Factors Influencing Childhood Swimming Instruction: Evaluation of the "Safe Water Initiative: Maryland" Program for Drowning Prevention

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Background: Increasing swimming ability is a key preventive step in decreasing childhood drowning, a leading cause of unintentional mortality in the U.S. Yet, it remains unclear what factors influence parents to ensure that their children learn to swim. This study examined how attitudes, beliefs, perceptions, and barriers relate to parents' intentions and decisions to seek swimming instruction for their children. The evaluation also examined whether free introductory swimming lessons may be a useful model in changing any of these factors. Methods: The Safe Water Initiative: Maryland (SWI:M) community-based program provided free introductory lessons in summer 2010 to over 100 children who had previously never received swimming instruction. Parents/guardians completed pretest (N = 81) and posttest (N = 79) written surveys as well as a second follow-up online survey six weeks after the program ended (N = 71). The pre-and post-test surveys included questions about barriers as well as two scales on attitudes/beliefs about swimming importance and perceptions about drowning risk. These two scales were developed and their reliability (alpha=.70-.89) and validity evaluated as part of this study. Results: Participants were predominantly African-American mothers, the majority of whom had little to no swimming ability. Results revealed significant increases in attitudes/beliefs, perceptions, and intentions from the beginning to the end of the SWI:M program. While attitudes/beliefs and perceived susceptibility were significant predictors of intentions, strong intentions did not predict behavior, as only 14% of participants' children had received additional swimming lessons by the second post-test. Cost was reported as a significant barrier to pursuing additional instruction. Conclusions: This study provides preliminary findings for future research investigating factors influencing childhood swimming instruction. Reduced- or no-cost swimming lessons may be a key drowning prevention method, but additional research is warranted to find ways to address prevailing barriers. Evaluating the effectiveness of this and other programs is an important step in potentially decreasing morbidity and mortality due to drowning.