The peer-led training intervention
fatigue
The peer-led, also referred to as peer-to-peer training intervention program was identified through a participatory approach in a stakeholder insight workshop. At least ten peers from each of the intervention sites were selected and trained for two days to become trainers of their colleagues through formation of ‘lifejacket clubs’. A peer was defined as a boater who is a drowning survivor who was wearing a lifejacket at the time of the incident, and this should have occurred in the last two years. The two years were preferred to minimize recall bias as they shared their experiences with their colleagues during the lifejacket wear promotion sessions. In situations where a drowning survivor was not available, the replacement was a person who was a consistent user of a lifejacket. A consistent user was defined as a person who reported having worn a lifejacket for all the last five boat trips to the lake, and with proof of having lifejacket. In addition, the peers had to be known members of the landing site, with no known criminal record. These were chosen so that they could share their experiences about drowning and lifejacket wear and to improve their credibility. All the peers were volunteers who acted in the spirit of citizen watch for safety on the lake.The peers were trained to train their colleagues on various aspects of lifejackets and lifejacket wear. The training largely focused on observation of pre-departure safety precautions, most important of which was having a lifejacket on by all the boat occupants. They trained their colleagues on the importance of wearing lifejackets correctly, emphasized by regular reminders. Correct lifejacket donning procedures were taught through demonstrations. Emphasis was put on wearing a lifejacket, regardless of the seaworthiness of the lifejacket. The training was conducted continuously for six months by the resident peers at their respective landing sites. General sessions were held every two weeks at each of the intervention sites. This frequency was chosen with the aim of ensuring ‘adequacy of the intervention’ to provide a detectable dose-response relationship. In addition, the fortnightly training sessions were hoped to minimize message fatigue so people do not get ‘irritated’ by the same messages. This frequency was successful in a previous quasi experimental study among similar fishing communities on Lake Victoria in central Uganda [