ABSTRACT

Handwashing with soap at critical times helps prevent diarrhoeal diseases. Changing handwashing practices through behaviour change communication remains a challenge. This study designed and tested a scalable intervention to promote handwashing with soap. A cluster-randomised, controlled trial compared our intervention against standard practice. Subjects were men, women and children in 14 villages in Cross-River state, Nigeria. The primary outcome was the proportion of observed key events on which hands were washed with soap. Binomial regression analysis calculated prevalence differences between study arms. The intervention had minimal effect on the primary outcome (+2.4%, p = 0.096). The intervention was associated with increased frequency of handwashes without soap before food contact (+13%, p = 0.017). The intervention failed to produce significant changes in handwashing with soap at key times. The low dose delivered (two contact points) may have increased scalability at the cost of effectiveness, particularly in the challenging context of inconvenient water access.

摘要

在关键时刻用肥皂洗手有助于预防腹泻病。通过行为改变交流来改变洗手习惯仍然是一个挑战。本研究设计并测试了一种可扩展的干预措施，以促进用肥皂洗手。一项整群随机对照试验将我们的干预与标准实践进行了比较。受试者是尼日利亚克罗斯河州 14 个村庄的男性、女性和儿童。主要结果是观察到的用肥皂洗手的关键事件的比例。二项式回归分析计算了研究组之间的患病率差异。干预对主要结果的影响很小（+2.4%，p = 0.096）。干预与食物接触前不使用肥皂洗手的频率增加有关（+13%，p = 0.017）。干预未能在关键时刻对用肥皂洗手产生重大变化。提供的低剂量（两个接触点）可能会以效率为代价增加可扩展性，特别是在取水不便的挑战性背景下。