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Background: Educating swimming pool users about hygienic swimming behaviours, such as not swimming whilst suffering from diarrhoea and vomiting, is key to reducing the transmission of cryptosporidium, which is an infectious disease. There is limited literature focusing on hygienic swimming behaviours. Aim: To explore awareness of hygienic swimming behaviours and to develop and evaluate a public health intervention to reduce the transmission of cryptosporidium. Methods: A study was conducted using a exploratory sequential design, involving semi-structured interviews with 28 stakeholders (e.g. swimmers, pool operators). These findings informed the development of a questionnaire completed by 407 swimmers/parents of swimmers. These studies explored awareness and ways to raise awareness of hygienic swimming behaviours. The findings informed the development of a poster to raise awareness of such behaviours, and a small-scale evaluation was conducted with 153 respondents. Findings and discussion: Many factors were identified which influenced hygienic swimming behaviours, including current awareness, cultural factors and the design of swimming facilities. Respondents identified a variety of methods for raising awareness, of hygienic swimming behaviours with a poster in the changing rooms being the most preferred method. Positive feedback was provided about the poster, which was perceived as being easy to read and informative. Of note, respondents also reported that the poster had encouraged them to consider their own hygienic swimming behaviours. Implications and recommendations: A resource has been created as part of this study, and it is hoped that it will be used by swimming facilities across Wales, and potentially further, to encourage people to swim, and to do so hygienically. The poster developed has raised awareness of hygienic swimming behaviours and received positive feedback in terms of evaluation from swimmers/parents of swimmers and endorsement from Public Health Wales. Permission to include the Public Health Wales logo on the poster demonstrates the value and importance of the message, especially as currently there is no legal requirements for swimming pools to display such information.

An exploration of the awareness of hygienic swimming behaviours and an evaluation of a public health intervention, to reduce the transmission of cryptosporidium