PDF(Pubmed)
Abstract：
The burden of drowning among occupational boaters in low and middle-income countries is highest globally. In Uganda, over 95% of people who drowned from boating-related activities were not wearing lifejackets at the time of the incident. We implemented and evaluated a peer-led training program to improve lifejacket wear among occupational boaters on Lake Albert, Uganda.
We conducted a two-arm cluster randomized controlled trial in which fourteen landing sites were randomized to the intervention and non-intervention arm with a 1:1 allocation ratio. In the intervention arm, a six-month peer-to-peer training program on lifejacket wear was implemented while the non-intervention arm continued to receive the routine Marine Police sensitizations on drowning prevention through its community policing program. The effect of the intervention was assessed on self-reported and observed lifejacket wear using a test of differences in proportions of wear following the intention to treat principle. The effect of contamination was assessed using mixed effect modified Poisson regression following the As Treated analysis principle at 95% CI. Results are reported according to the CONSORT statement-extension for cluster randomized trials.
Self-reported lifejacket wear increased markedly from 30.8% to 65.1% in the intervention arm compared to the non-intervention arm which rose from 29.9% to 43.2%. Observed wear increased from 1.0% to 26.8% in the intervention arm and from 0.6% to 8.8% in the non-intervention arm. The test of differences in proportions of self-reported lifejacket wear (65.1%- 43.2% = 21.9%, p-value <0.001) and observed wear (26.8%- 8.8% = 18%, p-value <0.001) showed statistically significant differences between the intervention and non-intervention arm. Self-reported lifejacket wear was higher among boaters who received peer training than those who did not (Adj. PR 1.78, 95% CI 1.38-2.30).
This study demonstrated that peer-led training significantly improves lifejacket wear among occupational boaters. The government of Uganda through the relevant ministries, and the Landing Site Management Committees should embrace and scale up peer-led training programs on lifejacket wear to reduce drowning deaths.
We conducted a two-arm cluster randomized controlled trial in which fourteen landing sites were randomized to the intervention and non-intervention arm with a 1:1 allocation ratio. In the intervention arm, a six-month peer-to-peer training program on lifejacket wear was implemented while the non-intervention arm continued to receive the routine Marine Police sensitizations on drowning prevention through its community policing program. The effect of the intervention was assessed on self-reported and observed lifejacket wear using a test of differences in proportions of wear following the intention to treat principle. The effect of contamination was assessed using mixed effect modified Poisson regression following the As Treated analysis principle at 95% CI. Results are reported according to the CONSORT statement-extension for cluster randomized trials.
Self-reported lifejacket wear increased markedly from 30.8% to 65.1% in the intervention arm compared to the non-intervention arm which rose from 29.9% to 43.2%. Observed wear increased from 1.0% to 26.8% in the intervention arm and from 0.6% to 8.8% in the non-intervention arm. The test of differences in proportions of self-reported lifejacket wear (65.1%- 43.2% = 21.9%, p-value <0.001) and observed wear (26.8%- 8.8% = 18%, p-value <0.001) showed statistically significant differences between the intervention and non-intervention arm. Self-reported lifejacket wear was higher among boaters who received peer training than those who did not (Adj. PR 1.78, 95% CI 1.38-2.30).
This study demonstrated that peer-led training significantly improves lifejacket wear among occupational boaters. The government of Uganda through the relevant ministries, and the Landing Site Management Committees should embrace and scale up peer-led training programs on lifejacket wear to reduce drowning deaths.
摘要：
背景：低收入和中等收入国家的职业划船者溺水负担在全球范围内最高。在乌干达,事件发生时，超过95%的因划船相关活动溺水的人没有穿救生衣。我们实施并评估了同行主导的培训计划，以改善阿尔伯特湖上职业划船者的救生衣穿着，乌干达。
方法：我们进行了一项双臂整群随机对照试验，其中14个着陆点以1:1的分配比例随机分配到干预组和非干预组。在干预臂中，实施了为期六个月的救生衣穿衣对等培训计划，而非干预部门继续通过其社区警务计划接受水警对溺水预防的常规敏感性。根据意向治疗原则，使用磨损比例差异测试，对自我报告和观察到的救生衣磨损进行了干预效果评估。在95%CI下,遵循经处理的分析原则,使用混合效应改进的泊松回归评估污染的影响。结果根据CONSORT声明扩展报告，用于整群随机试验。
结果：自我报告的救生衣穿着在干预臂中从30.8%增加到65.1%，而非干预臂从29.9%增加到43.2%。观察到的磨损在干预臂中从1.0％增加到26.8％，在非干预臂中从0.6％增加到8.8％。自报告救生衣穿着比例差异的测试（65.1％-43.2％=21.9％，p值<0.001）和观察到的磨损（26.8%-8.8%=18%，p值<0.001）显示干预组和非干预组之间的统计学差异。接受同伴训练的划船者的自我报告的救生衣穿着高于未接受同伴训练的划船者（Adj.PR1.78，95%CI1.38-2.30）。
结论：这项研究表明，同伴主导的培训可以显着改善职业划船者的救生衣穿着。乌干达政府通过相关部委，着陆点管理委员会应接受并扩大同行主导的救生衣培训计划，以减少溺水死亡。
方法：我们进行了一项双臂整群随机对照试验，其中14个着陆点以1:1的分配比例随机分配到干预组和非干预组。在干预臂中，实施了为期六个月的救生衣穿衣对等培训计划，而非干预部门继续通过其社区警务计划接受水警对溺水预防的常规敏感性。根据意向治疗原则，使用磨损比例差异测试，对自我报告和观察到的救生衣磨损进行了干预效果评估。在95%CI下,遵循经处理的分析原则,使用混合效应改进的泊松回归评估污染的影响。结果根据CONSORT声明扩展报告，用于整群随机试验。
结果：自我报告的救生衣穿着在干预臂中从30.8%增加到65.1%，而非干预臂从29.9%增加到43.2%。观察到的磨损在干预臂中从1.0％增加到26.8％，在非干预臂中从0.6％增加到8.8％。自报告救生衣穿着比例差异的测试（65.1％-43.2％=21.9％，p值<0.001）和观察到的磨损（26.8%-8.8%=18%，p值<0.001）显示干预组和非干预组之间的统计学差异。接受同伴训练的划船者的自我报告的救生衣穿着高于未接受同伴训练的划船者（Adj.PR1.78，95%CI1.38-2.30）。
结论：这项研究表明，同伴主导的培训可以显着改善职业划船者的救生衣穿着。乌干达政府通过相关部委，着陆点管理委员会应接受并扩大同行主导的救生衣培训计划，以减少溺水死亡。
