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Private Well Testing in Peri‐Urban African‐American Communities Lacking Access to Regulated Municipal Drinking Water: A Mental Models Approach to Risk Communication
Author(s) -
MacDonald Gibson Jacqueline,
III Frank Stillo,
Wood Erica,
Lockhart Sydney,
Bruine de Bruin Wändi
Publication year - 2022
Publication title -
risk analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.972
H-Index - 130
eISSN - 1539-6924
pISSN - 0272-4332
DOI - 10.1111/risa.13799
Subject(s) - odds , psychological intervention , randomized controlled trial , odds ratio , risk perception , test (biology) , environmental health , medicine , intervention (counseling) , gerontology , psychology , perception , nursing , logistic regression , surgery , ecology , neuroscience , biology
Majority African‐American neighborhoods on the edges of North Carolina municipalities are less likely than white peri‐urban neighborhoods to be served by a community system regulated under the Safe Drinking Water Act. These households rely on unregulated private wells, which are at much higher risk of contamination than neighboring community water supplies. Yet, risk awareness of consuming well water is low, and no prior research has tested risk communication interventions for these communities. We present a randomized‐controlled trial of an oversized postcard to promote water testing among this audience. The postcard design followed the mental models approach to risk communication. To our knowledge, this is the first U.S. randomized‐controlled trial of a mailed communication to promote water testing in any audience and one of few trials of the mental models approach. We evaluated the postcard's effects on self‐reported water testing with and without a free water test offer (vs. no‐intervention control) via a survey mailed one month after the interventions. The combined communication and free test doubled the odds of self‐reported water testing, compared to the control group ( p = 0.046). It increased the odds of testing by 65%, compared to the free test alone. Recall of receiving a postcard about water testing increased the odds of self‐reported testing twelve‐fold ( p < 0.001). Although these results suggest that targeted risk information delivered by mail can promote water testing when paired with a free test, the mechanism remains unclear. Additional research on beliefs influencing perceptions about well water may yield interventions that are even more effective.