Evidence map›Paper›PMID 39962442›Full record

Trial reportBMC public health2025

Better floors, better health: a theory of change for an improved household flooring intervention in rural communities in Kwale and Bungoma counties, Kenya.

Stella Kepha, Hugo Legge, Katherine E Halliday, Victoria Ochwal, Lynne Elson, Jacinta Mwongeli, William E Oswald, Beatrice Kakoi, James Wambua, Charles Mwandawiro and 3 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Stella Kepha *Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.
Hugo Legge *Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK. Hugo.legge@lshtm.ac.uk.
Katherine E HallidayDepartment of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
Victoria OchwalInternational Centre of Insect Physiology and Ecology, Nairobi, Kenya.
Lynne ElsonKEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Jacinta MwongeliJomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
William E OswaldDepartment of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
Beatrice KakoiJomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
James WambuaJomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Charles MwandawiroEastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.
Ulrike FillingerInternational Centre of Insect Physiology and Ecology, Nairobi, Kenya.
Rachel PullanDepartment of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
Doris NjomoEastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.

Funding

UK Research and Innovation MR/T029811/1
6 · The paper itself

Abstract

backgroundHousehold flooring is increasingly being investigated as a determinant of health, however the pathways through which flooring may impact health and wellbeing are not yet well understood. The SABABU study is a cluster-randomised controlled trial evaluating the impact of an improved flooring intervention on soil-transmitted helminthiasis, tungiasis, and enteric infections in Bungoma and Kwale counties, Kenya. This paper presents the findings from a theory of change development process that was undertaken as part of the formative research phase of the SABABU project.

methodsA co-creation workshop (n = 1), stakeholder meetings (n = 2), and community meetings (n = 2) were held with a range of participants including community members (n = 36), village-level leaders (n = 28), and local government stakeholders (n = 14) to draft and refine the theory of change framework. These meetings were informed by a previous formative research phase conducted in study communities - comprised of household observations, in-depth interviews, and focus group discussions with community members - to investigate daily routines, use of space within homes, and attitudes towards home improvement.

resultsThe theory of change framework demonstrates how the improved household flooring intervention aims to reduce prevalence of soil-transmitted helminthiasis, enteric infections and tungiasis and improve psychological wellbeing among children and caregivers. Reductions in infections are predicated on limited contact between improved floors and animals, regular floor cleaning, and household members conducting their daily routines on the new floors. Gains in psychological wellbeing are tied to increased feelings of pride, self-efficacy, and social progress, as well as improved quality of life through reduced morbidity from enteric and parasitic infections.

conclusionThis study presents a theory of change framework mapping the pathways through which an improved flooring intervention may impact health and wellbeing. The results can be of use to researchers or programmes that are in the design or evaluation phase of a household flooring project in Kenya or other settings where access to improved floors is limited.

Indexed as

SoilAdultChildFamily CharacteristicsFemaleFocus GroupsHelminthiasisHumansKenyaMaleRural PopulationTungiasisSoilEntericHousing FlooringSTHTheory of ChangeTungiasis

Identifiers

PMID39962442
PMCPMC11834233

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.