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OBJECTIVE: To determine and assess the distribution and use of Sudden Impact, a video designed by Think First and SportsSmart Canada, to help prevent spinal cord injury caused by careless shallow water diving among teenagers in the high risk group (15-24 years old). DESIGN: Survey of 92 public secondary schools in Toronto, Canada. SUBJECTS: The heads of the physical and health education departments of the 92 secondary public schools in the Metropolitan Toronto region. RESULTS: The response rate was 64% (59 schools), of which 76% (45) had actually received the video. Forty one schools (91%) of those that received the video reported using it. Eighty per cent of responding schools showed it to grade 11 students. Eighty per cent of schools with swimming pools used the video compared with only 42% of schools without swimming pools. CONCLUSIONS: There is a need for improvements in the system of distribution to ensure greater use of material such as this video. These may include direct distribution to principals, continuing contact with the schools, or mandatory inclusion of diving safety into the school curriculum. [ABSTRACT FROM AUTHOR]