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）：腹泻是五岁以下儿童的第二大死因，每年导致约 200 万人死亡。对低收入、中等收入和高收入国家的肥皂洗手研究进行的荟萃分析估计，腹泻风险总体降低 47%。尽管洗手对健康有益，但来自许多环境的数据证实，人们没有在适当的时间保持良好的手部卫生。确定哪些个人层面的因素有利于改善手部卫生以响应洗手宣传，这一点至关重要。我们假设那些患有重病儿童的母亲对疾病风险的认知会更高，因此更容易接受鼓励洗手行为作为降低疾病风险策略的信息。因此，我们建议研究孩子目前患有腹泻的母亲是否比孩子目前健康的母亲在接受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 2x2 析因随机对照试验，招募 400 个 2 岁以下儿童家庭。其中，200户为急性腹泻儿童家庭，200户为健康儿童家庭。我们将在每组中分配 100 个家庭进行强化洗手宣传，并分配 100 个家庭继续日常的手部卫生习惯（对照）。我们将使用由嵌入肥皂中的运动传感器组成的创新方法测量急性腹泻发作期间以及腹泻缓解后几周的洗手行为，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，而无需使用肥皂。一名人类观察者在场。带有运动传感器的肥皂提供了肥皂使用的客观测量，并克服了因洗手行为的人类观察者的存在而发生的反应。除了方法上的创新之外，拟议的研究在概念上也很新颖。已发表的随机对照试验中没有关于风险认知是否是采取改进洗手行为的激励因素的信息。这些信息将为未来有关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，儿童患腹泻的次数就会大大减少，而腹泻是全世界幼儿死亡的第二大原因。这个创新项目旨在评估患病儿童的母亲是否比健康儿童的母亲更有可能改善洗手行为。这项研究的结果将对全世界努力减少每年 200 万人因腹泻死亡的国际组织和民间社会组织有用。