Drowning prevention strategies for migrant adults in Australia: a qualitative multiple case study.

Drowning is a global public health issue, with minority populations, including migrants, experiencing significant disparities in drowning. The World Health Organization recommends learning to swim as a strategy to reduce drowning. In Australia, migrants are identified as a priority population for drowning prevention, accounting for approximately one-third of all drowning deaths.This study aimed to identify swimming and water safety programs aimed at adult migrant populations in Australia and to explore how these programs are meeting the needs of migrant adults.Using a qualitative multiple case study methodology a desktop review was conducted of 30 publicly accessible swimming and water safety programs across Australia aimed at migrant communities. From this review, six programs were purposively selected for in-depth analysis. Interviews and focus groups with 63 participants (program, managers, swim teachers and program participants), were conducted, guided by the Health Belief Model and Theory of Planned Behaviour. Data was thematically analysed using a deductive approach.Four overlapping key themes with 14 sub-themes were identified: (1) Motivations for establishing programs for migrant adults, (2) Perceived barriers to participation, (3) Addressing cultural and socio-economic determinants of health and (4) Factors and challenges to program success. Findings revealed that drowning among migrant communities was the catalyst for establishing programs, and that staff consciously design these swim programs to make programs accessible and relevant to migrants. This includes offering single-gender programs, providing culturally appropriate swimwear, having bilingual teachers, low or no cost participation fees and ensuring training pathways to employment in the aquatic industry.Swimming and water safety programs that acknowledge and respond to migrants' needs and characteristics offer multiple benefits beyond drowning prevention, including improved physical, social and mental health, and positive settlement experiences. These programs highlight the importance of acquiring water safety awareness, knowledge and skills, and how this can influence generational attitudes and behaviour towards drowning risk and water engagement. Drowning is a complex public health issue, with collaboration among multisectoral stakeholders required to create an impact and reduce inequities, especially for vulnerable populations such as migrant adults.