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. 2020 Jun;26(3):240-247.
doi: 10.1136/injuryprev-2019-043156. Epub 2019 Mar 30.

Developing drowning prevention strategies for rivers through the use of a modified Delphi process

Amy E Peden  1   2 , Richard C Franklin  3   2 , Peter A Leggat  2   4
Affiliations

Developing drowning prevention strategies for rivers through the use of a modified Delphi process

Amy E Peden et al. Inj Prev. 2020 Jun.

Abstract

Introduction: Internationally, rivers are a leading drowning location, yet little evidence exists evaluating river drowning prevention strategies. This study aims to use expert opinion to identify strategies more likely to be effective.

Methods: Using a modified Delphi process, a virtual panel of 30 experts from 12 countries considered, grouped and prioritised strategies for river drowning prevention. Proposed strategies were assessed against known evidence and suitability in high-income countries (HICs) as well as low-income and middle-income countries (LMICs) using expert opinion. The final phase consolidated a list of strategies whose effectiveness was assessed against 10 evidence-based river drowning scenarios.

Results: An initial list of 424 prevention strategies was refined to 22. After being assessed against the 10 scenarios, a final list of 13 strategies was derived. Strategies addressed alcohol consumption around rivers, flood mitigation, improving child supervision, learning to swim, increased lifejacket wear and achieving community-wide resuscitation skills.

Discussion: While all 13 strategies were assessed as being effective in both LMICs and HICs by at least 60% of the respondents, further work is required to define river drowning at a country level and therefore allow for effective solutions to be developed, particularly in LMICs. No strategy will be effective in isolation and must be implemented alongside policy and behaviour change, public awareness and education. Evaluation should be incorporated as part of any future implementation of strategies.

Conclusion: This Delphi process identified 13 drowning prevention strategies for rivers. Further research is required to validate the efficacy of these findings through implementation and evaluation.

Keywords: behavior change; drowning; education; enforcement; methodology; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of the modified Delphi process. HIC, high-income country; LMIC, low-income and middle-income country.
See this image and copyright information in PMC

References

    1. Pearn JH, Nixon JW, Franklin RC, et al. Safety legislation, public health policy and drowning prevention. Int J Inj Contr Saf Promot 2008;15:122–3. 10.1080/17457300802150587 - DOI - PubMed
    1. Bugeja L, Franklin RC. An analysis of stratagems to reduce drowning deaths of young children in private swimming pools and Spas in Victoria, Australia. Int J Inj Cont Saf Promot 2012:1–13. - PubMed
    1. Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health 2000;90:523–6. - PMC - PubMed
    1. World Health Organization Preventing drowning: an implementation guide. World Health Organization, 2017.
    1. Peden AE, Franklin RC, Mahony AJ, et al. Using a retrospective cross-sectional study to analyse unintentional fatal drowning in Australia: ICD-10 coding-based methodologies verses actual deaths. BMJ Open 2017;7 10.1136/bmjopen-2017-019407 - DOI - PMC - PubMed

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