Using Child Health Outcomes to Identify Effective Measures of Handwashing

Luby, Stephen P.; Halder, Ajay; Huda, Tarique Md. Nurul; Unicomb, Leanne; Johnston, Richard B.

doi:10.4269/ajtmh.2011.11-0142

Cited by 30 publications

(31 citation statements)

References 38 publications

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“…These tend to be biased due to socially desirable answering tendencies or memory effects so that it is preferable to observe the behaviour instead (Biran et al, 2008;Halder et al, 2010). Nevertheless, the present results are highly relevant, because self-reported handwashing is associated with child diarrhoea, child diarrhoea mortality and cholera infection (Hutin et al, 2003;Luby, et al, 2011b;Water Sanitation and Hygiene Research Group, 2012). Further, all participants, including those in the control arm, received an intervention and should, thus, have been equally inclined to answer in a socially desirable way.…”

Section: Strengths Limitations and Perspectivesmentioning

confidence: 72%

“…However, it may still be seen as valid outcome measure as it has been found to be associated with critical health effects, such as child diarrhoea (e.g. Luby, et al, 2011b; for more details see the ''Discussion''). Surveyed key times were those usually promoted in handwashing interventions focusing on diarrhoea prevention (Luby, et al, 2011a), that is after defecation, wiping a child's bottom or other kinds of contact with stool (stoolrelated handwashing, SRH); before eating, preparing food, breastfeeding or feeding a child, and handling drinking water (food-related handwashing, FRH).…”

Section: Stool-and Food-related Handwashingmentioning

confidence: 98%

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Social-cognitive factors mediating intervention effects on handwashing: a longitudinal study

Contzen

Inauen

2015

J Behav Med

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Handwashing with soap effectively prevents diarrhoea, a leading cause of death in infants. Theory-based interventions are expected to promote handwashing more successfully than standard approaches. The present article investigates the underlying change processes of theory-based handwashing interventions. A nonrandomised field study compared a standard approach to two theory-based interventions that were tailored to the target population, the inhabitants of four villages in southern Ethiopia (N = 408). Data were collected before and after interventions by structured interviews and analysed by mediation analysis. In comparison to the standard approach (i.e., education only), education with public commitment and reminder was slightly more effective in changing social-cognitive factors and handwashing. Education with an infrastructure promotion and reminder was most effective in promoting handwashing through enhancing social-cognitive factors. The results confirm the relevance of testing interventions' underlying change processes.

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Section: Strengths Limitations and Perspectivesmentioning

confidence: 72%

Section: Stool-and Food-related Handwashingmentioning

confidence: 98%

Social-cognitive factors mediating intervention effects on handwashing: a longitudinal study

Contzen

Inauen

2015

J Behav Med

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“…We did not use other methods to assess handwashing behavior because of resource limitation to carry out sufficient direct observations and because of the questionable validity of measuring handwashing behavior through hand microbiology and other proxies. 16,47,51,62,63 Over-reporting bias for handwashing frequency is very likely. However, the goal of this study was not to report and analyze absolute handwashing rates, but rather to assess the relative impact of the different contextual and psychosocial factors on handwashing frequency.…”

Section: Discussionmentioning

confidence: 99%

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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“…19 Whereas self-reports are prone to reporting bias, they have been found to be associated with child diarrhea 20 and child diarrhea mortality, 21 and are thus worthy of study.…”

mentioning

confidence: 98%

Identifying the psychological determinants of handwashing: Results from two cross-sectional questionnaire studies in Haiti and Ethiopia

Contzen

Mosler

2015

American Journal of Infection Control

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Using Child Health Outcomes to Identify Effective Measures of Handwashing

Abstract: * Odds ratio was calculated using a generalized estimated equations model that accounted for neighborhood clustering and repeated household sampling using a nested correlation structure. † For the multivariate analysis.

Cited by 30 publications

References 38 publications

Social-cognitive factors mediating intervention effects on handwashing: a longitudinal study

Social-cognitive factors mediating intervention effects on handwashing: a longitudinal study

The Influence of Contextual and Psychosocial Factors on Handwashing

Identifying the psychological determinants of handwashing: Results from two cross-sectional questionnaire studies in Haiti and Ethiopia

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