Evaluation of a Pilot Drowning Prevention Program in Ohio

BACKGROUND:  Drowning is the leading cause of injury deaths in children ages 1-4 in Ohio; it is the third leading cause of injury deaths in children ages 5-9 and 10-14. Survivors of severe drowning incidents can experience long-term disabilities including memory problems, learning deficiencies, and loss of basic cognitive functioning. Ohio does not currently collect detailed information on public swimming pool-related injuries or deaths. Recognizing the usefulness of these details for preventing drowning incidents, the Ohio Department of Health (ODH) initiated a Drowning Prevention Pilot Project to 1) better understand the circumstances surrounding these incidents, and 2) inform data-driven revision of public swimming pool rules. To gather these data, ODH developed the Public Pool and Spa Injury Incident Report Form based on Model Aquatic Health Code guidelines and other states’ data collection practices, and piloted it with 23 local health districts (LHDs) during the 2015 outdoor swim season. To prepare for the 2016 season, we sought to evaluate the form’s effectiveness, feasibility and usefulness as a data collection tool and identify successes and challenges associated with project implementation.

METHODS:  We analyzed submitted data for indicators of data quality and form acceptability (i.e., number of forms submitted per LHD, number of pools reporting, completeness of forms, and validity of responses). We surveyed participating LHDs for qualitative data on the form’s usefulness, simplicity, and acceptability.

RESULTS:  ODH received 85 reports of pool-related injuries from 9 of 23 LHDs. Approximately 91% of reports included the incident’s date, time and location; however, characteristics of sustained injuries (i.e., injury type, injured area, how injury occurred) were either missing or invalidly coded on 13% of forms. Surveys were completed by 18 LHDs – 58% of respondents indicated that the forms were useful for tracking pool-related incidents. However, many districts experienced challenges collecting forms from pools primarily due to pool managers’ liability concerns, limited personnel, and reluctance to participate.

CONCLUSIONS:  The Public Pool and Spa Injury Incident Report Form was useful for understanding the circumstances surrounding pool-related incidents in Ohio. This information, along with feedback from LHDs, will support changes to the public swimming pool rules requiring that incidents be reported for the purposes of reducing pool-related injuries and deaths. Limitations of the pilot included low participation among pools, lack of reports from unguarded pools, and missing or invalid responses. Form revision and training will be implemented in future swim seasons and strategies explored to improve pool cooperation.