Keeping Household Water Quality Safe

Delivering clean tap water is a high priority for cities and states. But old lead pipes and unsafe service lines can compromise water quality, disproportionately harming Black and other marginalized communities.

The city of Chicago is ensuring that drinking water remains safe as infrastructure improvements materialize. One part of their strategy is providing free lead testing kits. While getting a kit is easy—thousands of residents request them—the multi-step testing process meant that only a small proportion were returned. 

How do you enable people to act on their good intentions?

Impact of a kit redesign and SMS reminders

In 2022, we used behavioral insights to help Chicago achieve a 52.8% lead testing kit return rate, which may be the highest in the nation (to the best of our knowledge).

We did this by simplifying the design of the kit itself, which resulted in a 20 percentage point increase in return rates, and sending SMS reminders, which further increased the likelihood of residents returning their kits by a 3.8 percentage points. For more, here’s the full report.

Pinpointing the problem

Through the Bloomberg Philanthropies What Works Cities Certification program—launched by Bloomberg Philanthropies—our team had the opportunity to support Chicago’s Department of Water Management (DWM) to design and evaluate a project to increase uptake of the city’s lead testing program.

This work began by developing a behavioral map outlining all the steps needed to successfully complete the lead testing kit, along with the barriers that might impede progress (plus enablers that could help).

A simplified behavioral map outlining the steps in the testing process.

A few of the key barriers residents faced were:

• Intimidating, confusing, and overwhelming kit materials
• Finding six hours to let water stagnate (i.e., not use the faucet) before testing
• Remembering to let people they live with know not to use any water either

These obstacles came to light through rigorous qualitative research, including interviews with residents, DWM staff, and water management staff from peer cities; an analysis of city data; and a literature review. We also requested a kit to experience the process firsthand ourselves.

The lead testing kit redesign

Approaching the original kit and materials from a behavioral science lens revealed a few elements working against it, including how text and graphics were used and the way the instructions were presented, which made them feel challenging to residents.

BEFORE: Part of the lead testing kit instructions

AFTER: Lead testing kit, including instructions, return form, and stickers 

In collaboration with the DWM, we fully redesigned the kit using behavioral science principles to make the materials clear and actionable. In particular, we:

• Streamlined information. The original kit came with a cover letter and an information sheet which included caveats and technical details that were not relevant to the majority of residents. Removing this letter and other non-essentials helped ensure the most important information stood out.
• Leveraged color. We used color-coding across the instructions and testing bottles to help ensure residents used the correct bottle at each step, reducing confusion and errors.
• Added timely prompts. To help residents remember to not use their sink during the stagnation period, we added “DON’T USE” stickers for them to place on their faucets and toilets.

Redesign results

Before sending out SMS reminders, we observed the return rates for the redesigned kits (comparing the last three batches of original kits and first three batches of new kits). The average return rate for the original kits was 23.5%, while the new kits was 44.9%—a roughly 20 percentage point increase. See the full report here for details on the redesign and SMS reminder.

Results have remained consistent over a year later. In June 2023, return rates even topped 50% (Source: Chicago DWM).

Key takeaways for cities

Consider doing qualitative research

If you have a program, but aren’t getting the best results, listening to residents (through user testing, interviews, etc.) can help you figure out why—and inform solutions that will work for them.

For instance, in our research, we identified specific challenges residents had with the process, such as other household members forgetting about water stagnation (stickers helped with this) and thinking that every field on the form was required (moving all non-essential questions to the back page simplified the form). 

Our Chicago DWM partner particularly valued this process, “…it allowed me to view the program through different eyes and reconsider aspects I had thought were clear and understandable.” 

Sometimes it’s best to start fresh

While it can be challenging to fully scrap a set of materials instead of making improvement tweaks, sometimes a fresh start is needed. We were excited that our city partners were open to redesigning the kit from scratch—we believe the overhaul helped the kit have a bigger impact than pursuing an incremental approach.

Reduce administrative burdens where you can

For example, we eliminated as many questions as possible from the original instructions and online form. But if that’s not possible, explore where extra support can be provided. For example, SMS reminders are a well–tested intervention, and they alone helped increase return rates of the original kits by 3.8 percentage points.

Behavioral insights and water lead

As the Environmental Protection Agency funds infrastructure improvements to remove lead from drinking water, behavioral insights can help increase uptake of existing abatement programs. If your city is interested in this approach, please contact us here. For inspiration and more detail on our work with the Chicago DWM, explore the full report.