation in formal swimming lessons and/or swimming within the school curriculum had no significant impact on water safety knowledge, skills or attitudes of these young adults, and there were few significant gender differences. While it is important to conduct further studies to confirm that these findings are consistent with a more representative sample of young adults, our findings are the first to provide empirical evidence of the value of a comprehensive aquatic education program as a drowning prevention strategy for young adults.

Ground condition as a risk factor in sports injury aetiology studies: the level of concordance between objective and subjective measures.

BACKGROUND: It is well known that the condition and type of sporting ground influences the risk of sports injury. However, the lack of evidence on the relationship between subjective and objective sporting ground condition assessments in sports injury aetiology studies has implications for the development of effective injury prevention strategies. This paper aims to examine concordance between subjectively rated and objective ground hardness and moisture measurements to inform data collection methods for future sports injury aetiology studies. METHODS: Subjective, observational assessments of ground hardness and soil moisture were recorded on 36 occasions during an Australian football season using two four-point scales of 'very soft' to 'very hard' and 'very wet' to 'very dry', respectively. Independent, objectively measured hardness and soil moisture were also undertaken at nine locations on the same grounds. The maximum and minimum ground values and the computed average of ground hardness and soil moisture were analysed. Somer's d statistic was calculated to measure the level of concordance between the subjective and objective measures. RESULTS: A significant, moderate to substantial level of agreement was found between the subjective ratings and the average objective hardness values (d = 0.467, p <0.001), but there was perfect agreement on just less than half of the occasions. The level of concordance between the subjective and objective moisture ratings was low to moderate or trivial for all moisture measures (0.002 < d <0.264, p >0.05). CONCLUSIONS: Compared to objective measures, the subjective assessments were more accurate for ground hardness than for soil moisture levels and raters were just as likely to underestimate or overestimate the condition under review. This has implications for future sports injury aetiology studies that include ground condition assessments and particularly the use of subjective measures to underpin the development of future injury prevention strategies.

The relationship between ground conditions and injury: what level of evidence do we have?

OBJECTIVES: To identify studies which address the relationship between ground conditions and injury, in a sporting context and to evaluate current practice and provide recommendations for future studies that measure ground conditions and injury risk. DESIGN: Systematic review. METHODS: A comprehensive search of electronic databases from the earliest records available until the end of 2011, and supplemental hand searching was conducted to identify relevant studies. A classification scale was used to rate the methodological quality of studies. RESULTS: 79 potentially relevant articles were identified, and 27 met all inclusion criteria. They varied in methodological quality, with analytical observational studies the most common design, although four descriptive observational studies, considered to be of lower quality were also identified. Only five studies objectively measured ground conditions, and of studies that used subjective assessment, only one provided descriptors to explain their classifications. It appears that harder/drier grounds are associated with an increased injury risk but the presence of major limitations necessitates cautious interpretation of many key findings. CONCLUSIONS: There is limited high quality evidence of the relationship between injury risk and ground conditions. Further research with high quality designs, and measurement of ground conditions are required to draw more definitive conclusions regarding this relationship.

Adapting an established measure of supervision for beach settings: is the parent supervision attributes profile questionnaire reliable?

The Parent Supervision Attributes Profile Questionnaire (PSAPQ), developed to measure aspects of caregiver supervision and protectiveness and previously applied within playgrounds and in the home, was modified for implementation in a beach setting. To assess the test-retest reliability of the PSAPQ beach modification (PSAPQ-BEACH), 20 caregivers completed the PSAPQ-BEACH twice, over a mean interval of 18 days (range 10-24). The test-retest reliability and internal consistency of the PSAPQ-BEACH scores were compared to those of the PSAPQ. All scores on the PSAPQ-BEACH were higher than the PSAPQ, providing evidence that the questionnaire remains reliable after its adaptation to beach settings.