No abstract

Abstract. Cholera is a well-known and feared disease in developing countries, and is linked to high rates of morbidity and mortality. Contaminated drinking water and the lack of sufficient treatment are two of the key causes of high transmission rates. This article presents a representative health survey performed in Chad to inform future intervention strategies in the prevention and control of cholera. To identify critical psychological factors for behavior change, structured household interviews were administered to N = 1,017 primary caregivers, assessing their thoughts and attitudes toward household water treatment according to the Risk, Attitude, Norm, Ability, and Self-regulation model. The intervention potential for each factor was estimated by analyzing differences in means between groups of current performers and nonperformers of water treatment. Personal risk evaluation for diarrheal diseases and particularly for cholera was very low among the study population. Likewise, the perception of social norms was found to be rather unfavorable for water treatment behaviors. In addition, self-reported ability estimates (self-efficacy) revealed some potential for intervention. A mass radio campaign is proposed, using information and normative behavior change techniques, in combination with community meetings focused on targeting abilities and personal commitment to water treatment.

No abstract

The effectiveness of household water treatment practices relies heavily on consumers' compliance. However, what is driving these behaviors from a health psychological perspective is not well understood. A review of studies on safe water collection, treatment, handling and storage practices was conducted to identify important socio-psychological determinants. The objectives are to show which determinants commonly explain safe water consumption practices and how well they do so, and to identify behavior- and population-specific determinants to be targeted in different contexts. The results of the review reveal that all the practices studied can be explained well, with a mean of 62% explained variance between performers and non-performers. Social norms, action knowledge, and perceived self-efficacy were shown to be the most common influential factors for safe water practices. Instrumental beliefs around costs and benefits as well as affective beliefs such as taste are important in a majority of cases but varied more strongly, both for different target behaviors and between specific settings and populations, and are thus to be evaluated from case to case. The review gives clear recommendations on which behavioral factors to address with priority and corresponding behavior change techniques to be made use of in contexts where formative research is not possible.

Abstract:Behavior that has changed following promotion campaigns is usually not maintained at its initial level. Psychosocial factors for initiating behavior are often not the same as for the continuation of health behaviors such as water treatment and are much less understood. Better knowledge of factors for behavioral continuation would help to improve programs, both in the design of strategies for sustainable behavior change and by defining stronger criteria for the evaluation of sustainability. This study compared the mindsets of caregivers who continuously performed household drinking water treatment over time with individuals that stopped doing so in a population sample from Chad. Several factors from health psychology based on the Risks, Attitudes, Norms, Abilities, and Self-Regulation (RANAS) model were used to compare the two groups and examine their differing development. Normative factors such as others' behavior, personal obligation, social support and discourse, perceived self-efficacy convictions, action control, and intention best discriminated between the two groups and developed significantly more positively over time for continuers of water treatment. These factors should be considered when designing future interventions intended to lead to sustainable behavior change.