Childhood Illness and Risk Perception: Opportunity to Improve Handwashing

儿童疾病和风险认知：改善洗手的机会

• 批准号: 7666451
• 负责人: Pavani Kalluri Ram
• 金额: $ 7.93万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-10 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7666451
• 关键词: 1 year old; 15 year old; 2 year old; 4 year old; 5 year old; Acute; Address; Adoption; Bangladesh; Behavior; Caregivers; Cause of Death; Cessation of life; Child; Childhood; Country; Data; Decision Making; Diarrhea; Eating; Enrollment; Event; Food; Future; General Population; Hand; Handwashing; Health; Health Benefit; Health Promotion; Health behavior; Hour; Household; Human; Hygiene; Income; India; Individual; International; Intervention; Low income; Measures; Meta-Analysis; Methodology; Methods; Modeling; Morbidity - disease rate; Mothers; Motion; Pakistan; Perception; Prevalence; Prevention; Process; Publishing; Randomized Controlled Trials; Research; Resolution; Resources; Risk; Risk Reduction; Rural; Soaps; Structure; Time; behavior change; civil society; disorder risk; group intervention; high risk; improved; innovation; interest; intervention program; member; mortality; novel; programs; public health relevance; response; risk perception; sensor; transmission process

DESCRIPTION (provided by applicant): Diarrhea is the second leading cause of death among children less than five years old, causing about 2 million deaths annually. A meta-analysis of studies on handwashing with soap from low-, middle-, and high-income countries estimated a summary diarrhea risk reduction of 47%. Despite the proven health benefits of handwashing, data from numerous settings confirm that individuals do not practice good hand hygiene at the appropriate times. It is critical to identify which individual-level factors are conducive to adoption of improved hand hygiene in response to handwashing promotion. We hypothesize those mothers with acutely ill children will have heightened perceptions of disease risk and will, therefore, show greater receptivity to a message encouraging handwashing behavior as a disease risk reduction strategy. Therefore, we propose to examine whether mothers whose children are currently suffering from diarrhea are more likely to improve handwashing behavior following a handwashing promotion intervention than are mothers of children who are currently well. To achieve this specific aim, we will conduct a 2x2 factorial randomized controlled trial in New Delhi, India in which we will enroll 400 households of children < 2 years old. Of these, 200 will be households of children with acute diarrhea and 200 will be households of children who are well. From each group, we will assign 100 households to intensive handwashing promotion and 100 households to continue their usual hand hygiene practices (control). We will measure handwashing behavior during the acute diarrhea episode and again several weeks following resolution of the diarrhea using an innovative method consisting of motion sensors embedded in soap, which provide information on the number of times soap is used in the time period of interest without having a human observer present. The soap with motion sensor provides an objective measure of soap use and overcomes the reactivity that has been shown to occur in response to the presence of a human observer of handwashing behavior. In addition to this methodological innovation, the proposed study is conceptually novel. There is no information from published randomized controlled trials about whether risk perception is a motivating factor for the adoption of improved handwashing behavior. Such information will substantively inform future research on the decision-making processes involved in good hand hygiene and guide handwashing promotion programs in resource-poor countries where handwashing with soap at scale promises to reduce substantially the morbidity and mortality from diarrhea. PUBLIC HEALTH RELEVANCE: When mothers and other household members improve handwashing with soap, children suffer substantially fewer episodes of diarrhea, which is the second leading cause of death of young children worldwide. This innovative project aims to assess whether mothers of ill children are more likely to improve hand washing behavior compared to mothers of well children. Results from this study will be useful for international and civil society organizations worldwide that are trying to reduce the two million deaths from diarrhea occurring each year.

描述(申请人提供)：腹泻是五岁以下儿童的第二大死亡原因，每年造成约200万人死亡。一项对来自低收入、中等收入和高收入国家的肥皂洗手研究的荟萃分析估计，总结起来腹泻风险降低了47%。尽管洗手的好处已得到证实，但来自许多环境的数据证实，个人在适当的时间没有养成良好的手部卫生习惯。关键是要确定哪些个人层面的因素有助于采取改进的手部卫生，以应对洗手推广。我们假设，那些有急病孩子的母亲会对疾病风险有更高的感知，因此会更容易接受鼓励洗手行为作为降低疾病风险的策略的信息。因此，我们建议研究孩子目前患有腹泻的母亲是否比目前身体状况良好的孩子的母亲在洗手促进干预后更有可能改善洗手行为。为了实现这一具体目标，我们将在印度新德里进行一项2x2因子随机对照试验，在该试验中，我们将招募400个2岁儿童家庭。其中，200个是急性腹泻儿童家庭，200个是健康儿童家庭。在每组中，我们会指定100个住户进行密集洗手推广，以及100个住户继续他们惯常的手部卫生习惯(控制)。我们将使用一种创新的方法测量急性腹泻发作期间和腹泻解决后几周的洗手行为，该方法由嵌入肥皂的运动传感器组成，该方法提供有关在感兴趣的时间段内使用肥皂的次数的信息，而没有人类观察员在场。带有运动传感器的肥皂提供了肥皂使用的客观测量，并克服了已被证明响应人类洗手行为观察者的存在而发生的反应性。除了这一方法创新之外，拟议的研究在概念上也是新颖的。从已发表的随机对照试验中，还没有关于风险感知是否是采用改进洗手行为的激励因素的信息。这些信息将为未来关于良好手部卫生的决策过程的研究提供实质性信息，并指导资源贫乏国家的洗手推广计划，在这些国家，大规模使用肥皂洗手有望大幅降低腹泻的发病率和死亡率。 公共卫生相关性：当母亲和其他家庭成员改进用肥皂洗手时，儿童腹泻的发作大大减少，腹泻是全球幼儿死亡的第二大原因。这一创新项目旨在评估与健康儿童的母亲相比，患病儿童的母亲是否更有可能改善洗手行为。这项研究的结果将对国际和世界各地的民间社会组织有用，这些组织正在努力减少每年发生的200万腹泻死亡人数。