Evidence‐Based Tailoring of Behavior‐Change Campaigns: Increasing Fluoride‐Free Water Consumption in Rural Ethiopia with Persuasion

Abstract

Two hundred million people worldwide are at risk of developing dental and skeletal fluorosis due to excessive fluoride uptake from their water. Since medical treatment of the disease is difficult and mostly ineffective, preventing fluoride uptake is crucial. In the Ethiopian Rift Valley, a fluoride-removal community filter was installed. Despite having access to a fluoride filter, the community used the filter sparingly. During a baseline assessment, 173 face-to-face interviews were conducted to identify psychological factors that influence fluoride-free water consumption. Based on the results, two behavior-change campaigns were implemented: a traditional information intervention targeting perceived vulnerability, and an evidence-based persuasion intervention regarding perceived costs. The interventions were tailored to household characteristics. The campaigns were evaluated with a survey and analyzed in terms of their effectiveness in changing behavior and targeted psychological factors. While the intervention targeting perceived vulnerability showed no desirable effects, cost persuasion decreased the perceived costs and increased the consumption of fluoride-free water. This showed that altering subjective perceptions can change behavior even without changing objective circumstances. Moreover, interventions are more effective if they are based on evidence and tailored to specific households.

Contextual and sociopsychological factors in predicting habitual cleaning of water storage containers in rural Benin

“…Interestingly, in the present study, perceived vulnerability did not predict habitual cleaning, although perceived severity did. Other studies in the water, sanitation, and hygiene (WASH) domain did not find the latter as a predictor of behavior, neither in a negative nor in a positive association [ Huber et al ., ; Inauen et al ., ; Sonego and Mosler , ]. Hence, the phenomenon needs further investigation.…”

The Influence of Contextual and Psychosocial Factors on Handwashing

“…The model integrates different theories of behavior change and includes a broad set of factors predicting behavior. The approach has successfully been applied to increase safe water consumption in Ethiopia and Bangladesh 10,11 and has moreover proven its effectiveness in increasing handwashing behavior in water-scarce regions in southern Ethiopia. 12 Contextual factors.…”

Continuation of Health Behaviors: Psychosocial Factors Sustaining Drinking Water Chlorination in a Longitudinal Study from Chad

“…By comparing different groups from the same sample, interviewing them with the same instruments, we expect the problem of bias to be equally distributed. Further, it has been shown that successful interventions in changing behavior can be designed on the basis of self-reported behavioral data [15][16][17]61,62]. It might not be relevant after all to measure exact behavior and to validate self-reports about it when we can still explain what factors differentiate between users and non-users of technologies or groups of high and low performers of relevant health behaviors.…”