Article type
Year
Abstract
Background: The Belgian Red Cross (BRC) uses systematic reviews (SRs) to:
1) achieve an evidence-based substantiation of its activities; 2) identify relevant knowledge gaps; and 3) fill gaps by setting up primary research.
One of these gaps concerns the effect of hand washing and sanitation (HW&S) promotion programs to induce behavior change in low- and middle-income countries (LMIC), for which a mixed-methods SR (MMSR) was conducted.
Objectives: To use a MMSR to: 1) identify knowledge gaps concerning HW&S promotion programs; 2) design a primary field study.
Methods: The MMSR studied: 1) the effectiveness of HW&S promotional programs, and 2) factors influencing their implementation. The primary outcome was HW&S behavior change, which was subdivided into uptake (during implementation), adherence (≤ 12 months follow-up ) or longer-term use (> 12 months follow-up). Knowledge gaps were defined as topics for which ≤ 1 study was identified, or when the available evidence was of very low quality. These gaps were discussed with a group of stakeholders with HW&S field experience. A balance was made between gaps in evidence and operational context and needs.
Results: The MMSR identified 42 quantitative and 28 qualitative studies. Figure 1 shows the available HW&S evidence and the identified knowledge gaps (in grey). The MMSR showed that: 1) HW&S promotional programs can be effective, 2) a single most effective program could not be identified and a combination of different promotional elements is probably the most effective strategy. We identified several barriers and facilitators for implementation i.e. using short communication messages. Following a stakeholder discussion, BRC decided to design a primary field study, investigating the effectiveness of a community-based (CB) program versus a combined intervention, i.e. CB + theory-based, on HW&S behavior during uptake and adherence in Tanzania. By incorporating identified barriers and facilitators in the design of the study, effectiveness of the intervention may increase.
Conclusions: Quantitative and qualitative input from a MMSR can be useful to identify knowledge gaps and to inform the design of a primary field study.
Patient or healthcare consumer involvement: The MMSR and the primary study take into account the needs of people from LMIC by closely working with stakeholders with field experience.
1) achieve an evidence-based substantiation of its activities; 2) identify relevant knowledge gaps; and 3) fill gaps by setting up primary research.
One of these gaps concerns the effect of hand washing and sanitation (HW&S) promotion programs to induce behavior change in low- and middle-income countries (LMIC), for which a mixed-methods SR (MMSR) was conducted.
Objectives: To use a MMSR to: 1) identify knowledge gaps concerning HW&S promotion programs; 2) design a primary field study.
Methods: The MMSR studied: 1) the effectiveness of HW&S promotional programs, and 2) factors influencing their implementation. The primary outcome was HW&S behavior change, which was subdivided into uptake (during implementation), adherence (≤ 12 months follow-up ) or longer-term use (> 12 months follow-up). Knowledge gaps were defined as topics for which ≤ 1 study was identified, or when the available evidence was of very low quality. These gaps were discussed with a group of stakeholders with HW&S field experience. A balance was made between gaps in evidence and operational context and needs.
Results: The MMSR identified 42 quantitative and 28 qualitative studies. Figure 1 shows the available HW&S evidence and the identified knowledge gaps (in grey). The MMSR showed that: 1) HW&S promotional programs can be effective, 2) a single most effective program could not be identified and a combination of different promotional elements is probably the most effective strategy. We identified several barriers and facilitators for implementation i.e. using short communication messages. Following a stakeholder discussion, BRC decided to design a primary field study, investigating the effectiveness of a community-based (CB) program versus a combined intervention, i.e. CB + theory-based, on HW&S behavior during uptake and adherence in Tanzania. By incorporating identified barriers and facilitators in the design of the study, effectiveness of the intervention may increase.
Conclusions: Quantitative and qualitative input from a MMSR can be useful to identify knowledge gaps and to inform the design of a primary field study.
Patient or healthcare consumer involvement: The MMSR and the primary study take into account the needs of people from LMIC by closely working with stakeholders with field experience.