| Objective Health education on drowning prevention based on school was carried out using a parallel controlled quasi trial in order to evaluate the short-term effectiveness of intervention measures in Lianping county, Guangdong province.Methods Eight townships selected randomly from Lianping were divided into an intervention group and a control group, every group with four townships. All students from intervention townships were exposed to health education for one and half year, but not for students from control townships. One primary school was selected randomly from each township and all students from grades four to six were surveyed at baseline. After one and half year, all students from grades four to six at the same schools as baseline were surveyed again by questionnaires to evaluate the effectiveness of intervention. Analysis of covariance and Logistic regression models were used to evaluate effectiveness controlling confounding factors.Results1. A random sample of 3 015 students at baseline was analyzed. Mean scores of knowledge for primary school students grade four to six was 58.46 (SD 23.56) and the incidence of risk behavior in the past year was 42.2%. Three hundred and fourty one students reported that they had experienced drowning events in the past year, with the incidence 11.3%. The analysis of the latest drowning events showed that most non-fatal drownings occurred in summer (78.3%) and often occurred in the afternoon (66.0%). Natural bodies of water such as river and pond (68.4%) were the most common sites, following by swimming pool (26.7%). Swimming, falling into water accidentally and diving were the major reasons of drowning, with the proportions of 40.6%,19.2%,18.6%, respectively.2. From the data of baseline survey, there was no significant difference in gender, personality, relationship with classmates and relationship with family members between the intervention group and the control group. But mean age in the intervention group was lower than that in the control group. Comparing with the control group, the proportion of incapable of swimming in the intervention group was lower, while that with good swimming skills was higher. The equilibriums in the environment around home and on the way to school were also good, but the proportion that there was open water around school less than 100 meters far in the intervention group was lower. Except that the mean score of knowledge among intervention group students was lower by 3.65, the risk behaviors and non-fatal drowning incidences between groups were well balanced.3. After controlling potential confounding factors, in the intervention group, mean score of knowledge at post-intervention was 64.56 (SD 23.08) higher than that at baseline by 6.51 (95%CI 4.93 to 8.10), and the difference of mean scores between baseline(56.55, SD 24.29) and post-intervention (52.08, SD 24.98) stages was not significant in the control group. For risk behaviors, the incidence at post-intervention was 35.3% lower than that at baseline (42.9%) in the intervention group, but that at post-intervention (44.5%) was higher compared to baseline (41.1%) among control group students. It was also found that there was no statistical difference in non-fatal drowning incidence between baseline (11.1%) and post-intervention (11.0%) stages, but in the control group, the incidence at post-intervention (15.8%) was higher than that at baseline (11.6%).Conclusions The school-based health education on drowning prevention is effective to improve children's knowledge, decrease their risk behaviors and prevent non-fatal drowning incidence.
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