Converting weather warnings into water safety: a comparative case study of drowning prevention using an extended COM-B framework

Drowning remains a preventable but persistent public health problem, particularly during weather-related emergencies in which sudden storms, typhoons, floods and rapidly changing water conditions can compress the time available for protective action. Although weather warnings, safety regulations and emergency plans are increasingly available, water-related casualties continue to occur when warnings are not translated into timely, feasible and enforceable action. This study examines how warning information is converted, or fails to be converted, into water-safety behaviour. This study used a document-based comparative case study design to analyse drowning prevention and water safety during weather-related emergencies in China. Publicly available official reports, government notices and media accounts were reviewed. Cases were selected to capture variation in outcomes, including water-related emergencies with severe casualties and comparative cases in which early protective action reduced exposure. The analysis was guided by an extended Capability–Opportunity–Motivation–Behaviour framework. Physical opportunity referred to hazard intensity, water conditions and the available action window. Social opportunity referred to warning delivery, operational restrictions, supervision, rescue capacity and organisational coordination. Motivation captured safety prioritisation, risk perception, responsibility acceptance and compliance avoidance. Capability included risk recognition, decision-making under stress, command capacity, life-jacket enforcement, return-to-shore organisation, evacuation and rescue mobilisation. Across the cases, differences in protective-action outcomes were consistently associated with how opportunity, motivation and capability aligned within the available warning-to-action window. Physical opportunity constrained the time and conditions available for action, while social opportunity was closely associated with whether warnings were translated into enforceable measures. The case evidence suggests that safety prioritisation, risk recognition, responsibility acceptance and practical execution capacity were key features distinguishing protective-action pathways from failure pathways. Failure pathways were characterised by warnings remaining informational rather than operational, delayed or insufficient responses to escalating risk, and limitations in practical water-safety capability. Drowning prevention should be understood not only as an individual skill issue but also as a behavioural systems and implementation challenge. An extended COM-B framework helps identify where the warning-to-action chain breaks down and where public health interventions can be strengthened. The findings highlight the potential importance of actionable warning protocols, enforceable operating rules, frontline command capacity, consistent use of safety equipment, public risk communication and scenario-based training for water safety during weather-related emergencies.