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（由申请人提供）：腹泻是不到五岁的儿童的第二大死亡原因，每年造成约200万人死亡。低，中和高收入国家的肥皂进行洗手的研究的荟萃分析估计，腹泻风险降低了47％。尽管洗手的健康有效，但来自众多环境的数据证实，在适当的时候，个人不会练习良好的手工卫生。至关重要的是要确定哪些个人级别因素有助于采用改进的手洗手升级。我们假设那些患有急性病的母亲对疾病风险的看法会更高，因此，对一条促进洗手行为作为降低疾病风险的策略的信息会显示出更大的接受能力。因此，我们建议检查目前患有腹泻的母亲是否比目前良好的孩子的母亲更有可能改善洗手行为。为了实现这一特定目标，我们将在印度新德里进行2x2阶乘随机对照试验，在该试验中，我们将在其中注册400户2岁以下的儿童家庭。其中，有200个将是患有急性腹泻儿童的家庭，有200个将是良好的儿童家庭。从每个小组中，我们将分配100个家庭进行密集的洗手促销和100个家庭，以继续其通常的手动卫生实践（对照）。我们将使用嵌入肥皂中的运动传感器组成的创新方法来测量急性腹泻发作期间的洗手行为，并在腹泻分辨率后几周，在不存在人类观察者的情况下使用肥皂的次数。带有运动传感器的肥皂提供了对肥皂使用的客观度量，并克服了已证明是响应人类洗手行为观察者而发生的反应性。除了这项方法上的创新外，拟议的研究在概念上是新颖的。没有发表的随机对照试验中有关风险感知是否是采用改善洗手行为的动机因素的信息。这些信息将实质上为未来的研究提供了有关良好手卫生涉及的决策过程的未来研究，并指导资源贫乏的国家的洗手促销计划，在这些国家中，使用SOAP按大规模进行洗手有望减少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用肥皂改善洗手时，儿童的腹泻发作少得多，这是全球幼儿死亡的第二大死亡原因。这个创新的项目旨在评估患病儿童的母亲与健康良好的母亲相比是否更有可能改善洗手行为。这项研究的结果对于全球国际和民间社会组织将很有用，这些组织试图减少每年腹泻的200万人死亡。