Private well water testing promotion in pediatric preventive care: A randomized intervention study

Area of Science:

• Environmental Health
• Pediatric Public Health
• Clinical Practice Improvement

Background:

• Millions rely on private wells, posing public health risks due to contaminants like arsenic.
• Children are especially vulnerable to arsenic exposure from contaminated well water.
• Effective strategies for engaging pediatric clinicians in promoting private well testing are needed.

Purpose of the Study:

• To identify effective practice approaches for increasing private well water testing completion in pediatric care.
• To evaluate the impact of test result access and follow-up systems on parental participation.

Main Methods:

• A block randomized trial involving 12 primary care clinics was conducted.
• Interventions included parent/clinic access to test results and staff follow-up systems.
• Parents of young children (under 12 months) using private wells were eligible to receive prepaid water tests.

Main Results:

• Overall parental test completion rate averaged 29%.
• Clinics with both clinic access to results and a staff follow-up system showed 2.3 times higher completion rates.
• Clinician-distributed kits, compared to nursing staff, resulted in 2.4 times greater completion.

Conclusions:

• Systematic screening for drinking water sources in pediatric care can be enhanced.
• Structured follow-up and clinician involvement are key factors in improving well water testing completion.
• Integrating well testing into routine pediatric care requires optimized clinic processes and staff engagement.