Online Program

Evaluating the effectiveness of a community-based hygiene promotion program in santa clara, El Salvador

Monday, November 4, 2013

Elizabeth Andrade, DrPH, MPH, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC
Kathryn Zoerhoff, MPH, MA, Research Triangle International
Emily Putzer, MA, Maryland Multicultural Youth Center, Hyattsville, MD
Jeffrey Bingenheimer, MPH, PhD, School of Public Health & Health Services, George Washington University, Washington, DC
Mark Edberg, PhD, MA, Department of Epidemiology & Biostatistics, George Washington University School of Public Health & Health Services, Washington, DC
Tilly Gurman, DrPH, MPH, Department of Global Health, The George Washington University School of Public Health and Health Services, Washington, DC
BACKGROUND: Due to the lack of adequate hygiene, potable water and sanitation, diarrheal disease still poses a substantial threat to human health in developing communities. While there have been considerable advances in the WASH sector, there is still a lack of evidence on theory-based program models for hygiene behavior change. This research study aimed to advance knowledge around hygiene behavior change strategies through the evaluation of a two-year community-based hygiene promotion pilot program implemented in rural Santa Clara, El Salvador by local health promoters.

METHODS: This study used a community-level quasi-experimental pretest-posttest design with repeated follow ups (2008-2010) to determine whether the hygiene promotion program achieved changes in hygiene knowledge and behavior. One community received the intervention while the other served as a comparison. Interviewer-administered surveys were collected from a representative sample using community-based participatory methods. Thirteen measures of hygiene knowledge and behavior for water, sanitation, personal, domestic and food hygiene were constructed using a hygiene cluster framework and were tested for reliability. ANOVA, one-way ANOVA with posthoc analysis using Tukey's HSD for multiple comparisons and linear regression were used.

RESULTS/DISCUSSION: Hygiene knowledge and behaviors related to sanitation and food hygiene increased more in the intervention than in the comparison community. Study results suggest that limited improvements in water and domestic hygiene may be related to an inadequate enabling environment for behavior change, with water source and availability of mechanisms for adequate trash disposal playing a role in this process. Recommendations for public health practice and research are also offered.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe methods for evaluating a community-based hygiene promotion program. Explain the community-based participatory research methods used. Discuss results of the study and implications for the field of evaluation of community-based health promotion programs. Describe recommendations for future public health research and practice.

Keyword(s): Evaluation, Public Health Education and Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a public health researcher with over 10 years experience working in areas of health disparities, Latino health and community-based development programs. I am the principal investigator of the study described in the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.