Development and Application of Novel Caregiver Hygiene Behavior Measures Relating to Food Preparation, Handwashing, and Play Environments in Rural Kenya

Breanna K. Wodnik, Matthew C. Freeman, Anna S. Ellis, Emily Awino Ogutu, Amy Webb Girard and Bethany A. Caruso
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Breanna K. Wodnik: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Matthew C. Freeman: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Anna S. Ellis: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Emily Awino Ogutu: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Amy Webb Girard: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Bethany A. Caruso: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

IJERPH, 2018, vol. 15, issue 9, 1-23

Abstract: Exposure to fecal pathogens results in both acute and chronic sequalae in young children. Diarrhea causes nearly 20% of all under-five mortality, while even sub-clinical enteric infections may lead to growth shortfalls. Stunting affects nearly 165 million children globally and results in lifelong and intergenerational effects for the world’s poorest populations. Caregiver hygiene behaviors, such as those surrounding handwashing and food preparation, play a critical role in exposure to fecal pathogens; standard metrics to assess these behaviors are warranted to provide a means of quantifying the impact these behaviors have on enteric infections and to evaluate the success or failure of interventions and programs. This paper documents the development of three novel caregiver hygiene behavior measures: hygienic food preparation and storage, handwashing at key times, and provision of a safe play environment for children under two years. We developed these measures using formative qualitative work, survey creation and deployment theoretically underpinned by the COM-B model of behavior change, and exploratory and confirmatory factor analysis. The final measure for hygienic food preparation and storage includes 10 items across two factors; the final measure for handwashing at key times includes 15 items across three factors; and the final measure for safe play environment contains 13 items across three factors. Future researchers may employ these measures to assess caregiver behaviors in other populations, identify specific behavioral dimensions that should be the focus of interventions, and evaluate interventions and programs.

Keywords: stunting; handwashing; food hygiene; play environment; animal feces; factor analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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