Seattle Children’s Hospital

2014 Flotation Device Use While Swimming Report

Conducted by

Thomas W. Mangione Wendy Chow

Heather Lisinski Elizabeth Heitz

Funded in part by a contract with Washington State Department of Health Emergency Medical Services

Spring, 2015

Contents

A. Introduction ....................................................................................................................................... 1

B. Methodology for Swim Observations ................................................................................................ 2

C. Results of the Swim Observations ..................................................................................................... 4

Table C1. Rates of Floatation Device Use (%), By Type & Swimmer Characteristics

All WA Swim Sites .............................................................................................................................. 7

Table C2. Rates of Types of Floatation Device Use (%), By Age of Swimmer ....................................... 8

All WA Swim Sites .............................................................................................................................. 8

Table C3. Rates of Types of Floatation Device Use (%), By Gender within Age Groups

All WA Swim Sites .............................................................................................................................. 9

Table C4. Rates of Floatation Device Use for Toddlers (0-5) Comparing by Distance from an Adult. 10

All WA Swim Sites ............................................................................................................................ 10

D. Methodology for Parental Swim Surveys ........................................................................................ 11

E. Results for Loaner Board Surveys .................................................................................................... 11

Table E1. Distribution of Family Types Surveyed ................................................................................ 13

Table E2. Proportion of Families Bringing Any Flotation Devices And Types of Devices Brought ...... 14

Table E3. Ease of Understanding Standard Loaner Board Design ...................................................... 15

Table E4. Utilization of Loaner Boards & Awareness Among Families with Children Under 13 years

of Age at Loaner Board Sites ........................................................................................................... 16

F. Parent Suggestions for Loaner Boards and Swimming Safety ......................................................... 17

G. Discussion ........................................................................................................................................ 18

H. Recommendations ........................................................................................................................... 19

Appendices .................................................................................................................................................. 21

I. Site and Trainer List ...................................................................................................................... 22

II. Number of Observations at Each Swim Site by Age and Gender ................................................. 23

III. Site Observation Form .............................................................................................................. 24

IV. Swimmers’ Observation Form .................................................................................................. 26

V. Family Swim Survey .................................................................................................................. 27

VI. Pictures of Loaner Boards at 4 sites .......................................................................................... 29

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Seattle Children’s Hospital

2014 Flotation Device Use While Swimming Report

A. Introduction

This report provides results of a 2014 life jacket observation study conducted in the

summer months across Washington State by JSI Research and Training Institute, Inc. for Seattle

Children’s Hospital. The focus of the report is the use of flotation devices while swimming and

to assess the impact of loaner boards on use of life jackets. The report is divided into seven

sections: (A) Introduction; (B) Methodology for Swim Observations; (C) Flotation Device Use

Results; (D) Methodology for Parental Swim Survey; (E) Parental Swim Survey Results; (F)

Parental Suggestions for Loaner Boards and Approaches to Encouraging Life Jacket Wear; (G)

Discussion and (H) Recommendations.

Life jacket loaner boards are a strategy to encourage life jacket use at swim sites and at

boating sites. Loaner boards provide two key functions: (a) they encourage swimmers or

boaters to wear a life jacket, and (b) they provide loaner life jackets to those who may not have

one. The loaner boards are stocked with life jackets of different sizes and the instructions on

the board show how to properly wear a life jacket and to make sure it fits properly. There are

over 150 life jacket loaner boards at swimming and boating areas in Washington State.

The goal of this study is to provide useful information as to current flotation device use

while swimming in designated swim areas. A specific goal of this study is to determine possible

age and gender differences in use of flotation devices. Two secondary goals were to evaluate

the possible impact of loaner boards of use of life jackets and to gain parental input on their

awareness and opinions about loaner boards. Below is the standard loaner board format that is

encouraged for display at swim and boating locations. Sites that were studied had a range of

loaner board visuals.

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B. Methodology for Swim Observations

In order to provide reliable and valid indicators of future changes in flotation device use at

swimming locations, and to provide a basis for comparing results to other studies (e.g. National

Park Service Observations), it was essential for observation procedures to remain as close as

possible to those used by JSI Research and Training Institute, Inc. The following is a detailing of

the methods used in the Washington state 2014 study.

Time period – 2014 observations were conducted during the summer months (July and August),

since that is the season of peak swimming activity. The study was carried out in conjunction

with a study conducted for the Washington State Parks and Recreation Boating Program on life

jacket use among boating participants which was also conducted in this time period.

Site selection – Researchers at Seattle Children’s Hospital made efforts to identify sites across

the state of Washington where loaner boards were present at swim locations and where there

were not any loaner boards present. Five sites were chosen that had loaner boards and five

sites were chosen that did not have loaner boards. None of the sites selected had life guards

present. Contacts responsible for the designated swim areas all said that the sites selected had

high volumes of swimmers during July and August. The sites were both in Western and Eastern

Washington State. All sites were chosen because they also had suitable sections from which

observations of life jacket wear could be made from shore using high-powered binoculars

However, upon conducting observations at the loaner board sites, 2 sites were determined to

actually not have an operating loaner board. One of the 2 sites was still in the planning stages

and not actually in place while the other site actually did have a loaner board, but it was

inactive with no life jackets being stocked at the board.

Observational procedures - Observations were conducted for four-hour periods on a Saturday

or Sunday. The goal was to observe as many swimmers as possible during a four-hour time

frame. Two-person teams observed swimming activity and the use of flotation devices. One

team member made the observations using high-powered binoculars (if necessary) and called

out the information, which was then recorded on observation forms by the second team

member. Team members alternated responsibilities frequently to ward off fatigue. In addition

to recording information on flotation device use, observers recorded data about the site. This

included information on weather and water conditions.

In order to avoid undue duplication of swimmers being observed, the observers were

instructed to start at one end of the swimming area and move slowly in a 180 degree sweep,

recording individuals as they went. Upon reaching the end of the sweep, observers took a short

break from observations to let the activity in the swim area change. Then they repeated the

process. Inevitably some swimmers were observed more than once, but to what extent this

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happened is unknown. As time passed at the site, it was reasonable to include someone who

might have been observed earlier, since they were at continued risk and may have changed

their behavior related to wearing a life jacket.

Recruitment and Training of Observers. The observers used to observe at the swim locations

were also the same observers who worked on the boating observation study that was being

conducted by JSI at the same time. In 2010 many observer teams were used to observe at one

or two sites of the boating sites. In 2014 we desired to have fewer teams who would each

conduct observations at some boating sites and some swim sites. (see Appendix for a list of all

site, observers and training dates) JSI contacted all the 2010 observer teams to find out if they

would be interested in doing the study again, but at more sites. From these contacts 7 teams

were assembled. The observers were paid $150 per site which included all of their expenses

and wages. JSI project staff trained the observers during a half-day session. Two trainings were

conducted—one in western Washington and one in eastern Washington. The half-day training

consisted of reviewing the observation procedures, observation forms, and required equipment

using a PowerPoint presentation. The training included pictures of swimmers of different ages.

After the classroom portion of the training, all teams went to a nearby viewing site and

practiced observations with JSI staff present.

Observation Forms - There were two observation forms used matching closely the forms used

in previous JSI data collections. The first was the swimmer observation form, which was

intended to record information about each person in the water. The second form was the site

form, which was designed to record information about the site, weather and water conditions.

A) Swimmer Forms (see Appendix) - Observers recorded the observation time period in

two hour blocks of time (7:59 or earlier, 8am – 9:59am, 10am – 11:59pm, 12pm – 1:59pm, 2pm

– 3:59pm, 4pm – 5:59pm, 6pm or later); the gender of the swimmer was recorded (male,

female, or unknown); age (less than six, 6 - 12, 13 - 17, 18 - 64, 65 or older); for the less than six

year olds two situations were noted (a) was the child “within an arm’s length of an adult” or (b)

were they further than an arm’s length away from an adult; flotation device use (none, using a

floating object, water wings, other pool toys, actual inner tubes, and life jackets). There was

room to observe 30 swimmers per form.

B) Site Forms (see appendix) - At each site, the observers recorded the beginning time

and ending time of the observation period, water type (lake/pond/reservoir; river; or

harbor/bay/sound; water temperature). The following environmental factors were measured

by observers at each two hour time block during the observation period: air temperature; wind

speed; wave height (less than six inches, six inches up to two feet, or over two feet); weather

(sunny, partly cloudy, cloudy, raining, or stormy); and visibility (good, fair, or poor).

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Observers were also instructed to take a photo of the loaner board if there was one at

the site (see Appendix).

Scanning and File Building. When JSI received forms mailed from the observers, the

forms were reviewed for completeness and clarity of the marking of the bubbles for scanning.

The sheets were then scanned using Teleform. This program determines in the scanning

process whether any marks are ambiguous or whether observers incorrectly filled out two

bubbles when only one was allowed. These situations were called to the attention of a human

reviewer who made a final judgment on how the information should be coded.

C. Results of the Swim Observations

A total of 1967 swimmers were observed at the 10 swimming locations—212 children under

the age of 6, 652 children 6 to 12 years of age, 325 teenagers 13 -17 years of age, and 778

adults (18+ years old). In the Appendix a chart is shown with the exact numbers of swimmers

observed by age and gender at each of the sites. The following results are for all sites combined;

the limited number of swimmers at the three sites with loaner boards precluded any evaluation

comparing data between sites with and without life jacket loaner boards.

Flotation Device Use. We classify two general types of flotation device use: (a) actually wearing

a Coast Guard approved life jacket or (b) using some type of flotation assist device which does

not meet Coast Guard standards (i.e. Water wings, pool toys, hanging onto floating objects and

inner-tubes) which we label substandard flotation. In the following Table C1, use of flotation

devices by gender and age group are presented. In this table all types of flotation devices are

shown. This is a descriptive table with no significance tests shown. In Tables 2-4 we provide

significance tests for various comparisons. Table 2 tests for age differences; Table 3 tests for

gender differences within each age grouping; and Table 4 tests for differences among children

0-5 years of age and compares flotation device use for those children who are within an “arms-

length” of an adult and those that are further away from an adult. The designation of within an

“arm’s length” was a judgement call, but literally was meant to be that the adult could reach

out and touch the child.

Age Differences. In Table C2 the age comparisons are shown. The trends are relatively

straight-forward with use of “no” flotation devices increasing as swimmers get older. In

children 0-5 34% are not using any flotation device whereas for adults 76.5% are not using any

type of flotation device. Use of some type of flotation is significantly greater for children under

6 and 6 to 12 year olds compared to teens and adults. For life jacket wear, the rates decrease

sharply as age increases. Children under 6 wear life jackets at 50.5% whereas for teens only

3.1% and for adults we found only 2.2% wearing a life jacket. Children 6-12 are significantly less

likely to wear a life jacket than younger children (20.9% vs 50.5%) but significantly greater use

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than teenagers (20.9% vs 3.1%). Teens and adults have similar (and extremely low) wear rates

(3.1% and 2.2% respectively). For use of “substandard flotation devices” the rates of use are

similar among various age groups with rates ranging from 15.5% for children under 6 to 25.9%

for 6 to 12 year olds, 26.5% for teenagers and 21.3% for adults. In terms of types of

“inadequate flotation devices” used, as might be expected water wings are more common

among young children whereas pool toys are mainly used by 6-12 year olds and teenagers while

the use of floating objects and inner tubes are used frequently by teens and adults.

Gender Differences with age groupings. In Table C3 we test for gender differences within each

of the age groups. For young children under the age of 6, girls are somewhat more likely (but

not statistically significant) to be using some type of flotation compared to boys (37.0% vs

31.4% respectively for using “nothing”). Boys are more likely to wear Coast Guard approved life

jackets compared to girls (58.8% versus 42.6%) whereas girls are more likely to use “inadequate

flotation devices” compared to boys (20.4% versus 9.8%) primarily the use of water wings and

pool toys. For children 6-12 years of age the use of any type of flotation device is relatively

similar (51.4% for boys and 54.8% for girls using “no” flotation) and also use of “substandard”

flotation devices in girls and boys (28.8% versus 22.9%) However, just like the younger children,

boys are more likely to use life jackets compared to girls (25.5% versus 16.5%). For teenagers

the use behaviors between boys and girls are almost identical for all three types of use-- not

using anything (69.7% versus 71.2%); for using “substandard floatation devices” (27.0% versus

25.8%) and for using life jackets (3.2% versus 2.9%). For adults, males are more likely to use

“substandard flotation devices” than females (24.2% versus 18.0%). Males are also somewhat

more likely to not use any flotation devices compared to females. Life jacket use is almost

identical (and very low) between adult males and females (2.1% versus 2.3%). When all

swimmers are combined together females are more likely than males to use substandard

flotation (25.5% vs 20.4%) and males are more likely to use a life jacket than females (16.6% vs

11.1%).

Arm’s-Length versus Further-Than-An-Arm’s-Length Among Children under 6. In Table C4 we

test for both overall differences in flotation device use between those toddlers (0-5 years old)

that are within an arm’s length of an adult and those that are further away from an adult as

well as gender differences between and within the two groups. As we indicated above, this was

a judgement call as to whether the adult was close enough to the child to reach out and touch

them. It should be noted that the N’s for each group are relatively small and therefore we have

low power in testing for differences. Therefore, we will also comment on differences that seem

note-worthy even though they do not reach the typical standard for statistical significance. We

first compare all toddlers within an arm’s length to those that are further than an arm’s length

away. There are no significant differences for use of “no” floatation or using “substandard”

flotation or using a life jacket. However, in general for this age group, those that are closer to

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an adult tend to more often not use any flotation at all (36.7% vs 29.8% using no flotation).

Also, those who are further away from an adult tend to more often use substandard flotation

(19.1% vs 12.7%). Life jacket use, however, is almost identical for these two groups (50.0% vs

51.2%).

For children within an arm’s length of an adult boys and girls have similar rates of using

no flotation (38.1% for boys and 36.5% for girls) but boys are more likely to use life jackets than

girls (54.0% versus 46.0%) while girls are more likely to use “substandard flotation devices”

(17.5% versus 8.0%)--primarily due to an increased use of water wings (11.2% versus 3.2%).

This same pattern is seen for children further than an arm’s length away from an adult but the

differences get greater; boys are significantly more likely to wear life jackets (66.7% versus

37.8%) but girls are more likely to use “substandard flotation devices” (24.5% versus 12.8%)

(again primarily due to the greater use of pool toys by girls--15.6% versus 5.1%).

When looking at the behavior of boys across these two situations, we find that when

boys are further than an arm’s length they are more likely to use a life jacket (66.7% vs 54.0%)

(p < .21). When boys go further than an arm’s length from an adult, they are less likely to use

“no flotation” (38.1% within an arm’s length and 20.5% further than an arm’s length). For girls

between the two situations we do not find any differences of note. These different findings for

boys and girls implies that parents may think girls are less at risk either because they are more

likely to know how to swim or more likely to stay close by or less likely to be rambunctious.

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Table C1 Rates of Floatation Device Use (%), By Type & Swimmer Characteristics

All WA Swim Sites*

Group Total N No Flotation

Use Floating Objects

Water Wings Pool Toys Inner-Tube PFD

(n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%)

All Toddlers, 0-5 yrs 212 72 34 3 1.4 15 7.1 13 6.1 2 0.9 107 50.5%

Toddler Males 102 32 31.4 2 2 4 3.9 4 3.9 . . 60 58.8%

Toddler Females 108 40 37 1 0.9 10 9.3 9 8.3 2 1.9 46 42.6%

All Preteen, 6-12 652 347 53.2 58 8.9 10 1.5 63 9.7 38 5.8 136 20.9%

Preteen Males 317 163 51.4 29 9.1 2 0.6 26 8.2 16 5 81 25.6%

Preteen Females 334 183 54.8 29 8.7 8 2.4 37 11.1 22 6.6 55 16.5%

All Kids, 0-12 864 419 48.5 61 7.1 25 2.9 76 8.8 40 4.6 243 28.1%

Male Kids 419 195 46.5 31 7.4 6 1.4 30 7.2 16 3.8 141 33.7%

Females Kids 442 223 50.5 30 6.8 18 4.1 46 10.4 24 5.4 101 22.9%

All Teens, 13-17 325 229 70.5 46 14.2 . . 14 4.3 26 8 10 3.1%

Teenaged Males 155 108 69.7 23 14.8 . . 7 4.5 12 7.7 5 3.2%

Teenaged Females 170 121 71.2 23 13.5 . . 7 4.1 14 8.2 5 2.9%

All Adults, 18+ 778 595 76.5 92 11.8 . . 32 4.1 42 5.4 17 2.2%

Adult Males 350 279 79.7 40 11.4 . . 6 1.7 17 4.9 8 2.3%

Adult Females 427 315 73.8 52 12.2 . . 26 6.1 25 5.9 9 2.1%

All Swimmers 1967 1243 63.2 199 10.1 25 1.3 122 6.2 108 5.5 270 13.7%

All Males 924 582 63 94 10.2 6 0.6 43 4.7 45 4.9 154 16.7%

All Females 1039 659 63.4 105 10.1 18 1.7 79 7.6 63 6.1 115 11.1%

*Excluding 66 missing PFD status (59) or gender/age (7)| 4 unknown gender included, not shown

JSI Research & Training Institute, Inc., 2015

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Table C2

Rates of Types of Floatation Device Use (%), By Age of Swimmer

All WA Swim Sites*

Age Group Total N No Flotation

Use Substandard** Flotation Use PFD

(n) (%) (n) (%) (n) (%)

Toddlers (0-5) 212 72 34 33 15.5 107 50.5

Preteen (6-12) 652 347 53.2 169 25.9 136 20.9

All Kids (0-12) 864 419 48.5 202 23.4 243 28.1

Teens (13-17) 325 229 70.5 86 26.5 10 3.1

Adults (18+) 778 595 76.5 166 21.3 17 2.2

Significance Tests Significant differences between age groups for

each PFD status

Significant Differences between Age Groups for Each Type of Use

Toddlers (0-5) vs Preteen (6-12) *** ** ***

Toddlers (0-5) vs Teens (13-17) *** ** ***

Toddlers (0-5) vs Adults (18+) *** ns ***

Preteen (6-12) vs Teens (13-17) *** ns ***

Preteen (6-12) vs Adults (18+) *** * ***

Kids (0-12) vs Teens (13-17) *** ns ***

Kids (0-12) vs Adults (18+) *** ns ***

Teens (13-17) vs Adults( 18+) * ns ns

*p<0.05, **p<0.01, ***p<0.0001

*Excluding 66 missing PFD status (59) or gender/age (7)| 4 unknown gender included, not shown

** Substandard Flotation Device Use includes using floating objects, water wings, pool toys or inner-tubes.

JSI Research & Training Institute, Inc., 2015

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Table C3

Rates of Types of Floatation Device Use (%), By Gender within Age Groups

All WA Swim Sites*

Genders within Age Groups Total N No Flotation Use Substandard** Flotation

Use PFD

(n) (%) (n) (%) (n) (%)

Toddlers (0-5)

Males 102 32 31.4 10 9.8 60 58.8

Females 108 40 37 22 20.4 46 42.6

Significance Test

ns

*

*

Preteen (6-12)

Males 317 163 51.4 73 22.9 81 25.5

Females 334 183 54.8 96 28.8 55 16.5

Significance Test

ns

ns

**

All Kids (0-12)

Males 419 195 46.5 83 19.8 141 33.6

Females 442 223 50.5 118 26.7 101 22.9

Significance Test

ns

*

**

Teenagers (13-17)

Males 155 108 69.7 42 27 5 3.2

Females 170 121 71.2 44 25.8 5 2.9

Significance Test

ns

ns

ns

Adults (18+)

Males 350 279 79.7 63 18 8 2.3

Females 427 315 73.8 103 24.2 9 2.1

Significance Test

*

*

ns

All Swimmers

Males 924 582 63 188 20.4 154 16.6

Females 1039 659 63.4 265 25.5 115 11.1

Significance Test

ns

**

**

Significant differences between males and females within each age group for each PFD status: *p<0.05, **p<0.01, ***p<0.0001

*Excluding 66 missing PFD status (59) or gender/age (7)| 4 unknown gender included, not shown

** Substandard Flotation Device Use includes using floating objects, water wings, pool toys or inner-tubes.

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Table C4

Rates of Floatation Device Use for Toddlers (0-5) Comparing by Distance from an Adult

All WA Swim Sites*

Toddlers Total N

No Flotation Use

Floating Objects

Water Wings

Pool Toys

Inner-Tubes

Substandard** Flotation Use PFD

(n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%) (n) (%)

All Toddlers(0-5) 212 72 34 3 1.4 15 7.1 13 6.1 2 0.9 33 15.5 107 50.5%

Within an Arm’s Length 128 47 36.7 2 1.6 10 7.8 4 3.1 1 0.8 16 12.7 64 50.0%

Boys 63 24 38.1 1 1.6 2 3.2 2 3.2 . . 5 8 34 54.0%

Girls 63 23 36.5 1 1.6 7 11.1 2 3.2 1 1.6 11 17.5 29 46.0%

Significance Test M vs F

ns

ns (.11)

ns

NOT Within an Arm’s Length 84 25 29.8 1 1.2 5 6 9 10.7 1 1.2 16 19.1 43 51.2%

Boys 39 8 20.5 1 2.6 2 5.1 2 5.1 . . 5 12.8 26 66.7%

Girls 45 17 37.8 . . 3 6.7 7 15.6 1 2.2 11 24.4 17 37.8%

Significance Test M vs F ns (.08) ns (.17) **

Additional Significance Tests

All Arm’s Length vs NOT Arm’s Length ns

ns ns

Males Arm’s Length vs NOT Arm’s Length ns (.06)

ns ns (.21)

Females Arm’s Length vs NOT Arm’s Length ns

ns ns

*Excluding 66 missing PFD status (59) or gender/age (7); 4 unknown gender included not shown

** Substandard Flotation Use includes using floating objects, water wings, pool toys or inner-tubes

Note: * = p < .05; ** = p < .01; *** = p < .001

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D. Methodology for Parental Swim Surveys

Parent Swim Interview. In addition to the observations, the observer teams attempted to administer a

short survey on use of flotation devices and loaner board issues at all of the sites (see Appendix for survey

form). The survey consisted of at most 10 questions. All parents were asked (1) how many children in each of

the following age groups came with you today: under 6, 6-12, 13-17 years old (choices for each were 0, 1, 2, 3,

4, 5 or more); (2) Did your family bring any flotation devices for children or adults to use while swimming

(choices—“no”, “yes, for children only”, “yes, for adults only”, and “yes for both children and adults”); (3) If

they brought flotation devices, what kind of flotation devices did you bring with you (choices check all that

apply--water wings, plastic tubes, pool toys, inner tubes, or US Coast Guard approved life jackets); (4) How

easy or hard is it to understand the life jacket loan board (picture of preferred board shown)—very easy,

somewhat easy, somewhat hard, or very hard; (5) Do you have any suggestions which would convince parents

that it is a good idea for children to wear life jackets while playing, wading or swimming in the water (free

response). In addition to these questions, for parents at a site that had a loaner board they were asked (6)

Before you came today, did you know that there was a life jacket loaner board here for swimmers to use; (7) If

yes to knowing about the board, Was knowing there was a life jacket loaner board here, one of the reasons

you chose to come to this beach; (8) Did you notice the life jacket loaner board when you arrived at the beach;

(9) Did the presence of the life jacket loaner board encourage anyone in your family to wear a life jacket while

swimming; and (10) Did anyone in your family use a life jacket from the life jacket loaner board (choices—yes,

no, wanted to but none available or not right size available, or no, not needed).`

A total of 109 surveys were completed; 70 at nonloaner board sites and 39 at loaner board sites.

E. Results for Loaner Board Surveys

Types of Families Surveyed. Table E1 shows the number of families completing the survey who had some

children under the age of 6 (36%); or some children between 6-12 years of age (61%); or some teenagers

(38%). Only 6% of the families had no children with them.

Whether Brought Flotation Devices with Them (and What Brought). Table E2 shows that 66% of families

brought flotation devices with them. Among all families 26% brought life jackets; 16% brought plastic rings;

9% brought water wings; 39% brought other pool toys; and 8% brought inner tubes. Among all those families

bringing any type of flotation 39% brought life jackets; 17% plastic rings; 14% water wings, 60% other pool

toys and 13% inner tubes. These proportions change notably for all families with kids under 6; 62% brought

life jackets, 18% water wings, 28% plastic rings, 44 % other pool toys and 3 % inner tubes. For Families with

kids under 6 who brought some type of flotation device, 73% brought life jackets, 21% brought water wings,

33% brought plastic rings; 52% brought other pool toys and 3% brought inner tubes.

Ease of Understanding Standard Loaner Board Design. When shown a picture of a preferred loaner

board design, the vast majority thought the board was easy to understand; 67% saying very easy and 22%

saying somewhat easy. Only 11 % thought it was somewhat hard to understand.

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Utilization and Awareness of Loaner Boards. For sites in which there was an active loaner board present

(only 3 of the 10 sites visited turned out to have an active loaner board), additional questions were asked of

the parents about their awareness of the loaner board and their utilizations. Furthermore, we present the

answers from those families who had children under the age of 13 with them at the swim site (n = 30).

Because of the small sample size, the findings described below should be viewed with caution

(see Table E4).

Were they aware that the board was at this site before you came? Forty three percent of the families

were aware of the loaner boards’ presence at that site.

If they knew, was that why you came to this site? Forty six percent of the families that knew the board

was present before they arrived (about 20% of all families), said that was one of the reasons they came to this

location.

Did you notice the board when you arrived at the beach? Forty percent noticed the board upon arrival.

Did the presence of the loaner board encourage anyone in your family to wear a life jacket while

swimming? Thirty six percent said the board encouraged use of a life jacket.

Did anyone in your family use a life jacket from the loaner board? Fifteen percent said they did use a life

jacket from the loaner board; another 8% said they wanted to use a life jacket but none were available; and

the majority of the families (77%) said they were not needed.

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Table E1

Distribution of Family Types Surveyed Family Type n percent of all

kids only under 6 12 11%

kids under 6 + 6-12 19 17%

kids under 6 + teens 2 2%

kids under 6 + 6-12 + teens 6 6%

kids only 6-12 24 22%

kids 6-12 + teens 17 16%

only teens 22 20%

no kids--only adults 7 6%

Total 109 100%

Family Type Combinations*

Some Kids under 6 39 36%

Some Kids 6-12 66 61%

Some Teenagers 41 38%

*Percents add to more than 100% because of multiple age groups in family party

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Table E2 Proportion of Families Bringing Any Flotation Devices

And Types of Devices Brought

Brought a device? All Families

(n=109)

Yes

66%

No

34%

What Devices Brought? All Families

(n=109)

Only Families Bringing Some Type of Flotation Device

(n=72)

PFD's

26%

39%

Water Wings

9%

14%

Plastic Rings

16%

17%

Other Pool Toys 39%

60%

Inner Tubes

8%

13%

What Devices Brought by

With Kids Under 6

Families with Kids Under 6 Bringing

Families with Kids Under 6?

All Families (n=39)

Some Type of Flotation Device (n=33)

PFD's

62%

73%

Water Wings

18%

21%

Plastic Rings

28%

33%

Other Pool Toys 44%

52%

Inner Tubes

3%

3%

15

Table E3 Ease of Understanding Standard

Loaner Board Design

How Easy/Hard Is It Understand Board (shown picture of standard board) (n=94)

Percents

Very Easy

67%

Somewhat Easy

22%

Somewhat Hard

11%

16

Table E4

Utilization of Loaner Boards & Awareness Among Families with Children Under 13 years of Age at Loaner Board Sites (n = 30)

Loaner Board Questions

% Families Children < 13 yrs

a. Before you arrived did you know board was here? Yes 43%

No 57%

b. (If knew) Is that why you came to this site? (n=13) Yes 46%

No 54%

c. Did you notice board upon arrival? Yes 40%

No 60%

d. Did loaner board encourage anyone in family to wear Yes 36%

a life jacket while swimming? No 64%

e. Did anyone in family use a life jacket from loaner board? Yes 15%

Wanted to 8%

but Not Available

Not Needed 77%

17

F. Parent Suggestions for Loaner Boards and Swimming Safety

For each of the parental surveys completed at the swim sites, the interviewers asked if the parents had

any suggestions which would convince parents that it was a good idea for children to wear life jackets while

playing, wading or swimming in the water. Most parents did not offer any suggestions. However, some did,

and we present those themes in the categories below:

Where no loaner boards were present, many parents expressed the desire to have one at this site (this

question came right after asking them to comment on the ease of reading the standard board by showing

them a picture of it). “Need a program; life jackets sold out in stores; one less thing to pack”. “We didn’t think

even think about it but would have put it on the kids if a loaner board were in place.” “Would like a program”

“So expensive, would like to borrow as kids grow” “Need loaner board at beach area”.

Parent also had ideas for improving the boards and loaner program. “Information in more languages

(Spanish, Russian); “More life jackets available on the board” “More adult size life jackets available” “Make

the signs more visible—right in middle of beach or where you walk in” “Make signs more visible” “Bigger” “Put

signs at all entrances”. “Too much copy on the sign and pictures don’t explain well enough what to do”. “Have

an artist design it” “Graphics are not easy to understand—especially second icon”. “Too much information on

the board, takes too long to read. Not clear what ‘fasten all the straps’ means”.

They also suggested making an effort to keep the life jackets dry and clean “because of body secretions”

“We would use if they didn’t smell or were dirty” “how would you clean them?” “need cleaner dispenser at

the board” “jackets need to be rinsed daily”.

Parents also had other safety suggestions. There should be encouragement in general to wear life jackets

“huge sign with statement put life jackets on all non- swimmers and children under 48 inches tall” “More

signage of an educational nature” “TV commercials”. “Watch a video that shows what happens if you don’t

wear a life jacket”. “Warning signs about depth of water, strength of current, and temperature of water”

Parents also had complaints about the types of life jackets available to buy (or use) for small children.

“Don’t know how to hook under legs of small children” “life jacket too big and bulky for 8 month old baby to

wear” “need thinner material like a swim shirt”

There was a strong sentiment for teaching kids to swim. “We came to swim so teaching child without

floaties” “teach kids to swim and be next to them when learning so not dependent on life jacket”; “learn how

to swim rather than rely on life jackets”. “My kids have been swimming since 6 months old and that is more

important than a life jacket”.

There was also a strong sentiment for parent responsibility for closely supervising their children “always

attend; never leave them” “Common sense to protect child’s safety” “Make it a law to have mandatory

supervision with a fine for failure for kids over 4 since they assumed parents would be closely monitoring kids

under 4 and therefore those do not need a life jacket”.

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G. Discussion

Swim Observations

Based on the observational data shown in Section C, we see that life jacket use while swimming is

almost exclusively a behavior for children under the age of 13 and within that group primarily for children

under the age of 6. The use of what we have referred to as “substandard” flotation devices is relatively

similar among different aged groups. However, given the patterns of behavior it can be surmised that

most (if not all) of that behavior is related to having fun in the water and not characterized as use for

perceived safety reasons. An exception perhaps is the use of water wings by the under 6 group.

What is also notable, however, are gender differences in use of life jackets and “substandard” flotation

among the toddler group (0-6 years of age). Boys are more likely than girls to be seen wearing a life jacket

particularly when the child is more than an arm’s length away from an adult. Whether this is due to parent

assuming boys will be more adventuresome or risk taking and they are playing it safe, or whether this is

due to differences in swimming abilities for the genders among this age group , is not known.

Loaner Board Survey

Although the number of surveys collected was relatively small, particularly at sites with loaner boards,

the answers provided do give some indication of the parental thought processes with respect to flotation

device utilization. Families brought a variety of flotation devices with them, both life jackets and

“substandard” flotation devices. It is encouraging to see that nearly three-quarters of the families with

children under the age of 6, brought life jackets with them. Of course, we do not know the proportion of

their children that actually wore them while swimming, but at least the parents brought them.

Families brought a variety of flotation devices and those that we are classifying as “substandard”

flotation, were most likely being brought for fun and games in the water and not for their perceived

(vs. actual) potential as a safety device. If parents do view these types of flotation as adequate safety

protection, then this type of utilization becomes a target for educational messaging.

Based on their comments to the open question about how to promote life jacket use among children

while swimming, two perceptions seem to block the use of life jackets. One was the notion that if a child

can swim, then a life jacket is not needed. The second was that parents should be vigilant and that is of

greater priority as a message than wearing a life jacket. It seems that the idea of wearing a life jacket

almost is either an admission of “my child can’t swim” or “I don’t want to take the effort to be right next to

my child in the water so I will put them in a life jacket”. On the other hand, parents felt it was a good idea

to have loaner boards, either for those who could not afford a life jacket or for those who forgot to bring

one.

Other comments included useful ideas about the way that loaner boards and loaner life jackets could be

improved. Parents felt that additional signage was needed to alert parents to the existence (and location)

of the loaner board. They felt that the information needed more detail about how to buckle straps for

young children. They felt that the signs should have clearer visuals and be in other languages too.

19

Parents also thought that the life jackets were not in good condition and in particular were dirty or

unsanitary. There were suggestions of having “disinfectant wipes” available at the boards or have

someone be responsible for keeping them clean.

H. Recommendations

Recommendations for Increasing Life Jacket Use While Swimming

1. Expand the number of sites with loaner board programs/signs across the state

2. Increase general signage encouraging/teaching/warning about drowning potential and the role of life

jacket use

3. Improve the content of the Boards (clarity, languages, small children strapping instructions)

4. Improve/expand signage which notifies public that loaner boards are present

5. Improve the placement of the loaner board to be more visible.

6. Expand availability of number of life jackets available in all sizes

7. Incorporate standards for stocking, cleaning and drying of loaner jackets

8. Address educational messages to the fact that knowing how to swim does not mean you shouldn’t

wear a life jacket.

9. Educate parents about cold water shock and hyperthermia as to the role they play in drownings and

the role of life jackets to mitigate these problems

10. Promote/educate parents on new styles of life jackets for small kids (i.e., Coast Guard approved

‘waterwing’ design shown below).

Sterns Puddle Jumper Coast Guard Approved Life Jackets

20

Recommendations for Further Research on Life Jacket Use

While Swimming in Designated or Other Swim Areas

1. Increase the number of observational sites to include both a reliable number of loaner board sites and

a reliable number of non-loaner board sites.

2. Increase the mix of river swim sites and lake/reservoir swim sites.

3. Increase the hours and days of observations at swim sites so more reliable comparisons could be made

as to differences.

4. Test whether parental behaviors change when either water or air temperatures are cooler by

conducting observations in the cooler weather months--early summer (May and June) and the early

fall (September and October) as well as continuing observations in the key summer months (July and

August).

5. Conduct observations before and after the placement of loaner boards at a particular site

6. Increase the number of parental surveys at each type of site

7. Get more detailed survey data on a variety of topics and consider collecting this additional information

when parents get home using incentives to improve response rates—

a. Determine what types of flotation parents bring specifically for use by each age group

b. Ask how many of their kids can swim well

c. Ask reasons they think a child should wear a life jacket even if they can swim

d. Knowledge of cold water shock and hypothermia

e. Opinions about attractiveness of life jackets for different aged kids (paddle jumpers; orange

horseshoe; vest) and willingness of kids to wear.

f. Ask why they do NOT use the loaner board.

g. Ask would they pay to rent higher quality, guaranteed clean life jackets

21

Appendices

I. Site and Trainer List

This list shows the 10 swim sites, of these which were initially thought to have active loaner boards

and which actually had active loaner boards. The list also shows which observer team collected the

data at the site and the training date for the team.

II. Number of observations by age and gender at each of the 10 swim sites.

III. Weather and Environmental Condition Form (Site Form)

IV. Swim Observation Form

V. Pictures of Loaner Boards at 4 sites that had signs (although one was not active as a loan station)

22

I. Site and Trainer List

SITE SITE DATE SITE TIME SITE NAME WATER NAME CITY COUNTY

Initial Info on Loaner Board

Actual Presence of

Loaner Board

TEAM & TRAINING DATE

32 8/3/2014 2-4:30pm Tibbets Beach Lake Sammamish Issaquah King yes yes Team ONE 7/12/2014

34 7/13/2014 1-3pm Allan York City Park Lake Tapps Bonney Lake Pierce yes yes Team TWO 7/12/2014

31 7/19/2014 1-5pm Battle Ground Lake State Park Battle Ground Lake Battle Ground Clark yes no*

33 8/10/2014 10am-12pm Mayfield Lake Park Mayfield Lake Mossyrock Lewis no no

35 8/9/2014 1:30-4:30pm Millersylvania State Park Deep Lake Olympia Thurston yes yes/no** Team THREE 7/12/2014

36 7/19/2014 10am-3pm Howard Amon Park Columbia River Richland Benton yes yes Team FOUR 7/13/2014

40 7/20/2014 2-6pm Bear Lake Regional Park Bear Lake Chattaroy Spokane no no Team FIVE 7/13/2014

37 7/26/2014 1:30-4:30pm Lake Chelan State Park Lake Chelan Chelan Chelan no no Team SIX 7/13/2014

38 7/27/2014 10am-2pm Orondo River Park Columbia River Orondo Douglas no no

39 8/2/2014 10am-2pm Sun Lakes Dry Falls State Park Park Lake Coulee City Grant no no

*Loaner board has not been constructed yet.

**Loaner board was present but they did not put any life jackets out anymore

23

II. Number of Observations at Each Swim Site by Age and Gender

Bear Lake

Regional Park

Lake Chelan

State Park

Mayfield Lake Park

Orondo River Park

Sun Lakes Dry Falls

State Park

Battle Ground Lake

State Park

Millersylvania State Park

Allan York City

Park

Howard Amon Park

Tibbets Beach

Total

Toddlers (0-5) 8 49 5 0 40 32 5 22 5 44 210

Males 8 26 2 0 18 13 2 12 4 17 102

Females 0 23 3 0 22 19 3 10 1 27 108

Preteen (6-12) 25 93 41 6 75 80 113 98 11 109 651

Males 8 44 18 4 34 46 61 52 3 47 317

Females 17 49 23 2 41 34 52 46 8 62 334

All Kids (0-12) 33 142 46 6 115 112 118 120 16 153 861

Males 16 70 20 4 52 59 63 64 7 64 419

Females 17 72 26 2 63 53 55 56 9 89 442

Teenagers (13-17) 27 41 18 13 47 32 26 54 47 20 325

Males 9 20 9 8 32 12 15 22 19 9 155

Females 18 21 9 5 15 20 11 32 28 11 170

Adults (18+) 28 114 18 12 132 107 100 126 16 124 777

Males 14 50 9 6 67 45 40 63 7 49 350

Females 14 64 9 6 65 62 60 63 9 75 427

All Swimmers 88 297 82 31 294 251 244 300 79 297 1963

Males 39 140 38 18 151 116 118 149 33 122 924

Females 49 157 44 13 143 135 126 151 46 175 1039

Red = No Loaner Board

Orange = No Active Board/Or planned

Green = Loaner Board in Place and Actively Stocked

24

III. Site Observation Form

25

BACK PAGE OF SITE OBSERVATION FORM

26

IV. Swimmers’ Observation Form

27

V. Family Swim Survey

28

BACK PAGE OF PARENT SWIM SURVEY

29

VI. Pictures of Loaner Boards at 4 sites

Site 32. Tibbets Beach, Lake Sammamish

30

Site 34. Allen York City Park, Lake Tapps

31

Site 35. Millersylvania State Park, Deep Lake (Not Stocked with Life Jackets Anymore)

32

Site 36. Howard Amon Park, Columbia River