The Effect of Behaviour Change Interventions on Use of Public Handwashing Stations in Bangladesh
Hand Washing, Handwashing, Covid19
About this trial
This is an interventional prevention trial for Hand Washing focused on measuring Covid19, Handwashing, Hand Washing, COVID-19 Virus Prevention, COVID-19 Virus Infection, Behavioural Science, Nudges, Incentives, Social proof, Randomised controlled trial, Public handwashing stations
Eligibility Criteria
Note: the sample consists of villages that have received at least one public handwashing station from BRAC, rather than human participants, though the investigators are measuring the use of the stations by human participants.
The initial sample of villages has been chosen from a set of 1,899 villages identified by BRAC as being eligible for this project based on criteria related to COVID-19 cases, existing BRAC programs and village characteristics. The villages are spread across 3 of Bangladesh's 8 divisions, 8 of its 64 districts, and 20 of its 492 subdistricts ('upazilas'). While most of the 'villages' are located in rural parts of Bangladesh, roughly 15 percent are better characterised as wards or towns within urban and peri-urban municipalities.
Inclusion Criteria:
Villages identified by BRAC as being eligible for this based on:
- COVID-19 cases
- Existing BRAC programs
- village characteristics
- viable location for a handwashing station (space/water source)
- local community members willing to 'sponsor' and maintain handwashing station
Exclusion Criteria:
- Lack of viable location for a handwashing station.
- Villages that received handwashing stations as part of the pilot phase
- Villages randomly selected in a related impact evaluation measuring the impact of the stations themselves
Sites / Locations
- BRAC
- BRAC Khulna
- BRAC Mymensingh
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Experimental
Experimental
T1: Business as Usual (BAU)
T2: BAU + Low Intensity Nudges
T3: BAU + High Intensity Activities
Handwashing station plus standard BRAC programming, i.e. in-person community WASH (water, sanitation and hygiene) demonstrations conducted in households/communal areas, and sticker signs/posters placed on walls in the 'catchment area' of the handwashing station, alerting people to the stations and roughly pointing the way.
T1 plus a bundle of 'low-intensity' passive interventions, including: Large mirrors installed above handwashing station sinks to attract more people to the station 7 to 8 large hand-shaped signposts pointing to the station and leading up to the station, placed on the ground in the vicinity of the station, starting from the nearest 'busy spot'
T1 plus an additional bundle of 'high-intensity' active interventions delivered for three weeks, including: Free soap and free facemasks provided to handwashing station users in regular giveaways at key times, along with encouragement to return to the station and to spread the word. A 'community message board' along with encouragement to make a mark on a "scoreboard" at the top of the board before/after use of the station to increase commitment and as an additional social cue. This will also visually show cumulative number of uses as a persistent cue of the social norm. General encouragement to use the stations, provided by the intervention delivery team while they are at the station. Intervention team members are equipped with a loudhailer to assist this. In addition, village handwashing station committees will be encouraged to try out their own ideas for encouraging more people to use the stations.