Accident Analysis and Prevention 70 (2014) 188–194

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Accident Analysis and Prevention

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Preventing adolescent drowning: Understanding water safety

knowledge, attitudes and swimming ability. The effect of a short
water safety intervention
Lauren A. Petrass ∗ , Jennifer D. Blitvich
Faculty of Health Federation University Australia Mt Helen, Ballarat, VIC, Australia

a r t i c l e i n f o a b s t r a c t

Article history: Worldwide, epidemiological data indicate that children are a high-risk group for drowning and while
Received 15 August 2013 progress has been made in understanding toddler drownings, there is a lack of empirical evidence
Received in revised form 1 April 2014 regarding the drowning risk and protective factors inherent for adolescents and young adults. This study
Accepted 10 April 2014
used a self-report questionnaire to establish swimming and water safety knowledge and attitudes of
young adults and objectively measured their actual swimming ability using formal practical testing
Keywords:
procedures. Participants then completed a short, 12-week intervention that encompassed swimming,
Adolescent drowning
survival and rescue skills, along with water safety knowledge applicable to a range of aquatic environ-
Swim ability
Aquatic knowledge
ments. Knowledge, attitudes and swimming ability were then re-measured following the intervention
Water safety attitudes to evaluate its effectiveness. The Wilcoxon matched pairs signed ranks test was performed to detect
whether there were significant differences between knowledge, attitude and swim ability scores pre-
intervention and post-intervention. A total of 135 participants completed the baseline and follow up
questionnaire and all practical testing. Results indicated that these young adults had a very low level of
water safety knowledge pre-intervention, although the majority had sound swimming and water safety
skills and attitudes. Overall, significant improvements were evident in knowledge (p < 0.001) and swim
ability (p < 0.001) post-intervention, although no changes were observed in attitudes (p = 0.079). Previ-
ous participation in formal swimming lessons and/or swimming within the school curriculum had no
significant impact on water safety knowledge, skills or attitudes of these young adults, and there were
few significant gender differences. While it is important to conduct further studies to confirm that these
findings are consistent with a more representative sample of young adults, our findings are the first to
provide empirical evidence of the value of a comprehensive aquatic education program as a drowning
prevention strategy for young adults.
© 2014 Published by Elsevier Ltd.

1. Introduction 2008). In contrast, there is a lack of empirical evidence regarding

Worldwide, epidemiological data indicate that children are a
high-risk group for drowning (Taneja et al., 2008). In Australia,
for example, between July 2002 and June 2011, there were 589
drowning deaths in the 0–19 year age group. Significant progress
has been made in understanding toddler drownings in Australia
and other high income counties. Drowning prevention measures
for toddlers and young children typically include strategies such
as isolation swimming pool fencing (Thompson and Rivara, 1998),
supervision (Petrass et al., 2011) and child safe play areas (Fragar
et al., 2003), and teaching parents skills such as CPR (Marchant et al.,
∗ Corresponding author. Tel.: +61 3 5327 9392.
E-mail address: l.petrass@federation.edu.au (L.A. Petrass).
the drowning risk and protective factors inherent in the later age
groups and the diversity of drowning locations and activities within
these groups makes prevention a significant challenge.
Research relating to drowning deaths among young adults (both
male and female) has predominantly focused on a small num-
ber of key risk factors including alcohol and drug use; risk-taking
behaviour; and swimming ability. The negative effect of alco-
hol consumption in and around aquatic environments has been
widely documented (American Academy of Pediatrics, Committee
on Injury, Violence, and Poison Prevention 2003; Driscoll et al.,
2004; Quan and Cummings, 2003). A recent Australian study inves-
tigating drowning in the 15–19 years age group identified that
alcohol was involved in 21% of all drowning deaths, most com-
monly at rivers, creeks and streams (Royal Life Saving Society
Australia [RLSSA], 2012a), and this has been identified as a priority

http://dx.doi.org/10.1016/j.aap.2014.04.006
0001-4575/© 2014 Published by Elsevier Ltd.
 L.A. Petrass, J.D. Blitvich / Accident Analysis and Prevention 70 (2014) 188–194
concern (Australian Water Safety Council, 2012). Further, during
adolescence there is a complex interaction among psychological,
cognitive and physical developmental processes which cumulates
in increased risk taking and novelty seeking behaviours (Steinberg,
2004). This, combined with increasing autonomy and the need
to gain peer approval and acceptance, results in heightened vul-
nerability to injury (Johnson and Jones, 2011; Steinberg, 2004),
particularly drowning in aquatic settings. Supervision remains as a
drowning prevention strategy for young adults however, due to
their increased autonomy, supervision changes from being pro-
vided by parents to almost entirely being provided by lifeguards
and peers (Royal Life Saving Society Australia [RLSSA], 2012a).
Accordingly, young adults need to be equipped with sufficient
swimming and water safety knowledge and skills to make informed
decisions and take appropriate action in a variety of situations
where a drowning risk is present.
While limited research connects increased swimming ability
(though some form of instruction) to a decrease in drownings
(Smith, 1995), swimming ability continues to be considered a pre-
ventative strategy that may be beneficial for persons of all ages
(Brenner et al., 2003, 2009). Accordingly, RLSSA promotes that
every child should have access to a quality swimming and water
safety education program that includes swimming, survival and
rescue skills, and water safety knowledge suitable for use in a range
of aquatic settings (Royal Life Saving Society Australia [RLSSA],
2012b). For young children, research indicates that swimming skills
are more readily attained when motor development is at least the
level of a 5 year old (Blanksby et al., 1995; Parker and Blanksby,
1997). However, it remains unknown whether the swimming and
water safety skills and knowledge acquired through participation
in formal swimming lessons as a young child are retained at older
ages. Further, it is also unknown whether swimming and water
safety education programs conducted through the primary and sec-
ondary school years impact on young adults’ (18–34 years) water
safety skills and knowledge.
Recent international research investigating the relationship
between perceived and real swimming ability of first year colle-
giate physical education students (aged 17–29 years) in Australia,
Japan, New Zealand and Norway confirmed that most students had
a sound aquatic skill base. This was expected, given that partici-
pants were undertaking a program where aquatic activities were
part of their professional development (Moran et al., 2012; Petrass
et al., 2012). In contrast, a self-report study that examined the
swimming ability of US adults, which claimed to be representative
of the US population, indicated that 37% of respondents reported
limited swimming ability (defined as unable to swim/could not
swim the length of a standard pool [24 yd or 22 m]) (Irwin et al.,
2009). Equivalent research on the swimming competence of young
Australian adults is lacking, and to our knowledge no research has
considered the swimming and water safety knowledge and atti-
tudes of this population. Therefore this study fulfils three purposes:
(1) to ascertain the water safety knowledge, attitudes and swim-
ming ability of young Australian adults; (2) to explore demographic
variables that significantly influence water safety knowledge, atti-
tudes and swimming ability; and (3) to determine the effect of a
12-week swimming and water safety intervention on young adults’
swimming and water safety knowledge, attitudes and ability of
young adults.
2. Method
2.1. Participants and procedure
The “Can You Swim Intervention” study was conducted between
February and June 2010. All first year Bachelor of Exercise and
189
Sports Science students were invited to participate as the swim-
ming and water safety intervention program was embedded within
the Swimming and Water Safety course that formed part of the
students’ undergraduate degree. General background information
relating to the study was provided in the first practical class
and students interested in the intervention completed a substan-
tially extended version of the “Can You Swim” self-report survey
(described in Section 2.2) which provided baseline data. Follow-
ing the completion of the survey, practical swimming assessment
commenced (to gather baseline practical skills data) and all practi-
cal assessment was completed within the first four practical classes,
well before the specific skills were introduced, to eliminate the pos-
sibility of learning in the course impacting pre-intervention results.
To decrease the likelihood of participant response bias, students
were not informed that some of the survey questions paralleled
the practical test items. To enable comparisons between pre- and
post-intervention, in the final practical session of the swimming
and water safety intervention program the “Can You Swim Inter-
vention” self-report survey and practical assessment items were
repeated. Ethical approval was granted by the University Human
Research Ethics Committee and informed consent was obtained
from all participants prior to the completion of the survey and
practical swimming assessment.
2.2. Instruments
The “Can You Swim Intervention” self-report survey was an
extended version of the survey validated for similar use and applied
in a large international study that included New Zealand, Norway,
Japan and Australia (Moran et al., 2012; Petrass et al., 2012). Modifi-
cations to the original survey included the addition of ten multiple
choice questions that assessed swimming, water safety and aquatic
knowledge (e.g., which of the following categories of drowning
victims is least likely to wave or call for help?). Twelve attitude
statements were included, with participants required to indicate
the extent of agreement to each statement on a five-point Lik-
ert scale (ranging from strongly agree to strongly disagree). For
example, it is safe to swim at surf beaches and rivers after consum-
ing more than 1–2 standard alcoholic drinks. Eight closed-ended
response questions were also added that enabled characterisation
of aquatic participation and behaviour (e.g., in the past year how
often did you swim at the following venues: home swimming pool;
public swimming pool; surf beach; lake, pond, water hole; river,
creek).
To establish content validity of the additional 30 questions in
the “Can You Swim Intervention” survey, the entire instrument was
reviewed by a panel of eight experts with extensive swim coaching
and teaching experience. Two academics with psychology back-
grounds also reviewed the instrument, specifically focussing on the
attitude and behaviour questions. Experts were invited to provide
suggestions for modifications, additions or deletions to the sur-
vey content. Expert feedback was collated and condensed and a
small number of modifications were made to the wording within
the survey. The amended version was piloted with a small num-
ber of Bachelor of Education students, a group similar to the study
participant group. This pilot trial enabled face validity to be deter-
mined, ambiguity within questions identified and addressed, and
instructions and question wording clarified where necessary. All
feedback received from the pilot study was addressed for ques-
tionnaire improvement.
Test–retest reliability of the extended “Can You Swim Inter-
vention” survey was conducted one month prior to the data
collection. Reliability was assessed through repeat completion of
the questionnaire over a short time interval (mean 14 days) with a
group of 50 Bachelor of Education students. Kappa statistics were
190 L.A. Petrass, J.D. Blitvich / Accident Analysis and Prevention 70 (2014) 188–194

Table 1
The teaching sequence and content included in the 12-week intervention program.

Week Theory sessions Practical 1 Practical 2

1 Introduction to swimming and water safety Water confidence games; breathing Body orientation; basic sculling
2 Drowning epidemiology Survival sculling, sculling for movement; Backstroke
synchronised swimming skills
3 Fluid mechanics Backstroke continued Freestyle
4 Fluid mechanics Freestyle continued Breaststroke kick, survival backstroke
5 Entries, focussing on teaching safer diving Breaststroke continued Entries; safe diving skills
skills
6 Survival issues and techniques Sidestroke Survival skills (clothed); PFDs; HELP and
huddle positions
7 Survival issues and techniques Practical survival test Butterfly
8 Starts and turns Butterfly continued Competitive starts and turns
9 Rescue Introduction to rescues: rope throw; dry rescue Victim simulation; defence and escape
positions
10 Spinal injury management Accompanied rescues; non-contact rescues Contact rescues and spinal cord injury
management
11 Aquatic instruction, and designing sessions for Initiative and judgement Initiative and judgement
different settings
12 Revision of qualitative analysis of swimming Squad organisation and training Practical 200 m individual medley time trial
strokes

used to establish test–retest reliability and values were categorised
according to the scale of Landis and Koch (1977).
The practical skills assessment consisted of five skills that
addressed individual swimming, survival, and rescue skills and cor-
responded to the extended “Can You Swim Intervention” survey.
The items assessed included a continuous swim of up to 425 m
(participant choice of stroke, no speed requirement) assessed on an
eight-point scale ranging from 1, does not attempt test to 8, com-
pleted 425 m; a 100 m swim on the back (assessed on a 7-point
scale ranging from 1, does not attempt test to 7, completes task
easily with excellent form and pace; floating, with minimal swim-
ming action (up to 10 min, with the time in minutes recorded as
the participants’ score). An underwater swim (up to 25 m); and a
dive entry (into 2 m water depth) were both assessed on a 6-point
scale. A 25 m contact rescue of a simulated unconscious person was
also included but is not reported in this paper. Following the prac-
tical testing all scores were re-coded on a scale of 0, minimum to
10, maximum to enable comparison of practical items on the same
scale. For further details of the practical test items and how consis-
tency in assessment of practical items was established, see Moran
et al. (2012) and Petrass et al. (2012).
2.3. Intervention program
critical thinking and there is persuasive evidence that students
engaged in collaborative learning achieve higher levels of thought
and retain information longer than students who work individu-
ally, (Johnson and Johnson, 1986; Totten et al., 1991) and this was
considered desirable.
The intervention program was conducted over 12 weeks (to
fit in with the University semester) and each week all par-
ticipants were required to attend two scheduled 1-h practical
swimming sessions and one, 1-h theory session where atten-
dance was expected, although not compulsory. All students could
also attend an additional 1-h optional practical swimming session
for further assistance, although this session was primarily imple-
mented for students with low level entry skills. Five qualified
AUSTSWIM instructors with extensive experience teaching swim-
ming and water safety and experience teaching at a tertiary level
were employed to conduct the scheduled practical sessions. Each
of the practical sessions contained a maximum of 30 students and
was team-taught by two of the AUSTSWIM qualified instructors.
The 1 h theory session was also conducted by an AUSTSWIM quali-
fied instructor and course presenter with extensive teaching and
research experience in injury prevention and risk management,
particularly within the area of water safety and drowning preven-
tion.

The swimming and water safety intervention program was
embedded within the Swimming and Water Safety course that
formed part of the students’ undergraduate degree. The inter-
vention was a comprehensive program that encompassed a
combination of personal swimming, survival and rescue skills along
with water safety knowledge applicable to a range of aquatic envi-
ronments (Table 1). This was considered important, particularly as
Australian drowning statistics indicate that older children (5–19
years) are likely to be swimming and recreating at inland water-
ways including rivers, streams and creeks immediately prior to
drowning (Royal Life Saving Society Australia [RLSSA], 2012a).
The program also focused on developing student understanding
of teaching strategies and teaching sequences for aquatic skills
including survival and competitive swimming strokes (Table 1). A
collaborative and social learning pedagogy (i.e., participative learn-
ing) was implemented as this enabled students to exchange ideas in
small groups, engage in discussion, and take responsibility for their
own learning (for example, students were frequently required to
observe peers, assess causes of faulty technique and apply effec-
tive teaching practices and strategies to correct the identified
faults). Research indicates that this pedagogical approach promotes
2.4. Statistical analysis
To enable comparison between pre-intervention and post-
intervention survey and practical data, each participant was
allocated a unique eight digit identification number at the com-
mencement of the study. All data were double entered and cleaned
in Microsoft Excel and the cleaned data were transferred to SPSS
(version 19) for statistical analysis.
Frequencies and percentages were used to summarise categor-
ical variables, particularly demographic information and aquatic
participation and behaviour data. As the data were categorical and
ordinal, non-parametric statistics were conducted. The Wilcoxon
matched pairs signed ranks test was performed to detect any sig-
nificant differences between knowledge, swimming ability and
attitude scores pre- and post-intervention. Mann–Whitney tests
were used to establish whether there were significant differences
in swimming ability, attitudes and knowledge pre-intervention
and post-intervention for male and females and also for those
who had previously participated in formal swimming lessons
and/or swimming as part of the school curriculum and those that
had not. Finally, Spearman’s correlation coefficient was used to
 L.A. Petrass, J.D. Blitvich / Accident Analysis and Prevention 70 (2014) 188–194
determine the relationship between participants’ baseline self-
rated swimming ability and pre-intervention practical testing and
the equivalent post-intervention measures.
3. Results
Test–retest assessment indicated that the majority (40.9%) of the
new questions had substantial agreement. Other questions were
calculated to have slight (7.6%), fair (4.5%), moderate (30.3%) or
almost perfect (16.7%) agreement. Accordingly, as less than 10%
of questions had slight agreement (and these were predominately
related to the attitude questions) the extended “Can You Swim
Intervention” survey was considered appropriate for this study.
A total of 154 students were enrolled in the Swimming and
Water Safety course, however, removal of missing data (e.g., where
the student left the Bachelor of Exercise and Sport Science course;
was injured part-way through the intervention program; did not
attend 90% of practical swimming sessions; or was absent at
the time of follow-up testing) reduced the sample size to 135
(88%). Gender balance was relatively even (56.4% males and 43.6%
females) and the majority were aged between 18 and 19 years
(82.2%) with a few participants aged 20–24 years (17.8%). Slightly
more than half (57.5%) reported that they had undertaken formal
swimming lessons (outside of school) however, of these only 55.8%
reported the length of time they were enrolled in lessons. The
majority (67.4%) reported that they had completed ≤2 years, whilst
32.6% had completed >2 years. Almost half (44.8%) of the partici-
pants reported that they had taken part in high school swimming
and close to one fifth (18.7%) reported that they had participated
in squad level swimming (defined as advanced swimming instruc-
tion focussing on stroke correction and fitness). Reported level of
participation in aquatic activities within the last 12 months varied
according to the aquatic environment, for example the majority of
participants reported never or not often swimming at rivers, creeks
(69.9%) and lakes or ponds (72.6%). In contrast, over half the par-
ticipants reported swimming often or very often at public pools
and beaches (51.9% and 54.9%, respectively). Very few participants
held a pool lifeguard certificate (11.9%) or an AUSTSWIM Teacher
of Swimming and Water Safety (5.9%) qualification.
At baseline, participants typically had a low level of swim-
ming, water safety and aquatic knowledge (Mdn = 40). In relation
to gender differences, males were significantly more likely to
receive a higher knowledge score than females (Mdn = 40 versus 30,
respectively) on the baseline survey (U = 1677.5, z = −2.20, p = 0.028,
r = 0.19). Neither formal swimming lessons (Mdn = 35) (adjusted
for the length of time enrolled) nor participation in swimming
lessons/classes within the school curriculum (Mdn = 40) had a sig-
nificant impact on participants’ baseline swimming, water safety
and aquatic knowledge (U = 177.0, z = −0.52, p = 0.601, r = 0.08 and,
U = 89.5, z = −1.49, p = 0.137, r = 0.19, respectively). Following the
12-week intervention program there was a significant increase
(z = −1.49, p < 0.001, r = 0.13) in participants’ swimming, water
safety and aquatic knowledge, evidenced by an improved median
score of 70. There were no statistically significant post-intervention
differences in the level of knowledge between male and female
participants (Mdn = 70.00 for both males and females, U = 1980.0,
z = −0.74, p = 0.460, r = 0.06) or for participants who had reported
that they had undertaken formal swimming lessons (Mdn = 70,
U = 151.5, z = −1.37, p = 0.172, r = 0.21) or swimming lessons/classes
within school (Mdn = 70, U = 127.0, z = −0.52, p = 0.600, r = 0.06).
Evaluation of participant attitudes pre (Mdn = 39) and post-
intervention (Mdn = 40) indicated there was no significant
change in attitudes overall (z = −1.75, p = 0.079, r = −0.15). When
statements were analysed individually, only one third of state-
ments had a significantly different response pre-intervention to
191
Fig. 1. Median scores (out of a maximum score of 10) on the five practical test
items pre-intervention and post-intervention (both males and females, combined).
*
Denotes significant improvement from pre-intervention to post-intervention,
p < 0.001.
post-intervention (Table 2). For those statements that were signifi-
cantly different, with the exception of one statement (regardless of
your swim ability, you should always swim between the flags) par-
ticipants reported a more conservative response post-intervention
(Table 2). Mann–Whitney tests indicated that females were sig-
nificantly more conservative in their pre-intervention attitudes
(Mdn = 40) than males (Mdn = 38) (U = 1575.5, z = −2.73, p = 0.006,
r = −0.24), but there were no significant gender differences post-
intervention (U = 1994.0, z = −0.82, p = 0.410, r = −0.07).
Compared with the pre-intervention practical testing, post-
intervention showed statistically significant improvement in
the participants’ overall swimming ability (z = −8.87, p < 0.001,
r = −0.77). When analysed according to each individual skill, sta-
tistically significant improvement was evident in all skills except
the float, which was essentially at ceiling level pre-intervention
(Fig. 1).
Prior to and following the intervention, participants rated their
swimming ability on a 10 point scale from 0, not at all confident to
10, very confident. Results indicated that participants’ perceptions
of their own swimming ability mirrored the change that was evi-
dent in the practical swimming ability pre-and post-intervention.
At baseline, perceived swimming ability was rated significantly
lower (Mdn = 6) than after the intervention (Mdn = 8) (z = −4.22,
p = <0.001, r = 0.36). Further analysis indicated that participant
baseline self-rated swimming ability was positively correlated with
their pre-intervention practical testing (rs = 0.48, p < 0.001) as were
the equivalent post-intervention measures (rs = 0.41, p < 0.001).
There was no significant difference in the overall pre-
intervention swimming ability of participants who reported
undertaking formal swimming lessons (Mdn = 40) or swimming
lessons/classes within the school curriculum (Mdn = 40) and those
who did not (Mdn = 41) (U = 1744.0, z = −1.88, p = 0.600, r = 0.16
and, U = 106.0, z = −1.08, p = 0.278, r = 0.19, respectively). Further,
there was no difference in swimming ability when length of
time in formal lessons was accounted for (Mdn = 40, U = 142.5,
z = −1.57, p = 0.116, r = 0.24). However, the participants who had
undertaken either formal swimming lessons (Mdn = 43.8) or swim-
ming lessons/classes within the school curriculum (Mdn = 42.1)
were of a significantly higher standard following the interven-
tion (U = 1684.5, z = −2.30, p = 0.021, r = 0.28 and U = 55.0, z = −2.35,
p = 0.019, r = 0.29, respectively), regardless of whether they were
involved for ≤2 years or >2 years. Unlike the knowledge compo-
nent, there were no statistically significant pre-post intervention
differences in the level of swimming ability between male and
192 L.A. Petrass, J.D. Blitvich / Accident Analysis and Prevention 70 (2014) 188–194

Table 2
Changes in attitude statements from pre-intervention to post-intervention measured by a five point scale (1 = strongly agree, 5 = strongly disagree).

Attitude statement Median pre (IQRˆ) Median post (IQR) z Value p Value

Regardless of your swim ability, you should always swim between the flags 1 (1) 2 (1) −2.71 0.007*
Drinking alcohol on a small boat or yacht is ok if skipper does not drink 3 (2) 3 (1) −2.98 0.003*
It is ok to swim under the influence of drugs or alcohol 5 (1) 5 (1) −2.61 0.009*
Swimming in the surf after the surf patrol is finished is ok if other people 3 (1) 3 (1) −2.19 0.029*
are still in the water
Swimming outside the flags is ok if the surf looks safe and you’re a good 4 (1) 4 (1) −0.30 0.762
swimmer
It is ok to dive into water without knowing the depth if you know how to 5 (1) 4 (1) −1.91 0.057
perform a safe dive
It is safe to swim at surf beaches and rivers after consuming more than 1–2 4 (1) 4 (1) −1.51 0.130
standard alcoholic drinks
You should never ignore water safety signs or swim in prohibited aquatic 2 (1) 2 (1) −0.96 0.338
settings
Swimming at night is only risky if you are not familiar with the 4 (2) 4 (1) −1.01 0.311
environment
Consuming alcoholic drinks in and around a private pool is safe, if 4 (1) 4 (1) −0.239 0.811
everyone can touch the bottom
Swimming alone is risky even if you are a good swimmer 4 (1) 2 (0) −1.46 0.143
If you are a competent swimmer you should not have to wear a PFD when 4 (1) 4 (1) −1.62 0.105
jet skiing, water skiing or boating

ÎQR = interquartile range.

female participants (pre U = 2134.0, z = −0.05, p = 0.956, r = 0.01;
post U = 2031.0, z = −0.66, p = 0.512, r = 0.05).
4. Discussion
There is consensus among the water safety education commu-
nity that teaching water safety knowledge and skills will shape
positive water safety attitudes, perceptions and behaviour in
aquatic environments (Moran, 2008). Further, it is thought the
swimming and water safety skills that are taught to children at
a young age (from the age of 5 years) can provide young adults
with the skills required to safely enjoy the aquatic environment,
and potentially provide the rescue and resuscitation skills nec-
essary to assist others in aquatic emergencies (Australian Water
Safety Council, 2012). To our knowledge however, no studies to
date have investigated the water safety knowledge, attitudes and
swimming ability of young Australian adults or considered whether
participation in formal swimming and water safety lessons and/or
involvement in swimming programs within the school curriculum
has a significant impact on the water safety knowledge, attitudes
and swimming ability of young adults.
This study established the swimming and water safety knowl-
edge and attitudes of a group of young adults and directly
measured their actual swimming ability using formal testing pro-
cedures. Knowledge, attitudes and swimming ability were then
re-measured following a comprehensive 12-week swimming and
water safety intervention program, taught by highly qualified and
experienced instructors, to determine its effectiveness. A large
number of young adults in this study reported they had undertaken
previous formal swimming and water safety lessons and/or had
involvement in swimming programs within the school curriculum.
This could be influenced by the availability of aquatic environments
and learn to swim centres in Australia; the existence of a National
swimming and water safety program; or a bias associated with a
sample drawn from a Bachelor of Exercise and Sport Science cohort.
The effectiveness of school swimming programs in educat-
ing students in a wide variety of swimming and water safety
skills that includes general swimming techniques and treading
water, survival techniques and strategies, floating and rescue skills
is unknown. However, according to the “Royal Life Saving Soci-
ety Australia Swim and Survive Program”, participants should be
exposed to the aforementioned swimming and water safety skills
and also obtain knowledge in specific areas including dangers in the
aquatic environment, and personal safety and survival techniques
(Royal Life Saving Society Australia [RLSSA], 2010). The lack of
water safety knowledge exhibited by young adults in this study was
therefore disconcerting, and more so as there was no knowledge
difference between individuals who reported previous participa-
tion in formal swimming and water safety lessons or swimming as
part of the school curriculum. This lack of awareness is especially
alarming because in Australia, rivers, creeks and streams are the
leading location for drowning deaths in the 15–19 year age group
(Royal Life Saving Society Australia [RLSSA], 2012a), however over
half (54.1%) of study participants indicated that private swimming
pools were the main location for drownings. Furthermore, when
asked when swimming in a river or lake should be attempted, the
majority (70.7%) selected one of the least safe options. The limited
understanding that these young adults have of rivers, creeks and
streams may be associated with their lack of familiarity in these
settings, as evidenced by the majority of participants reporting
that they had never, or not often swam at rivers, creeks, lakes or
ponds. This lack of aquatic knowledge and familiarity within these
settings, coupled with increased risk-taking that is characteristic
of this age group (Johnson and Jones, 2011; Steinberg, 2004) is
likely to contribute to increased drowning risk in these aquatic
environments.
A lack of knowledge was also evident in relation to personal
safety and survival techniques, despite the fact that this is included
in the latter levels of the RLSSA swim and survive program (Active
Award 6: Swim and Survive; and Active Award 7: Senior Swim
and Survive) (Royal Life Saving Society Australia [RLSSA], 2010).
It remains unclear whether the poor knowledge is associated with
a lack of retention of information or whether water safety knowl-
edge is not actually taught within some swimming and water safety
programs. Results from a recent survey of Australian swim schools
indicated that over half reported that they incorporate water safety
knowledge in every lesson either through water safety tips fol-
lowed by oral questioning or dry land activities (Royal Life Saving
and AUSTSWIM Ltd., 2010). However, confirmation of the accuracy
of reporting and evaluation of the effectiveness of this approach
to teaching water safety knowledge should be considered. Many
swim schools also reported that they conducted a water safety
week once per school term to cover all the water safety content but
also commented that these are the lessons that children are most
likely to miss (Royal Life Saving and AUSTSWIM Ltd., 2010). For
this reason, RLSSA promotes that water safety skills and knowledge
 L.A. Petrass, J.D. Blitvich / Accident Analysis and Prevention 70 (2014) 188–194
should be integrated throughout every lesson within a program
(Royal Life Saving Society Australia [RLSSA], 2012b). Education of
parents and young adults is also required, and must highlight the
importance of swimming and water safety knowledge, combined
with adequate swimming and survival skills to decrease drowning
risk.
Despite the low level of water safety knowledge identified in
this study, the findings from this research show that the major-
ity of young adults had sound swimming and water safety skills,
and an excellent ability to float in deep water with all partici-
pants able to float for 10 minutes. This result is consistent with
research on skill learning, which has demonstrated that physi-
cal tasks display less skill decay than cognitive tasks following a
period of non-practice or non-use (Arthur et al., 1998). When swim-
ming ability was analysed by gender, there were no significant skill
differences evident between males and females prior to, or fol-
lowing the intervention, a finding which is in contrast to studies
that have measured self-reported swimming ability, where adoles-
cent males typically report higher levels of swimming ability than
females (Howland et al., 1996; McCool et al., 2008; Morgan et al.,
2009).
Further, there were no differences in swimming and water
safety skills prior to the intervention for participants who reported
undertaking formal swimming lessons or swimming within the
school curriculum. These participants were however, of a signif-
icantly higher standard following the intervention. It has been
recognised that skill decay is problematic in circumstance where
individuals receive skills and knowledge that they then may not
use for an extended period of time (Arthur et al., 1998), and this
may in part explain why there was no difference in swimming abil-
ity at the start of this study. One of the main challenges of working
with young adults is capturing this age group for refresher train-
ing. Wisher et al. (1991) found that after formal training, only a
limited amount of refresher training, if any, is needed to reacquire
any skill that has been lost among military recruits. Accordingly,
the intervention in this study is likely to have been a refresher
for participants who had undertaken formal swimming lessons or
swimming within the school curriculum, and therefore these par-
ticipants may have experienced a greater level of overlearning, thus
enabling them to move beyond a competent level of skill acquisi-
tion to a proficient or expert level. While Universities are an ideal
place to capture this age group for further formal and/or refresher
training, a large portion of the population do not attend university
and thus strategies to more broadly recruit the young adult age
group are required.
It has been well documented that attitude has an important
influence on behaviour (Fishbein and Ajzen, 1975), however there is
lack of evidence of interventions that influence attitude change over
a period of time. It has been recognised that adult education may
play a role in changing attitudes, although there is little evidence
to support how or why this occurs (Preston and Feinstein, 2004).
Results of this study demonstrated that there was no significant
change in attitudes overall, following the intervention. This finding
corroborates with findings from a school-based water safety inter-
vention conducted in Greater Athens, where no significant changes
were observed in high school students’ attitudes pre- and post-
intervention (Terzidis et al., 2007). When results from the current
study were analysed according to gender, female attitudes were ini-
tially very conservative and they changed to be less conservative
post-intervention. This change may be suitable, given the increased
water safety skills and knowledge obtained through the interven-
tion program. Because little other information exists regarding how
attitude impacts on young adults’ behaviour and risk taking in
aquatic environments, or how to effectively change young adults
water safety attitudes, there is a need for further research to more
fully understand this area.
193
Overall, this study provides insight into swimming and water
safety knowledge, attitudes and the actual swimming ability of
young adults and also illustrates that a short, comprehensive water
safety intervention significantly improved water safety knowledge
and swimming ability in this group. As with all studies, there are
several limitations that must be acknowledged and that merit con-
sideration when planning future studies. First, although this study
had a high response rate and a relatively large cohort completed
both questionnaires and practical swimming assessment pre- and
post-intervention, the sample was drawn from a very active group
that were doing this program as part of their studies and as such,
were more likely to be motivated to participate than other young
adults. Future work should therefore consider recruiting a more
representative national or state sample as this will help draw more
solid conclusions related to the water safety knowledge, attitudes
and ability of young adults. Second, self-reporting of involvement
in formal swimming and water safety lessons may be viewed as
problematic. While these young adults appeared to be able to recall
whether they had undertaken lessons, questions requiring them to
recall the duration of time they were enrolled in lessons and the
age they commenced lessons were poorly answered and may have
impacted on the findings of this study. How best to collect accu-
rate information relating to young adults’ participation in formal
swimming and water safety lessons requires further consideration.
In addition, information regarding the content covered within for-
mal swimming lessons and school swimming programs, and the
ethos of the organisation would enable a better understanding
of the value of swimming and water safety lessons for drowning
prevention. Finally, as this study primarily aimed to ascertain the
water safety knowledge, attitudes and swimming ability of young
Australian adults and determine the effect of a short swimming
and water safety intervention, post-testing was completed in the
final week of the program to increase the response rate. How-
ever, as research indicates that there is substantial skill loss with
non-practice and non-use, future studies should consider imple-
menting a longitudinal study design to track skill retention and
decay. It would also be of interest to identify whether a core set
of major factors influence the retention or decay of swimming
and water safety skills and knowledge over extended periods of
non-use.
5. Conclusion
Results indicate that young adults in this study had a very low
level of water safety knowledge, which, if coupled with increased
risk-taking that is characteristic of this age group is likely to con-
tribute to increased drowning risk in aquatic environments. Despite
the low level of water safety knowledge, findings showed that the
majority of young adults had sound swimming and water safety
skills and attitudes. This study suggests that participation in formal
swimming lessons or swimming within the school curriculum did
not influence the pre-intervention water safety knowledge, skills
or attitudes of young adults, and there were few significant gen-
der differences. Following the intervention, participants who had
reported previous swimming lesson experience demonstrated a
significantly higher practical skill level than those without a his-
tory of previous lessons. Importantly, this study also identified that
a short but comprehensive swimming and water safety interven-
tion, comprised of a combination of swimming, survival and rescue
skills along with water safety knowledge, played a positive role in
shaping the water safety knowledge and swimming and survival
skills of young adults, with significantly improved scores following
the intervention. While it is important to conduct further studies
to confirm that these findings are consistent with a more represen-
tative sample of young adults, our findings are the first to provide
194 L.A. Petrass, J.D. Blitvich / Accident Analysis and Prevention 70 (2014) 188–194

empirical evidence of the value of a comprehensive aquatic educa-
tion program as a drowning prevention strategy for young adults.
Acknowledgements
This study would not have been possible without the active
involvement of the University of Ballarat Bachelor of Exercise and
Sports Science students. The authors would also like to thank Dr.
Peter Kremer (Deakin University) and Dr. Peta White (University
of Ballarat) for their contributions to the extended “Can You Swim
Intervention” survey and Holly Burton for assistance with data col-
lection.
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