Motivational Interviewing enhances the adoption of water disinfection practices in Zambia

These studies represent the first adaptation of the Motivational Interviewi ng (MI) behavior change approach in the developing world, using health work ers directly from the community. The objective was to compare the effective ness of the standard practice of health education (comparison group) to MI (experimental group) in initiating and sustaining safe water treatment and storage behavior. Methods: focus groups and community surveys were conducte d prior to health worker training. The main outcome variables were detectab le disinfectant levels in stored household water (for Field Trial 1) and di sinfectant sales (for Field Trial 2). Results: in Field Trial 1 (n = 185 ho useholds), a very high adherence rate was achieved (range 71.1-94.7%), with no statistical differences between the groups. Field Trial 2 (n = 427 hous eholds) incorporated lessons learned from the previous trial and resulted i n much higher purchase rates of the disinfectant in the MI group, t(7) = 10 .69, p < 0.0001, eta(2) = 0.94. Conclusion: MI intervention appears promisi ng for public health initiatives in the developing world. Further work in t his area is indicated.