A community engagement strategy to sustain safe drinking water in Guatemala.

We sought to examine a community engagement (CE) strategy, defined as a monetary contribution, on water filter usage DESIGN: A natural, quasi-experimental study was conducted in Guatemala following the distribution of water filters. Households in the 2014-2015 group (free water filter) were compared with households in the 2018-2019 group (CE strategy: US$5.50 for water filter) SAMPLE: One-year post-distribution, the comparison group (n = 56) and intervention group (n = 38) completed a survey on family health and water filter use RESULTS: Households in the CE group had almost five times higher odds (OR = 4.7, p = .022) of having a working water filter 1 year later. Using a multivariable logistic regression model, the single best predictor to explain working water filters was the CE strategy CONCLUSIONS: CE strategies that support ownership and dignity might sustain public health initiatives, in conjunction with collaborative international partnerships. Future research could include linking villages with local and international organizations that support safe drinking water initiatives.