Social marketing and motivational interviewing as community interventions for safe water behaviors: Follow-up surveys in Zambia

To address the need for innovative approaches to diarrhea prevention in developing countries, we conducted two studies in Zambia to compare the effect of social marketing alone (SM) with social marketing plus motivational interviewing (SM+MI) on the adoption and continued use of a household-based water chlorination and storage intervention called the safe water system (SWS). In Study 1, we conducted a baseline survey, implemented SM+MI in intervention households, SM in comparison households, implemented the SWS, then compared chlorine residuals in stored water in SM and SM+MI households. In Study 2, we compared chlorine residuals in SM and SM+MI households 16 months after a similar implementation project in a different population. The proportion of SM+MI households with adequate chlorine residuals was 16-fold higher in Study 1 and 2-fold higher in Study 2 than SM households. MI is a promising method for motivating the adoption and sustained use of safe water behaviors.