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Issues: The surrounding social and commercial context, including alcohol advertising, heavily influences alcohol consumption. Alcohol use is a major risk factor for both fatal and non-fatal drowning, particularly for young people., Approach: We conducted a scoping review to explore the peer-reviewed literature on the use of alcohol by young people (aged 15-34 years) in the context of aquatic environments. Five electronic academic databases were searched for English-language studies conducted in high-income countries and published in the last 15 years (since 2008). The MetaQAT framework was used to assess methodological quality of included studies., Key Findings: The review included a total of 24 studies, including those addressing the prevalence of and/or risk factors for alcohol use in aquatic environments among young people (n = 13); the epidemiology of alcohol-related unintentional drowning in young people (n = 9); and interventions to reduce alcohol-related harm around water (n = 3). Findings suggest that young people commonly consume alcohol around water, particularly young men. We found multiple influences on this behaviour, including the perception of risk, location of aquatic activity and presence of others, particularly peers., Implications: Understanding the literature addressing alcohol use around water among young people will assist in identifying and setting priorities for drowning prevention, including the need to mitigate the effects of alcohol advertising which promotes drinking in and around water., Conclusion: There is a clear imperative to address the use of alcohol by young people in aquatic environments. These findings have key implications for public health policy, advocacy and practice., (© 2024 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

This systematic review identifies and describes the use of the Expert Recommendation for Implementing Change (ERIC) concepts and strategies using public health approaches to drowning prevention interventions as a case study. International calls for action have identified the need to better understand the implementation of drowning prevention interventions so that intervention design and implementation is improved. In high-income countries (HICs), interventions are sophisticated but still little is known or written about their implementation. The review was registered on PROSPERO (number CRD42022347789) and followed the PRISMA guidelines. Eight databases were searched. Articles were assessed using the Public Health Ontario Meta-tool for quality appraisal of public health evidence. Forty-nine articles were included. Where ERIC strategies were reported, the focus was on evaluative and iterative strategies, developing partnerships and engaging the target group. The review identified few articles that discussed intervention development and implementation sufficiently for strategies to be replicated. Findings will inform further research into the use and measurement of implementation strategies by practitioners and researchers undertaking work in drowning prevention in HICs and supports a call to action for better documentation of implementation in public health interventions.

Adult drowning is a complex and multifactorial public health challenge requiring community, national and global efforts to mitigate impacts. This study updates the evidence base for public health interventions that address adult fatal and non-fatal drowning. A systematic review was undertaken of the peer-reviewed literature for English-language primary studies published between 2011 and 2021describing a drowning intervention with adults. Twenty-two studies were included. Most studies (n = 16) were conducted in high-income countries. Yearly trends in drowning prevention intervention publications were analysed with 2015 (n = 6) the peak publishing year. Over half of the study designs were pre-post (n = 15). Intervention duration ranged from 4 hours to 11 years. Ten studies described either behaviour change theory or formative evaluation to inform design. Thirteen studies targeted interventions at a population level, seven at a group level and two at individual level. Studies identified a range of prevention strategies, categorised as behavioural (n = 9) (e.g., swimming lessons), socio-ecological (n = 8) (e.g., mandatory personal flotation devices) and mixed (n = 5) (e.g., awareness campaign and barriers to prevent access to water). A range of outcomes were described including changes in awareness, water safety knowledge, attitudes, water safety behaviours and skills, environmental, policy and regulation changes and drowning rates. Findings indicate a small but important increase in the evaluation and publication of effective interventions to prevent adult drowning. The complexity of the issues surrounding drowning requires multi-strategy and context -specific adult focused prevention interventions. Contemporary evidence that identifies effective interventions that contribute to prevention efforts is an essential first step in addressing the challenge., (© 2023. The Author(s).)

Objectives: The aim of this study was to explore factors associated with drowning among older adults aged 65 years and over in Western Australia., Methods: This paper was concerned with illuminating older adults experience and perspectives of water safety and drowning prevention. The study used in-depth, semi-structured interviews (n = 15) to examine knowledge, attitudes, beliefs and behaviours. The interviews were analysed using a phenomenological hermeneutical interpretation whereby three steps were taken to identify common patterns of meaning from individual's lifeworld., Discussion: Interviews captured the voices of those who identified as swimmers and those who identified as nonswimmers and revealed nine constitutive patterns which support a central theme of life around water. This study provides insights into perceptions and experiences of water safety as individuals' age. The findings suggest individuals who perceived themselves as strong swimmers had a decreased perception of risk, while participants who self-identified as weak swimmers were more likely to avoid risks and modified their behaviour accordingly. Findings highlighted low water safety literacy and suggest that older people not only underestimate their drowning risk, but also lack an understanding of the risk factors for drowning. SO WHAT?: The findings from this study will have a direct impact on the development of a WA health promotion program to prevent drowning among older adults., (© 2021 Australian Health Promotion Association.)

Issue Addressed: Drowning is a leading cause of death globally. Opportunities to promote drowning prevention in news media may be overlooked for attention-grabbing headlines, imagery and narrative. This study examines news media coverage of fatal drowning events in Western Australia (WA)., Methods: Coronial fatal drowning data in WA were extracted for two summer time periods (2014-2016) by date, age, gender, location and description. Corresponding print and online news articles were captured using: (i) Media Alert; (ii) Google News; (iii) Factiva. A content and frame analysis protocol was developed. A qualitative approach was taken to analyse the news angle. A subgroup analysis was undertaken for drowning focused articles., Results: The final sample (n = 50) news articles matched 17 individual drowning events (T1, n = 9; T2, n = 8). Drowning stories rarely appeared on page 1 (n = 2), but were located in the first 2-10 pages (n = 20) (66.6%). In the subanalysis, one-fifth (22%) of the articles employed a news angle relating to community spirit and celebration of life. There were 32 mentions of "who was responsible for the drowning event." Environmental factors were most cited for "what was responsible" (20.4%). Experts were cited in 66.7% of articles and drowning prevention strategies were mentioned in nine of the 50 articles., Conclusion: Drowning was considered newsworthy; however, not the front page news. Reporting infrequently prioritised drowning prevention or discussed prevention strategies. SO WHAT?: Working closely with news outlets to embed drowning prevention messages in news stories during high-risk periods such as summer is an imperative., (© 2019 Australian Health Promotion Association.)

Objectives: Drowning is a public health challenge. Children of migrants may be at increased risk as parents may be unaware of local water safety issues. This study explores differences between Australian-born and migrant parents in Western Australia for: (1) swimming ability; (2) supervision; (3) water familiarisation; and (4) cardiopulmonary resuscitation (CPR) training., Methods: A cross-sectional survey of parents and carers of children aged under 5 years residing in WA (n = 1506) captured demographics, knowledge of appropriate supervision, water safety knowledge and skills. Logistic regression was conducted., Results: Migrants were significantly less likely to identify adequate supervision (p = 0.004); have participated in child water familiarisation programmes (p = 0.000); or perceived themselves as able swimmers (p = 0.000). Significantly less migrants had also undertaken CPR training (p = 0.000)., Conclusions: Findings add to the small but growing body of literature highlighting the importance of tailored drowning prevention strategies for migrants in countries such as Australia with a strong aquatic culture.

Objectives: Drowning in children under the age of 5 is a frequently occurring, yet preventable event. This research used behavioural theory to test the suitability and appropriateness of a drowning prevention message in a community service video., Design: This qualitative study used content analysis of focus groups. Constructs from the Health Belief Model guided the data analysis., Setting: Community organisations and playgrounds in Perth, Western Australia., Participants: Participants were parents or carers of at least one child under 5 years residing in Western Australia. Seven focus groups (n=57) were conducted with eight participants in each group. Most participants were parents (96%), female (95%), aged between 25 and 34 years (63%) and were born in Australia (68%)., Results: Participants indicated the community service video was credible in communicating the message that young children were susceptible to drowning in shallow water and that various water hazards existed in and around the home. However, a range of external factors, such as the child's age, type of water hazard, presence of siblings and other environmental factors, influenced risk perceptions. Child drowning was seen as a serious issue. Controlling access to water and the role of supervision were understood to be important factors in preventing drowning., Conclusions: The lack of published drowning prevention interventions shaped by behavioural theory limits the understanding of best practice. Using constructs from the Health Belief Model, this research confirmed the perceived seriousness, devastating and unforgettable consequence of drowning; however, findings were mixed regarding cues to action. Future development of drowning prevention media messages should test strategies to increase susceptibility and self-efficacy among the target group and explore the impact of different message senders. The findings provide a valuable understanding of possible messages and their execution for use in media campaigns, as one component of an effective public health intervention to prevent child drowning underpinned by behavioural theory., Competing Interests: Competing interests: LN was responsible for securing funding for the delivery of the Child Drowning Prevention programme described in this study., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Globally, drowning is one of the ten leading causes of child mortality. Children aged <5 years are particularly at risk, and children and young people continue to be overrepresented in drowning statistics. Accordingly, evidence informed interventions to prevent children drowning are of global importance. 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.

Drowning is a frequently occurring and preventable public health issue. Internationally, drowning literature has focussed on children under 5 years, however, evidence based interventions to prevent adult drowning are needed to reduce deaths on a global scale. 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 .

Issue Addressed: Alcohol and participation in aquatic activities are major risk factors for drowning, amongst young adults. This study explored and mapped young people's knowledge, attitudes and behaviours regarding alcohol consumption and participation in aquatic activities using the Health Belief Model. Methods: Using a semi-structured guide, eight focus groups were conducted with young people, 18–24 years, in Perth (n = 41). Alcohol consumption and its combination with aquatic activity and media messages were discussed. Results: Participants reported having consumed alcohol and participated in water-based activities, typically during social events and celebrations. Participants identified key events, peer-presence and social acceptability of drinking as a cultural norm influencing young people's decisions around mixing alcohol consumption and water-based activity. Conclusions: Consumption of alcohol around water is common practice amongst young adults increasing their risk of drowning. Young people are aware of the risks but also see a range of benefits. To shift cultural norms regarding alcohol consumption, risk-taking and water-based activity, further research would be beneficial to examine young people's social influences. An intervention focus on young men may be beneficial given the overrepresentation of men in Western Australian fatal drowning statistics. So What? Findings support the emergence of an 'aquatic alcogenic environment'. Well-resourced, long-term interventions are needed including those targeting self-efficacy and that contain segmented messages as well as environmental and social supports to address the impact of impairment or increased risk-taking resulting from alcohol consumption in aquatic environments. [ABSTRACT FROM AUTHOR]