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Cited by 151Child Nutrition and Water AccessSchool Health and Nursing EducationBehavioral Health and Interventions

The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.

Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh

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Dreibelbis, Robert, Kroeger, Anne, Hossain, Kamal, Venkatesh, Mohini, Ram, Pavani·2016·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph13010129PMC PMC4730520
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Abstract

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing traditional handwashing infrastructure, and at multiple time periods following targeted handwashing nudges (1 day, 2 weeks, and 6 weeks). No additional handwashing education or motivational messages were completed. Handwashing with soap among school children was low at baseline (4%), increasing to 68% the day after nudges were completed and 74% at both 2 weeks and 6 weeks post intervention. Results indicate that nudge-based interventions have the potential to improve handwashing with soap among school-aged children in Bangladesh and specific areas of further inquiry are discussed.

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Figure 1 School latrine and water infrastructure prior to nudges in School (A) and School (B).
Figure 1 School latrine and water infrastructure prior to nudges in School (A) and School (B).CC BY · PubMed Central
Figure 2 Nudges following final phase of construction, including: dedicated handwashing station, paved paths, and painted foot—and handprints in School (A) and School (B) (photo taken immediately following construction and prior to soap being made available during the next school day).
Figure 2 Nudges following final phase of construction, including: dedicated handwashing station, paved paths, and painted foot—and handprints in School (A) and School (B) (photo taken immediately following construction and prior to soap being made available during the next school day).CC BY · PubMed Central
Figure 3 Percentage of children washing both hands with soap following latrine use in two primary schools in rural Bangladesh. HW infrastructure (water tank and raised platform), Nudges: footpath only, and Nudges: footpaths & painting were completed the school day immediately following construction.
Figure 3 Percentage of children washing both hands with soap following latrine use in two primary schools in rural Bangladesh. HW infrastructure (water tank and raised platform), Nudges: footpath only, and Nudges: footpaths & painting were completed the school day immediately following construction.CC BY · PubMed Central

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Metadata

Authors
Dreibelbis, R., Kroeger, A., Hossain, K., Venkatesh, M., & Ram, P.
Affiliations
  • University of Oklahoma (US)
  • Save the Children (BD)
  • Save the Children (US)
  • University at Buffalo, State University of New York (US)
Corresponding author
Dreibelbis, Robert
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2016-01-14
Volume
13
Issue
1
Pages
129
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph13010129
PMC
PMC4730520
OpenAlex
W2234246835
Cited by
151
References
31
Citations by year
2026: 7 · 2025: 17 · 2024: 10 · 2023: 10 · 2022: 10 · 2021: 28 · 2020: 33 · 2019: 15 · 2018: 6 · 2017: 7 · 2016: 6
FWCI
11.87
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
University of Oklahoma
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords
handwashing with soap, nudging, behavior change, behavior change communication, elementary school students, toilet use, environmental cues, hygiene practices, low-cost interventions, rural Bangladesh
MeSH terms
Adolescent, Audiovisual Aids, Bangladesh, Child, Communication, Decision Making, Female, Hand Disinfection, Health Promotion, Humans, Male, Motivation, Pilot Projects, Rural Population, Schools, Students, Health Behavior, Risk Reduction Behavior

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