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DS 3 Form Stakeholder Panel to Link Drowning Data Across Agencies

Key area

Data Surveillance

Develop a panel of stakeholders to link existing data systems across the drowning spectrum (e.g., lifeguarding, law enforcement emergency medical service, emergency department, hospitalization, and medical examiner data) to allow more complete analysis of risk and protective factors for drowning prevention.

Spectrum level: Changing Organizational Practices Fostering Coalitions and Networks

Evidence level: Low

Implementation levels: Community County State

Rationale:

Developing a panel of stakeholders to link existing data systems across the drowning spectrum can improve drowning surveillance. There are many benefits of a coordinated and linked data systems, some of which include:

  • Enhancing the ability to perform ongoing surveillance and improving opportunities for research studies.
  • Improving the understanding of the epidemiology of drowning across the spectrums of age and outcomes.
  • Developing at the national level with implementation locally can allow for comparison of drowning across jurisdictions improving ability to monitor effects of local and state efforts.
  • Improving the ability to assess risk and protective factors, as well as outcomes of drowning.
  • Allows for the monitoring of impact of behavior change efforts like life jacket use, water competency, fencing/barriers, CPR, etc.

Anticipated Impact:

After implementing this recommendation, you can expect to experience the following outcomes:

  • Improved drowning surveillance.
  • Enhanced ability to perform ongoing surveillance and improvement in opportunities for research studies.
  • Improved understanding of the epidemiology of drowning across the spectrums of age and outcomes.
  • Development at the national level, with implementation locally, allows for comparison of drowning across jurisdictions improving ability to monitor effects of local and state efforts.
  • An improved ability to assess risk and protective factors, as well as outcomes of drowning.
  • Allows for the monitoring of impact of behavior change efforts like life jacket use, water competency, barriers, CPR, etc.

Evidence:

Data linkages have been used in several injury areas to more fully explore the circumstances that led to injury. For instance, the National Violent Death Reporting System collects information from both law enforcement and death certificates to be able to fully describe violent events (such as murder/suicide events (CITE). Second, linked data were used to examine motor vehicle crash related injuries in the rear seating position and then leveraging that information to improve seatbelt laws (CITE). Third, some drowning data from linked systems are collected by Cardiac Arrest Registry to Enhance Survival (CARES) but this system does not capture the majority of drowning events (CITE). Finally, Child Death Review has the potential to capture data from multiple systems but only reviews child drownings.

Evidence Sources:

Surveillance of all types of deaths in 2020 in King County WA revealed 60% increase in drowning death https://kingcounty.gov/legacy/depts/dnrp/newsroom/newsreleases/2023/July/03-Open-Water-Safety.aspx

CDC Core SVIP programs doc https://www.cdc.gov/violenceprevention/datasources/nvdrs/index.html

Using Crash Outcome Data Evaluation System (CODES) to examine injury in front vs. rear-seated infants and children involved in a motor vehicle crash in New York State. https://link.springer.com/article/10.1186/s40621-021-00328-8

CARES (Cardiac Arrest Registry to Enhance Survival) https://mycares.net

High Risk Populations Addressed:

Populations whose risk of drowning decreases the most with the implementation of this recommendation may have one or more of the following characteristics:

  • Children aged 1-4
  • Males
  • American Indian and Alaska Native individuals aged 29 and younger
  • Black or African American individuals
  • Individuals with seizure disorders and other or health conditions

Evaluation Metrics:

Indicators of long-term impact:

  • Linked data system are available for surveillance and epidemiological study
  • Key risk and protective factors identified for prevention efforts
  • Valid and reliable data for indicators and general use are created
  • Availability of data for regular monitoring of fatal and nonfatal drowning (e.g., # of annual drowning reports at local or state level)

Indicators of intermediate impact:

  • Appropriate stakeholders and convening of meetings to address data linkage are identified
  • Documentation of partnership development at federal, state, and local levels
  • Number of standardized data sources that are successfully linked increases

Indicators of initial impact:

  • Meetings held to establish standardization of each data source
  • Outreach undertaken
  • Data sets linked, piloted and validated
  • Guidance and training developed
  • Resources identified

Implementation:

Consider the following to ensure successful implementation:

  • Involve CDC, USCG, National Parks, CPSC, National Parks and Recreation Association, Pediatrics groups(American Academy of Pediatrics), Emergency medical services providers, hospital data system managers, medical examiners/coroners (National Association of Medical Examiners).

Challenges to Implementation:

When implementing this recommendation, you might encounter challenges related to the following factors.

  • Standardization of data collected so that systems can be linked may be a challenge.
  • There may be controversy on items discussed and reaching consensus among stakeholders therefore may be difficult.
  • Implementation and, or, maintenance may be costly.
  • There may be liability concerns (e.g., release of data to others).
  • There may be a lack of infrastructure.

Potential Facilitators:

The following factors might facilitate the implementation of this recommendation.

  • Agencies may collaboration and provide supporting funding.
  • Congressional and high-level agency support and commitment.
  • Leadership entity, such as the CDC, with proposed funding is considered and underway with Congress,
  • A University, or an injury control and research entity may have funding to support.
  • Consensus among stakeholders to work together to develop the system.
  • Integration among related groups may provide ways to engage in efforts addressing the same risk and protective factors (e.g., impaired motor vehicle operators become impaired boaters, and vice versa).

GAP Recommendation:

None