Evaluating the Impact of Behavioral Nudges on Student Hand-washing in Elementary Schools in the Philippines

NCT04244799 | Completed

• 1 other identifier: 005
• Study Type: interventional
• Target: 99
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Hand Disinfection

Keywords

Handwashing; Behavioral nudge; Contextual cue; Philippines; Health behavior; Nudge; Environmental cue; Behavior change

Outcome Measures

Primary Outcomes (2)

• 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

Secondary Outcomes (4)

• The number of functioning handwashing facilities at the school

  4 months

• The number of functioning handwashing facilities with soap and water at the school

  4 months

• The probability that a toilet facility has a nearby functioning handwashing facility

  4 months

• The probability that a toilet facility has a nearby functioning handwashing facility with water and soap

  4 months

Study Arms (2)

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.

Behavioral: Behavioral nudges; Behavioral: National WASH policy

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.

Behavioral: National WASH policy

Interventions

Behavioral nudges BEHAVIORAL

Behavioral nudges include the following: 1. Colorful pathway overlaid with footprints leading from the toilet to the handwashing station 2. Rotating posters in toilet areas with messages targeting behavioral motivators for handwashing (disgust, social affiliation) 3. Sticker of a pair of eyes placed above the handwashing station 4. Soap dish with an arrow beside it on the sink or counter to remind children to wash their hands with soap

Behavioral nudges

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.

Behavioral nudges; Control group

Eligibility Criteria

• Age: 5 Years - 12 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Water for handwashing is available at the school for at least certain days of the week
• The overall pupil to toilet ratio equals 100 or lower
• School has at least one individual handwashing station or group handwashing station
• School is situated in a district deemed safe by DepEd
• School does not have any planned WASH programming in the upcoming 2019-20 school year beyond standard WinS activities

You may not qualify if:

• Water for handwashing is not available at the school for all days of the week
• The overall pupil to toilet ratio equals over 100
• School does not have either an individual handwashing station nor a group handwashing station
• School is situated in a district deemed unsafe by DepEd
• School has at least one planned WASH programming in the upcoming 2019-20 school year beyond standard WinS activities

Sponsors & Collaborators

• IDinsight: lead
• United States Agency for International Development (USAID): collaborator
• UNICEF: collaborator
• Philippines Department of Education: collaborator

Study Sites (1)

IDinsight

Manila, Philippines

Location

MeSH Terms

Conditions

Health Behavior

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Haijing Huang, PHD

  IDinsight

  PRINCIPAL INVESTIGATOR

• Meghan Battle, MPH

  IDinsight

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Economist

Study Record Dates

• First Submitted: January 21, 2020
• First Posted: January 28, 2020
• Study Start: February 10, 2020
• Primary Completion: March 2, 2020
• Study Completion: March 2, 2020
• Last Updated: March 27, 2020

Record last verified: 2020-03

Locations

PH (1)