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.