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| Name | Class |
|---|---|
| United States Agency for International Development (USAID) | FED |
| UNICEF | OTHER |
| Philippines Department of Education | UNKNOWN |
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This study evaluates the impact of school-based behavioral "nudges" installed in toilets and handwashing facilities on handwashing behavior among students in the Philippines. Nudges include: visible signage crafted to trigger behavioral motivators for handwashing; colorful pathway overlaid with footprints leading from the toilet to the handwashing station; sticker of a pair of eyes placed above the handwashing station; soap dish with an arrow beside it on the sink or counter to remind children to wash their hands with soap. The study's main hypothesis is that behavioral nudges will increase the percentage of students who wash their hands with water and soap after toilet use by 7 percentage points or more among schools where nudges were installed compared to control schools without nudges. The study is taking place in public primary schools in Zamboanga Del Norte, Philippines between October 2019 and May 2020.
The impact of the behavioral nudge intervention will be evaluated using a cluster randomized controlled trial (RCT). The investigators will randomly select 132 Department of Education (DepEd) schools across Zamboanga Del Norte province to comprise the study sample. 66 schools will be assigned to the treatment group, and 66 schools to the control group. Treatment schools will receive the behavioral nudge intervention, while control group will not. Both treatment and control schools will receive DepEd's national WASH in Schools (WinS) policy. WinS promotes "correct hygiene and sanitation practices among school children and a clean environment in and around schools" and includes initiatives related to infrastructure, knowledge, and behavior change, but does not include other programs with an explicit focus on handwashing promotion.
Four months after installing nudges, enumerators will conduct structured observations in study schools, observing whether pupils wash their hands with soap, wash without soap, or do not wash, after they have used classroom toilets. This will be used to estimate the causal impact of the nudges intervention on rates of independent handwashing with water and soap after toilet use.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Behavioral nudges | Experimental | Schools randomized to this arm will receive the behavioral nudges intervention and the Philippines Department of Education national WASH in Schools (WinS) policy. |
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| Control group | Active Comparator | Schools in the control group will not receive handwashing nudges but will receive DepEd's national WASH in Schools (WinS) policy. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Behavioral nudges | Behavioral | Behavioral nudges include the following:
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| Measure | Description | Time Frame |
|---|---|---|
| The probability that a student was observed to wash their hands with soap and water after toilet use | Unit of analysis: student | 4 months |
| The probability that a student was observed to wash their hands with water after toilet use | Unit of analysis: student | 4 months |
| Measure | Description | Time Frame |
|---|---|---|
| The number of functioning handwashing facilities at the school | Unit of analysis: school | 4 months |
| The number of functioning handwashing facilities with soap and water at the school | Unit of analysis: school |
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Inclusion criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Haijing Huang, PHD | IDinsight | Principal Investigator |
| Meghan Battle, MPH | IDinsight | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| IDinsight | Manila | Philippines |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 20, 2020 | Mar 25, 2020 | SAP_000.pdf |
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| ID | Term |
|---|---|
| D015438 | Health Behavior |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| National WASH policy | Behavioral | The Philippines' Department of Education National WASH in Schools (WinS) policy promotes "correct hygiene and sanitation practices among school children and a clean environment in and around schools" and includes initiatives related to infrastructure, knowledge, and behavior change, but does not include other programs with an explicit focus on handwashing promotion. |
|
| 4 months |
| The probability that a toilet facility has a nearby functioning handwashing facility | Unit of analysis: toilet facility. A "nearby" handwashing facility means inside the classroom for toilet facilities located inside classrooms and within 10 meters of toilet facilities located outside classrooms. | 4 months |
| The probability that a toilet facility has a nearby functioning handwashing facility with water and soap | Unit of analysis: toilet facility. A "nearby" handwashing facility means inside the classroom for toilet facilities located inside classrooms and within 10 meters of toilet facilities located outside classrooms. | 4 months |