Planned, motivated and habitual hygiene behaviour: an eleven country review.

Handwashing with soap (HWWS) may be one of the most cost-effective means of preventing infection in developing countries. However, HWWS is rare in these settings. We reviewed the results of formative research studies from 11 countries so as to understand the planned, motivated and habitual factors involved in HWWS. On average, only 17% of child caretakers HWWS after the toilet. Handwash 'habits' were generally not inculcated at an early age. Key 'motivations' for handwashing were disgust, nurture, comfort and affiliation. Fear of disease generally did not motivate handwashing, except transiently in the case of epidemics such as cholera. 'Plans' involving handwashing included to improve family health and to teach children good manners. Environmental barriers were few as soap was available in almost every household, as was water. Because much handwashing is habitual, self-report of the factors determining it is unreliable. Candidate strategies for promoting HWWS include creating social norms, highlighting disgust of dirty hands and teaching children HWWS as good manners. Dividing the factors that determine health-related behaviour into planned, motivated and habitual categories provides a simple, but comprehensive conceptual model. The habitual aspects of many health-relevant behaviours require further study

Behaviour Centred Design: towards an applied science of behaviour change.

Behaviour change has become a hot topic. We describe a new approach, Behaviour Centred Design (BCD), which encompasses a theory of change, a suite of behavioural determinants and a programme design process. The theory of change is generic, assuming that successful interventions must create a cascade of effects via environments, through brains, to behaviour and hence to the desired impact, such as improved health. Changes in behaviour are viewed as the consequence of a reinforcement learning process involving the targeting of evolved motives and changes to behaviour settings, and are produced by three types of behavioural control mechanism (automatic, motivated and executive). The implications are that interventions must create surprise, revalue behaviour and disrupt performance in target behaviour settings. We then describe a sequence of five steps required to design an intervention to change specific behaviours: Assess, Build, Create, Deliver and Evaluate. The BCD approach has been shown to change hygiene, nutrition and exercise-related behaviours and has the advantages of being applicable to product, service or institutional design, as well as being able to incorporate future developments in behaviour science. We therefore argue that BCD can become the foundation for an applied science of behaviour change

Unintentional behaviour change.

We argue that the authors ignore a broad range of possible means of changing behaviour: unintentional change. Most of the behaviours that people seek to change - either in themselves or that are the subject of public health campaigns-are habitual, and hence not necessarily responsive to intentions. An evolutionary approach should take into account all kinds of evolved behavioural responses

Theory-based formative research on oral rehydration salts and zinc use in Lusaka, Zambia.

BACKGROUND: A theoretically grounded formative research study was carried out to investigate behaviour related to the use of Oral Rehydration Salts (ORS) and zinc tablets. The purpose was to inform the design of the behaviour change component of the Programme for Awareness and Elimination of Diarrhoea in Lusaka Province, Zambia, which aims to reduce childhood morbidity and mortality from diarrhoeal disease. METHODS: Fourteen behaviour trials were conducted among caregivers of children under-five with diarrhoea. Caregivers were recruited from two clinics situated in rural and peri-urban Lusaka. Trials took ten days and data were captured using video, observation and repeated interviews. Additional data were collected through focus group discussions with mothers, observations in clinics and pharmacies and interviews with clinic and pharmacy staff. Findings were organised according to categories of behavioural determinants from Evo-Eco theory. RESULTS: Participants were all familiar with ORS and most knew its purpose. ORS use was motivated by symptoms of dehydration, rather than the start of a diarrhoea episode, and was stopped when the child had visibly recovered energy. Only four of 14 behaviour trial participants were observed to correctly prepare ORS. Errors were mainly associated with measurement, resulting in a solution that was too concentrated. ORS was not observed to be given to children at clinics. Although zinc was unknown in this population, it was positively received by mothers keen to learn whether zinc would work better than alternative treatments to stop diarrhoea. CONCLUSIONS: ORS was sub-optimally prepared and used at home. It was not used while waiting to be seen at a clinic. In homes, the behaviour change intervention should promote early and continued use of correctly prepared ORS. In the longer-term, these behaviours may best be encouraged by changing the product design or sachet size. Despite its unfamiliarity, this population was well disposed to the use of zinc as a treatment for diarrhoea; when zinc is new to a population, promoting zinc as a solution to stopping diarrhoea, which mothers seek, may drive initial trial. Ensuring the availability of zinc in public clinics and private pharmacies prior to commencement of any promotion activities is crucial

Near-Real-Time Monitoring of Insect Defoliation Using Landsat Time Series

Introduced insects and pathogens impact millions of acres of forested land in the United States each year, and large-scale monitoring efforts are essential for tracking the spread of outbreaks and quantifying the extent of damage. However, monitoring the impacts of defoliating insects presents a significant challenge due to the ephemeral nature of defoliation events. Using the 2016 gypsy moth (Lymantria dispar) outbreak in Southern New England as a case study, we present a new approach for near-real-time defoliation monitoring using synthetic images produced from Landsat time series. By comparing predicted and observed images, we assessed changes in vegetation condition multiple times over the course of an outbreak. Initial measures can be made as imagery becomes available, and season-integrated products provide a wall-to-wall assessment of potential defoliation at 30 m resolution. Qualitative and quantitative comparisons suggest our Landsat Time Series (LTS) products improve identification of defoliation events relative to existing products and provide a repeatable metric of change in condition. Our synthetic-image approach is an important step toward using the full temporal potential of the Landsat archive for operational monitoring of forest health over large extents, and provides an important new tool for understanding spatial and temporal dynamics of insect defoliators

Understanding precision nitrogen stress to optimize the growth and lipid content tradeoff in oleaginous green microalgae

Nitrogen deficiency promotes lipid formation in many microalgae, but also limits growth and lipid productivity. In spite of numerous studies, there is poor understanding of the interactions of growth and lipid content, the time course of lipid accumulation and the magnitude of nitrogen deficiency required to stimulate lipid formation. These relationships were investigated in six species of oleaginous green algae, comparing high and low levels of deficiency. Nitrogen stress typically had disproportionate effects on growth and lipid content, with profound differences among species. Optimally balancing the tradeoffs required a wide range in nitrogen supply rate among species. Some species grew first and then accumulated lipids, while other species grew and accumulated lipids concurrently which resulted in increased lipid productivity. Accumulation of high lipid content generally resulted from a response to minimal stress. The data highlight the tremendous biodiversity that may be exploited to optimally produce lipids with precision nitrogen stress

The Determinants of Reported Personal and Household Hygiene Behaviour: A Multi-Country Study.

A substantial proportion of the total infectious disease burden world-wide is due to person-to-person spread of pathogens within households. A questionnaire-based survey on the determinants of hand-washing with soap and cleaning of household surfaces was conducted in at least 1000 households in each of twelve countries across the world (N = 12,239). A structural equation model of hygiene behaviour and its consequences derived from theory was then estimated on this dataset for both behaviours, using a maximum likelihood procedure. The analysis showed that the frequency of handwashing with soap is significantly related to how automatically it is performed, and whether or not someone is busy, or tired. Surface cleaning was strongly linked to possessing a cleaning routine, the perception that one is living in a dirty environment and that others are doing the behaviour, whether one has a strong sense of contamination, as well as a felt need to keep one's surroundings tidy. Being concerned with good manners is also linked to the performance of both behaviours. This study is the first to identify the role of manners, orderliness and routine on hygiene behaviours globally. Such findings should prove helpful in designing programs to improve domestic hygiene practices

Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in Nepal.

AbstractIn this study, we report on the results of a trial of an intervention to improve five food hygiene behaviors among mothers of young children in rural Nepal. This novel intervention targeted five behaviors; cleanliness of serving utensils, handwashing with soap before feeding, proper storage of cooked food, and thorough reheating and water treatment. Based on formative research and a creative process using the Behavior-Centered Design approach, an innovative intervention package was designed and delivered over a period of 3 months. The intervention activities included local rallies, games, rewards, storytelling, drama, competitions linking with emotional drivers of behavior, and "kitchen makeovers" to disrupt behavior settings. The effect of the package on behavior was evaluated via a cluster-randomized before-after study in four villages with four villages serving as controls. The primary outcome was the difference in the mean cluster level proportions of mothers directly observed practicing all five food hygiene behaviors. The five targeted food hygiene behaviors were rare at baseline (composite performance of all five behaviors in intervention 1% [standard deviation (SD) = 2%] and in control groups 2% [SD = 2%]). Six weeks after the intervention, the target behaviors were more common in the intervention than in the control group (43% [SD = 14%] versus 2% [SD = 2%], P = 0.02) during follow-up. The intervention appeared to be equally effective in improving all five behaviors in all intervention clusters. This study shows that a theory-driven, systematic approach employing emotional motivators and modifying behavior settings was capable of substantially improving multiple food hygiene behaviors in Nepal

Exploring a New Population of Compact Objects: X-ray and IR Observations of the Galactic Centre

I describe the IR and X-ray observational campaign we have undertaken for the purpose of determining the nature of the faint discrete X-ray source population discovered by Chandra in the Galactic Center (GC). Data obtained for this project includes a deep Chandra survey of the Galactic Bulge; deep, high resolution IR imaging from VLT/ISAAC, CTIO/ISPI, and the UKIDSS Galactic Plane Survey (GPS); and IR spectroscopy from VLT/ISAAC and IRTF/SpeX. By cross-correlating the GC X-ray imaging from Chandra with our IR surveys, we identify candidate counterparts to the X-ray sources via astrometry. Using a detailed IR extinction map, we are deriving magnitudes and colors for all the candidates. Having thus established a target list, we will use the multi-object IR spectrograph FLAMINGOS-2 on Gemini-South to carry out a spectroscopic survey of the candidate counterparts, to search for emission line signatures which are a hallmark of accreting binaries. By determining the nature of these X-ray sources, this FLAMINGOS-2 Galactic Center Survey will have a dramatic impact on our knowledge of the Galactic accreting binary population.Comment: 4 pages, 2 figures, to appear in the Proceedings of The Second Kolkata Conference on Observational Evidence for Black Holes in the Universe'', ed. S. Charkrabarti, Kolkata, India; AIP Conf. Serie