A Data-driven Community-level Program on Drowning Prevention

Rohit Shenoi, MD
Laura Miranda
Shaheni Mendis
Shabana Yusuf, MD., MEd
Ned Levine, PhD

The US Water Safety Action Plan recommends evidence-informed action and evaluation, equity, intersectoral collaboration and local action when developing drowning countermeasures. Unfortunately, there are no community level drowning prevention programs existing in metropolitan Houston. We describe the efforts of the Community Advisory Group (CAG) for Water Safety to address drowning in Harris County, Texas.

In 2023-24, results from a fatal drowning data linkage project identified high-risk populations, locations, and circumstances, including events involving children with autism. Drowning in autistic children involved a predominance of pool-related incidents, lack of swimming ability, and frequent absence of secure barriers. Harris County has about 115,000 swimming pools, a major river, a major lake, two large reservoirs and many flood control structures such as bayous, creeks, canals, and ponds. In 2024, the population of Harris County was 5 million; 25% were children. The county comprised Non-Hispanic Whites (33%), African-Americans (19%), and Asians (8%). Hispanic persons were 45% of the population. A Community Advisory Group (CAG) on Water Safety in Harris County was formed in 2023 to foster safe aquatic environments in the county. The stakeholders include clinicians, community advocates, caregivers, and public health, aquatic, and injury?prevention specialists. Meetings occur virtually every month. Meeting minutes were utilized to obtain information on ongoing projects. The CAG is unfunded, but stakeholders provide in-kind resources. Undergraduate students perform project work as part of their practicum. Selected community outcome measures (Community Organization, Information, and Environmental Conditions) from the Washington State Drowning Prevention Project were utilized to develop, implement, and evaluate the project.

Based on local drowning epidemiology, the CAG focused on preparing and disseminating water safety resources to families with autistic children and sharing information about high-risk drowning locations and sub-populations with local and state departments. The CAG prepared adaptive aquatics resources, identified local sites that offer swimming and adaptive aquatics, partnered with the Texas Center for Missing Children to compile elopement prevention resources, and provided stakeholder input on drowning prevention interventions, including those relevant to autistic children. Information on high-risk drowning locations and at-risk risk groups were shared with the county water safety department, regional trauma center coordinators, county fatality review board, the local regional planning organization, Texas Water Safety Coalition, and the State Epidemiology unit in order to stimulate local drowning countermeasures. The challenges faced by the CAG include member motivation, scarce financial resources, and the absence of a governing structure. For sustainability, the CAG utilizes a core group of stakeholders to complete tasks and provides drowning resources, epidemiology, and meeting minutes to stakeholders. Future directions include strengthening current projects and pursuing a state fencing law using locally derived data.

A local drowning prevention coalition can positively impact water safety in high-risk population groups

1) Integrate local epidemiology and risk factors to craft a community-based drowning prevention program.
2) Utilize data-driven methods to evaluate community-based drowning countermeasures.
3) Understand the challenges and strengths of a community-facing drowning prevention coalition.