Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos
Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos
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DOI：
10.3390/ijerph15040570
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发表时间：
2018-04-01
影响因子：
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通讯作者：
Freeman, Matthew C.
中科院分区：
文献类型：
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作者：
Chard, Anna N.;Freeman, Matthew C.
学校水、环境卫生和个人卫生（WASH）干预措施对学生缺勤和健康影响的证据好坏参半。很少有WinS评估严格报告产出和结果的措施，允许进行干预措施之间的有效性比较，或了解为什么程序成功。老挝小学水、环境卫生和卫生促进健康和教育研究（WASH HELPS）是一项随机对照试验，旨在衡量联合国儿童基金会老挝WinS项目对儿童健康和教育的影响。我们还测量了干预产出和结果的可持续性，并分析了团体卫生活动对行为改变和习惯形成的有效性。在这里，我们介绍了这项研究的设计和中间结果。我们发现WinS项目改善了干预学校的WASH环境; 87.8%的学校接受了每项设计的干预。学校一级对产出的坚持程度较低;平均而言，学校符合61.4%的坚持相关标准。WinS项目使学生在学校的讲卫生行为发生了积极变化，特别是增加了厕所的使用和每天集体洗手。日常团体卫生活动是改善学校WASH行为的有效策略，但在关键时刻，需要同时促进有效和持续的个人洗手实践的补充策略。
Evidence of the impact of water, sanitation, and hygiene (WASH) in schools (WinS) interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS) study was a randomized controlled trial designed to measure the impact of the United Nations Children's Fund (UNICEF) Laos WinS project on child health and education. We also measured the sustainability of intervention outputs and outcomes, and analyzed the effectiveness of group hygiene activities on behavior change and habit formation. Here, we present the design and intermediate results from this study. We found the WinS project improved the WASH environment in intervention schools; 87.8% of schools received the intervention per design. School-level adherence to outputs was lower; on average, schools met 61.4% of adherence-related criteria. The WinS project produced positive changes in pupils' school WASH behaviors, specifically increasing toilet use and daily group handwashing. Daily group hygiene activities are effective strategies to improve school WASH behaviors, but a complementary strategy needs to be concurrently promoted for effective and sustained individual handwashing practice at critical times.