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LJ 17 Integrate Life Jacket Education into Learn-to-Swim and Water Safety Programs

Key area

Life Jackets

Integrate education that meets the national minimum life jacket educational standards into learn-to-swim programs, both dry land and in water safety programs, and instructor or provider training for swim instructors, health care providers. boating instructors, teachers, and other instructors (such as childcare providers, camp staff, parks and recreation, boat clubs and rentals).

Spectrum level: Educating Providers

Evidence level: High

Implementation levels: National

Rationale:

There is currently no standard instructional curriculum for learn to swim or water safety programs, their instructors, teachers, and providers that trains how to choose, fit, and properly use life jackets. Organizations that have a national curriculum, such as the National Association of State Boating Law Administrators, the American Red Cross or the American Canoe Club each have their own content. In addition, those who are teaching instructors may be coming with different base knowledge and experience with life jackets. Beyond, national organizations, local organizations may have their own way of teaching instructors or may not have anything explicit. Once an accredited national life jacket education standard has been developed, the related curriculum is needed. The goal of this action is to create consistency, accuracy, and comfort (self-efficacy) in teaching others how to choose, fit, and use a life jacket. Additionally, evidence shows that standardized teaching in many different settings, including health care, has led to improved performance.

Anticipated Impact:

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

  • A standard instructional curriculum for learn to swim and water safety programs, as well as their instructors, teachers, and providers on how to choose, fit, and use a life jacket.
  • Greater consistency, accuracy, and comfort (self -efficacy) in teaching others how to choose, fit, and use a life jacket.
  • Consistent messaging by instructors.
  • Greater efforts in data collection.
  • Less potential for errors due to misinformation or incorrect demonstration of use.

Evidence:

Water safety literature identifies life jackets as an essential part of water competence, and recommends that life jackets are promoted, that instructions on, and practice with proper fit and wear are provide, that donning should be practiced in all programs, and that all water competencies should be practiced with a life jacket. Additionally, life jacket competence, with practice, should be incorporated into programs that focus on swim and survival skills training.

There is evidence that having the experience of practicing skills with a life jacket can dramatically change perceptions (of risks and benefits).

Research suggests that life jacket education messages should be standardized consistency across the field and safety instructions should be specific to individual boat types. Stakeholders identified issues with varying information and the lack of consistent and accurate training for swim instructors. Additionally, there is evidence that many canoers and kayakers receive no formal or informal instruction on life jacket wear.

Successful education interventions are:

  • Specific in their content
  • Targeted in their reach
  • Delivered in settings appropriate to the target age groups
  • Contained information tailored to the specific devices provided.

Increasing life jacket wear requires:

  • Consistent messaging.
  • Role modeling
  • Pediatricians discussing life jackets with families, as water safety education is often taught by families, and families may not have institutional knowledge.
  • Educating about the benefits and appropriate uses of different life jacket types
  • Using PFD’s instead of air-filled swim aids

Educators in safety, lifesaving and swimming increasingly agree that promoting the use of life jackets in non-boating related activities is needed. However, it is important to ensure all caregivers are aware of the proper level of supervision required near any body of water, stressing that life jackets are not a substitute for appropriate supervision. Future studies should evaluate effective ways to increase life jacket use through boating safety courses, use in swimming lessons, and other education and training programs.

Evidence Sources:

Stallman R.K., Moran K., Quan L., & Langendorfer S. (2017). From swimming skill to water competence: Towards a more inclusive drowning prevention future. International Journal of Aquatic Research and Education, 10(2) Article 3, 1-35. https://doi.org/10.25035/ijare.10.02.03 Moran K. (2019) Can you float? Part 2 - Perceptions and practice of lifejacket use among young adults. International Journal of Aquatic Research and Education, 11(3) Article 4. https://doi.org/10.25035/ijare.11.03.04 World Health Organization. (2017). Preventing drowning: an implementation guide. https://www.who.int/publications/i/item/preventing-drowning-an-implementation-guide Cox K.L., Bhaumik S., Gupta M., & Jagnoor J. (2022). Facilitators and barriers of life jacket use for drowning prevention: Qualitative evidence synthesis. Journal of Safety Research, Feb.(80), 135-147. https://doi.org/10.1016/j.jsr.2021.11.010

Bennett E., Cummings P., Quan L., & Lewis F.M. (1999). Evaluation of a drowning prevention campaign in King County, Washington. Injury Prevention, 5,109-113. http://dx.doi.org/10.1136/ip.5.2.109

Wallis B.A., Watt K., Franklin R.C., Taylor M., Nixon J.W., & Kimble R.M. (2015). Interventions associated with drowning prevention in children and adolescents: systematic literature review. Injury Prevention, 21(3), 195-204. https://doi.org/10.1136/injuryprev-2014-041216

Ramos W., Beale A., Chambers P., Dalke S., Fielding R., Kublick L., Langendorfer S., Lees T., Quan L., & Wernicki P. (2015). Primary and secondary downing interventions: The American Red Cross circle of drowning prevention and chain of drowning survival. International Journal of Aquatic Research and Education, 9(1), 89-101. https://doi.org/10.25035/ijare.09.01.08 Quan L. (2014). Personal flotation devices. In J. Bierens (Ed), Drowning Prevention, Rescue, Treatment (2nd ed, pp. 225-229). Springer-Verlag. https://doi.org/10.1007/978-3-642-04253-9_33 Quan L, & Gilchrist J. (2022). The epidemiology and prevention of drowning. Boulton M.L., & Wallace R.B.(Eds.), Maxcy-Rosenau-Last Public Health & Preventive Medicine (16th ed.). McGraw Hill. https://accessmedicine.mhmedical.com/content.aspx?bookid=3078&sectionid=257531213

Quan L., Bennett E., Cummings P., Trusty M.N., & Treser C.D. (1998). Are life vests worn? A multiregional observational study of personal flotation device use in small boats. Injury Prevention, 4, 203-205. http://dx.doi.org/10.1136/ip.4.3.203

Stempski S., Schiff M., Bennett E., & Quan L. (2014). A case-control study of boat-related injuries and fatalities in Washington state. Injury Prevention, 20(4), 232-237. https://doi.org/10.1136/injuryprev-2013-041022

McKnight J.A., Becker W.W., Pettit A.J., & McKnight S.A. (2007). Human error in recreational boating. Accident Analysis and Prevention, 39, 398-405. https://doi.org/10.1016/j.aap.2006.09.004

Outdoor Foundation. (2019). Special report on paddlesports and safety. https://americancanoe.org/wp-content/uploads/documents/sei-educationalresources/2019specialreporton_paddl.pdf

Yuma P., Carroll J., & Morgan M. (2006). A guide to personal flotation devices and basic open water safety for pediatric health care practitioners. Journal Pediatric Health Care, 20(3), 214-2188. https://doi.org/10.1016/j.pedhc.2006.02.008

Mangione T. (ed). (2021). Summary of suggestions for increasing life jacket use. Unpublished survey notes from online survey conducted with persons indicating interest in life jackets via https://www.watersafetyusa.org/nwsap.html-

Bauer M.E., Giles A.R., Marianayagam J., & Toth K.M. (2020) Kids don’t float…and their parents don’t either: using a family-centered approach in Alaska’s kids don’t float program. International Journal of Aquatic Research and Education, 12 (4), Article 9, 1-5. https://doi.org/10.25035/ijare.12.04.09

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:

  • Anyone taking a learn to swim or water safety class outside of a K-12 classroom
  • Parents and families
  • Individuals with limited financial resources or who aren’t familiar with the water
  • Any instructor or educator who is going to provide information about life jackets
  • Providers (for example health care providers) who are educating parents on life jacket use and fit

Evaluation Metrics:

Indicators of long-term impact:

  • Increased life jacket use in boaters and among people recreating in open water:

Indicators of intermediate impact:

  • Increase in the number of associations, clubs, groups, and organizations that are using a standard instructional curriculum for choosing, fitting, and using a life jacket
  • Increase in the number of certifications issued for people trained
  • Documentation of people saved due to proper use of the recommended training
  • Positive changes in knowledge and attitudes about life jacket use in both boating and nonboating situations

Indicators of initial impact:

  • Standard instructional curriculum is developed

Implementation:

Consider the following to ensure successful implementation:

  • Consider NASBLA as the key organization in the development and dissemination of the recommended standard for education of open water safety for children which lends itself well to national implementation.
  • Partner with stakeholders such as the state level Boating Law Administrator and educators, state and county Public Health, Injury Prevention, and national organizations and agencies including Army Corps of Engineers, Centers for Disease Control, Safe Kids, Safe States Alliance, Bureau for Indian Affairs, Indian Health Services, United States Coast Guard and Coast Guard Auxiliary, America’s Boating Club, American Canoe Association Instructors.
  • Reference programs that already have an evaluated life jacket component such as the "Kids Don’t Float" program in Alaska.
  • Focus on both boating and non boating scenarios where life jackets can be used.
  • Develop curriculum that can be taught in water and/or on dry land.
  • Partner with local and State Drowning Prevention Task Forces, National Drowning Prevention Alliance, America's Boating Club and US Coast Guard Auxiliary.
  • Review the Water Safety, Water Competency and Swimming recommendations for related actions.
  • Evaluate the developed educational program before it becomes widely adopted.
  • Train learners, educators, and instructors adequately and consistently using this national standard.

*Any educator group or individual who teaches boating safety education must go through an approval process to teach a NASBLA course, to be recognized for the state required boating credentials. All states except 5 require an operator to complete a NASBLA approved course. NASBLA utilizes the Education Standards Panel to establish national standards that utilizes a consensus approach and methodology/process overseen by the American National Standards Institute. Because of the consensus process and standards established,

Challenges to Implementation:

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

  • Aquatic Centers may not have appropriate life jackets for training and practice.
  • Liability concerns and the perceived lack of time to include as part of a curriculum may be potential barriers.
  • People may not do the training if they don’t see it as important.
  • The current organizational focus on the aspects of wearing a life jacket that pertain to their context may be difficult to overcome.
  • The limited assessment of existing life jacket educational programs may make it difficult to provide inform on what works and what doesn’t to the field.
  • Including life jacket education outside of the context of boating may be difficult as the majority of life jacket education programs are focused on boating.
  • Current recommendations on life jackets for recreational swimmers or for children playing in water are inconsistent and vary widely.
  • Finding one organizational body who can be seen as the expert in developing training and education for life jacket use across settings may be difficult.

Potential Facilitators:

The following factors might facilitate the implementation of this recommendation:

  • Organizations that presently teach life jacket use (the USCG issues grants to states and non-profits for boating related education, including life jackets).
  • Life jacket education is already a part of many learn to swim standard trainings such as for American Red Cross or YMCA learn to swim, these curriculums an be reviewed for consideration. The same holds true for instructor trainings such as with marine patrol and swim instructors.
  • Private companies that dredge, tow, or are involved with recovery such as Tow Boat US also have some life jacket training already in place.
  • USCG Auxiliary and Power Squadrons have specific curriculum focused on the end user (vs the instructor) that could be adapted for instructor training.
  • The National Safe Boating Council and American Canoe Association will be important to include in the development and implementation of this recommendation.
  • BoatUS Foundation, Safe Kids Worldwide and SeaTow Foundation should be considered as critical partners.
  • US Coast Guard Auxiliary members are actively teaching how to choose, fit, check, and use a life jacket, though primarily in a boating environment.
  • National programs that already include a life jacket component should be consulted, including the "Kids Don’t Float".
  • There are existing local level efforts focusing on specific groups. For example, Texas Children’s Hospital and Baylor College of Medicine are doing a study to test the effectiveness of a water safety education intervention including life jackets specifically designed for pediatricians. These results should be reviewed for consideration and lessons learned.
  • Local and State Drowning Prevention Task Forces, National Drowning Prevention Alliance, America's Boating Club, and US Coast Guard Auxiliary will be helpful in implementing this standard.

Development of an accredited national education standard to guide the development of a standardized curriculum will be key. It sets the stage for harmonization of the curriculum and ensures the most important points related to both boating and nonboating applications are covered on dry land and in a pool/open water.

GAP Recommendation:

Note-we chose to embed the need for evaluation within the Action Recommendation vs putting it as a Gap recommendation.