Keiki Water Safety Initiative

Keiki Water Safety Initiative  #

Purpose  #

To prepare the children of Hawaiʻi with the knowledge, skills, and experience they need to become Water Safer for Life®.

Overview  #

The Hawaii Aquatics Foundation (HAF) is an IRS 501(c)(3) tax-exempt non-profit organization formed for the purpose of providing, promoting, and supporting aquatic safety education and training. The Keiki Water Safety Initiative is led by the Hawaii Aquatics Academy (HAA), the education branch of HAF. It aims to provide aquatic safety education through safety knowledge and physical skill instruction, in a combination of classroom and pool settings, for all of Hawaiʻi’s children, regardless of their physical condition or their social or economic circumstance. The initial phase of the project is focused on providing aquatic safety education during school hours for all of Hawaiʻi’s 2nd grade elementary school aged children.

Background  #

The World Health Organization (WHO) defines drowning as “the process of experiencing respiratory impairment from submersion/immersion in liquid.” Further, the international consensus experts assigned to develop this definition affirm that it encompasses both fatal and nonfatal drowning cases.[1][1] van Beeck, E. F.; Branche, C. M.; Szpilman, D.; Modell, J. H.; & Bierens, J. J. L. M. (2005). “A new definition of drowning: towards documentation and prevention of a global public health problem”, Bulletin of the World Health Organization. 83(11): 853–856.

According to the Hawaii Department of Health (DOH), between 2014 and 2018, injuries were responsible for more deaths of Hawaiʻi’s children, ages 1 through 14, than all other causes, including infectious diseases and chronic diseases, such as cancer. The leading cause of injury-related mortality for Hawaiʻi’s children during that period was drowning — more than motor vehicle occupant and pedestrian accidents combined.[2][2] Hawaii Department of Health, Injury Prevention and Control Section (2019). “Injury - A Major Public Health Problem in Hawaii”.

From 2014 through 2018, non-residents accounted for 54% of the fatal drownings in Hawaiʻi for all ages combined. By contrast, Hawaiʻi’s children, ages 0 through 17, accounted for 96% of the fatal child drownings in the state.[3][3] Galanis, D. (2019). “Child Drowning in Hawaii” [PowerPoint presentation], Hawaii Department of Health, Injury Prevention and Control Section.

During the same 5-year period, there were an average of 70 EMS-attended nonfatal child drownings in Hawaiʻi per year.[3][3] Galanis, D. (2019). “Child Drowning in Hawaii” [PowerPoint presentation], Hawaii Department of Health, Injury Prevention and Control Section. Nonfatal drowning injuries can cause severe brain damage, similar to blunt force trauma, and can result in long-term disabilities, such as memory problems, learning disabilities, and permanent loss of basic functioning (i.e., permanent vegetative state).

Justification  #

According to the Centers for Disease Control and Prevention (CDC), “Most drowning deaths and injuries are predictable and preventable.”[4][4] Centers for Disease Control and Prevention (2012). “Reducing Drowning Injuries in Children”, A National Action Plan for Child Injury Prevention. The WHO Global Report on Drowning states that “Long-term declines in drowning in a number of countries are associated with the establishment and community actions of lifesaving societies.”[5][5] World Health Organization (2014). “Global report on drowning: preventing a leading killer”. 28. The International Life Saving Federation (ILS) Position Statement for Swimming and Water Safety Education provides the following statements and recommendations:

  • Death by drowning is a leading public health problem in all countries. Prevention requires public and government support.
  • The vast majority of deaths by drowning can be prevented.
  • Everyone, ideally commencing at a young age and regardless of ability and background, should have access to training in water safety, personal survival, and water rescue.
  • Knowledge and understanding of water environments and their associated hazards should be taught to everyone at the earliest possible age.
  • This awareness training should be accompanied by the provision of swimming teaching, in the safest manner possible and to at least a basic level of skill that provides the capacity for survival after unexpected and sudden immersion in water.[6][6] International Lifesaving Federation (2007). “Swimming and Water Safety Education”, Lifesaving Position Statement. LPS-06: 3.

Pre-instruction assessments of basic aquatic skills administered during the first pool lesson of HAA’s Aquatic Safety Education elementary school program strongly suggest that a majority of 2nd grade students in Hawaiʻi are not adequately prepared with the knowledge and skills needed to survive an unexpected entry into water. A multi-island survey conducted by HAF during the spring of 2017 identified that less than 10% of public/charter elementary schools and less than 20% of private elementary schools provide aquatic safety instruction — for any grade — during their physical education classes. Of the schools that do, it is through their own initiative, as there is no Hawaii Department of Education (DOE) requirement, nor any legislative funding provided. Independent of school participation, parent surveys indicate that less than half of public school students in Hawaiʻi have been taught aquatic safety skills in a formal setting, and even fewer have been taught situational aquatic survival skills.

To ensure that all the children of Hawaiʻi are provided equal access to a standards-based aquatic safety education program, instruction needs to be administered during school hours. Reaching this position acknowledges various factors that limit the effectiveness of existing extracurricular options: the cost of private lessons is prohibitive for many families, municipal programs lack the resources to meet public demand for aquatic safety education, and after-school and weekend lesson formats tend to emphasize competitive swimming strokes as opposed to aquatic safety competencies.[7][7] Quan, L.; Ramos, W.; Harvey, C.; Kublick, L.; Langendorfer, S.; Lees, T. A.; Fielding, R. R.; Dalke, S.; Barry, C.; Shook, S.; & Wernicki, R. (2015). "Toward Defining Water Competency: An American Red Cross Definition", International Journal of Aquatic Research and Education. 9(1)(3): 2. Other factors that influence parents’ decision to not have their children participate in formal aquatic safety education include cultural upbringing, their own fearfulness of the water, and overconfidence in their child’s swimming abilities.

To overcome these and other barriers, the most effective path to broad implementation and student participation is for schools to adopt aquatic safety education programs that align with their existing health and physical education standards and wellness objectives. Such programs must have defined aquatic safety learning objectives and should contribute to overall core-competency objectives.

Education  #

Aquatic safety education provides for the development of aquatic safety competencies, through the acquisition of safety knowledge, physical skills, and situational experience, that are essential to both the avoidance of and the recovery from hazardous aquatic situations. Addressing the range of concerns encompassed in drowning prevention/aquatic safety education requires more than traditional learn-to-swim instruction. Comprehensive safety education curricula are based on knowledge and skills for situation avoidance, situation recovery, and age-appropriate rescue. In achieving their objectives, such curricula apply all three of the learning domains — cognitive, affective, and psychomotor — to define learning outcomes. Lesson plans and instructional activities should incorporate dialogue, role play, and situational simulations that contribute to the simultaneous development of multiple competencies.

HAA’s Aquatic Safety Education programs include curricula that are based on Aquatic Safety Competencies and align with state health and physical education standards. The HAA Elementary School Curriculum provides a course designed to be taught in one 5-week session with two lessons per week or in one 10-week session with one lesson per week. Each session consists of 1 hour of classroom-based cognitive skill instruction (typically two 30-minute lessons) and 4 hours of pool-based cognitive and physical skill instruction (typically eight 30-minute lessons).

The classroom and pool lesson plans for this curriculum are organized and taught with the aim of developing students’ knowledge, self-dependence, and self-confidence. The aquatic safety competencies and skills taught in these lessons include, but are not limited to, risk assessment, knowledge of local hazards, breathing, surface recovery, floating, treading, swimming in all three body positions (i.e., prone/front, supine/back, and lateral/side), change of orientation and direction, underwater skills, energy conservation, and situational skills.

Three progressive levels for the pool lessons plans are designed to accommodate the wide range of students’ physical abilities and prior experiences: Beginner Level, Fundamental Level, and Intermediate Level. Students at each level are taught and assessed on both knowledge objectives and physical skills, using age-appropriate methods and scoring rubrics. Development of pre-K, grades 6–8, and grades 9–12 curricula will begin during the 2019–20 school year.

Scope / Cost  #

There are approximately 300 public, private, and charter elementary schools in Hawaiʻi with an average of 17,000 students per grade. Effective aquatic safety education and learn-to-swim instruction programs have a 1-to-4 instructor-to-student ratio for elementary school aged students, with additional staff required for lifeguarding and deck management duties. Administrative, instructor and support staff, insurance, and supply costs are estimated at $100 per student for the 5-hour program. Adaptive students (e.g., mentally and physically impaired) have an estimated cost of $300 per student. The annual statewide cost per grade, excluding transportation expenses, is estimated at $1,500,000.

Timeline  #

During the 2017–18 school year, approximately 500 students on the islands of Kauaʻi, Maui, and Oʻahu participated in the first year of HAA’s Aquatic Safety Education program. During the 2018–19 school year, approximately 1,000 students on the islands of Kauaʻi, Maui, and Oʻahu participated in the second year of the program. The goal for the 2019–20 school year is to reach 2,000 students, with participants from the islands of Hawaiʻi, Kauaʻi, Lānaʻi, Maui, and Oʻahu. The 5-year goal is to have 100% elementary school participation, statewide, in aquatic safety education programs.

Conclusion  #

Providing all the children of Hawaiʻi with equal access to a standards-based aquatic safety education program is essential for the goal of reducing the risk of both fatal and nonfatal child drownings in our state. The most effective path to broad implementation and student participation is for schools to adopt programs that align with their existing health and physical education standards and wellness objectives as well as other core-competency objectives.

The Hawaii Aquatics Foundation is dedicated to providing the attention and resources needed to develop, promote, and provide comprehensive aquatic safety education programs. The goals of the Keiki Water Safety Initiative are aligned with recommendations by the CDC, WHO, ILS, and internationally recognized aquatic safety education researchers. Achieving these goals will require a cooperative effort of the state, counties, local communities, and like-minded organizations. We are actively seeking support and the assistance of donors “To prepare the children of Hawaiʻi with the knowledge, skills, and experience they need to become Water Safer for Life®.”

References:

  1. van Beeck, E. F.; Branche, C. M.; Szpilman, D.; Modell, J. H.; & Bierens, J. J. L. M. (2005). “A new definition of drowning: towards documentation and prevention of a global public health problem”, Bulletin of the World Health Organization. 83(11): 853–856.
  2. Hawaii Department of Health, Injury Prevention and Control Section (2019). “Injury - A Major Public Health Problem in Hawaii”.
  3. Galanis, D. (2019). “Child Drowning in Hawaii” [PowerPoint presentation], Hawaii Department of Health, Injury Prevention and Control Section.
  4. Centers for Disease Control and Prevention (2012). “Reducing Drowning Injuries in Children”, A National Action Plan for Child Injury Prevention.
  5. World Health Organization (2014). “Global report on drowning: preventing a leading killer”. 28.
  6. International Lifesaving Federation (2007). “Swimming and Water Safety Education”, Lifesaving Position Statement. LPS-06: 3.
  7. Quan, L.; Ramos, W.; Harvey, C.; Kublick, L.; Langendorfer, S.; Lees, T. A.; Fielding, R. R.; Dalke, S.; Barry, C.; Shook, S.; & Wernicki, R. (2015). "Toward Defining Water Competency: An American Red Cross Definition", International Journal of Aquatic Research and Education. 9(1)(3): 2.