Behavioral determinants
cancers, diabetes
CANCERS, HEART DISEASE, DIABETES
The community-led SHWS program was designed to target the behavioral determinants of arsenic-safe water use in the RANAS model [
Example behavioral determinants measured in the SHWS, and corresponding behavior change techniques delivered in the SHWS interventionAll: Phone calls at 1-week, and 1-, 3-, and 5-months after arsenic filter installation to provide information on the health risks associated with arsenic exposure.Intensive: Video testimonials about the health risks associated with exposure to arsenic through drinking water, including cancers, heart disease, and diabetes.All: FAQ and letter to the household including information about arsenic, health effects of arsenic exposure, and mitigation options.Intensive: Video testimonials about the properties of arsenic (e.g., cannot be seen, smelled, or tasted), health risks associated with exposure to arsenic through drinking water, behaviors that may increase exposure to arsenic (e.g., boiling arsenic unsafe water for consumption), and mitigation options (e.g., testing private well water for arsenic, installing an arsenic filter, and drinking and cooking with arsenic safe water).All: Informing households that the same intervention was provided to other households with elevated arsenic in their community to improve water quality for people with private wells.Intensive: Video testimonials about community members testing private wells for arsenic, installing an arsenic filter, and using arsenic safe water for drinking and cooking.All: Phone calls at 1-week, and 1-, 3-, and 5-months after arsenic filter installation to troubleshoot challenges households faced when using the arsenic filter, discuss strategies to overcome challenges, and provide suggestions for how to facilitate using water from the filter faucet for all drinking and cooking needs.Intensive: Video testimonials from community members about trouble-shooting arsenic filter use; Important Reminders Sheet with advice on how to make sure one is able to use arsenic safe water for drinking and cooking.All: Provision of one replacement arsenic filter cartridge and written instructions (device manual) on how to change the filter cartridge; phone calls at 3-, and 5-months after arsenic filter installation with reminders of when to change the filter cartridge and to refer to provided instructions.Intensive: Step-by-step video on how to change the arsenic filter cartridge, as demonstrated by a community member; making an action plan for when to change the arsenic filter cartridge.All: FAQ stating that the tribal municipal water supply is monitored to make sure it meets EPA standards for arsenic.Intensive: Video testimonial from community elder stating that the municipal water is arsenic safe.