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

International Journal of Environmental Research and Public Health
Robert DreibelbisPavani K Ram

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.

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Citations

Oct 30, 2016·Health Psychology Review·Robert Aunger, Valerie Curtis
Apr 27, 2016·The American Journal of Tropical Medicine and Hygiene·Victoria TriniesMatthew C Freeman
Mar 27, 2019·Journal of Health Communication·James B TidwellMyriam Sidibe
Oct 28, 2019·International Journal of Environmental Research and Public Health·Hassan VallyPaola Tobias
Mar 12, 2020·The American Journal of Tropical Medicine and Hygiene·Sheillah SimiyuRobert Dreibelbis
Oct 13, 2018·Health Promotion International·Tabonga NaluondeDavid A Larsen
Dec 15, 2019·International Journal of Environmental Research and Public Health·Aaron Lawson, Marie Vaganay-Miller
Feb 26, 2020·International Journal of Environmental Research and Public Health·Chanelle MulopoMoses J Chimbari
May 18, 2017·International Quarterly of Community Health Education·Genevieve La ConRobert Quick
Jan 31, 2019·International Journal of Environmental Research and Public Health·Celia McMichael
Aug 9, 2016·Transactions of the Royal Society of Tropical Medicine and Hygiene·Matthew C FreemanThomas Clasen
Jun 26, 2020·Journal of Food Protection·Tressie Barrett, Yaohua Feng
Oct 8, 2020·The American Journal of Tropical Medicine and Hygiene·Shwapon Kumar BiswasChristine Marie George
Mar 30, 2020·International Journal of Hygiene and Environmental Health·Sian WhiteVal Curtis
Nov 21, 2020·International Journal of Environmental Research and Public Health·Hattaya ChutiphimonPolathep Vichitkunakorn
Feb 5, 2021·The Cochrane Database of Systematic Reviews·Regina I Ejemot-NwadiaroJulia A Critchley
May 1, 2021·International Journal of Environmental Research and Public Health·Yolisa NaluleRobert Dreibelbis

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