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Behavior change in Water, Sanitation and Hygiene (WASH) promotion programs

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Behavior change in Water, Sanitation and Hygiene (WASH) promotion programs: a review of reviews to identify evidence gaps

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Behavior change in Water, Sanitation and Hygiene (WASH) promotion programs

  1. 1. Behavior change in Water, Sanitation and Hygiene (WASH) promotion programs: a review of reviews to identify evidence gaps Hans Van Remoortel, Emmy De Buck, Thashlin Govender, Vittoria Lutje, Philippe Vandekerckhove, Taryn Young
  2. 2. I have no actual or potential conflict of interest in relation to this presentation. Project is funded by
  3. 3. Introduction: WASH interventions?
  4. 4. Overall aim of the project ✚ To explore which promotional approaches are effective to change WASH behaviour, and which implementing factors affect the success or failure of such an intervention (in low- and middle-income countries). ✚ This goal will be achieved by answering two different types of review questions: • in a quantitative arm of the review (EFFECTIVENESS) • in qualitative arm of the review (IMPLEMENTATION)
  5. 5. Project plan Phase 1: Overview of systematic reviews Phase 2: Systematic review: review of primary studies Phase 3: Communication and dissemination AIM: • Identify existing systematic reviews and create evidence gap map • Help prioritizing research questions for Phase 2 of the project • Use information in Theory of Change
  6. 6. Selection criteria review of reviews (phase 1) Population: • low- and middle-income countries • individual, household, community level or school settings Interventions: • WASH interventions: water supply, water treatment, water storage, latrine use, sewer connection, drainage system, hand hygiene, faeces disposal practices. • Promotional approaches: education, communication, social marketing principles, financial incentives, community-led total sanitation or any combination of these approaches. Outcomes (EFFECTIVENESS): I. Primary outcomes: behavior change outcomes II. Secondary outcomes: behavioral factors, health outcomes Outcomes (IMPLEMENTATION): I. Perceptions/experiences (applicability-appropriateness of the program) that can influence WASH behaviour change Study design: systematic reviews that (1) at least searched two electronic databases, (2) reported their search strategy and (3) reported their selection criteria.
  7. 7. Information Retrieval Specialist Embase research medline Campbell Collaboration Library Cochranedatabase ofScience Social Science Research Network Electronic Library WebofScience Socialsciences citationindex education resources information center An extensive search in electronic databases and grey literature…
  8. 8. Reviewer 1 Reviewer 2 TIAB screening, full text assessment, data- extraction and quality appraisal (ROBIS) by 2 reviewers independently
  9. 9. Results of the search process
  10. 10. Evidence gap map WASH intervention Promotional approach Outcomes Q1 (EFFECT) OutcomesQ2 (IMPL) Primary Secondary
  11. 11. Evidence gap map WASH intervention Promotional approach Outcomes Q1 (EFFECT) OutcomesQ2 (IMPL) SecondaryPrimary Sanitation Water quality source Water supply source
  12. 12. Evidence gap map WASH intervention Promotional approach Outcomes Q1 (EFFECT) OutcomesQ2 (IMPL) SecondaryPrimary Financialincentives
  13. 13. Evidence gap map WASH intervention Promotional approach Outcomes Q1 (EFFECT) OutcomesQ2 (IMPL) SecondaryPrimary Intention Sustainability
  14. 14. Our “QUANTITATIVE” review questions: before vs after 1) What is the effectiveness of approaches aiming to promote WASH behaviour change in low- and middle income countries? 1) What is the effectiveness of different approaches (I) to promote handwashing and sanitation behaviour change (O) in communities in low- and middle income countries (P) [compared to other approaches (C)]?
  15. 15. 2) How do the perceptions and experiences of participants in terms of the program’s feasibility, appropriateness and meaningfulness influence WASH behaviour change? 2) What are the factors influencing implementation of approaches to promote handwashing and sanitation behaviour change in communities in low- and middle income countries? Our “QUALITATIVE” review questions: before vs after
  16. 16. Conclusions ✚ Mapping evidence gaps, based on a review of reviews, will inform researchers about potentially relevant future SRs within the WASH domain and behavior change ✚ We specifically used this information to fine-tune the scope of our own mixed-methods SR, which will be published in 2017.
  17. 17. Acknowledgements Thashlin Govender (CEBHC, Stellenbosch University) Emmy De Buck (Manager CEBaP, BRC) Taryn Young (Manager CEBHC, Stellenbosch University) Vittoria Lutje (Information specialist) Philippe Vandekerckhove (CEO, BRC)
  18. 18. Questions? Suggestions? Remarks?

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