278 - Pediatric drowning prevention: Assessment of parent, child, and adolescent risk factors

Publication Number: 2268.278

Kady Palmer, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Margaret LaPorte, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Taylor J. Lofton, Medical University of South Carolina, Charleston, SC, United States; Keila Magafas, Medical University of South Carolina, 328 Hollywood drive, SC, United States; Kelsey A. Hearing, Medical University of South Carolina College of Medicine, Charleston, SC, United States; DeWitt M. Coleman, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Sharon Smith, University of Connecticut School of Medicine, Hartford, CT, United States; Mary Olivia E. Titus, Medical University of South Carolina College of Medicine, Johns Island, SC, United States

Background: Drowning is a leading cause of death in children ages 1-4 years and adolescents in the United States despite various mechanisms and resources available for prevention.

Objective: Assess factors that may influence risks of drowning in children and adolescents.

Design/Methods: Parents of children ages 0-17 years old and adolescents 13-17 years old who presented to a coastal pediatric emergency department were included. Excluded were those with mental health crises and level 1 triage. General demographic information (race, sex, religion, parental income and education level) was collected. The survey only allowed multiple selections for complete identification of race. Parental rating of their child's swimming ability on a 1-4 scale (1-2 categorized as poor swimmers, 3-4 categorized as good swimmers), American Red Cross swimming competency items (ability to perform all 5 skills is competent), and safety quiz (passing = 70% correct) were also assessed. Comparisons of mean age, swimming competency, and "poor" vs "good" abilities were analyzed using Mann-Whitney U testing. Further comparison between race, sex, religion, and parental education/skill level with child skills were analyzed using Pearson Chi square testing.

Results: Data included 103 total survey responses, of which 95 were completed in their entirety. Ages ranged from 1-17 years old, with a mean of 8.8 years old. Increased age displayed a relationship between generalized skill level (poor vs good), with 62 participants categorizing their skills as good and 32 participants categorizing their skills as poor (p < 0.001). Significantly more Non-Hispanic Black children were rated as good swimmers compared to Non-Hispanic White and Hispanic children (p=0.03) (Table 1). Increased age also displayed a relationship between ability to complete individualized American Red Cross skills for swimming competency (p < 0.001) (Fig 1). 19 participants met competency using American Red Cross items (11 Non-Hispanic Black and 8 Non-Hispanic White children). Swimming abilities were similar by family income, parental education, and parental swimming levels (Fig 2). Only 48 parents passed the safety quiz.

Conclusion(s): Most participants were classified as poor swimmers and only 20% could reportedly complete all skills outlined by the American Red Cross defining swimming competency. Age and race were associated with swimming skills but not income or parental education/swim level. Addressing poor swimming skills and knowledge surrounding water safety may decline drowning risk. Public health messages and age-appropriate pediatrician anticipatory guidance may be useful.

Fig 1. Comparison of swimming abilities and age of survey participants.
Increased age of participants directly related to identification as a good swimmer vs poor swimmer based on parent rating scales (p <0.001).

Fig 2. Parent swimming abilities compared to their child's swimming classification (good vs poor).
Results did not show an identifiable relationship.

Table 1. Participant demographics.
No significant relationship was identified between swimming ability and sex, household income, parent education status, and religion. A significant relationship was identified between swimming ability, age, and race.