Promoting Drowning Preventive Behaviors Among Caregivers of Children Under 5 Years Through a Health Belief Model-Based Educational Program in Thailand: A Community Study

Background/Objectives: Drowning among children younger than five years remains a major public health problem in Thailand, particularly in residential water environments. Caregivers’ supervision and home safety practices play an important role in preventing childhood drowning. This study evaluated the association between participation in the Be SAFE Program, a community-based educational intervention developed using the Health Belief Model (HBM), and changes in caregivers’ health beliefs and self-reported drowning prevention behaviors. Methods: A quasi-experimental pretest–posttest control group study was conducted among 60 caregivers of children younger than five years recruited from two community settings in Ubon Ratchathani Province, Thailand. Participants were assigned to either an intervention group (n = 30) or a control group (n = 30). The intervention group participated in the HBM-based Be SAFE Program, whereas the control group received routine care. Outcomes included HBM constructs and self-reported drowning prevention behaviors. Baseline-adjusted analyses of covariance (ANCOVA) were performed to compare post-intervention outcomes between groups. Holm adjustment was applied to account for multiple comparisons. Results: After adjustment for baseline scores, caregivers in the intervention group demonstrated significantly greater improvements than those in the control group in perceived susceptibility, perceived severity, perceived benefits, cues to action, self-efficacy, and self-reported drowning prevention behaviors, together with significantly lower perceived barriers (all Holm-adjusted p < 0.05). Large effect sizes were observed across all measured outcomes. Conclusions: The findings suggest that the HBM-based Be SAFE Program was associated with greater short-term improvements in caregivers’ health beliefs and self-reported drowning prevention behaviors than routine care. These findings support the potential value of theory-based community educational programs for childhood drowning prevention while highlighting the need for larger multi-site studies with longer follow-up to confirm the program’s effectiveness and broader applicability.