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| Name | Class |
|---|---|
| Emory Ethiopia | UNKNOWN |
| Amhara Regional Health Bureau | UNKNOWN |
| Ministry of Health, Ethiopia | OTHER_GOV |
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This study is a two-year evaluation investigating the impacts of an enhanced, demand-side sanitation and hygiene intervention on sustainable adoption of improved water, sanitation, and hygiene (WASH) practices and mental well-being.
This study utilizes a cluster randomized, controlled trial design to examine the impacts of an enhanced, demand-side sanitation and hygiene intervention on behavior change and health in Amhara, Ethiopia. The study will test hypotheses set out in the investigation team's theory of change through the measurement and evaluation of process indicators, intermediate and shorter-term behavioral outcomes, and longer-term behavioral and health impacts, including mental well-being.
The study aims to: (1) identify ways in which WASH-related behavior change components preventive for neglected tropical diseases (NTDs) can be mainstreamed into the government-led Health Extension Program; (2) document the effectiveness of an enhanced demand-side sanitation and hygiene intervention; (3) investigate whether changes in personal hygiene, sanitation, and water behaviors are sustained; (4) document the cost-effectiveness of integrated WASH-related NTD-preventive behavior change promotion; and (5) assess whether collective efficacy and water security modify intervention effectiveness.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Enhanced demand-side sanitation, hygiene | Experimental | The intervention group will receive a package of enhanced, demand-side sanitation and hygiene interventions that are informed by formative research and facilitated by local government and Emory Ethiopia partners. |
|
| Standard of care | Active Comparator | The comparison group will receive the current standard of care, including potential implementation of government-led policies and programs. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced demand-side sanitation, hygiene | Behavioral | The enhanced, demand-side sanitation and hygiene intervention package will be informed by findings from formative research, and will consist of interventions designed to enhance sanitation and hygiene messaging to better facilitate behavior change, and intensify implementation of related community-based interventions via engagement of various delivery modalities. |
| Measure | Description | Time Frame |
|---|---|---|
| Sustainability of WASH-related behaviours, including NTD-preventive WASH behavior measures | Sustainability of WASH-related behaviors, as measured through changes in the proportion of individuals and households practicing targeted improved NTD-preventive WASH behaviors. | Endline (Up to two years) |
| Mental well-being measures | Mental well-being, as measured through the changes in mental well-being scale scores | Up to two years |
| Measure | Description | Time Frame |
|---|---|---|
| Shorter-term behavioral outcome measures | Proportion of households with improved or shared, but otherwise improved household latrine and washing facilities that are functional and available for use; proportion of households using functional latrines and washing facilities; proportion of households with all members exclusively using a latrine for defecation purposes; proportion of households disposing of child feces in an improved latrine; proportion of households with all children in the household with a clean face and hands. |
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Inclusion criteria:
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Matthew Freeman, PhD | Emory University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Amhara | Amhara National Regional State | Ethiopia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36962125 | Derived | Freeman MC, Delea MG, Snyder JS, Garn JV, Belew M, Caruso BA, Clasen TF, Sclar GD, Tesfaye Y, Woreta M, Zewudie K, Gobezayehu AG. The impact of a demand-side sanitation and hygiene promotion intervention on sustained behavior change and health in Amhara, Ethiopia: A cluster-randomized trial. PLOS Glob Public Health. 2022 Jan 7;2(1):e0000056. doi: 10.1371/journal.pgph.0000056. eCollection 2022. | |
| 31226957 |
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|
| Standard of care | Behavioral | The comparison group will receive the current standard of care, including potential implementation of government-led policies and programs. |
|
| Up to two years |
| Intermediate behaviour change antecedent measures | Proportion of households with improved knowledge regarding the implications of improved WASH practices; proportion of households that indicate positive attitudes, perceptions toward improved sanitation and good hygiene practices; change in normative beliefs and behaviors related to open defecation, exclusive latrine use for defecation, and personal hygiene practices. | Up to two years |
| Water insecurity measures | Water insecurity, as measured through changes in water insecurity scale scores | Up to two years |
| Sanitation insecurity measures | Sanitation insecurity, as measured through changes in sanitation insecurity scale scores | Up to two years |
| Collective efficacy measures | Collective efficacy, as measured through changes in collective efficacy scale scores | Up to two years |
| Derived |
| Delea MG, Snyder JS, Belew M, Caruso BA, Garn JV, Sclar GD, Woreta M, Zewudie K, Gebremariam A, Freeman MC. Design of a parallel cluster-randomized trial assessing the impact of a demand-side sanitation and hygiene intervention on sustained behavior change and mental well-being in rural and peri-urban Amhara, Ethiopia: Andilaye study protocol. BMC Public Health. 2019 Jun 21;19(1):801. doi: 10.1186/s12889-019-7040-6. |
| ID | Term |
|---|---|
| D000092862 | Psychological Well-Being |
| D058069 | Neglected Diseases |
| ID | Term |
|---|---|
| D010549 | Personal Satisfaction |
| D001519 | Behavior |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D006920 | Hygiene |
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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