Trial Outcomes & Findings for Using Behaviour Change Messaging to Improve Communal Toilets in Dhaka, Bangladesh (NCT NCT02324075)

NCT ID: NCT02324075

Last Updated: 2021-01-07

Results Overview

Assessment by observer in unannounced visit to the shared latrine to determine presence of visible feces inside the pan (both inside and outside the hole in the pan).

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 1226 participants
• Primary outcome timeframe: Assessed at 6 months post intervention
• Results posted on: 2021-01-07

Participant Flow

In this cluster trial, communities were randomized either to receive a behavior change messaging intervention or no intervention. 1226 shared latrines were analyzed within these communities. One person using the shared latrine was asked to complete study surveys (baseline and month 6), and respondents were considered to be enrolled in the study.

Unit of analysis: Shared latrines

Participant milestones

Measure	Behavior Change Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm Standard habits and practices
Overall Study STARTED	612 612	614 614
Overall Study COMPLETED	609 605	605 605
Overall Study NOT COMPLETED	3 7	9 9

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Measure	Behavior Change n=612 Participants Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=614 Participants Standard habits and practices	Total n=1226 Participants Total of all reporting groups
Age, Categorical <=18 years	0 Participants n=612 Participants	0 Participants n=614 Participants	0 Participants n=1226 Participants
Age, Categorical Between 18 and 65 years	612 Participants n=612 Participants	614 Participants n=614 Participants	1226 Participants n=1226 Participants
Age, Categorical >=65 years	0 Participants n=612 Participants	0 Participants n=614 Participants	0 Participants n=1226 Participants
Age, Continuous	33 years STANDARD_DEVIATION 11 • n=612 Participants	34 years STANDARD_DEVIATION 13 • n=614 Participants	33.5 years STANDARD_DEVIATION 12 • n=1226 Participants
Sex: Female, Male Female	452 Participants n=612 Participants	461 Participants n=614 Participants	913 Participants n=1226 Participants
Sex: Female, Male Male	160 Participants n=612 Participants	153 Participants n=614 Participants	313 Participants n=1226 Participants
Race and Ethnicity Not Collected	—	—	0 Participants Race and Ethnicity were not collected from any participant.
Region of Enrollment Bangladesh	612 Participants n=612 Participants	614 Participants n=614 Participants	1226 Participants n=1226 Participants

PRIMARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle with waste pan. Pans that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine presence of visible feces inside the pan (both inside and outside the hole in the pan).

Outcome measures

Measure	Behavior Change n=912 pans Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=883 pans Standard habits and practices
Number of Pans With Presence of Visible Feces Inside the Pan Baseline	282 pans	203 pans
Number of Pans With Presence of Visible Feces Inside the Pan Month 6	83 pans	124 pans

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle with waste pan. Pans that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine presence of visible feces outside the pan.

Outcome measures

Measure	Behavior Change n=912 pans Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=883 pans Standard habits and practices
Number of Pans With Presence of Visible Feces Outside the Pan Baseline	68 pans	64 pans
Number of Pans With Presence of Visible Feces Outside the Pan Month 6	21 pans	31 pans

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Assessment by observer in unannounced visit to the shared latrine to determine presence of feces on the path leading up to the shared toilet.

Outcome measures

Measure	Behavior Change n=612 Shares latrines Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=614 Shares latrines Standard habits and practices
Visible Feces on the Path Leading up to the Latrine Baseline	57 Shares latrines	72 Shares latrines
Visible Feces on the Path Leading up to the Latrine Month 6	55 Shares latrines	56 Shares latrines

SECONDARY outcome

Timeframe: baseline and 6 months post intervention

Population: Data were not collected for this outcome measure.

Assessment by observer in unannounced visit to the shared latrine to determine presence of feces near the latrine but not on the path leading to the latrine.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle toilet. Toilets that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine if the cubicle toilet is fully functional.

Outcome measures

Measure	Behavior Change n=919 toilets Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=935 toilets Standard habits and practices
Number of Functional Cubicle Toilets Baseline	906 toilets	916 toilets
Number of Functional Cubicle Toilets Month 6	877 toilets	877 toilets

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle with waste pan. Pans that were evaluated were included in the analysis.

Observer in unannounced visit assess if feces is visible inside the hole of the pan

Outcome measures

Measure	Behavior Change n=912 pans Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=883 pans Standard habits and practices
Visible Feces Inside the Hole of the Pan Baseline	433 pans	399 pans
Visible Feces Inside the Hole of the Pan Month 6	297 pans	351 pans

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle. Cubicles that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine problems with cleanliness. Observations were made for spit/cough on walls/doors. The count of units that had the problem is presented for each problem type.

Outcome measures

Measure	Behavior Change n=908 Cubicles Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=876 Cubicles Standard habits and practices
Latrine Cleanliness - Spit/Cough on Walls/Doors Spit/cough on walls/doors (baseline)	199 Cubicles	257 Cubicles
Latrine Cleanliness - Spit/Cough on Walls/Doors Spit/cough on walls/doors (month 6)	153 Cubicles	187 Cubicles

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle. Cubicles that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine problems with cleanliness. Observations were made for cigarette butts in toilets. The count of units that had the problem is presented for each problem type.

Outcome measures

Measure	Behavior Change n=906 Cubicles Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=916 Cubicles Standard habits and practices
Latrine Cleanliness - Cigarette Butts Cigarette Butts (baseline)	95 Cubicles	112 Cubicles
Latrine Cleanliness - Cigarette Butts Cigarette Butts (month 6)	50 Cubicles	73 Cubicles

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle. Cubicles that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine problems with cleanliness. Observations were made for waterlogging in toilets. The count of units that had the problem is presented for each problem type.

Outcome measures

Measure	Behavior Change n=906 Cubicles Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=916 Cubicles Standard habits and practices
Latrine Cleanliness - Waterlogging Waterlogging (baseline)	90 Cubicles	77 Cubicles
Latrine Cleanliness - Waterlogging Waterlogging (month 6)	35 Cubicles	41 Cubicles

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle. Cubicles that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine problems with cleanliness. Observations were made for presence of household waste/waste wrapped in polythene. The count of units that had the problem is presented for each problem type.

Outcome measures

Measure	Behavior Change n=906 Cubicles Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=916 Cubicles Standard habits and practices
Latrine Cleanliness - Presence of Household Waste/Waste Wrapped in Polythene Household or polythene-wrapped waste (baseline)	91 Cubicles	43 Cubicles
Latrine Cleanliness - Presence of Household Waste/Waste Wrapped in Polythene Household or polythene-wrapped waste (month 6)	36 Cubicles	26 Cubicles

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle. Cubicles that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine problems with cleanliness. Observations were made for presence of rags/sanitary pads. The count of units that had the problem is presented for each problem type.

Outcome measures

Measure	Behavior Change n=906 Cubicles Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=916 Cubicles Standard habits and practices
Latrine Cleanliness - Presence of Rags/Sanitary Pads Rags/Sanitary Pads (baseline)	43 Cubicles	47 Cubicles
Latrine Cleanliness - Presence of Rags/Sanitary Pads Rags/Sanitary Pads (month 6)	12 Cubicles	23 Cubicles

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle. Cubicles that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine problems with cleanliness. Observations were made for smell of feces. The count of units that had the problem is presented for each problem type.

Outcome measures

Measure	Behavior Change n=906 Cubicles Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=916 Cubicles Standard habits and practices
Latrine Cleanliness - Smell of Feces Smell of Feces (baseline)	521 Cubicles	504 Cubicles
Latrine Cleanliness - Smell of Feces Smell of Feces (month 6)	319 Cubicles	382 Cubicles

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle. Cubicles that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine problems with cleanliness. Observations were made for smell of urine. The count of units that had the problem is presented for each problem type.

Outcome measures

Measure	Behavior Change n=906 Cubicles Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=916 Cubicles Standard habits and practices
Latrine Cleanliness - Smell of Urine Smell of Urine (baseline)	463 Cubicles	516 Cubicles
Latrine Cleanliness - Smell of Urine Smell of Urine (month 6)	264 Cubicles	333 Cubicles

SECONDARY outcome

Timeframe: Assessed at 6 months post intervention

Population: Shared latrines may have had more than one cubicle. Cubicles that were evaluated were included in the analysis.

Assessment by observer in unannounced visit to the shared latrine to determine problems with cleanliness. Observations were made for smell of cigarettes. The count of units that had the problem is presented for each problem type.

Outcome measures

Measure	Behavior Change n=906 Cubicles Behavior change messaging with facilitating hardware Behavior change: Non governmental organization delivers communication intervention with facilitating hardware, a waste bin and bucket	Control Arm n=916 Cubicles Standard habits and practices
Latrine Cleanliness - Smell of Cigarettes Smell of cigarettes (baseline)	83 Cubicles	111 Cubicles
Latrine Cleanliness - Smell of Cigarettes Smell of cigarettes (month 6)	54 Cubicles	65 Cubicles

Adverse Events

Behavior Change

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Control Arm

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Prof. Stephen P. Luby, MD

Stanford University

Phone: +1-650-723-4129

Email: sluby@stanford.edu

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place