Background Drowning prevention has been recognised as a priority area in health by state and federal governments in Australia. However, generating change in water safety through education, marketing, policy and advocacy to reduce the drowning toll remains a challenge to all water safety, public health and community organisations. Play It Safe by the Water (PISBTW) is a state-wide initiative that aims to promote safe participation in aquatics throughout the community in Victoria, Australia. From the beach to inland waterways, the pool and in the home, this major water safety initiative combines public awareness campaigns, targeted education programs, lifesaving service development, policy and advocacy. The PISBTW network comprises various water safety and aquatic sporting organisations, industry, government and the community.

Methods Data were collected on drowning incidents across Victoria from 1997/1998 to 2016/2017. Public awareness of and attitudes to water safety and related advertising was assessed pre- and post-campaign across campaign seasons from 2004–2017. Telephone or online surveys were conducted with a random sample of 400–500 Victorians on each occasion. Evaluation of a subset of education programs was undertaken to determine changes in participant knowledge, awareness and skills.

Findings Since the inception of the PISBTW campaign the unintentional drowning rate in Victoria decreased from 1.39/100,000 in 1997/1998 to 0.72/100,000 in 2016/2017. Shifts in the drowning rate particularly in young children were identified. Survey results indicated a recall of advertising by up to 77.0% of respondents. Throughout the study period awareness differed across demographic segments; age and geographical variation, and to a lesser extent gender differences were found. In addition, policy and legislative changes were made.

Conclusion PISBTW provides an example of a multi-focussed, multi-sectoral approach to drowning prevention and the way in which epidemiological drowning data is utilised to inform the direction for future drowning prevention strategies.