Hand DisinfectionNCT04244799
Evaluating the Impact of Behavioral Nudges on Student Hand-washing in Elementary Schools in the Philippines
A study testing Behavioral nudges and National WASH policy in people with Hand Disinfection, run by IDinsight at 1 site in Philippines.
Trial summary
This study evaluates the impact of school-based behavioral "nudges" installed in toilets and handwashing facilities on handwashing behavior among students in the Philippines. Nudges include: visible signage crafted to trigger behavioral motivators for handwashing; colorful pathway overlaid with footprints leading from… Read more about this study
- Who is it for?
- Ages 5 to 12 yearsHealthy volunteers can take part
- Conditions the study is for
- Hand Disinfection
- What is being tested?
- Behavioral nudges and National WASH policy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 99 participants
- Where
- 1 sitePhilippines
- Study dates
- 10 Feb 2020to 2 Mar 2020
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 5 to 12 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Water for handwashing is available at the school for at least certain days of the week
- The overall pupil to toilet ratio equals 100 or lower
- School has at least one individual handwashing station or group handwashing station
- School is situated in a district deemed safe by DepEd
- School does not have any planned WASH programming in the upcoming 2019-20 school year beyond standard WinS activities
Who cannot join
- Water for handwashing is not available at the school for all days of the week
- The overall pupil to toilet ratio equals over 100
- School does not have either an individual handwashing station nor a group handwashing station
- School is situated in a district deemed unsafe by DepEd
- School has at least one planned WASH programming in the upcoming 2019-20 school year beyond standard WinS activities
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Evaluating the Impact of Behavioral Nudges on Student Independent Hand-washing Practices in Elementary Schools in the Philippines
This study evaluates the impact of school-based behavioral "nudges" installed in toilets and handwashing facilities on handwashing behavior among students in the Philippines. Nudges include: visible signage crafted to trigger behavioral motivators for handwashing; colorful pathway overlaid with footprints leading from the toilet to the handwashing station; sticker of a pair of eyes placed above the handwashing station; soap dish with an arrow beside it on the sink or counter to remind children to wash their hands with soap. The study's main hypothesis is that behavioral nudges will increase the percentage of students who wash their hands with water and soap after toilet use by 7 percentage points or more among schools where nudges were installed compared to control schools without nudges. The study is taking place in public primary schools in Zamboanga Del Norte, Philippines between October 2019 and May 2020.
Read the detailed description
The impact of the behavioral nudge intervention will be evaluated using a cluster randomized controlled trial (RCT). The investigators will randomly select 132 Department of Education (DepEd) schools across Zamboanga Del Norte province to comprise the study sample. 66 schools will be assigned to the treatment group, and 66 schools to the control group. Treatment schools will receive the behavioral nudge intervention, while control group will not. Both treatment and control schools will receive DepEd's national WASH in Schools (WinS) policy. WinS promotes "correct hygiene and sanitation practices among school children and a clean environment in and around schools" and includes initiatives related to infrastructure, knowledge, and behavior change, but does not include other programs with an explicit focus on handwashing promotion.
Four months after installing nudges, enumerators will conduct structured observations in study schools, observing whether pupils wash their hands with soap, wash without soap, or do not wash, after they have used classroom toilets. This will be used to estimate the causal impact of the nudges intervention on rates of independent handwashing with water and soap after toilet use.
- Conditions
- Hand Disinfection
- Being tested
- Behavioral nudges, National WASH policy
- Keywords
- Handwashing, Behavioral nudge, Contextual cue, Philippines, Health behavior, Nudge, Environmental cue, Behavior change
- Medical subject headings
- Health Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Behavioral nudgesBehavioural
Behavioral nudges include the following:
- Colorful pathway overlaid with footprints leading from the toilet to the handwashing station
- Rotating posters in toilet areas with messages targeting behavioral motivators for handwashing (disgust, social affiliation)
- Sticker of a pair of eyes placed above the handwashing station
- Soap dish with an arrow beside it on the sink or counter to remind children to wash their hands with soap
National WASH policyBehavioural
The Philippines' Department of Education National WASH in Schools (WinS) policy promotes "correct hygiene and sanitation practices among school children and a clean environment in and around schools" and includes initiatives related to infrastructure, knowledge, and behavior change, but does not include other programs with an explicit focus on handwashing promotion.
| Study group | Role | What they receive |
|---|---|---|
| Behavioral nudges | Experimental | Schools randomized to this arm will receive the behavioral nudges intervention and the Philippines Department of Education national WASH in Schools (WinS) policy. Receives: Behavioral: Behavioral nudges; Behavioral: National WASH policy |
| Control group | Active comparator | Schools in the control group will not receive handwashing nudges but will receive DepEd's national WASH in Schools (WinS) policy. Receives: Behavioral: National WASH policy |
What is being measured
The primary outcome is the main question the study is designed to answer.
The probability that a student was observed to wash their hands with soap and water after toilet use
Unit of analysis: student
Measured: 4 months
The probability that a student was observed to wash their hands with water after toilet use
Unit of analysis: student
Measured: 4 months
Secondary outcomes (4)
The number of functioning handwashing facilities at the school
Unit of analysis: school
Measured: 4 months
The number of functioning handwashing facilities with soap and water at the school
Unit of analysis: school
Measured: 4 months
The probability that a toilet facility has a nearby functioning handwashing facility
Unit of analysis: toilet facility. A "nearby" handwashing facility means inside the classroom for toilet facilities located inside classrooms and within 10 meters of toilet facilities located outside classrooms.
Measured: 4 months
The probability that a toilet facility has a nearby functioning handwashing facility with water and soap
Unit of analysis: toilet facility. A "nearby" handwashing facility means inside the classroom for toilet facilities located inside classrooms and within 10 meters of toilet facilities located outside classrooms.
Measured: 4 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jan 2020
- Study start10 Feb 2020
- Primary completion2 Mar 2020
- Study completion2 Mar 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hand DisinfectionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 99 participants (actual)
Sponsor and investigators
- Lead sponsor
- IDinsight
- Sponsor type
- University, hospital or other
- Collaborators
- United States Agency for International Development (USAID), UNICEF, Philippines Department of Education
- Responsible party
- Principal investigator, Haijing Huang, IDinsight
- Investigators
- Haijing Huang, PHD, Principal investigator, IDinsightMeghan Battle, MPH, Principal investigator, IDinsight
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04244799
- Sponsor's protocol ID
- 005
- Status last verified
- Mar 2020
- First submitted
- 21 Jan 2020
- Last updated
- 27 Mar 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 27 Mar 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluating the Impact of Behavioral Nudges on Student Independent Hand-washing Practices in Elementary Schools in the Philippines
- ClinicalTrials.gov ID
- NCT04244799
- Acronym / sponsor ID
- 005
- Conditions
- Hand Disinfection
- Keywords
- Handwashing, Behavioral nudge, Contextual cue, Philippines, Health behavior, Nudge, Environmental cue, Behavior change
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 99 participants (actual)
- Lead sponsor
- IDinsightUniversity, hospital or other
- Collaborators
- United States Agency for International Development (USAID), UNICEF, Philippines Department of Education
- Study start
- 10 Feb 2020 (actual)
- Primary completion
- 2 Mar 2020 (actual)
- Study completion
- 2 Mar 2020 (actual)
- First posted
- 28 Jan 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study evaluates the impact of school-based behavioral "nudges" installed in toilets and handwashing facilities on handwashing behavior among students in the Philippines. Nudges include: visible signage crafted to trigger behavioral motivators for handwashing; colorful pathway overlaid with footprints leading from the toilet to the handwashing station; sticker of a pair of eyes placed above the handwashing station; soap dish with an arrow beside it on the sink or counter to remind children to wash their hands with soap. The study's main hypothesis is that behavioral nudges will increase the percentage of students who wash their hands with water and soap after toilet use by 7 percentage points or more among schools where nudges were installed compared to control schools without nudges. The study is taking place in public primary schools in Zamboanga Del Norte, Philippines between October 2019 and May 2020.
Detailed description
The impact of the behavioral nudge intervention will be evaluated using a cluster randomized controlled trial (RCT). The investigators will randomly select 132 Department of Education (DepEd) schools across Zamboanga Del Norte province to comprise the study sample. 66 schools will be assigned to the treatment group, and 66 schools to the control group. Treatment schools will receive the behavioral nudge intervention, while control group will not. Both treatment and control schools will receive DepEd's national WASH in Schools (WinS) policy. WinS promotes "correct hygiene and sanitation practices among school children and a clean environment in and around schools" and includes initiatives related to infrastructure, knowledge, and behavior change, but does not include other programs with an explicit focus on handwashing promotion.
Four months after installing nudges, enumerators will conduct structured observations in study schools, observing whether pupils wash their hands with soap, wash without soap, or do not wash, after they have used classroom toilets. This will be used to estimate the causal impact of the nudges intervention on rates of independent handwashing with water and soap after toilet use.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Behavioral nudges | Experimental | Behavioral: Behavioral nudges, Behavioral: National WASH policySchools randomized to this arm will receive the behavioral nudges intervention and the Philippines Department of Education national WASH in Schools (WinS) policy. |
| Control group | Active comparator | Behavioral: National WASH policySchools in the control group will not receive handwashing nudges but will receive DepEd's national WASH in Schools (WinS) policy. |
Who may qualify
- Ages
- 5 to 12 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (5 listed)
- Water for handwashing is available at the school for at least certain days of the week
- The overall pupil to toilet ratio equals 100 or lower
- School has at least one individual handwashing station or group handwashing station
- School is situated in a district deemed safe by DepEd
- School does not have any planned WASH programming in the upcoming 2019-20 school year beyond standard WinS activities
Key exclusion criteria (5 listed)
- Water for handwashing is not available at the school for all days of the week
- The overall pupil to toilet ratio equals over 100
- School does not have either an individual handwashing station nor a group handwashing station
- School is situated in a district deemed unsafe by DepEd
- School has at least one planned WASH programming in the upcoming 2019-20 school year beyond standard WinS activities
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Behavioral nudgesBehavioral nudges include the following: 1. Colorful pathway overlaid with footprints leading from the toilet to the handwashing station 2. Rotating posters in toilet areas with messages targeting behavioral motivators for handwashing (disgust, social affiliation) 3. Sticker of a pair of eyes placed above the handwashing station 4. Soap dish with an arrow beside it on the sink or counter to remind children to wash their hands with soap | Behavioural | Behavioral nudges |
| National WASH policyThe Philippines' Department of Education National WASH in Schools (WinS) policy promotes "correct hygiene and sanitation practices among school children and a clean environment in and around schools" and includes initiatives related to infrastructure, knowledge, and behavior change, but does not include other programs with an explicit focus on handwashing promotion. | Behavioural | Behavioral nudges, Control group |
Primary outcome
The probability that a student was observed to wash their hands with soap and water after toilet use
Time frame: 4 months
Unit of analysis: student
The probability that a student was observed to wash their hands with water after toilet use
Time frame: 4 months
Unit of analysis: student
4 secondary outcomes
The number of functioning handwashing facilities at the school
Time frame: 4 months
The number of functioning handwashing facilities with soap and water at the school
Time frame: 4 months
The probability that a toilet facility has a nearby functioning handwashing facility
Time frame: 4 months
The probability that a toilet facility has a nearby functioning handwashing facility with water and soap
Time frame: 4 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Mar 2020.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Haijing Huang, PHD principal investigator
IDinsight
Meghan Battle, MPH principal investigator
IDinsight
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Behavioral nudges and National WASH policy in people with Hand Disinfection, run by IDinsight at 1 site in Philippines.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 27 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Philippines. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The probability that a student was observed to wash their hands with soap and water after toilet use (time frame: 4 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Mar 2020.