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[Webinar Summary] Designing and Implementing Handwashing Programs

October 23, 2020

By: Lily McCann, FHI 360/Global Handwashing Partnership

On October 1, 2020, the Global Handwashing Partnership launched the Handwashing Thursday Series. The series aims to amplify the launch of the Partnership’s most recent publication: The Handwashing Handbook. The handbook launched on Global Handwashing Day 2020, and it serves as an all-in-one resource for handwashing programming.

The second webinar of the series was held on October 22, 2020 with a focus on the third chapter of the Handwashing Handbook titled “Designing and Implementing Handwashing Programs.” This webinar followed the Handwashing Handbook chapter, emphasizing the need to design and implement initiatives that trigger lasting handwashing habits.

The Shift in Handwashing Behavior Change Programming

Ms. Nga Nguyen, a Senior WASH & Social and Behavior Change Advisor at USAID, presented the shift in handwashing programming. Her presentation began by explaining that education alone is insufficient to change handwashing behavior. Instead, designing effective strategies to change handwashing behavior requires attending to three key decisions, highlighted below.

Graphic Design by Mike Grant, CAWST

Through her presentation, Ms. Nguyen highlighted the first of these three key decisions, stressing the importance of understanding your target audience and identifying the desired behavior. This can vary by setting. Thus, it is important to design context-specific handwashing programs.

Key Decisions for Program Design

Ms. Julia Rosenbaum, a Senior Technical Advisor at FHI 360, followed by explaining the second key decision: what factors or determinants influence handwashing behavior? A behavioral determinant is a factor demonstrated to be highly influential in the performance, or non-performance, of a behavior. Every behavior often has a cluster of determinants that influence a behavior for an audience. In addition to knowledge, some of the most influential determinants of handwashing include social norms, beliefs and attitudes, products and services that are required or facilitate the behavior, and emotional drivers like status, disgust and fear.

She emphasizes the importance of formative research when designing a handwashing program. Through formative research, planners can identify which behavioral determinants will influence handwashing. By understanding factors that will influence a specific audience, both at a conscious and subconscious level, planners can set up programs that truly form handwashing habits.

Translating Behavioral Insights into Handwashing Activities

Ms. Sian White, who works for the London School of Hygiene and Tropical Medicine and the COVID-19 Hygiene Hub, presented on the third key decision, translating those behavioral insights into handwashing activities. She provided 6 examples of various behavior change techniques including: making people think differently about handwashing behavior, motivating people to take action, making handwashing convenient and desirable, cuing behavior at the right times, rewarding good behavior, and making handwashing normative. Regardless of the technique being used, it is helpful to use a theory of change to effectively transition from behavioral insights to program activities.

First, identify the target audience’s behavioral insight on handwashing, which would have been gathered from formative research. Next, it is important to determine the desired behavior and the desired belief. Finally, using this information, begin to craft a context-relevant intervention.

Case Study: Safeguard China Behavior Change Programming

Ms. Cheryl Li works for P&G in scientific communications and is responsible for all the Great China Personal Cleansing & Care brands including Safeguard. Ms. Li showcased a video that aimed to catalyze handwashing behavior change among modern moms (and their children) in China.

The video provides a great example of the three decisions highlighted in the previous presentations. First, Safeguard identified moms as their target audience. Their desired behavior was to get the mothers to support child handwashing using Safeguard products. To support the creation of this video, they conducted research, using a “Germ Map” in kindergarten to rank the top 10 locations where germs thrive. The video brought key knowledge to their audience and evoked strong emotions of disgust, which helped to drive handwashing behavior. To disseminate their video, Safeguard posted the video to Weibo and Wechat, two main social media platforms used in China. Additionally, the video was released on Global Handwashing Day along with a series of handwashing events to catch both online and offline consumers’ attraction. Overall, the video provides a good example of the three decisions to design effective handwashing behavior change initiatives.

Moderated Panel Discussion and Key Takeaways:

A moderated panel discussion followed the presentations, diving deeper into various topics highlighted throughout the presentations and answering audience questions. Overall, the key takeaways from the webinar are:

  • Follow a systematic process. Behavior change programs are more likely to succeed when they follow an evidence-based, theory-driven and systematic process.
  • Know the audience. Handwashing behavior change is context dependent. Different determinants affect the handwashing behavior of different audiences. It is critical to understand the target audience and determine what would motivate and support handwashing.
  • Identify determinants that influence handwashing practice through formative research. It is important to consider the two systems of the brain — “System 1” (more irrational, habitual determinants) versus “System 2” (more rational, conscious decision-making determinants) —when designing behavior change activities. Consider emotional drivers as well as environmental cues.
  • Build on what is known. There is no need to start from scratch. Rather, consult and confirm available data and apply best practices.

The full webinar recording is available below.

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