The Attitude-Practice Gap Revisited: Risk Reduction Beliefs and Behaviors Among Owners of Residential Swimming Pools

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Abstract
Complete pool fencing and effective by-stander resuscitation are both believed to reduce the risk of childhood drowning. The relationship between support for, and prevalence of, a complete pool barrier and current cardiopulmonary resuscitation certification was investigated among an equal probability sample of 795 owners of residential swimming pools in Sacramento County, California. Only 50% (95% confidence interval [CI] 44%, 56%) of respondents who favored a cardiopulmonary resuscitation certification requirement for pool owners represented a household with any members so certified. Only 35% (95% CI 26%, 44%) of respondents who endorsed a complete barrier requirement for all pools had a fence surrounding their own pool. Support for a cardiopulmonary resuscitation requirement was associated with a modestly higher prevalence of current cardiopulmonary resuscitation certification (46% vs 33%, difference = 13%, 95% CI for difference 2%, 24%). Endorsement of a pool barrier requirement was associated with a substantially higher prevalence of complete pool fencing (35% vs 7%, difference = 28%, 95% CI for difference 19%, 37%). The proportion of the pool-owning population endorsing these risk reduction behaviors is much larger than the proportion actually adopting them. The results suggest that an effective pool drowning-prevention program will rely primarily on legislative approaches, with health education serving as a useful adjunct.

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