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For people affected by disaster, whether wars, earthquakes, or disease epidemics, conditions of life can change suddenly and in ways that require rapid adjustments. Often, adaptation includes taking greater care to prevent transmission of disease, in order to minimize the new threats to public health. Understanding what enables and influences changes in human behavior is key to developing and evaluating strong hygiene programs, so Eawag placed the issue—and the science—of behavior change front and center in its study.
The overarching research question was this: “Which specific promotion activities are the most effective in changing perceptions and beliefs about washing hands with soap and are thus capable of changing hand-washing behavior at key times?” In June 2011, the researchers undertook a cross-sectional, correlational study of communities that had experienced Oxfam hygiene-promotion activities. A team of local students and scientists conducted 811 structured interviews with household members who function as primary caregivers—88 percent of whom were female—in Port-au-Prince, Gressier, Petit-Goâve, Grand-Goâve, and Leogane. The interviews revolved around demographics, practices related to washing hands with soap, and Oxfam hygiene-promotion activities. There were also approximately 60 questions focused primarily on attitudes, beliefs, and norms about washing hands—questions pertinent to the issue of behavior change.

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