Well water testing in African-American communities without municipal infrastructure: Beliefs driving decisions.

Some peri-urban African-American communities in North Carolina remain excluded from nearby municipal water service, forcing them to rely on unregulated private wells. Despite evidence of elevated drinking water contamination risks in these communities, water monitoring is rare. To identify factors influencing decisions to test private wells, we developed and administered a survey to residents of affected areas. A factor analysis identified three constructs significantly associated with a decreased likelihood of water testing: (1) the misconception that contaminants can be detected by sensory perception, (2) concerns about costs of testing and/or water treatment, and (3) not knowing how to get a water test or having time to do so. Increased knowledge about how to test and the importance of testing was significantly associated with a decreased concern about costs which, in turn, was significantly associated with an increased odds of testing. These results suggest the need for targeted risk communications that correct the misperception that contaminants can be tasted, smelled, or seen. The results also suggest the need for clear information about how to get a water test and for low-cost testing programs. Increased monitoring could empower residents to take protective actions and potentially mobilize political support for water service extensions.