Adult drowning is a complex and multifactorial public health challenge requiring community, national and global efforts to mitigate impacts. This study updates the evidence base for public health interventions that address adult fatal and non-fatal drowning. A systematic review was undertaken of the peer-reviewed literature for English-language primary studies published between 2011 and 2021describing a drowning intervention with adults. Twenty-two studies were included. Most studies (n = 16) were conducted in high-income countries. Yearly trends in drowning prevention intervention publications were analysed with 2015 (n = 6) the peak publishing year. Over half of the study designs were pre-post (n = 15). Intervention duration ranged from 4 hours to 11 years. Ten studies described either behaviour change theory or formative evaluation to inform design. Thirteen studies targeted interventions at a population level, seven at a group level and two at individual level. Studies identified a range of prevention strategies, categorised as behavioural (n = 9) (e.g., swimming lessons), socio-ecological (n = 8) (e.g., mandatory personal flotation devices) and mixed (n = 5) (e.g., awareness campaign and barriers to prevent access to water). A range of outcomes were described including changes in awareness, water safety knowledge, attitudes, water safety behaviours and skills, environmental, policy and regulation changes and drowning rates. Findings indicate a small but important increase in the evaluation and publication of effective interventions to prevent adult drowning. The complexity of the issues surrounding drowning requires multi-strategy and context -specific adult focused prevention interventions. Contemporary evidence that identifies effective interventions that contribute to prevention efforts is an essential first step in addressing the challenge.

This systematic review identifies and describes the use of the Expert Recommendation for Implementing Change (ERIC) concepts and strategies using public health approaches to drowning prevention interventions as a case study. International calls for action have identified the need to better understand the implementation of drowning prevention interventions so that intervention design and implementation is improved. In high-income countries (HICs), interventions are sophisticated but still little is known or written about their implementation. The review was registered on PROSPERO (number CRD42022347789) and followed the PRISMA guidelines. Eight databases were searched. Articles were assessed using the Public Health Ontario Meta-tool for quality appraisal of public health evidence. Forty-nine articles were included. Where ERIC strategies were reported, the focus was on evaluative and iterative strategies, developing partnerships and engaging the target group. The review identified few articles that discussed intervention development and implementation sufficiently for strategies to be replicated. Findings will inform further research into the use and measurement of implementation strategies by practitioners and researchers undertaking work in drowning prevention in HICs and supports a call to action for better documentation of implementation in public health interventions.

Aim: Injuries are a leading cause of death and disability for children and young people worldwide and a significant public health challenge. This updated review identifies and assesses public health interventions designed to prevent child drowning. It aimed to evaluate the global scope of literature and examine contributions made to the evidence since the last review was published. Subject and methods: The review follows processes established in previous reviews and recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Articles were peer-reviewed, published in English between 2011 and 2023 and described and evaluated child drowning primary prevention interventions. Fifteen databases were searched, and articles were managed in Endnote and Rayyan.AI. The MetaQAT framework was applied to quality appraisal. Results: We included a final sample of n = 43 studies. Most studies were from high-income countries and applied quantitative intervention designs. Just under half targeted children, most at the population level. Approximately one in three studies used behavioural theory to guide intervention development. Few studies reported formative research. Conclusion: The past decade has seen a threefold increase in the number of papers describing public health interventions to prevent children drowning. Despite this increase, interventions remain primarily educational, focusing on behavioural strategies. A call for more comprehensive and systems-level interventions that tackle the upstream determinants of child drowning is timely.

Issue addressed: Problem‐based learning (PBL) is a student‐directed pedagogy that promotes critical thinking, self‐directed learning and communication skills essential for health promotion students and practitioners. This paper reports on student results, student evaluation and staff experience of PBL in the face‐to‐face and fully online environment in an undergraduate health sciences unit in an Australian university.Methods: A single time‐point study using quantitative and qualitative administrative student data (2014–2020) and narrative reflection from teaching academics (n = 5) was undertaken. Descriptive, independent t test and bivariate analyses for student results data were conducted; an inductive approach was used to analyse qualitative data and create codes.Results: Student sample (n = 472) consisted face‐to‐face (n = 358, 75.8%) and online (n = 114, 24.2%) enrolments. Final Unit Mark was significantly higher for fully online students compared with face‐to‐face students in 2018 (P = .007) and 2019 (P = .001). Final Unit Achievement was significantly higher for fully online students compared with face‐to‐face students in 2018 (P = .017) and 2019 (P = .043). Three themes emerged: The PBL approach; Evolution of PBLs; Student skills and competencies.Discussion: PBL allows students to learn through facilitated problem solving and strong collaborative skills. The face‐to‐face and fully online PBLs improved the student and academic staff experience, while supporting the development of critical thinking and self‐directed research. Further, it supported students to develop their core health promotion competencies; and enhanced the online student learning experience.So what?: Vital for contemporary, global graduates, the fully online PBL approach allows students to build critical academic and professional skills utilising current information technology relevant for collaborative professional practice.