“Handwashing campaigns usually try to educate people with health messages about germs and diseases, but so far efforts to change handwashing behaviour on a large scale have had little success. Understanding the motivating factors for routine hand washing is essential to any initiative likely to achieve lasting behaviour change.”
An evaluation of the behaviour-change intervention, published by the Lancet Global Health journal today, shows that 6 months after the campaign was rolled out in 14 villages in rural India, rates of handwashing with soap increased by 31%, compared to communities without the programme, and were sustained for 12 months.
The intervention adapted the open access SHARE-funded global toolkit, and targeted emotional drivers found to be the most effective levers for behaviour change: disgust (the desire to avoid and remove contamination), nurture (the desire for a happy, thriving child), status (the desire to have greater access to resources than others), and affiliation (the desire to fit in).
At the start of the study, handwashing with soap was rare in both the intervention and control groups (1% vs 2%). After 6 weeks, handwashing was more common in the intervention group (19% vs 4%), and after 6 months, compliance in the intervention group had increased to 37% compared with 6% in the control group. One year after the campaign, and after the control villages had received a shortened version of the intervention, rates of handwashing with soap were the same in both groups (29%).
According to study co-author Katie Greenland, from LSHTM, “the SuperAmma campaign appears to be successful because it engages people at a strong emotional level, not just an intellectual level, and that’s why the behavioural change was long-lasting. Whether the observed increase in handwashing with soap is sufficient to reduce infection remains unclear, but in view of our promising results, public health practitioners should consider behaviour change campaigns designed along the lines of our approach.”