{"doi":"10.2471/blt.21.285915","title":"Changing hygiene behaviours: a cluster-randomized trial, Ethiopia","abstract":"OBJECTIVE: To determine whether a water, sanitation and hygiene intervention could change hygiene behaviours thought to be important for trachoma control. METHODS: We conducted a cluster-randomized trial in rural Ethiopia from 9 November 2015 to 5 March 2019. We randomized 20 clusters to an intervention consisting of water and sanitation infrastructure and hygiene promotion and 20 clusters to no intervention. All intervention clusters received a primary-school hygiene curriculum, community water point, household wash station, household soap and home visits from hygiene promotion workers. We assessed intervention fidelity through annual household surveys. FINDINGS: Over the 3 years, more wash stations, soap and latrines were seen at households in the intervention clusters than the control clusters: risk difference 47 percentage points (95% confidence interval, CI: 41-53) for wash stations, 18 percentage points (95% CI: 12-24) for soap and 12 percentage points (95% CI: 5-19) for latrines. A greater proportion of people in intervention clusters reported washing their faces with soap (e.g. risk difference 21 percentage points; 95% CI: 15-27 for 0-5 year-old children) and using a latrine (e.g. risk difference 9 percentage points; 95% CI: 2-15 for 6-9 year-old children). Differences between the intervention and control arms were not statistically significant for many indicators until the programme had been implemented for at least a year; they did not decline during later study visits. CONCLUSION: The community- and school-based intervention was associated with improved hygiene access and behaviours, although changes in behaviour were slow and required several years of the intervention.","journal":"Bulletin of the World Health Organization","year":2021,"id":197642,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9467,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":746255,"name":"Wondyifraw Tadesse","orcid":"0000-0003-4155-1274","position":1,"is_corresponding":false},{"id":759938,"name":"Adane Dagnew","orcid":"0000-0002-4105-6129","position":2,"is_corresponding":false},{"id":759939,"name":"Dagnachew Hailu","orcid":"0000-0002-1066-7197","position":3,"is_corresponding":false},{"id":771687,"name":"Melese Dubie","orcid":"0000-0003-1782-7058","position":4,"is_corresponding":false},{"id":392038,"name":"Dionna M. Wittberg","orcid":"0000-0002-9887-5993","position":5,"is_corresponding":false},{"id":392040,"name":"Jason Melo","orcid":"0000-0003-2116-4656","position":6,"is_corresponding":false},{"id":759940,"name":"Mahteme Haile","orcid":"0000-0001-9996-6742","position":7,"is_corresponding":false},{"id":759941,"name":"Tàye Zeru","orcid":"0000-0003-0736-2955","position":8,"is_corresponding":false},{"id":412053,"name":"Matthew C. Freeman","orcid":"0000-0002-1517-2572","position":9,"is_corresponding":false},{"id":392041,"name":"Scott D. Nash","orcid":"0000-0001-5741-8537","position":10,"is_corresponding":false},{"id":424270,"name":"E. Kelly Callahan","orcid":"0000-0002-4057-9411","position":11,"is_corresponding":false},{"id":393685,"name":"Zerihun Tadesse","orcid":null,"position":12,"is_corresponding":false},{"id":328639,"name":"Benjamin F. Arnold","orcid":"0000-0001-6105-7295","position":13,"is_corresponding":false},{"id":274651,"name":"Travis C. Porco","orcid":"0000-0001-8813-3171","position":14,"is_corresponding":false},{"id":274646,"name":"Thomas M. Lietman","orcid":"0000-0001-8216-0240","position":15,"is_corresponding":false},{"id":228841,"name":"Jeremy D. Keenan","orcid":"0000-0002-7118-1457","position":16,"is_corresponding":false},{"id":392037,"name":"Solomon Aragie","orcid":"0000-0003-4967-9627","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-18T23:50:23.532351Z","pmid":"34737469","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}