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Emotionally driven behavior interventions improved hand-washing practices
In rural India, behavioral interventions driven by emotional factors were successful in increasing hand-washing with soap, according to recent study results.
“Hand-washing campaigns usually try to educate people with health messages about germs and diseases, but so far efforts to change hand-washing behavior on a large scale have had little success,” study researcher Val Curtis, PhD, of the London School of Hygiene and Tropical Health, said in a press release. “Understanding the motivating factors for routine hand-washing is essential to any initiative likely to achieve lasting behavior change.”
The randomized study was conducted in the Chittoor district of southern Andhra Pradesh, India, from May 24, 2011, to Sept. 10, 2012. The researchers selected 14 villages for analysis by random sampling out of 57 villages that met eligibility criteria.
The villages were randomly assigned based on population (<1,200 vs. >1,200). The intervention group consisted of seven villages, and seven control group villages received only a truncated version of intervention near the end of the study.
The intervention was delivered in schools and in neighborhoods, and included an animated film, comic skits and “pledging ceremonies” in which groups of women promised to wash their hands at important times and agreed to do likewise for their children.
The results were gauged through direct observation in 20 to 25 households per village at baseline and at three follow-up visits at 6 weeks, 6 months and 12 months post-intervention. To minimize bias, the observers were not aware that the study pertained specifically to hand-washing.
The study’s primary outcome was defined as the percentage of those who washed their hands with soap at key events — after defecation, after diapering a child, before food preparation and before eating. At baseline, hand-washing with soap at important events was rare in both the intervention and control groups (1% vs. 2%). At 6 weeks, hand-washing with soap at key times was more common in the intervention group than the control group (19% vs. 4%). During this time, the intervention group had a rate of hand-washing with soap of 37% vs. 6% in the control group. At 12 months, after the control group received the abbreviated version of the intervention, the rate of hand-washing with soap was 29% for both groups.
The researchers said the effectiveness of the initiative, which could be expanded to larger populations, was due in part to the use of emotionally driven behavior modification practices.
“We attribute the success of the intervention to the attention paid to understanding the drivers of hand-washing behavior and a design process that allowed full use of these insights,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.