ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Aiello AE, Coulborn RM, Perez V, Larson EL, 2008. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health 98: 1372–1381.
-
2.
Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 3: 275–281.
-
3.
Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA, 2008. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev CD004265.
-
4.
Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, Hoekstra RM, 2005. Effect of handwashing on child health: a randomised controlled trial. Lancet 366: 225–233.
-
5.
Curtis V, Kanki B, Cousens S, Diallo I, Kpozehouen A, Sangare M, Nikiema M, 2001. Evidence of behavior change following a hygiene promotion programme in Burkina Faso. Bull World Health Organ 79: 518–527.
-
6.
Manun’Ebo M, Cousens S, Haggerty P, Kalengaie M, Ashworth A, Kirkwood B, 1997. Measuring hygiene practices: a comparison of questionnaires with direct observations in rural Zaire. Trop Med Int Health 2: 1015–1021.
-
7.
Stanton BF, Clemens JD, Aziz KM, Rahman M, 1987. Twenty-four-hour recall, knowledge-attitude-practice questionnaires, and direct observations of sanitary practices: a comparative study. Bull World Health Organ 65: 217–222.
-
8.
Biran A, Rabie T, Schmidt W, Juvekar S, Hirve S, Curtis V, 2008. Comparing the performance of indicators of hand-washing practices in rural Indian households. Trop Med Int Health 13: 278–285.
-
9.
Bentley M, Boot M, Gittelsohn J, Stallings R, 1994. The Use of Structured Observations in the Study of Health Behaviour. The Hague, The Netherlands: IRC International Water and Sanitation Centre.
-
10.
Cousens S, Kanki B, Toure S, Diallo I, Curtis V, 1996. Reactivity and repeatability of hygiene behaviour: structured observations from Burkina Faso. Soc Sci Med 43: 1299–1308.
-
11.
Curtis V, Cousens S, Mertens T, Trarore E, Kanki B, Diallo I, 1993. Structured observations of hygiene behaviors in Burkina Faso: validity, variability, and utility. Bull World Health Organ 71: 23–32.
-
12.
Last JM, 2001. A Dictionary of Epidemiology. New York: Oxford University Press.
-
13.
Russell A, Russell G, Midwinter D, 1992. Observer influences on mothers and fathers: self-reported influence during a home observation. Merrill-Palmer Q 38: 263–283.
-
14.
Pedersen DM, Keithly S, Brady K, 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169–170.
-
15.
Drankiewicz D, Dundes L, 2003. Handwashing among female college students. Am J Infect Control 31: 67–71.
-
16.
Munger K, Harris SJ, 1989. Effects of an observer on handwashing in a public restroom. Percept Mot Skills 69: 733–734.
-
17.
Zeitlyn S, Islam F, 1991. The use of soap and water in two Bangladeshi communities: implications for the transmission of diarrhea. Rev Infect Dis 13 (Suppl 4): S259–S264.
-
18.
Leary MR, 1996. Self-Presentation: Impression Management and Interpersonal Behavior. Boulder, CO: Westview Press.
-
19.
Tice DM, 1999. The looking glass self is also a magnifiying glass. Baumeister RF, ed. The Self in Social Psychology. Ann Arbor, MI: Taylor & Francis, 195–218.
-
20.
Curtis VA, Danquah LO, Aunger RV, 2009. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health Educ Res 24: 655–673.
-
21.
Gubbels JS, Kremers SP, Stafleu A, Dagnelie PC, de Vries NK, Thijs C, 2010. Child-care environment and dietary intake of 2- and 3-year-old children. J Hum Nutr Diet 23: 97–101.
-
22.
Gardner F, 2000. Methodological issues in the direct observation of parent-child interaction: do observational findings reflect the natural behavior of participants? Clin Child Fam Psychol Rev 3: 185–198.
-
23.
Bentley ME, 1988. The household management of childhood diarrhea in rural north India. Soc Sci Med 27: 75–85.
-
24.
Halvorson SJ, 2004. Women’s management of the household health environment: responding to childhood diarrhea in the Northern Areas, Pakistan. Health Place 10: 43–58.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 637 | 477 | 27 |
| Full Text Views | 623 | 23 | 2 |
| PDF Downloads | 318 | 31 | 4 |
Is Structured Observation a Valid Technique to Measure Handwashing Behavior? Use of Acceleration Sensors Embedded in Soap to Assess Reactivity to Structured Observation
Pavani K. Ram
Pavani K. Ram
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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Amal K. Halder
Amal K. Halder
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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Stewart P. Granger
Stewart P. Granger
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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Therese Jones
Therese Jones
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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Peter Hall
Peter Hall
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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David Hitchcock
David Hitchcock
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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Richard Wright
Richard Wright
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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Benjamin Nygren
Benjamin Nygren
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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M. Sirajul Islam
M. Sirajul Islam
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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John W. Molyneaux
John W. Molyneaux
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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Stephen P. Luby
Stephen P. Luby
University at Buffalo, Buffalo, New York; ICDDR,B: International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh; Unilever R&D, Bebington, Wirral, United Kingdom; 4-Front Research, Capenhurst, Cheshire, United Kingdom; Emory University, Atlanta, Georgia; Water and Sanitation Program, The World Bank, Washington, DC
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Structured observation is often used to evaluate handwashing behavior. We assessed reactivity to structured observation in rural Bangladesh by distributing soap containing acceleration sensors and performing structured observation 4 days later. Sensors recorded the number of times soap was moved. In 45 participating households, the median number of sensor soap movements during the 5-hour time block on pre-observation days was 3.7 (range 0.3–10.6). During the structured observation, the median number of sensor soap movements was 5.0 (range 0–18.0), a 35% increase, P = 0.0004. Compared with the same 5-hour time block on pre-observation days, the number of sensor soap movements increased during structured observation by ≥ 20% in 62% of households, and by ≥ 100% in 22% of households. The increase in sensor soap movements during structured observation, compared with pre-observation days, indicates substantial reactivity to the presence of the observer. These findings call into question the validity of structured observation for measurement of handwashing behavior.
Author Notes
Financial support: This study was commissioned by the Water and Sanitation Program with funding from the Bill and Melinda Gates Foundation to help the Water and Sanitation Program learn how to scale-up hand washing behavior change interventions. ICDDR,B acknowledges with gratitude the commitment of these institutions to the Centre’s research efforts.
Authors’ addresses: Pavani K. Ram, University at Buffalo, Buffalo, NY, E-mail: pkram@buffalo.edu. Amal K. Halder, M. Sirajul Islam, and Stephen P. Luby, ICDDR,B, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, E-mails: Amal_Halder@wvi.org, sislam@icddrb.org, and sluby@icddrb.org. Stewart P. Granger, Therese Jones, David Hitchcock, and Richard Wright, Unilever R&D, Port Sunlight, Bebington, Wirral, CH63 3JW, UK, E-mails: stewart.granger@southcentral.nhs.uk, therese.jones@unilever.com, davidh182@aim.com, and Richard.l.wright@unilever.com. Peter Hall, Unit 6, Capenhurst Technology Park, Capenhurst, Cheshire, CH16EH, United Kingdom, E-mail: Peter.Hall@4FrontResearch.co.uk. Benjamin Nygren, Rollins School of Public Health, Emory University, Atlanta, GA, E-mail: ghz8@cdc.gov. John W. Molyneaux, Water and Sanitation Program, The World Bank Group, MSN MC 6-622, Washington, DC, E-mail: jack_molyneaux@usa.net.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Aiello AE, Coulborn RM, Perez V, Larson EL, 2008. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health 98: 1372–1381.
-
2.
Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 3: 275–281.
-
3.
Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA, 2008. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev CD004265.
-
4.
Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, Hoekstra RM, 2005. Effect of handwashing on child health: a randomised controlled trial. Lancet 366: 225–233.
-
5.
Curtis V, Kanki B, Cousens S, Diallo I, Kpozehouen A, Sangare M, Nikiema M, 2001. Evidence of behavior change following a hygiene promotion programme in Burkina Faso. Bull World Health Organ 79: 518–527.
-
6.
Manun’Ebo M, Cousens S, Haggerty P, Kalengaie M, Ashworth A, Kirkwood B, 1997. Measuring hygiene practices: a comparison of questionnaires with direct observations in rural Zaire. Trop Med Int Health 2: 1015–1021.
-
7.
Stanton BF, Clemens JD, Aziz KM, Rahman M, 1987. Twenty-four-hour recall, knowledge-attitude-practice questionnaires, and direct observations of sanitary practices: a comparative study. Bull World Health Organ 65: 217–222.
-
8.
Biran A, Rabie T, Schmidt W, Juvekar S, Hirve S, Curtis V, 2008. Comparing the performance of indicators of hand-washing practices in rural Indian households. Trop Med Int Health 13: 278–285.
-
9.
Bentley M, Boot M, Gittelsohn J, Stallings R, 1994. The Use of Structured Observations in the Study of Health Behaviour. The Hague, The Netherlands: IRC International Water and Sanitation Centre.
-
10.
Cousens S, Kanki B, Toure S, Diallo I, Curtis V, 1996. Reactivity and repeatability of hygiene behaviour: structured observations from Burkina Faso. Soc Sci Med 43: 1299–1308.
-
11.
Curtis V, Cousens S, Mertens T, Trarore E, Kanki B, Diallo I, 1993. Structured observations of hygiene behaviors in Burkina Faso: validity, variability, and utility. Bull World Health Organ 71: 23–32.
-
12.
Last JM, 2001. A Dictionary of Epidemiology. New York: Oxford University Press.
-
13.
Russell A, Russell G, Midwinter D, 1992. Observer influences on mothers and fathers: self-reported influence during a home observation. Merrill-Palmer Q 38: 263–283.
-
14.
Pedersen DM, Keithly S, Brady K, 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169–170.
-
15.
Drankiewicz D, Dundes L, 2003. Handwashing among female college students. Am J Infect Control 31: 67–71.
-
16.
Munger K, Harris SJ, 1989. Effects of an observer on handwashing in a public restroom. Percept Mot Skills 69: 733–734.
-
17.
Zeitlyn S, Islam F, 1991. The use of soap and water in two Bangladeshi communities: implications for the transmission of diarrhea. Rev Infect Dis 13 (Suppl 4): S259–S264.
-
18.
Leary MR, 1996. Self-Presentation: Impression Management and Interpersonal Behavior. Boulder, CO: Westview Press.
-
19.
Tice DM, 1999. The looking glass self is also a magnifiying glass. Baumeister RF, ed. The Self in Social Psychology. Ann Arbor, MI: Taylor & Francis, 195–218.
-
20.
Curtis VA, Danquah LO, Aunger RV, 2009. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health Educ Res 24: 655–673.
-
21.
Gubbels JS, Kremers SP, Stafleu A, Dagnelie PC, de Vries NK, Thijs C, 2010. Child-care environment and dietary intake of 2- and 3-year-old children. J Hum Nutr Diet 23: 97–101.
-
22.
Gardner F, 2000. Methodological issues in the direct observation of parent-child interaction: do observational findings reflect the natural behavior of participants? Clin Child Fam Psychol Rev 3: 185–198.
-
23.
Bentley ME, 1988. The household management of childhood diarrhea in rural north India. Soc Sci Med 27: 75–85.
-
24.
Halvorson SJ, 2004. Women’s management of the household health environment: responding to childhood diarrhea in the Northern Areas, Pakistan. Health Place 10: 43–58.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 637 | 477 | 27 |
| Full Text Views | 623 | 23 | 2 |
| PDF Downloads | 318 | 31 | 4 |