Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
RANAS, Zurich, Switzerland.
BMJ Open. 2024 Aug 17;14(8):e082419. doi: 10.1136/bmjopen-2023-082419.
This multicountry analysis aimed to assess the prevalence of key hygiene prevention behaviours and their determinants, associated with international non-governmental organisation (WaterAid) hygiene behaviour change programmes for COVID-19 prevention. The goal of this analysis is to inform future outbreak preparedness and pandemic response in low and middle-income countries.
Cross-sectional study.
Households in seven countries where WaterAid implemented a first-phase COVID-19 response programme in 2020 (Ethiopia, Ghana, Nepal, Nigeria, Rwanda, Tanzania and Zambia).
3033 adults (1469 men and 1564 women, alternately sampled from one household to the next to maintain gender balance) in specific programme areas (211 villages) surveyed between October and November 2020.
Self-reported primary outcomes were: a composite measure of HWWS for prevention of respiratory infection/COVID-19 (total of 5 key moments); respondent increased HWWS behaviour after the COVID-19 pandemic; respondent always wears a mask in public spaces; respondent always practices physical distancing in public spaces.
Most respondents (80%) reported increasing their handwashing behaviour after the pandemic, but practice of HWWS at COVID-19-specific prevention moments was low. Mask wearing (58%) and physical distancing (29%) varied substantially between countries. Determinants of key behaviours were identified, including age and socioeconomic status, perceived norms, self-regulation and the motive of protecting others. Incidence rate ratios or odds ratios and 95% CIs for a range of psychosocial determinants for each of the four primary outcomes are reported.
These findings highlight that leveraging behaviour-specific emotional drivers and norms, reducing common barriers and promoting targeted messages about specific behaviours and actions individuals can take to reduce risk are necessary to support large-scale behaviour change. Learning from the COVID-19 response to more effectively integrate novel behaviours into existing health promotion will be vital for disease prevention and outbreak resilience.
本多国分析旨在评估与国际非政府组织（WaterAid）针对 COVID-19 预防的卫生行为改变计划相关的主要卫生预防行为及其决定因素的流行率。本分析的目的是为中低收入国家的未来疫情准备和大流行应对提供信息。
横断面研究。
2020 年 WaterAid 在七个国家实施第一阶段 COVID-19 应对计划的国家（埃塞俄比亚、加纳、尼泊尔、尼日利亚、卢旺达、坦桑尼亚和赞比亚）的家庭。
2020 年 10 月至 11 月期间在特定计划地区（211 个村庄）调查的 3033 名成年人（1469 名男性和 1564 名女性，为了保持性别平衡，每隔一户进行抽样）。
自我报告的主要结果是：预防呼吸道感染/COVID-19 的综合卫生用水和卫生设施措施（共 5 个关键时刻）；受访者在 COVID-19 大流行后增加卫生用水和卫生设施行为；受访者在公共场所始终戴口罩；受访者在公共场所始终保持身体距离。
大多数受访者（80%）报告在大流行后增加了洗手行为，但在 COVID-19 特定预防时刻的卫生用水和卫生设施措施的实施率较低。口罩佩戴（58%）和身体距离（29%）在国家之间存在很大差异。确定了关键行为的决定因素，包括年龄和社会经济地位、感知规范、自我调节和保护他人的动机。报告了针对四个主要结果中的每一个的一系列社会心理决定因素的发生率比或优势比和 95%置信区间。
这些发现表明，利用行为特定的情感驱动因素和规范，减少常见障碍，并促进关于个人可以采取的具体行为和行动以降低风险的针对性信息，对于支持大规模行为改变是必要的。从 COVID-19 应对中吸取经验教训，将新行为更有效地纳入现有健康促进活动，对于疾病预防和疫情应对能力至关重要。
