{"id":14165,"date":"2020-10-26T10:52:20","date_gmt":"2020-10-26T14:52:20","guid":{"rendered":"https:\/\/geiselmed.dartmouth.edu\/news\/?p=14165"},"modified":"2020-10-26T10:52:20","modified_gmt":"2020-10-26T14:52:20","slug":"geisel-study-examines-well-water-testing-promotion-in-pediatric-primary-care","status":"publish","type":"post","link":"https:\/\/geiselmed.dartmouth.edu\/news\/2020\/geisel-study-examines-well-water-testing-promotion-in-pediatric-primary-care\/","title":{"rendered":"Geisel Study Examines Well Water Testing Promotion in Pediatric Primary Care"},"content":{"rendered":"

Findings from a new study<\/a> conducted by a team of researchers at Dartmouth\u2019s Geisel School of Medicine and published in the journal Preventive Medicine Reports<\/em>, show that involving pediatric practices in the promotion of private well water testing can influence parental compliance.<\/p>\n

More than 43 million people living in primarily rural areas of the U.S. rely on private unregulated wells for their drinking water\u2014including northern New England, where 40 to 50 percent of the population depend on private wells. This puts families, and particularly vulnerable populations such as children, potentially at risk for ingesting harmful contaminants such as arsenic.<\/p>\n

Inorganic arsenic, a tasteless and odorless metalloid, is known to contaminate 10 to 20 percent of bedrock wells in New Hampshire. This raises a significant public health concern given arsenic is associated with a myriad of health conditions, including bladder and other cancers, and growing evidence indicates impacts on children\u2019s health and development.<\/p>\n

Yet, efforts to encourage well owners to periodically test their private wells, an activity that has fallen on the public health system (which lacks regulatory authority), have only seen limited success. Previous surveys in New Hampshire, for example, have reported that nearly 60 percent of residents hadn\u2019t tested their wells in at least three years and 15 percent had never had their wells tested. Lack of awareness among the physician community about the health risks of well water, parental confusion about which chemicals to test for, poor lab access, and the cost of testing have all been cited as reasons for poor compliance.<\/p>\n

\u201cWe 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,\u201d explains Carolyn Murray, MD, MPH, director of the Community Outreach and Translation Core for the Dartmouth Children\u2019s Environmental Health and Disease Prevention Research Center and lead author on the study.<\/p>\n

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\u2014a 250-member voluntary research organization of primary care practitioners located in New Hampshire, Vermont, and Maine. Parents of children under 12 months of age who use a private well were eligible, and a total of 240 kits were dispensed (at no cost).<\/p>\n

To determine the most effective practice approaches to achieve successful well water testing, two interventions (with two study arms each) were assessed. The first compared differences in testing completion when water analysis results were provided only to the parents versus being provided to both the parents and clinic. The second tested the effectiveness of doing after-visit parental reminders to complete testing versus not doing follow-up reminders.<\/p>\n

\u201cI\u2019d say we were very successful at getting all of the practices on board with asking parents, \u2018Where do you get your drinking water?\u2019 and raising clinician awareness of the prevalence of arsenic in private wells,\u201d says Murray, who is also an assistant professor of medicine, community and family medicine, and of The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine. \u201cWhat we did learn was that there\u2019s a lot more complexity to people\u2019s testing behavior beyond just cost and beyond just the doctor saying, \u2018You should do this.\u2019\u201d<\/p>\n

Well water testing completion rates ranged from 10 to 61 percent across the practices and study arms, with an average of 29 percent. 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 than other study arms. But having clinicians (versus other staff) distribute the kits, irrespective of study arm, was the strongest predictor of testing completion overall.<\/p>\n

\u201cI think our main takeaway was that we can engage primary care practices in screening for drinking water source and promoting well water testing,\u201d says Murray. \u201cBut we need to get more creative in how we work with clinicians and care teams on this important health issue. There\u2019s definitely room for improvement, but we\u2019re off to a good start.\u201d<\/p>\n

Margaret Karagas, PhD, director of the Dartmouth Children\u2019s Environmental Health and Disease Prevention Research Center and senior author on the study, agrees. \u201cThis was a great translational research opportunity, building on our close partnership with the Dartmouth CO-OP to test implementation strategies to reduce environmental threats to children\u2019s health and the health of their families.\u201d<\/p>\n

Grant funding from the U.S. Environmental Protection Agency and the National Institute for Environmental Health Sciences supported this study.<\/p>\n

Founded in 1797, the\u00a0Geisel School of Medicine at Dartmouth <\/strong>strives to improve the lives of the communities it serves through excellence in learning, discovery, and healing. The Geisel School of Medicine is renowned for its leadership in medical education, healthcare policy and delivery science, biomedical research, global health, and in creating innovations that improve lives worldwide. As one of America\u2019s leading medical schools, Dartmouth\u2019s Geisel School of Medicine is committed to training new generations of diverse leaders who will help solve our most vexing challenges in healthcare.<\/p>\n","protected":false},"excerpt":{"rendered":"

Findings from a new study conducted by a team of researchers at Dartmouth\u2019s Geisel School of Medicine and published in the journal Preventive Medicine Reports, show that involving pediatric practices in the promotion of private well water testing can influence parental compliance. <\/p>\n","protected":false},"author":26,"featured_media":14166,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1,182],"tags":[102,989],"class_list":["post-14165","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-press-release-news","tag-pediatrics","tag-water-testing","author-26"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2020\/10\/DrinkingWater_featured.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p4r3h1-3Gt","_links":{"self":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/14165","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/users\/26"}],"replies":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/comments?post=14165"}],"version-history":[{"count":1,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/14165\/revisions"}],"predecessor-version":[{"id":14167,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/14165\/revisions\/14167"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/media\/14166"}],"wp:attachment":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/media?parent=14165"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/categories?post=14165"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/tags?post=14165"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}