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Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh

Author

Listed:
  • Robert Dreibelbis

    (Center for Applied Social Research, University of Oklahoma, 201 Stephenson Parkway, Suite 4100, Norman, OK 73019, USA)

  • Anne Kroeger

    (Center for Applied Social Research, University of Oklahoma, 201 Stephenson Parkway, Suite 4100, Norman, OK 73019, USA)

  • Kamal Hossain

    (Save the Children—Bangladesh, House# CWN (A) 35, Road #43, Gulshan 2, Dhaka 1212, Bangladesh)

  • Mohini Venkatesh

    (Save the Children—USA, 2000 L Street NW, Suite 500, Washington, DC 20036, USA)

  • Pavani K. Ram

    (Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, 237 Farber Hall, Buffalo, NY 14214, USA)

Abstract

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing traditional handwashing infrastructure, and at multiple time periods following targeted handwashing nudges (1 day, 2 weeks, and 6 weeks). No additional handwashing education or motivational messages were completed. Handwashing with soap among school children was low at baseline (4%), increasing to 68% the day after nudges were completed and 74% at both 2 weeks and 6 weeks post intervention. Results indicate that nudge-based interventions have the potential to improve handwashing with soap among school-aged children in Bangladesh and specific areas of further inquiry are discussed.

Suggested Citation

  • Robert Dreibelbis & Anne Kroeger & Kamal Hossain & Mohini Venkatesh & Pavani K. Ram, 2016. "Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh," IJERPH, MDPI, vol. 13(1), pages 1-7, January.
    • Handle: RePEc:gam:jijerp:v:13:y:2016:i:1:p:129-:d:62162
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    References listed on IDEAS

    as
    1. Dreibelbis, R. & Freeman, M.C. & Greene, L.E. & Saboori, S. & Rheingans, R., 2014. "The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: A cluster-randomized trial in Kenya," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 91-97.
    2. Amy J Pickering & Annalise G Blum & Robert F Breiman & Pavani K Ram & Jennifer Davis, 2014. "Video Surveillance Captures Student Hand Hygiene Behavior, Reactivity to Observation, and Peer Influence in Kenyan Primary Schools," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-7, March.
    3. Contzen, Nadja & Meili, Iara Helena & Mosler, Hans-Joachim, 2015. "Changing handwashing behaviour in southern Ethiopia: A longitudinal study on infrastructural and commitment interventions," Social Science & Medicine, Elsevier, vol. 124(C), pages 103-114.
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    Cited by:

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    2. Yolisa Nalule & Helen Buxton & Alison Macintyre & Por Ir & Ponnary Pors & Channa Samol & Supheap Leang & Robert Dreibelbis, 2021. "Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia," IJERPH, MDPI, vol. 18(9), pages 1-16, April.
    3. Tzikas, Alexandros & Koulierakis, George, 2023. "A systematic review of nudges on hand hygiene against the spread of COVID-19," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 105(C).
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    5. Aaron Lawson & Marie Vaganay-Miller, 2019. "The Effectiveness of a Poster Intervention on Hand Hygiene Practice and Compliance When Using Public Restrooms in a University Setting," IJERPH, MDPI, vol. 16(24), pages 1-12, December.
    6. Hassan Vally & Celia McMichael & Claire Doherty & Xia Li & Gilbert Guevarra & Paola Tobias, 2019. "The Impact of a School-Based Water, Sanitation and Hygiene Intervention on Knowledge, Practices, and Diarrhoea Rates in the Philippines," IJERPH, MDPI, vol. 16(21), pages 1-14, October.
    7. Celia McMichael, 2019. "Water, Sanitation and Hygiene (WASH) in Schools in Low-Income Countries: A Review of Evidence of Impact," IJERPH, MDPI, vol. 16(3), pages 1-21, January.
    8. Astrid Hasund Thorseth & Jennifer Lamb & Constancia Vimbayi Mavodza & Mandikudza Tembo & Anesu Petra Mushangari & Eddington Zinyandu & Thomas Heath & Sian White, 2024. "Using Wash’Em to Design Handwashing Programmes for Crisis-Affected Populations in Zimbabwe: A Process Evaluation," IJERPH, MDPI, vol. 21(3), pages 1-25, February.
    9. Hattaya Chutiphimon & Apinya Thipsunate & Atigun Cherdchim & Bootsarakam Boonyaphak & Panat Vithayasirikul & Patiphan Choothong & Swit Vichathai & Pitchayanont Ngamchaliew & Polathep Vichitkunakorn, 2020. "Effectiveness of Innovation Media for Improving Physical Distancing Compliance during the COVID-19 Pandemic: A Quasi-Experiment in Thailand," IJERPH, MDPI, vol. 17(22), pages 1-10, November.

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