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These studies represent the first adaptation of the Motivational Interviewing (MI) behavior change approach in the developing world, using health workers directly from the community. The objective was to compare the effectiveness of the standard practice of health education (comparison group) to MI (experimental group) in initiating and sustaining safe water treatment and storage behavior. Methods: focus groups and community surveys were conducted prior to health worker training. The main outcome variables were detectable disinfectant levels in stored household water (for Field Trial 1) and disinfectant sales (for Field Trial 2). Results: in Field Trial 1 (n = 185 households), a very high adherence rate was achieved (range 71.1-94.7%), with no statistical differences between the groups. Field Trial 2 (n = 427 households) incorporated lessons learned from the previous trial and resulted in much higher purchase rates of the disinfectant in the MI group, t(7) = 10.69, p < 0.001, eta 2 = 0.94. Conclusion: MI intervention appears promising for public health initiatives in the developing world. Further work in this area is indicated.

Motivational Interviewing enhances the adoption of water disinfection practices in Zambia