TY - JOUR
T1 - Behavioral Determinants of Switching to Arsenic-Safe Water Wells
T2 - An Analysis of a Randomized Controlled Trial of Health Education Interventions Coupled With Water Arsenic Testing
AU - George, Christine Marie
AU - Inauen, Jennifer
AU - Perin, Jamie
AU - Tighe, Jennifer
AU - Hasan, Khaled
AU - Zheng, Yan
N1 - Funding Information:
We would like to thank the Eawag team, the Swiss Federal Institute of Aquatic Science and Technology, and the Christian Commission for Development Bangladesh for their support of our project. We also would like to thank our promoters, the project team at the UNICEF, and Columbia University office in Bangladesh, Sheikh Masudur Rahman, Patricia Portela Souza, Shirin Hussain, Mojahidul Hossain, Zakir Hossain, and Masud Noor. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by UNICEF.
Publisher Copyright:
© 2016, © 2016 Society for Public Health Education.
PY - 2017/2
Y1 - 2017/2
N2 - More than 100 million people globally are estimated to be exposed to arsenic in drinking water that exceeds the World Health Organization guideline of 10 µg/L. In an effort to develop and test a low-cost sustainable approach for water arsenic testing in Bangladesh, we conducted a randomized controlled trial which found arsenic educational interventions when combined with fee-based water arsenic testing programs led to nearly all households buying an arsenic test for their drinking water sources (93%) compared with only 53% when fee-based arsenic testing alone was offered. The aim of the present study was to build on the findings of this trial by investigating prospectively the psychological factors that were most strongly associated with switching to arsenic-safe wells in response to these interventions. Our theoretical framework was the RANAS (risk, attitude, norm, ability, and self-regulation) model of behavior change. In the multivariate logistic regression model of 285 baseline unsafe well users, switching to an arsenic-safe water source was significantly associated with increased instrumental attitude (odds ratio [OR] = 9.12; 95% confidence interval [CI] = [1.85, 45.00]), descriptive norm (OR = 34.02; 95% CI = [6.11, 189.45]), coping planning (OR = 11.59; 95% CI = [3.82, 35.19]), and commitment (OR = 10.78; 95% CI = [2.33, 49.99]). In addition, each additional minute from the nearest arsenic-safe drinking water source reduced the odds of switching to an arsenic-safe well by more than 10% (OR = 0.89; 95% CI = [0.87, 0.92]). Future arsenic mitigation programs should target these behavioral determinants of switching to arsenic-safe water sources.
AB - More than 100 million people globally are estimated to be exposed to arsenic in drinking water that exceeds the World Health Organization guideline of 10 µg/L. In an effort to develop and test a low-cost sustainable approach for water arsenic testing in Bangladesh, we conducted a randomized controlled trial which found arsenic educational interventions when combined with fee-based water arsenic testing programs led to nearly all households buying an arsenic test for their drinking water sources (93%) compared with only 53% when fee-based arsenic testing alone was offered. The aim of the present study was to build on the findings of this trial by investigating prospectively the psychological factors that were most strongly associated with switching to arsenic-safe wells in response to these interventions. Our theoretical framework was the RANAS (risk, attitude, norm, ability, and self-regulation) model of behavior change. In the multivariate logistic regression model of 285 baseline unsafe well users, switching to an arsenic-safe water source was significantly associated with increased instrumental attitude (odds ratio [OR] = 9.12; 95% confidence interval [CI] = [1.85, 45.00]), descriptive norm (OR = 34.02; 95% CI = [6.11, 189.45]), coping planning (OR = 11.59; 95% CI = [3.82, 35.19]), and commitment (OR = 10.78; 95% CI = [2.33, 49.99]). In addition, each additional minute from the nearest arsenic-safe drinking water source reduced the odds of switching to an arsenic-safe well by more than 10% (OR = 0.89; 95% CI = [0.87, 0.92]). Future arsenic mitigation programs should target these behavioral determinants of switching to arsenic-safe water sources.
KW - Bangladesh
KW - arsenic
KW - community health
KW - environmental health
KW - formative evaluation
KW - global health
KW - health communications
KW - health promotion
KW - water
UR - http://www.scopus.com/inward/record.url?scp=85011344701&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85011344701&partnerID=8YFLogxK
U2 - 10.1177/1090198116637604
DO - 10.1177/1090198116637604
M3 - Article
C2 - 27230268
AN - SCOPUS:85011344701
SN - 1090-1981
VL - 44
SP - 92
EP - 102
JO - Health Education and Behavior
JF - Health Education and Behavior
IS - 1
ER -