- Introduction
- Study Site and Experimental Methods
- Results
- Household characteristics.
- Changes in knowledge.
- Changes in hand hygiene behavior.
- Changes in water management practices.
- Multivariate modeling of reported changes in water management and hand hygiene practices.
- Changes in bacterial contamination of stored water and mothers' hands.
- Multivariate modeling of changes in water and hand contamination.
- Test cohort participants' reaction to intervention.
- Discussion
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
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1.
Cutler D, Miller G, 2005. The role of public health improvements in health advance: the twentieth-century United States. Demography 42: 1–22.
-
2.
Esrey SA, Feachem RG, Hughes JM, 1985. Interventions for the control of diarrhoeal diseases among young children: improving water supplies and excreta disposal facilities. Bull World Health Organ 63: 757–772.
-
3.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM, 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 42–52.
-
4.
Joint Monitoring Programme, 2008. Progress on Drinking Water and Sanitation: Special Focus on Sanitation. Geneva, Switzerland: World Health Organization.
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5.
Wright J, Gundry S, Conroy J, 2004. Household drinking water in developing countries: a systematic review of microbiological contamination between source and point-of-use. Trop Med Int Health 9: 106–117.
-
6.
Arnold BF, Colford JM Jr, 2007. Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis. Am J Trop Med Hyg 76: 354–364.
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7.
Clasen T, Roberts I, Rabie T, Schmidt W, Cairncross S, 2006. Interventions to improve water quality for preventing diarrhoea. Cochrane Database Syst Rev 3: CD004794.
-
8.
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.
-
9.
Luby SP, Agboatwalla M, Raza A, Sobel J, Mintz ED, Baier K, Hoekstra RM, Rahbar MH, Hassan R, Qureshi SM, 2001. Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan. Epidemiol Infect 127: 237–244.
-
10.
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.
-
11.
Chiller TM, Mendoza CE, Lopez MB, Alvarez M, Hoekstra RM, Keswick BH, Luby SP, 2006. Reducing diarrhoea in Guatemalan children: randomized controlled trial of flocculant-disinfectant for drinking-water. Bull World Health Organ 84: 28–35.
-
12.
Luby SP, Agboatwalla M, Bowen A, Kenah E, Sharker Y, Hoekstra RM, 2008. Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg 78: 382–387.
-
13.
Luby SP, Agboatwalla M, Bowen A, Kenah E, Sharker Y, Hoekstra RM, 2009. Difficulties in maintaining improved handwashing behavior, Karachi, Pakistan. Am J Trop Med Hyg 81: 140–145.
-
14.
Bandura A, 2005. The primacy of self-regulation in health promotion. Appl Psychol 54: 245–254.
-
15.
Maes S, Karoly P, 2005. Self-regulation assessment and intervention in physical health and illness: a review. Appl Psychol 54: 267–299.
-
16.
Abrams DB, Mills S, Bulger D, 1999. Challenges and future directions for tailored communication research. Ann Behav Med 21: 299–306.
-
17.
Strecher V, Wang C, Derry H, Wildenhaus K, Johnson C, 2002. Tailored interventions for multiple risk behaviors. Health Educ Res 17: 619–626.
-
18.
Smeets T, Kremers SP, de Vries H, Brug J, 2007. Effects of tailored feedback on multiple health behaviors. Ann Behav Med 33: 117–123.
-
19.
Iyer P, Davis J, Yavuz E, Evans B, 2005. Rural Water Supply, Sanitation, and Hygiene: A Review of 25 Years of World Bank Lending (1978–2003). Washington, DC: World Bank.
-
20.
Jalan J, Somanathan E, 2008. The importance of being informed: experimental evidence on demand for environmental quality. J Dev Econ 87: 14–28.
-
21.
City Mayors, 2009. The World's Fastest Growing Cities and Urban Areas from 2006 to 2020. Available at: http://www.citymayors.com/statistics/urban_growth1.html. Accessed May 17, 2009.
-
22.
Pickering AJ, Davis J, Walters SP, Horak HM, Keymer DP, Mushi D, Strickfaden R, Chynoweth JS, Liu J, Blum A, Rogers K, Boehm AB, 2010. Hands, water, and health: fecal contamination in Tanzanian communities with improved, non-networked water supplies. Environ Sci Technol 44: 3267–3272.
-
23.
United States Environmental Protection Agency, 2002. Method 1604: Total Coliforms and Escherichia coli in Water by Membrane Filtration Using a Simultaneous Detection Technique (MI Medium). United States Environmental Protection Agency.
-
24.
World Health Organization, 1997. Water Quality Guidelines for Rural Drinking Water Supplies. Surveillance and Control of Community Supplies, 2nd ed. Geneva, Switzerland: World Health Organization Press.
-
25.
Stanton B, Clemens J, 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.
-
26.
Curtis V, Cousens S, Mertens T, Traoré E, Kanki B, Diallo I, 1993. Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility. Bull World Health Organ 71: 23–32.
-
27.
Davis C, 1976. The effect of regression to the mean in epidemiologic and clinical studies. Am J Epidemiol 104: 493–498.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 711 | 581 | 56 |
| Full Text Views | 711 | 13 | 1 |
| PDF Downloads | 260 | 11 | 1 |
The Effects of Informational Interventions on Household Water Management, Hygiene Behaviors, Stored Drinking Water Quality, and Hand Contamination in Peri-Urban Tanzania
Jennifer Davis
Jennifer Davis
Department of Civil and Environmental Engineering, Stanford University, Stanford, California; Woods Institute for the Environment, Stanford University, Stanford, California; Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, California; Human Biology Program, Stanford University, Stanford, California; Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Amy J. Pickering
Amy J. Pickering
Department of Civil and Environmental Engineering, Stanford University, Stanford, California; Woods Institute for the Environment, Stanford University, Stanford, California; Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, California; Human Biology Program, Stanford University, Stanford, California; Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Kirsten Rogers
Kirsten Rogers
Department of Civil and Environmental Engineering, Stanford University, Stanford, California; Woods Institute for the Environment, Stanford University, Stanford, California; Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, California; Human Biology Program, Stanford University, Stanford, California; Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Simon Mamuya
Simon Mamuya
Department of Civil and Environmental Engineering, Stanford University, Stanford, California; Woods Institute for the Environment, Stanford University, Stanford, California; Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, California; Human Biology Program, Stanford University, Stanford, California; Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Alexandria B. Boehm
Alexandria B. Boehm
Department of Civil and Environmental Engineering, Stanford University, Stanford, California; Woods Institute for the Environment, Stanford University, Stanford, California; Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, California; Human Biology Program, Stanford University, Stanford, California; Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Safe water storage and hand hygiene have been shown to reduce fecal contamination and improve health in experimental settings; however, triggering and sustaining such behaviors is challenging. This study investigates the extent to which personalized information about Escherichia coli contamination of stored water and hands influenced knowledge, reported behaviors, and subsequent contamination levels among 334 households with less than 5-year-old children in peri-urban Dar es Salaam, Tanzania. One-quarter of the study participants received information about strategies to reduce risk of water- and sanitation-related illness. Respondents in another three study cohorts received this same information, along with their household's water and/or hand-rinse test results. Findings from this study suggest that additional work is needed to elucidate the conditions under which such testing represents a cost-effective strategy to motivate improved household water management and hand hygiene.
Author Notes
Authors' addresses: Jennifer Davis, Department of Civil and Environmental Engineering and Woods Institute for the Environment, Stanford University, Stanford, CA, E-mail: jennadavis@stanford.edu. Amy J. Pickering, Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, CA, E-mail: amyjanel@stanford.edu. Kirsten Rogers, Human Biology Program, Stanford University, Stanford, CA, E-mail: kirstenr@stanford.edu. Simon Mamuya, Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, E-mail: smamuya@muhas.ac.tz. Alexandria B. Boehm, Department of Civil and Environmental Engineering, Stanford University, Stanford, CA, E-mail: aboehm@stanford.edu.
- Introduction
- Study Site and Experimental Methods
- Results
- Household characteristics.
- Changes in knowledge.
- Changes in hand hygiene behavior.
- Changes in water management practices.
- Multivariate modeling of reported changes in water management and hand hygiene practices.
- Changes in bacterial contamination of stored water and mothers' hands.
- Multivariate modeling of changes in water and hand contamination.
- Test cohort participants' reaction to intervention.
- Discussion
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Cutler D, Miller G, 2005. The role of public health improvements in health advance: the twentieth-century United States. Demography 42: 1–22.
-
2.
Esrey SA, Feachem RG, Hughes JM, 1985. Interventions for the control of diarrhoeal diseases among young children: improving water supplies and excreta disposal facilities. Bull World Health Organ 63: 757–772.
-
3.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM, 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 42–52.
-
4.
Joint Monitoring Programme, 2008. Progress on Drinking Water and Sanitation: Special Focus on Sanitation. Geneva, Switzerland: World Health Organization.
-
5.
Wright J, Gundry S, Conroy J, 2004. Household drinking water in developing countries: a systematic review of microbiological contamination between source and point-of-use. Trop Med Int Health 9: 106–117.
-
6.
Arnold BF, Colford JM Jr, 2007. Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis. Am J Trop Med Hyg 76: 354–364.
-
7.
Clasen T, Roberts I, Rabie T, Schmidt W, Cairncross S, 2006. Interventions to improve water quality for preventing diarrhoea. Cochrane Database Syst Rev 3: CD004794.
-
8.
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.
-
9.
Luby SP, Agboatwalla M, Raza A, Sobel J, Mintz ED, Baier K, Hoekstra RM, Rahbar MH, Hassan R, Qureshi SM, 2001. Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan. Epidemiol Infect 127: 237–244.
-
10.
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.
-
11.
Chiller TM, Mendoza CE, Lopez MB, Alvarez M, Hoekstra RM, Keswick BH, Luby SP, 2006. Reducing diarrhoea in Guatemalan children: randomized controlled trial of flocculant-disinfectant for drinking-water. Bull World Health Organ 84: 28–35.
-
12.
Luby SP, Agboatwalla M, Bowen A, Kenah E, Sharker Y, Hoekstra RM, 2008. Difficulties in bringing point-of-use water treatment to scale in rural Guatemala. Am J Trop Med Hyg 78: 382–387.
-
13.
Luby SP, Agboatwalla M, Bowen A, Kenah E, Sharker Y, Hoekstra RM, 2009. Difficulties in maintaining improved handwashing behavior, Karachi, Pakistan. Am J Trop Med Hyg 81: 140–145.
-
14.
Bandura A, 2005. The primacy of self-regulation in health promotion. Appl Psychol 54: 245–254.
-
15.
Maes S, Karoly P, 2005. Self-regulation assessment and intervention in physical health and illness: a review. Appl Psychol 54: 267–299.
-
16.
Abrams DB, Mills S, Bulger D, 1999. Challenges and future directions for tailored communication research. Ann Behav Med 21: 299–306.
-
17.
Strecher V, Wang C, Derry H, Wildenhaus K, Johnson C, 2002. Tailored interventions for multiple risk behaviors. Health Educ Res 17: 619–626.
-
18.
Smeets T, Kremers SP, de Vries H, Brug J, 2007. Effects of tailored feedback on multiple health behaviors. Ann Behav Med 33: 117–123.
-
19.
Iyer P, Davis J, Yavuz E, Evans B, 2005. Rural Water Supply, Sanitation, and Hygiene: A Review of 25 Years of World Bank Lending (1978–2003). Washington, DC: World Bank.
-
20.
Jalan J, Somanathan E, 2008. The importance of being informed: experimental evidence on demand for environmental quality. J Dev Econ 87: 14–28.
-
21.
City Mayors, 2009. The World's Fastest Growing Cities and Urban Areas from 2006 to 2020. Available at: http://www.citymayors.com/statistics/urban_growth1.html. Accessed May 17, 2009.
-
22.
Pickering AJ, Davis J, Walters SP, Horak HM, Keymer DP, Mushi D, Strickfaden R, Chynoweth JS, Liu J, Blum A, Rogers K, Boehm AB, 2010. Hands, water, and health: fecal contamination in Tanzanian communities with improved, non-networked water supplies. Environ Sci Technol 44: 3267–3272.
-
23.
United States Environmental Protection Agency, 2002. Method 1604: Total Coliforms and Escherichia coli in Water by Membrane Filtration Using a Simultaneous Detection Technique (MI Medium). United States Environmental Protection Agency.
-
24.
World Health Organization, 1997. Water Quality Guidelines for Rural Drinking Water Supplies. Surveillance and Control of Community Supplies, 2nd ed. Geneva, Switzerland: World Health Organization Press.
-
25.
Stanton B, Clemens J, 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.
-
26.
Curtis V, Cousens S, Mertens T, Traoré E, Kanki B, Diallo I, 1993. Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility. Bull World Health Organ 71: 23–32.
-
27.
Davis C, 1976. The effect of regression to the mean in epidemiologic and clinical studies. Am J Epidemiol 104: 493–498.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 711 | 581 | 56 |
| Full Text Views | 711 | 13 | 1 |
| PDF Downloads | 260 | 11 | 1 |