Opportunities and challenges for implementation of drowning prevention and water safety interventions in high income countries: insights from practitioners and researchers

The development of strategies promoting effective implementation for drowning prevention interventions have been identified as a global priority. To impact the ‘know-do’ gap we must first understand how interventions are currently implemented. This qualitative study sought to understand how those working in drowning prevention and water safety approach intervention implementation in high income countries (HICs), specifically examining practitioners’ and researchers’ perspectives regarding the key factors influencing the successful implementation of interventions and the barriers and enablers for implementing interventions. Semi-structured interviews were conducted with twelve practitioners and researchers working on a range of drowning prevention interventions across five HICs. Interviews were held online and face-to face, and analysed using reflexive thematic analysis. Three themes were constructed to elucidate the approach participants take to implement drowning prevention interventions: getting the issue in focus; meeting people where they are; and thinking about success. We explored the application of implementation science frameworks and the impact of external factors and contextual considerations. Relationship building and trust were identified as pivotal to implementation, with a focus on the multisectoral workforce. In most instances interventions were considered more successful when the intervention team fostered a culture of learning. The role of monitoring and evaluation in interventions varied and impacted participants’ measures of success. This study provides insights into the complexities of implementing drowning prevention interventions in HICs. The findings indicate interventions could benefit from formulated assistance with systemic support to address persistent barriers and capacity building particularly with stakeholder engagement and evaluation.