Conclusions
Millions are exposed to unsafe levels of arsenic in water used for drinking and cooking globally. The community-led SHWS arsenic mitigation program conducted a theory-driven approach for intervention development and evaluation that allowed for behavioral determinants to be identified that were associated with the use of arsenic-safe water and changing one’s arsenic filter cartridge. This program increased perceived vulnerability to arsenic exposure and self-efficacy to obtain arsenic-safe water and these changes were associated with exclusive use of arsenic-safe water. Perceived vulnerability to arsenic exposure and self-efficacy were associated with changing one’s arsenic filter cartridge before the final follow-up. These results demonstrate that theory-driven, context-specific formative research can influence behavior change interventions to reduce water arsenic exposure. The SHWS can serve as a model for the design of theory-driven intervention approaches that engage communities to reduce their arsenic exposure.