An overview of the Be Well Home Health Navigator Program to reduce contaminants in well water: Design and methods
The Be Well Home Health Navigator Program is a 4-year study in Oregon that aims to reduce contaminants in private drinking water wells through a community health navigator program. The program will involve individualized feedback, positive reinforcement, and navigation to resources, and will be compared to usual care which only provides information. The results will demonstrate the effectiveness of the program and can be used by other organizations.
College of Health researcher(s)
Highlights
- Approximately 25% of private wells in the United States that are used for drinking water contain contaminants that are known to increase the risk of chronic diseases.
- Homeowners are responsible for maintaining the quality of the drinking water provided by their private wells.
- This intervention leverages the trusted relationships of Cooperative Extension Service Community Educators within local communities to educate, assist, and motivate well owners to mitigate arsenic, nitrate, or lead in their well water that is found to be above safe drinking water standards.
Abstract
Background
The Be Well Home Health Navigator Program is a prospective, randomized controlled trial (RCT) implemented to compare a community health navigator program to usual care program to reduce contaminants in drinking water.
Design and setting
This 4-year two-armed RCT will involve well owners in Oregon that have private drinking water wells that contain arsenic, nitrate, or lead above maximum contaminant levels.
Intervention
The intervention leverages the trusted relationship between Cooperative Extension Service (CES) Community Educators and rural well owners to educate, assist and motivate to make decisions and set actionable steps to mitigate water contamination. In this study, CES will serve as home health navigators to deliver: 1) individualized feedback, 2) positive reinforcement, 3) teach-back moments, 4) decision-making skills, 5) navigation to resources, 6) self-management, and 7) repeated contact for shaping and maintenance of behaviors. Usual care includes information only with no access to individual meetings with CES.
Measurable outcomes
Pre-specified primary outcomes include 1) adoption of treatment to reduce exposure to arsenic, nitrate, or lead in water which may include switching to bottled water and 2) engagement with well stewardship behaviors assessed at baseline, and post-6 and 12 months follow-up. Water quality will be measured at baseline and 12-month through household water tests. Secondary outcomes include increased health literacy scores and risk perception assessed at baseline and 6-month surveys.
Implications
The results will demonstrate the efficacy of a domestic well water safety program to disseminate to other CES organizations.