{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T10:51:55Z","timestamp":1791629515541,"version":"4.3.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000155","name":"Social Sciences and Humanities Research Council of Canada","doi-asserted-by":"publisher","award":["Joseph Armand Bombardier CGS-D (767-2018-2671)"],"award-info":[{"award-number":["Joseph Armand Bombardier CGS-D (767-2018-2671)"]}],"id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Sci Law"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Drowning is a leading cause of injury-related deaths among youth worldwide, often linked to inadequate supervision and ineffective guardianship. While paediatric studies have examined demographics and risk factors, little is known about how these variables interact to influence rescue likelihood. This study addresses that gap using a multivariate binary logistic regression model to assess the odds of not receiving a rescue attempt, using fatality records (n\u2009=\u2009638) from coroners and medical examiners across Canada (2006\u20132016). This approach captures all known accidental fatal drownings but findings cannot be generalized to include incidents in which the individual survived. The best model explained 45.1% of the variance in rescue outcomes (Nagelkerke Pseudo R\u00b2\u2009=\u2009.451) with 84.6% accuracy. Findings revealed that age, sex, alcohol use, perimortem activity, water body type and urban\/rural location significantly impacted rescue attempts. However, chronic medical conditions and general bystander presence showed no significant relationship at the bivariate level. When demographics and situational factors were considered, bystander type (with adult, minors only or alone\/not witnessed) became a key model contributor for predicting rescue attempt likelihood. Teenagers (15\u201318 years) accounted for 33.5% of drownings, followed by toddlers (2\u20134 years, 21.9%) and children (5\u201311 years, 20.5%). Compared to infants, older children and teens faced greater risks of not being rescued, and bystander presence does not equate to capable guardianship. Open water environments posed the highest risk, with ocean drownings 7.9 times more likely to result in no rescue attempt, compared to domestic settings.<\/jats:p>","DOI":"10.1177\/00258024251380964","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T17:04:51Z","timestamp":1762967091000},"page":"297-308","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Supervision and guardianship during drowning fatalities among Canadian youth: An 11-year review of a preventable paediatric public health crisis"],"prefix":"10.1177","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2297-5397","authenticated-orcid":false,"given":"Vienna Chichi","family":"Lam","sequence":"first","affiliation":[{"name":"Simon Fraser University"},{"name":"Simon Fraser University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1864-9089","authenticated-orcid":false,"given":"James Bryan","family":"Kinney","sequence":"additional","affiliation":[{"name":"Simon Fraser University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2222-1598","authenticated-orcid":false,"given":"Lisa","family":"Hanson Ouellette","sequence":"additional","affiliation":[{"name":"Lifesaving Society, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Byers","sequence":"additional","affiliation":[{"name":"Lifesaving Society, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1172-7953","authenticated-orcid":false,"given":"Gail Scott","family":"Anderson","sequence":"additional","affiliation":[{"name":"Simon Fraser University"},{"name":"Simon Fraser University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization. Drowning (WHO Factsheet) https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/drowning (2024)."},{"key":"e_1_3_3_3_2","volume-title":"Canadian Drowning Report","author":"Drowning Prevention Research Centre of Canada (DPRCC)","year":"2024","unstructured":"Drowning Prevention Research Centre of Canada (DPRCC). Canadian Drowning Report. Ontario, Canada: Lifesaving Society Canada, 2024."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.14423\/SMJ.0000000000001763"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-024-05771-5"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000003345"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2023.109788"},{"key":"e_1_3_3_8_2","unstructured":"Lifesaving Society. Study reveals new Canadian \u2018tweens\u2019 at higher risk for drowning: Lifesaving Society finds new Canadians aged 11-14 are five times more likely to be unable to swim https:\/\/www.lifesavingsociety.com\/media\/239967\/2016newsreleasefinal.pdf (2016 accessed 22 March 2025)"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X20000060"},{"key":"e_1_3_3_10_2","first-page":"1","article-title":"Out-of-hospital cardiac arrest due to drowning in North America: comparison of patient characteristics between survival and mortality groups","volume":"2020","author":"Xiong Y","year":"2020","unstructured":"Xiong Y, Liu Z, Liao J, et al. Out-of-hospital cardiac arrest due to drowning in North America: comparison of patient characteristics between survival and mortality groups. Cardiol Res Pract 2020; 2020: 1\u20136.","journal-title":"Cardiol Res Pract"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.13688"},{"key":"e_1_3_3_12_2","volume-title":"Canadian Drowning Prevention Plan","author":"Drowning Prevention Research Centre of Canada (DPRCC)","year":"2022","unstructured":"Drowning Prevention Research Centre of Canada (DPRCC). Canadian Drowning Prevention Plan. Ontario, Canada: Lifesaving Society Canada, 2022."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-27693-4_2"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-27693-4_3"},{"key":"e_1_3_3_15_2","unstructured":"HealthLink BC. Health and safety https:\/\/www.healthlinkbc.ca\/pregnancy-parenting\/parenting-preschoolers-3-5-years\/caring-your-preschooler\/health-and-safety-ages (2023 Accessed 29 November 2024)."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/7.9.637"},{"key":"e_1_3_3_17_2","volume-title":"Pediatric study plans: content of and process for submitting initial pediatric study plans and amended initial pediatric study plans guidance for industry","author":"FDA","year":"2020","unstructured":"FDA. Pediatric study plans: content of and process for submitting initial pediatric study plans and amended initial pediatric study plans guidance for industry. Silver Spring, MD: U.S. Department of Health and Human Services, 2020."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2025.162184"},{"key":"e_1_3_3_19_2","unstructured":"HealthLink BC. 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