title: Impact of Education on School-aged Children's Knowledge of and Participation in "The Choking Game".
abstract: OBJECTIVE
  To better understand school-aged children's awareness of and attitudes about the Choking Game (TCG). To determine if education can increase awareness of the risk of injury when playing TCG and to determine if education can decrease interest in TCG participation.
  
  
  METHODS
  Anonymous pre- and post-education surveys.
  
  
  METHODS
  Two middle/high schools; one in Utah and one in California.
  
  
  METHODS
  291 participants (163 in Utah, 128 in California) aged 9-18, 68% under age 15, 32% 15 and older; 65% white, 35% non-white; 52% female, 48% male.
  
  
  RESULTS
  76% of participants knew about TCG, of those 62% heard about it at school. 32% knew someone who had played, and twelve (4%) had played, usually with others. Most frequently cited as reasons for participation were curiosity, peer pressure, and competition. School was the most common location for playing. In California education significantly increased risk awareness, and significant positive attitude changes were observed regarding interest in playing TCG. Utah participants also exhibited attitude changes in the desired direction (less interest in playing TCG, would warn friends, and realized it was not safe to stop breathing), although results were not statistically significant, possibly due to previous education and four recent and highly publicized TCG deaths in the community.
  
  
  CONCLUSIONS
  Results indicate that interactive, standardized, and skills-based education can increase student awareness of TCG risks and decrease interest in participation. Students reported that the schools were often where they first heard about TCG and where TCG was commonly played. Educators and associated health care professionals should therefore be encouraged to provide preventative education as part of school curricula.
authors: University of California, Davis Medical Center, Sacramento, USA; Justin Paul Butler Memorial Education Foundation, USA.
authors: Kendall
authors: K
authors: Butler
authors: University of California, Davis Medical Center, Sacramento, USA.
authors: Bonnie
authors: B
authors: Raingruber
authors: Justin Paul Butler Memorial Education Foundation, USA.
authors: Eric
authors: E
authors: Butler
authors: Clinical and Translational Science Center, Division of Biostatistics, University of California, Davis, Sacramento, California, USA.
authors: Machelle
authors: M
authors: Wilson
keywords: Choking game; Risk of injury; Students