Oct 29, 2020

Dartmouth Study Examines Well Water Testing in Pediatric Primary Care

A team of researchers found that involving pediatric practices in the promotion of private well water testing can influence parental compliance and following-through with testing.

water well testing

Findings from a study by a team of researchers at Dartmouth's Geisel School of Medicine show that involving pediatric practices in the promotion of private well water testing can influence parental compliance.

"We wanted to see if we could move the needle on testing by integrating it into the clinical environment as part of routine pediatric preventive care," said Carolyn Murray, MD, MPH, director of the Community Outreach and Translation Core for the Dartmouth Children's Environmental Health and Disease Prevention Research Center and lead author of the study.

The research team conducted the study with 11 pediatric and family medicine clinics that are members of the Dartmouth CO-OP Primary Care Practice-based Research Network, reported Dartmouth. These primary care practitioners are located in New Hampshire, Vermont, and Maine. 

The goal was to determine the most effective practice approaches to achieve successful well water testing by using two interventions (with two study arms each). The first study arm compared differences in testing completion when water analysis results were provided only to the parents, according to the study. The second study arm tested the effectiveness of doing after-visit parental reminders to complete testing. 

Additionally, parents of children under 12 months who use a private well were eligible. According to the team, a total of 240 kits were dispensed for free.

Well water testing completion rates ranged from 10 to 61% across the practices and study arms, with an average of 29%. The study arm with both parent and clinic access to results and a follow-up system of reminders for parents was more than twice as likely to achieve test completion, according to the results. The researchers found that having clinicians distribute the kits was the strongest predictor of testing completion overall.

According to previous surveys in New Hampshire, nearly 60% of residents had not tested their wells in at least three years and 15% had never had their wells tested, reported Dartmouth. 

More than 43 million people, typically living in rural areas of the U.S. rely on private unregulated wells for their drinking water. 

"I'd say we were very successful at getting all of the practices on board with asking parents, 'Where do you get your drinking water?' and raising clinician awareness of the prevalence of arsenic in private wells," said Murray. "What we did learn was that there's a lot more complexity to people's testing behavior beyond just cost and beyond just the doctor saying, 'You should do this.'"

According to Murray, the team’s main takeaway was that we can engage primary care practices in screening for drinking water sources and promoting well water testing.

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