University at Buffalo, Buffalo, New York 14221, USA.
Am J Trop Med Hyg. 2010 Nov;83(5):1070-6. doi: 10.4269/ajtmh.2010.09-0763.
Structured observation is often used to evaluate handwashing behavior. We assessed reactivity to structured observation in rural Bangladesh by distributing soap containing acceleration sensors and performing structured observation 4 days later. Sensors recorded the number of times soap was moved. In 45 participating households, the median number of sensor soap movements during the 5-hour time block on pre-observation days was 3.7 (range 0.3-10.6). During the structured observation, the median number of sensor soap movements was 5.0 (range 0-18.0), a 35% increase, P = 0.0004. Compared with the same 5-hour time block on pre-observation days, the number of sensor soap movements increased during structured observation by ≥ 20% in 62% of households, and by ≥ 100% in 22% of households. The increase in sensor soap movements during structured observation, compared with pre-observation days, indicates substantial reactivity to the presence of the observer. These findings call into question the validity of structured observation for measurement of handwashing behavior.
结构观察常用于评估洗手行为。我们通过分发含有加速传感器的肥皂并在 4 天后进行结构观察来评估孟加拉国农村地区对结构观察的反应性。传感器记录肥皂移动的次数。在 45 个参与的家庭中，在预观察日的 5 小时时间块期间，传感器肥皂移动的中位数为 3.7（范围为 0.3-10.6）。在结构观察期间，传感器肥皂移动的中位数为 5.0（范围为 0-18.0），增加了 35%，P = 0.0004。与预观察日的同一 5 小时时间块相比，在 62%的家庭中，传感器肥皂移动的次数在结构观察期间增加了≥20%，在 22%的家庭中增加了≥100%。与预观察日相比，结构观察期间传感器肥皂移动的增加表明对观察者存在的明显反应性。这些发现对使用结构观察来测量洗手行为的有效性提出了质疑。
