Next steps for drowning prevention in rural and remote Australia: a systematic review of the literature

Taylor, Danielle H., Peden, Amy E., and Franklin, Richard C. (2020) Next steps for drowning prevention in rural and remote Australia: a systematic review of the literature. Australian Journal of Rural Health, 28 (6). pp. 530-542.

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Objective: To examine unintentional drowning by remoteness in Australia.

Design: A systematic review of both peer‐reviewed and grey literature published between January 1990 and December 2019 (inclusive).

Method: Using Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines, MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest), SPORTDiscus and Google Scholar were searched for studies exploring fatal and non‐fatal unintentional drowning by remoteness. Epidemiological data, common factors and prevention strategies were extracted and mapped to Australian standard geographical classifications (major cities, inner regional, outer regional, remote and very remote). Level of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation and prevention strategies aligned to the hierarchy of control.

Result: Thirty‐two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control.

Conclusion: Rural populations are proportionately overrepresented in drowning statistics. Proposed prevention strategies have unknown efficacy. Greater research into rural drowning of Australians is needed especially exploring behavioural motivations, program delivery, cost‐effectiveness and evaluation. Development and use of a standard definition for remoteness are recommended. Rural populations use water extensively; therefore, there is an urgent need to keep them safe.

Item ID: 65124
Item Type: Article (Research - C1)
ISSN: 1440-1584
Keywords: education/training; policy; public health; remote health; rurality
Copyright Information: © 2020 National Rural Health Alliance Ltd.
Date Deposited: 23 Nov 2020 22:59
FoR Codes: 42 HEALTH SCIENCES > 4206 Public health > 420603 Health promotion @ 50%
42 HEALTH SCIENCES > 4202 Epidemiology > 420210 Social epidemiology @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920409 Injury Control @ 100%
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