Trial reportBMJ global health2020
Impact of a demand-side integrated WASH and nutrition community-based care group intervention on behavioural change: a randomised controlled trial in western Kenya.
Trial report in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Behavioural factors influencing hand hygiene practices across domestic, institutional and public community settings: a systematic review and qualitative meta-synthesis.BMJ global health · 2025Pooled it
- Prevention of human exposure to livestock faecal waste in the household: a scoping study of interventions conducted in sub-Saharan Africa.BMC public health · 2023Pooled it
- Effects of Engaging Fathers and Bundling Nutrition and Parenting Interventions on Child Nutrition Outcomes and Related Parent Behaviors in Rural Tanzania: Results From EFFECTS, a Five-Arm Cluster-Randomized Controlled Trial.Maternal & child nutrition · 2026Trial
- Interventions for enhancing child survival practices among caregivers of under-five children in Sub-Saharan Africa: a scoping review.BMC public health · 2025Article
- Rewarding behavior change in rural communities: Pathways for a sustained inclusive change for child health.PLOS global public health · 2025Article
- Role of Psychosocial Factors and Mental Well-Being for Baby WASH- and Nutrition-Related Behaviors in Lao PDR.The American journal of tropical medicine and hygiene · 2024Article
- Core Principles and Practices for the Design, Implementation, and Evaluation of Social and Behavior Change for Nutrition in Low- and Middle-Income Contexts with Special Applications for Nutrition-Sensitive Agriculture.Current developments in nutrition · 2024Review
- Assessment of water, hygiene, and sanitation practice and associated factors among Bihari refugee camp in Bangladesh: A cross-sectional study.Health science reports · 2024Article
- Evidence-based complementary feeding recipe book for Kenyan caregivers: A novel approach.Maternal & child nutrition · 2024Article
- Patients' views on health promotion and disease prevention services provided by healthcare workers in a South African tertiary hospital.BMC health services research · 2023Article
- Influence of care group participation on infant and young child feeding, dietary diversity, WASH behaviours and nutrition outcomes in rural Zimbabwe.BMJ nutrition, prevention & health · 2023Article
- Safe infant feeding in healthcare facilities: Assessment of infection prevention and control conditions and behaviors in India, Malawi, and Tanzania.PLOS global public health · 2023Article
- Determinants of food preparation and hygiene practices among caregivers of children under two in Western Kenya: a formative research study.BMC public health · 2022Article
- Sustainable Elimination of Schistosomiasis in Ethiopia-A Five-Year Follow-Up Study.Tropical medicine and infectious disease · 2022Article
- Application of the Capabilities, Opportunities, Motivations, and Behavior (COM-B) Change Model to Formative Research for Child Nutrition in Western Kenya.Current developments in nutrition · 2022Article
- Evaluations of water, sanitation and hygiene interventions should not use diarrhoea as (primary) outcome.BMJ global health · 2022Review
- The Applications of Implementation Science in Water, Sanitation, and Hygiene (WASH) Research and Practice.Environmental health perspectives · 2021Review
- Benefits and Risks of Smallholder Livestock Production on Child Nutrition in Low- and Middle-Income Countries.Frontiers in nutrition · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionGrowth shortfalls and diarrhoeal diseases remain a major cause of morbidity and mortality in low-income settings. Due to the multifaceted causes of undernutrition and the identified limitations of siloed nutrition programmes, improving the delivery of integrated water, sanitation, hygiene (WASH) and nutrition programming could improve child health.
methodsWe conducted a cluster randomised trial in western Kenya to assess the impact on household behaviours of a novel, theory-informed and integrated WASH and nutrition intervention delivered through care groups as compared with the standard care group approach. We developed an intervention targeting practices relating to food hygiene, mealtime and feeding, and compound cleanliness, each using various behavioural change techniques to influence the uptake of targeted behaviours. Prespecified behavioural outcomes were verified through direct observation, 24 hours recall, and self-reported picture-based methods.
resultsCompared with control households, a greater proportion of intervention households had a hygienic food preparation area (Risk double difference (RDD) 0.81, 95% CI 0.68 to 0.96), had stored food hygienically (RDD 0.76, 95% CI 0.58 to 1.00), had a functional handwashing station (RDD 0.64, 95% CI 0.56 to 0.74), provided a safe space for their child to play (RDD 0.73, 95% CI 0.56 to 0.96), and who fed their children thickened porridge (RDD 0.56, 95% CI 0.51 to 0.63) at endline. The proportion of children 6-24 months in intervention households consuming a sufficient diversity of foods (RDD 0.81, 95% CI 0.64 to 1.04) was higher than in control households; however, there was a non-significant increase in the percentage of pregnant and lactating women receiving an adequate diversity of foods in their diets (RDD 0.86, 95% CI 0.70 to 1.05) among intervention compared with control households at endline.
conclusionOur integrated WASH and nutrition intervention resulted in important changes in behaviours. This theory-informed intervention could be added to existing care group programmes to considerable advantage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.