Cognitive and Behavioral Risk Factors for Unintentional Drowning Among Rural Chinese Children

Overview

Journal Int J Behav Med

Publisher Informa Healthcare

Date 2015 Oct 24

PMID 26493071

Citations 3

Authors

Jiabin Shen

Shulan Pang

David C Schwebel

Affiliations

Soon will be listed here.

Abstract

Background: Unintentional drowning is among the top causes of pediatric death worldwide and the leading cause of death for children under age 14 in China. Environmental factors such as abundant bodies of water and psychosocial factors such as lack of parental supervision contribute to heightened risk of pediatric drowning in rural China, but little is known about the role of individual characteristics such as knowledge and perceived vulnerability in the drowning risk of rural Chinese children.

Purpose: The present study aimed to explore the cognitive and behavioral risk factors for unintentional drowning among school-aged rural Chinese children.

Method: Two hundred and eighty children (mean age = 10.03 years, range 8-13) enrolled at an elementary school in rural Zhejiang Province, China completed self-report assessments of knowledge about drowning prevention, perceived vulnerability toward drowning, and history of non-fatal drowning experiences, as well as demographic information. A simulation task using a dollhouse assessed children's anticipated behaviors with water.

Results: Fifty-two percent of the sample reported exposure to water sources at least once daily, and 21 % of the sample reported at least one non-fatal drowning experience in their lifetime. Regression analysis showed that male gender, better swimming ability, less safety knowledge, and lower levels of perceived vulnerability were associated with more self-reported risky practice in/near water. More safety knowledge also predicted safer behaviors in the dollhouse simulation task. None of the risk factors predicted self-reported history of non-fatal drowning incidents.

Conclusion: High exposure to water sources and non-fatal drowning experiences were found among school-aged children in rural China. Drowning risk factors included demographic, cognitive, and behavioral characteristics of children. Results offer evidence for developing interventions in both Zhejiang Province and other regions with similar geographic and population characteristics.

Citing Articles

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References

Morrongiello B, Sandomierski M, Schwebel D, Hagel B . Are parents just treading water? The impact of participation in swim lessons on parents' judgments of children's drowning risk, swimming ability, and supervision needs. Accid Anal Prev. 2012; 50:1169-75. DOI: 10.1016/j.aap.2012.09.008. View

Shen J, Li S, Xiang H, Lu S, Schwebel D . Antecedents and consequences of pediatric dog-bite injuries and their developmental trends: 101 cases in rural China. Accid Anal Prev. 2013; 63:22-9. DOI: 10.1016/j.aap.2013.10.025. View

Cross C, Copping L, Campbell A . Sex differences in impulsivity: a meta-analysis. Psychol Bull. 2011; 137(1):97-130. DOI: 10.1037/a0021591. View

Brenner R, Saluja G, Smith G . Swimming lessons, swimming ability, and the risk of drowning. Inj Control Saf Promot. 2003; 10(4):211-6. DOI: 10.1076/icsp.10.4.211.16775. View

Fang Y, Dai L, Jaung M, Chen X, Yu S, Xiang H . Child drowning deaths in Xiamen city and suburbs, People's Republic of China, 2001 5. Inj Prev. 2007; 13(5):339-43. PMC: 2610602. DOI: 10.1136/ip.2007.016683. View

Ma W, Nie S, Xu H, Xu Y, Song X, Guo Q . An analysis of risk factors of non-fatal drowning among children in rural areas of Guangdong Province, China: a case-control study. BMC Public Health. 2010; 10:156. PMC: 2851686. DOI: 10.1186/1471-2458-10-156. View

Shen J, Li S, Xiang H, Pang S, Xu G, Yu G . Dog safety in rural China: children's sources of safety information and effect on knowledge, attitudes, and practices. Accid Anal Prev. 2013; 59:164-9. DOI: 10.1016/j.aap.2013.05.014. View

Yang L, Nong Q, Li C, Feng Q . [A case-control study on risk factors of drowning among children aged between 1 and 14 in rural areas of Guangxi]. Zhonghua Liu Xing Bing Xue Za Zhi. 2007; 27(10):853-6. View

Ding G, Bao Y . Editorial perspective: assessing developmental risk in cultural context: the case of 'left behind' children in rural China. J Child Psychol Psychiatry. 2014; 55(4):411-2. DOI: 10.1111/jcpp.12228. View

10.

Petrass L, Blitvich J . Preventing adolescent drowning: understanding water safety knowledge, attitudes and swimming ability. The effect of a short water safety intervention. Accid Anal Prev. 2014; 70:188-94. DOI: 10.1016/j.aap.2014.04.006. View

11.

Leavy J, Crawford G, Portsmouth L, Jancey J, Leaversuch F, Nimmo L . Recreational Drowning Prevention Interventions for Adults, 1990-2012: A Review. J Community Health. 2015; 40(4):725-35. DOI: 10.1007/s10900-015-9991-6. View

12.

Shen J, Pang S, Schwebel D . A randomized trial evaluating child dog-bite prevention in rural China through video-based testimonials. Health Psychol. 2015; 35(5):454-64. PMC: 4833565. DOI: 10.1037/hea0000273. View

13.

Schwebel D, Morrongiello B, Davis A, Stewart J, Bell M . The Blue Dog: evaluation of an interactive software program to teach young children how to interact safely with dogs. J Pediatr Psychol. 2011; 37(3):272-81. DOI: 10.1093/jpepsy/jsr102. View

14.

Yang L, Nong Q, Li C, Feng Q, Lo S . Risk factors for childhood drowning in rural regions of a developing country: a case-control study. Inj Prev. 2007; 13(3):178-82. PMC: 2598364. DOI: 10.1136/ip.2006.013409. View

15.

Bandura A . Social cognitive theory: an agentic perspective. Annu Rev Psychol. 2001; 52:1-26. DOI: 10.1146/annurev.psych.52.1.1. View

16.

Schwebel D, Pickett W . The role of child and adolescent development in the occurrence of agricultural injuries: an illustration using tractor-related injuries. J Agromedicine. 2012; 17(2):214-24. DOI: 10.1080/1059924X.2012.655120. View

17.

Liu Q, Zhang L, Li J, Zuo D, Kong D, Shen X . The gap in injury mortality rates between urban and rural residents of Hubei Province, China. BMC Public Health. 2012; 12:180. PMC: 3338362. DOI: 10.1186/1471-2458-12-180. View

18.

Wallis B, Watt K, Franklin R, Taylor M, Nixon J, Kimble R . Interventions associated with drowning prevention in children and adolescents: systematic literature review. Inj Prev. 2014; 21(3):195-204. DOI: 10.1136/injuryprev-2014-041216. View

19.

Shen J, Li S, Xiang H, Pang S, Xu G, Schwebel D . A multi-site study on knowledge, attitudes, beliefs and practice of child-dog interactions in rural China. Int J Environ Res Public Health. 2013; 10(3):950-62. PMC: 3709296. DOI: 10.3390/ijerph10030950. View

20.

Janz N, BECKER M . The Health Belief Model: a decade later. Health Educ Q. 1984; 11(1):1-47. DOI: 10.1177/109019818401100101. View