Home Health Navigator Program for Pollution Exposure

Overseen By Veronica L Irvin, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Oregon State University

Disqualifiers: Non-Oregon residents, Non-homeowners, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a program designed to help homeowners make safer choices about drinking water from private wells, which can sometimes contain harmful chemicals. It compares two groups: one receives water test results and educational materials, while the other also receives assistance from a trained community health worker (health navigator) to understand the results and make informed decisions. The study aims to determine if having a health navigator leads to better outcomes in reducing exposure to contaminated water. Homeowners in Oregon who rely on a private well for drinking water might be suitable for this trial. As an unphased trial, it offers participants the chance to contribute to important research that could enhance community health practices.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this program is safe for promoting well water safety?

Research shows that community health workers can safely help people reduce exposure to harmful substances like arsenic, nitrate, and lead in drinking water. Studies have found that these workers guide homeowners with private wells, which the Safe Drinking Water Act does not protect.

Community health workers primarily focus on education and support. They meet with homeowners to explain well water test results and assist in deciding how to reduce risks. Reports have not linked serious problems to this type of support.

Overall, community health worker programs have been well-received in similar situations, suggesting they are a safe option for managing potential water contamination issues. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Home Health Navigator Program for pollution exposure because it takes a unique, hands-on approach to helping homeowners understand and act on well water test results. Unlike standard practices that simply provide the test kit and results, this program includes a trained health navigator who meets with households three times. This navigator helps interpret results, boosts health literacy, assesses risks, and provides motivational coaching. The personalized support and guidance offered by the navigator aim to empower homeowners to make informed decisions about their water quality, which is a step beyond current options that often lack this level of direct engagement and support.

What evidence suggests that this trial's interventions could be effective for reducing exposure to contaminated well water?

Research has shown that community health workers can effectively help people make better decisions about their well water safety. In this trial, participants in the "Health navigator" arm will receive support from trained health guides, which studies indicate improves health understanding. This means people learn more about their water quality and health risks. This approach has shown promise in helping homeowners understand water test results and make informed choices about water treatment. In real-life trials, community health workers helped families set goals and take action to reduce their exposure to harmful contaminants. This method not only supports better decision-making but also encourages people to actively manage their water safety, ultimately protecting their health. ^{1 2 4 5 6}

Who Is on the Research Team?

Molly Kile, ScD

Principal Investigator

Oregon State University

Veronica Irvin, PhD

Principal Investigator

Oregon State University

Are You a Good Fit for This Trial?

This trial is for homeowners over 21 in Jackson County, OR, who use a private well as their main drinking water source and plan to stay in their home for at least the next year. They must be able to fill out a questionnaire in English or Spanish.

Inclusion Criteria

Currently live in the home with the private well and intend to live in the home for at least 12 months from now

I am at least 21 years old.

Be a homeowner with a private well

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive a free well water test kit and materials from the Oregon Health Authority. Health navigators meet with homeowners to assist in decision-making and promote environmental health.

12 months

3 visits (in-person or virtual)

Follow-up

Participants are monitored for changes in well stewardship behaviors and health outcomes through surveys and water testing.

12 months

What Are the Treatments Tested in This Trial?

Interventions

• Community health worker

Trial Overview The study tests if community health workers can effectively counsel homeowners on reducing exposure to arsenic, nitrate, and lead from private wells. It's a randomized controlled trial comparing two intervention methods for promoting safe water practices.

How Is the Trial Designed?

Group I: Arm 2: Health navigator Experimental Treatment 1 Intervention

People will receive a free well water test kit that is delivered by mail and the results from this water test. They will also be mailed material that is provided by the Oregon Health Authority's Domestic Well Stewardship Program which is the Water Well Owner's Handbook(in English or Spanish) and contaminant guides. In addition, a trained health navigator will meet with the homeowner three times to assist the homeowner's decision-making. Activities include: i) Interpreting results, ii) Improving health literacy and numeracy through teach-back moments, iii) Assessment of household risk for contaminants from well and septic, iv) Assessment of risk to family members, pets, livestock, etc v) Coaching to resolve ambivalence or lack of motivation and other barriers using elicit-provide-elicit motivational interviewing; vi) Assistance with decision-making and weighing financial options, and vii) Goal-setting and action plans.

Group II: Arm 1: Usual practice Active Control 1 Intervention

People will receive a free well water test kit that is delivered by mail and the results from this water test. They will also be mailed material that is provided by the Oregon Health Authority's Domestic Well Stewardship Program which is the Water Well Owner's Handbook(in English or Spanish) and contaminant guides.

Who Is Running the Clinical Trial?

Oregon State University

Lead Sponsor

Trials

51

Recruited

8,300+

National Institute of Environmental Health Sciences (NIEHS)

Collaborator

Trials

294

Recruited

1,233,000+

Oregon Health Authority

Collaborator

Trials

4

Recruited

24,100+

Oregon Health Authority

Collaborator

Trials

4

Recruited

24,100+

Published Research Related to This Trial

The community health worker (CHW) program helped 1600 frequent emergency department users in Buffalo, New York, achieve 43% of their health-related objectives, primarily focused on connecting clients to community resources and primary care.

Success in achieving these objectives was linked to higher client engagement with CHW services, indicating that improving access to resources and addressing systemic barriers could enhance the program's effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community Health Workers: Addressing Client Objectives Among Frequent Emergency Department Users. Kwan, BM., Rockwood, A., Bandle, B., et al.[2019]

A 15-hour training course significantly improved the asthma medication instruction abilities of 11 immigrant Mexican community health workers (CHWs), with median correct technique scores rising from 25% to 69% for metered dose inhalers and from 0% to 64% for spacers after training.

Post-training evaluations showed that all CHWs demonstrated adequate understanding of medication delivery techniques, indicating that with proper training, CHWs can effectively help families manage asthma medications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of an asthma medication training program for immigrant Mexican community health workers. Martin, MA., Mosnaim, GS., Rojas, D., et al.[2011]

A tailored community health worker (CHW) intervention significantly improved posthospital outcomes for low-socioeconomic status patients, increasing timely primary care follow-up from 47.9% to 60.0% and enhancing the quality of discharge communication.

The intervention also led to better mental health improvements and patient activation, while reducing the likelihood of multiple 30-day readmissions, indicating that CHWs can effectively address socioeconomic and behavioral factors affecting recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient-centered community health worker intervention to improve posthospital outcomes: a randomized clinical trial. Kangovi, S., Mitra, N., Grande, D., et al.[2018]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11065571/

An Overview of the Be Well Home Health Navigator Program ... Our intervention would focus on feedback on water test results and changes that can be made to water quality from using appropriate treatment, shaping of social ...

2. withpower.com withpower.com/trial/home-health-navigator-program-for-pollution-exposure-ceac0

Home Health Navigator Program for Pollution Exposure What data supports the effectiveness of the treatment Community health worker in the Home Health Navigator Program for Pollution Exposure? Research shows that ...

3. researchgate.net researchgate.net/publication/378895677_An_overview_of_the_Be_Well_Home_Health_Navigator_Program_to_reduce_contaminants_in_well_water_Design_and_methods

An overview of the Be Well Home Health Navigator ... Well water testing can help prevent negative health outcomes associated with consuming contaminated water. ... Well Communities and Community Water Systems ...

4. pubs.acs.org pubs.acs.org/doi/10.1021/acs.est.4c02835

Improving Private Well Testing Programs: Experimental ... The results suggest that 40% of households are at risk of pollution exposure. These households use their wells for drinking water but have not ...

5. healthaffairs.org healthaffairs.org/doi/10.1377/hlthaff.2019.00981

Evidence-Based Community Health Worker Program ... In this article we use outcomes data from this randomized controlled trial to calculate a return on investment for the program from the perspective of a ...

6. bohrium.com bohrium.com/paper-details/an-overview-of-the-be-well-home-health-navigator-program-to-reduce-contaminants-in-well-water-design-and-methods/974637469301473337-7334

An overview of the Be Well Home Health Navigator Program to ... The methodology likely involves reaching out to well owners, providing them with information about the risks of contaminants, and offering guidance on how to ...