1. Drowning Prevention on the Potomac River National Park Service (NPS) Ina Hysi, MPH Public Health Associate/Assigned to National Park Service Office for State, Tribal, Local and Territorial Support Centers for Disease Control and Prevention 2015 PHAP Class Summer Seminar May 17, 2016 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support

2. Public Health Significance  National parks represent diverse bodies of water and recreation opportunities where swimming is allowed or prohibited  Drowning is the leading cause of visitor mortality in national parks  Drowning represents over 35% of fatalities between fiscal years (FY) 2007-2013 Visitor Fatality Data FY07 - FY13

3.  Twenty five miles long  A combination of three national parks: George Washington Memorial Parkway (GWMP), Great Falls, and Chesapeake & Ohio Canal (CHOH)  River jurisdiction – Maryland Department of Natural Resources  It is illegal to enter the water 2  Visitors can receive a $210 fine for violating law  Recreational activities allowed:  Kayaking  Paddle boarding  Rescue response is a multiagency response (NPS and state and county emergency services Background: Potomac River Potomac River 1

4. Background: GWMP Drowning Incident Data  Despite water entry laws, there have been 56 drownings from 1972-2015 (nine in the last five years)  Data from 2015  2 drownings  Over 90 swift water rescues  303 Preventive Search and Rescue (PSAR)  95 citations  41 warnings Great Falls STE 3 Warning Sign 4

5. Study Objectives The objective of this study was to identify a target Person – Who is participating in behaviors (e.g. swimming, wading, cliff jumping etc.) that could lead to drowning? Place – Where are most incidents (e.g. PSAR, Near Misses etc.) occurring? Time – When (month, day, time) are most incidents occurring? for a tailored drowning prevention program. Great Falls STE 5

6. Methods  Two data sources  United States Park Police (USPP) water-related incident and fatality data (2010-2015)  Potomac Paddlers Volunteer Corps (PPVC) water-related incident data (2014-2015)  A total of 245 records  Frequencies were determined for the following variables:  participants’ age, sex, and race  incident location  incident time (month, weekday, and time of day)

7. Results  Person  Male (n=209; 63%)  White (n=176; 84%)  Ages 15-24 (n=108; 61%)  Place  Purple Horse Beach  Difficult Run  Time  May, June, July (n=67; 62%)  Saturday & Sunday (n=40; 60%)  12 PM – 4PM (n=20; 50%)

8. Target Location LOCATIONFATALITYIWENMPSARGrand Total Great Falls --52714 Wet Bottom to Spitzbergen 228--1545 Spitzbergen to Above Chutes 135--2864 Chutes to Anglers 22112448 Anglers to Carderock --2 13 Carderock to Brookmont Dam -- 123 O-Deck to S-Turn 18--1221 S-Turn to Rocky Island 121--1638 Lock 6 to Chain Bridge 12--69 Grand Total 81224111 245

9. 9 Chutes to Anglers (#2 priority location) Spitzbergen to Above Chutes (#1 priority location) Target Location

10. 10 Spitzbergen to Above Chutes Splat Rock - IWE -- 22 (Swimming: 21) - PSAR -- 6 Purple Horse Beach - IWE -- 7 (Swimming: 3) - PSAR -- 14 Target Location

11. 11 Difficult Run - IWE -- 12 - PSAR -- 14 Chutes to Anglers Target Location

12. Study Conclusion Findings suggest that drowning prevention efforts at GWMP should target white males between the ages of 15 and 24. The best time to reach this population is on weekends in the months of May, June, and July between 12:00 PM and 4:00 PM. Lastly, researchers should consider Difficult Run and Purple Horse Beach as priority locations for future interventions.

13. Implication for Public Health  Data driven decision making  For the first time the park will be able to make decisions based on water-related incident data  Tailored intervention  The park now has the ability to design a tailored intervention and effectively use its limited resources  Program evaluation  The park will be able to evaluate the effectiveness of the intervention and make an informed decision about whether or not to continue implementing it in future years

14. Share results with stakeholders Data Analysis Implement Intervention IRB and Park Research Permit submission Proposal of study designs Next Steps

15.  Data quality - Demographic data (age, sex, race) from PPVC are an approximation  Solution: Analyzed USPP data separately and compared results. Target population had the same characteristics (i.e. white males ages 15-24)  USPP location data were specific locations on land while PPVC location data were river sections  Solution: Worked with USPP and PPVC to create a location matrix that matched land locations to river sections  Inability to survey park visitors and find out why they are participating in risky behaviors  Solution: Develop a safety questionnaire and submitted to OMB for approval Challenges

16. 1. George Washington Memorial Parkway. (2016). Retrieved from http://inside.nps.gov/index.cfm?handler=parkmaps&alphacode=GWMP http://inside.nps.gov/index.cfm?handler=parkmaps&alphacode=GWMP 2. The National Park Service. (2016). About the park. Retrieved from insidenps.gov/Gwmp/about 3. Gonzalez, N. (2015). Share the Experience, Great Falls. 4. Hysi, I. (2015). Warning sign. 5. Morrison. R. (2015). Share the Experience, Great Falls. References

17. QUESTIONS ?

18. For more information, please contact CDC’s Office for State, Tribal, Local and Territorial Support 4770 Buford Highway NE, Mailstop E-70, Atlanta, GA 30341 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: OSTLTSfeedback@cdc.govWeb: http://www.cdc.gov/stltpublichealthOSTLTSfeedback@cdc.govhttp://www.cdc.gov/stltpublichealth The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Ina Hysi, MPH E-mail: LGU8@CDC.GOV Phone: 202-513-7217 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support