Peer-led training improves lifejacket wear among occupational boaters: Evidence from a cluster randomized controlled trial on Lake Albert, Uganda.
Autor: | Oporia F; Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda., Kibira SPS; Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda., Jagnoor J; The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia., Kobusingye O; Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda.; The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia., Makumbi FE; Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda., Isunju JB; Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda., Nuwaha F; Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda. |
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Jazyk: | angličtina |
Zdroj: | PloS one [PLoS One] 2023 Oct 20; Vol. 18 (10), pp. e0292754. Date of Electronic Publication: 2023 Oct 20 (Print Publication: 2023). |
DOI: | 10.1371/journal.pone.0292754 |
Abstrakt: | Background: 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. Methods: 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. Results: 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). Conclusion: 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. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2023 Oporia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
Databáze: | MEDLINE |
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