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Volume 11, Number 5—May 2005

Research

Assessing Parents' Perception of Children's Risk for Recreational Water Illnesses

Jacquelyn McClain*, Jay M. Bernhardt†Comments to Author , and Michael J. Beach‡
Author affiliations: *Council of State and Territorial Epidemiologists, Atlanta, Georgia, USA; †Emory University, Atlanta, Georgia, USA; ‡Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Table 1

Perceived risk subscales and factor loadings*

Item Factor
1 2
1. Disease vector acknowledgment (perceived vulnerability) (α = 0.76)†
A well-maintained pool is germ-free. 0.610 0.121
Chlorinated pool water is just as clean as drinking water. 0.607 0.005
Chlorine kills all germs instantly. 0.541 0.141
A swimming pool contains fewer germs than oceans or lakes that can make my child sick. 0.516 0.178
My child is more likely to get sick from germs in a restaurant than from a swimming pool. 0.501 0.173
Pool management makes sure that the pool my child swims in is germ-free. 0.483 0.007
My child is more likely to get sick from germs from a public restroom than a swimming pool. 0.459 0.009
Swimming in chlorinated water with other swimmers can spread germs. 0.404 0.271
2. Knowledge of germ transmission (perceived vulnerability) (α = 0.73)†
It is possible that there are germs in a pool that can cause eye infections. 0.140 0.698
It is possible that there are germs in a pool that cause skin infections. 0.211 0.653
Swallowing water while swimming in a pool increases the risk of getting sick from germs. 0.165 0.586
My child can get sick if she or he swims in a pool when another swimmer has diarrhea. 0.009 0.492
It is possible that there are germs in a pool that cause ear infections. 0.120 0.485
If one child in my family were to get sick with diarrhea from swimming in a chlorinated pool, she or he could infect the rest of the family. 0.004 0.423
3. Perceived severity of diarrheal illness (α = 0.65)‡
Diarrhea is dangerous to my child's health. 0.725 0.190
Diarrhea threatens a child's health. 0.611 0.150
It is difficult for children to get well from diarrhea. 0.422 0.185
Compared to other children, diarrhea is more dangerous to my child's health. 0.416 0.003
4. Perceived severity of nongastrointestinal illness (α = 0.63)‡
An eye infection from a germ in the pool is easily treated. 0.161 0.739
Children recover easily from earaches caused by germs in a chlorinated pool. 0.007 0.604
I am not worried about skin rashes that are caused by germs in the pool. 0.249 0.441
5. Response efficacy of behavioral modifications (α = 0.70)§
Taking children on frequent bathroom breaks will reduce the feces in the pool. 0.759 0.101
Taking children on frequent bathroom breaks will reduce the amount of urine that will get into the pool. 0.690 –0.008
If parents keep their children who are sick with diarrhea out of the pool, illness to other children will be reduced. 0.623 0.002
Maintaining chlorine levels will reduce the number of germs in the pool. 0.488 0.008
Parents who avoid changing diapers near the pool help keep germs out of the pool. 0.409 0.103
6. Response efficacy of swim diapers (α = 0.78)§
Swim diapers are effective in preventing feces from getting into the pool. 0.003 0.812
Swim diapers prevent germs from spreading in a pool. 0.129 0.796
7. Self-efficacy for gastrointestinal RWI prevention (α = 0.60)¶
It is difficult to interrupt my child for bathroom breaks while she or he is playing in the pool. 0.632
It would be difficult to stop my child from swimming for 2 weeks after his or her diarrhea stops. 0.524
It is difficult to tell my child that she or he cannot swim when she or he has diarrhea. 0.523
It is difficult to constantly supervise my children while they are playing in the pool. 0.465

*Bold numbers indicate the factors on which the items load. RWI, recreational water illness.
†Scales 1 and 2 combined: total variance 29.1%, α 0.79.
‡Scales 3 and 4 combined: total variance 36.8%, α 0.69.
§Scales 5 and 6 combined: total variance 45.6%, α 0.63.
¶Scale 7: total variance 38.2%.

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