Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial

Biran, Adam; Schmidt, Wolf‐Peter; Varadharajan, Kiruba Sankar; Rajaraman, Divya; Kumar, Rupesh; Greenland, Katie; Gopalan, BTech Balaji; Aunger, Robert; Curtis, Val

doi:10.1016/s2214-109x(13)70160-8

Cited by 248 publications

(289 citation statements)

References 26 publications

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“…Most studies found handwashing rates to increase if the household had a water connection, 15,19,52 whereas others could not find this association. 53 The lack of association between the time spent collecting water and reported handwashing practices in this study might also be due to the breakdown of the sample into two groups, that is water collection time above 30 minutes per roundtrip and below 30 minutes, which may have hindered detecting an effect of the time spent collecting water on handwashing practices. Although a number of studies suggest that access to water may play an important role in reducing childhood diarrhea, there is a need for better designed studies to further elucidate the impact of the distance that people have to carry water home on hygiene practices and health.…”

Section: Discussionmentioning

confidence: 79%

The Influence of Contextual and Psychosocial Factors on Handwashing

Seimetz¹,

Boyayo²,

Mosler³

2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Even though washing hands with soap is among the most effective measures to reduce the risk of infection, handwashing rates in infrastructure-restricted settings remain seriously low. Little is known about how context alone and in interaction with psychosocial factors influence hand hygiene behavior. The aim of this article was to explore how both contextual and psychosocial factors affect handwashing practices. A cross-sectional survey was conducted with 660 caregivers of primary school children in rural Burundi. Hierarchical regression analyses revealed that household wealth, the amount of water per person, and having a designated place for washing hands were contextual factors significantly predicting handwashing frequency, whereas the contextual factors, time spent collecting water and amount of money spent on soap, were not significant predictors. The contextual factors explained about 13% of the variance of reported handwashing frequency. The addition of the psychosocial factors to the regression model resulted in a significant 41% increase of explained variation in handwashing frequency. In this final model, the amount of water was the only contextual factor that remained a significant predictor. The most important predictors were a belief of self-efficacy, planning how, when, and where to wash hands, and always remembering to do so. The findings suggest that contextual constraints might be perceived rather than actual barriers and highlight the role of psychosocial factors in understanding hygiene behaviors.

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Section: Discussionmentioning

confidence: 79%

The Influence of Contextual and Psychosocial Factors on Handwashing

Seimetz¹,

Boyayo²,

Mosler³

2016

The American Society of Tropical Medicine and Hygiene

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“…A study conducted in India showed that interventions that were based on understanding local context and drivers of handwashing behavior significantly increased handwashing with soap at key event times (1% in baseline to 37% in 6-month follow-up visit) including during food preparation. 22 One study that we could identified, conducted in Mali, described the process of preparation for two food items and related hygiene practices. 23 However, generally, there are limited data on food preparation steps and related handwashing practices that can inform behavior change interventions and pinpoint when hands should be washed during food preparation, especially from low-income contexts where easy access to running water is uncommon.…”

Section: Introductionmentioning

confidence: 99%

Hygiene Practices During Food Preparation in Rural Bangladesh: Opportunities to Improve the Impact of Handwashing Interventions

Nizame

Leontsini

Luby

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. This study explored the steps of food preparation, related handwashing opportunities, current practices, and community perceptions regarding foods at high-risk of contamination such as mashed foods and salads. In three rural Bangladeshi villages, we collected qualitative and observational data. Food preparation was a complex and multistep process. Food preparation was interrupted by tasks that could contaminate the preparers' hands, after which they continued food preparation without washing hands. Community members typically ate hand-mixed, uncooked mashed food and salad as accompaniments to curry and rice at meals. Hand-mixed dried foods were mostly consumed as a snack. Observers recorded handwashing during preparation of these foods. Among 24 observed caregivers, of 85 opportunities to wash hands with soap during food preparation, washing hands with soap occurred twice, both times after cutting fish, whereas washing hands with water alone was common. A simple and feasible approach is promotion of handwashing with soap upon entering and re-entering the food preparation area, and ensuring that everything needed for handwashing should be within easy reach.

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“…18 In addition to the hardware described above, a comprehensive behavior change package using techniques recently found to be effective in India 19 was deployed by trained health promoters called intervention assistants (IAs) with the aim of promoting and sustaining behavior change among intervention households.…”

Section: Introductionmentioning

confidence: 99%

Pilot Cluster Randomized Controlled Trials to Evaluate Adoption of Water, Sanitation, and Hygiene Interventions and Their Combination in Rural Western Kenya

Christensen¹,

Dentz²,

Pickering³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. In preparation for a larger trial, the Water, Sanitation, and Hygiene (WASH) Benefits pilot study enrolled 72 villages and 499 subjects in two closely related randomized trials of WASH interventions in rural western Kenya. Intervention households received hardware and promotion for one of the following: water treatment, sanitation and latrine improvements, handwashing with soap, or the combination of all three. Interventions were clustered by village. A follow-up survey was conducted 4 months after intervention delivery to assess uptake. Intervention households were significantly more likely than controls to have chlorinated stored water (36-60 percentage point increases), covers over latrine drop holes (55-75 percentage point increases), less stool visible on latrine floors (16-47 percentage point reductions), and a place for handwashing (71-85 percentage point increases) with soap available (49-66 percentage point increases). The high uptake in all arms shows that combined interventions can achieve high short-term adoption rates if well-designed.

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Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial

Abstract: Wellcome Trust, SHARE.

Cited by 248 publications

References 26 publications

The Influence of Contextual and Psychosocial Factors on Handwashing

The Influence of Contextual and Psychosocial Factors on Handwashing

Hygiene Practices During Food Preparation in Rural Bangladesh: Opportunities to Improve the Impact of Handwashing Interventions

Pilot Cluster Randomized Controlled Trials to Evaluate Adoption of Water, Sanitation, and Hygiene Interventions and Their Combination in Rural Western Kenya

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