Adult migrants urgent need for drowning prevention in Australia: water safety perceptions, attitudes, and behaviours.

Drowning is a global public health issue with over 300 000 people fatally drowning annually. Inequities exist, with 90% of drowning concentrated in low- and middle-income countries. Populations more vulnerable to drowning across all countries and contexts include children, males, migrants, and First Nations peoples. In Australia, migrants account for 34% of drowning fatalities, therefore are a priority population for reducing drowning. This study aimed to explore the underlying factors influencing the knowledge, attitudes and behaviour towards water safety and drowning risk among adult migrants in Australia. A qualitative exploratory study was undertaken guided by the theory of planned behaviour. Fifty-seven adults residing across Australia participated in a semi-structured interview (n = 15) or a focus group (n = 42). Data were coded and thematically analysed using a deductive approach, guided by Braun and Clarke's framework. Participants originated from 19 different countries, 54% were female. Residential time in Australia ranged from 18 months to 25+ years. Four key thematic areas were identified: 'Water Safety experiences; Attitudes, beliefs and behaviour including cultural norms; Motivations and barriers to swimming; and Benefits of learning to swim'. This study highlighted that migrant's awareness, attitudes, and behaviour towards water safety were informed by factors linked to cultural norms and life experiences. Migrant adults perceived swimming as essential for inclusion in the Australian community. Identified risks included limited exposure to the water and a lack of safety knowledge and skills prior to migrating. These findings offer new insights to inform contemporary drowning prevention strategies that respond to changing population demographics, in Australia and globally.