Next Article in Journal
Horizontal and Vertical Distributions of Chromium in a Chromate Production District of South Central China
Next Article in Special Issue
Risk of Appendicitis among Children with Different Piped Water Supply: A Nationwide Population-Based Study
Previous Article in Journal
A Stratified Meta-Analysis of the Association between Exposure to Environmental Tobacco Smoke during Childhood and Adulthood and Urothelial Bladder Cancer Risk
Open AccessArticle

Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos

Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(4), 570; https://doi.org/10.3390/ijerph15040570
Received: 15 February 2018 / Revised: 12 March 2018 / Accepted: 12 March 2018 / Published: 22 March 2018
(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)
Evidence of the impact of water, sanitation, and hygiene (WASH) in schools (WinS) interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS) study was a randomized controlled trial designed to measure the impact of the United Nations Children’s Fund (UNICEF) Laos WinS project on child health and education. We also measured the sustainability of intervention outputs and outcomes, and analyzed the effectiveness of group hygiene activities on behavior change and habit formation. Here, we present the design and intermediate results from this study. We found the WinS project improved the WASH environment in intervention schools; 87.8% of schools received the intervention per design. School-level adherence to outputs was lower; on average, schools met 61.4% of adherence-related criteria. The WinS project produced positive changes in pupils’ school WASH behaviors, specifically increasing toilet use and daily group handwashing. Daily group hygiene activities are effective strategies to improve school WASH behaviors, but a complementary strategy needs to be concurrently promoted for effective and sustained individual handwashing practice at critical times. View Full-Text
Keywords: water; sanitation; hygiene; WASH; primary schools; handwashing; toilet use; behavior change; intervention fidelity water; sanitation; hygiene; WASH; primary schools; handwashing; toilet use; behavior change; intervention fidelity
Show Figures

Figure 1

MDPI and ACS Style

Chard, A.N.; Freeman, M.C. Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos. Int. J. Environ. Res. Public Health 2018, 15, 570.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop