Beyond tippy-taps: The role of enabling products in scaling up and sustaining handwashing
Factors that influence individuals’ opportunity to handwash have often been overlooked in hygiene promotion initiatives, with much of the focus having been on motivation. This article summarizes findings from the Water and Sanitation's Global Scaling Up Handwashing Project and other research that suggest that convenient access to water and soap when and where needed and having a designated place for HWWS are also important determinants for handwashing. Enabling products such as handwashing stations provide such a designated place in addition to an environmental cue to action and a stable context for handwashing, factors that the literature highlights as critical for habits to form and be maintained. WSP recently conducted a landscape of enabling products and many identified to date are tippy-taps. However, the learning from a design consultancy for a handwashing station for rural Vietnamese households is that appearances may matter and that designing features that take into account user preferences and practices is essential.Biran, A., Tabyshalieva, A. and Salmorbeka, Z. (2005) Formative Research for Hygiene Promotion in Kyrgyzstan, Oxford University Press, Oxford, UK.
Cairncross, S., Shordt, K., Zacharia, S. and Kumari Govindan, B. (2005) ‘What causes sustainable changes in hygiene behavior? A cross-sectional study from Kerala India’, Social Science and Medicine 61: 2212-20.
Cardosi, J., Curtis, V. and Scott, B. (2007) The Handwashing Handbook: A Guide for Developing a Hygiene Promotion Program to Increase Handwashing With Soap. Water and Sanitation Program, World Bank, Washington, DC.
Center for Diseases Control and Prevention (CDC), Morbidity Mortality Weekly Report Recommendations and Reports (2002) Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA, Hand Hygiene Task Force, October 25, 2002/51(RR16): 1-44.
Chapin, J. (2009) Designing a Handwashing Station for Rural Vietnamese Households, presentation, Water and Sanitation Program, World Bank, Washington, DC.
Coombes, Y. and Devine, J. (2009) Introducing FOAM : A Framework to Analyze Handwashing Behavior and Design Effective Handwashing Promotion Programs, working paper, Water and Sanitation Program, Washington, DC.
Curtis, V., Danquah, L. and Aunger, R. (2009) ‘Planned, motivated and habitual hygiene behavior: An eleven country review’, Health Education Research 24: 655-73.
Delisio, K. (2009) Behavioral Determinants of Handwashing among Peruvian Caregivers: Analysis of Baseline Data from The Water and Sanitation Program (WSP)'s Scaling Up Handwashing Behavior Change Initiative (Master's Thesis , John Hopkins University).
Indochina Research (Vietnam) (2007) Vietnam National Handwashing Initiative Consumer Research, Baseline Survey Final Report, Ho Chi Minh City: Indochina Research Limited.
Kane, M. (2009) Rapport Etude Lavage des Mains Au Savon Senegal, unpublished study, Water and Sanitation Program, World Bank, Washington, DC.
Luby, S., Halder, A., Tronchet, C., Akhter, S., Bhuiya, A. and Johnson, R. (2009) ‘Household characteristics associated with handwashing with soap in rural Bangladesh’, American Journal of Tropical Medicine and Hygiene 81: 882-7.
Pittet, D. (2000) ‘Improving compliance with hand hygiene in hospitals’, Infection Control and Hospital Epidemiology 21: 381-6.
Scott, B., Curtis, V. and Rabie, T. (2003) ‘Protecting children from diarrhea and acute respiratory infections: The role of handwashing promotion in water and sanitation programmes’, WHO Regional Health Forum 7: 42-7.
Scott, B., Curtis, V., Rabie, T. and Garbrah-Aidoo, N. (2007) ‘Health in our hands but not in our heads: Understanding hygiene motivation in Ghana’, Health Policy and Planning 22: 225-33.
Verplanken, B. and Orbell, S. (2003) ‘Reflections on past behavior: A self-report index of habit strength’, Journal of Applied Social Psychology 33: 1313-30.
Verplanken, B. and Wood, W. (2006) ‘Interventions to Break and Create Consumer Habits’, Journal of Public Policy & Marketing 25: 90-103.
Biran, A., Tabyshalieva, A. and Salmorbeka, Z. (2005) Formative Research for Hygiene Promotion in Kyrgyzstan, Oxford University Press, Oxford, UK.
Cairncross, S., Shordt, K., Zacharia, S. and Kumari Govindan, B. (2005) ‘What causes sustainable changes in hygiene behavior? A cross-sectional study from Kerala India’, Social Science and Medicine 61: 2212-20.
Cardosi, J., Curtis, V. and Scott, B. (2007) The Handwashing Handbook: A Guide for Developing a Hygiene Promotion Program to Increase Handwashing With Soap. Water and Sanitation Program, World Bank, Washington, DC.
Center for Diseases Control and Prevention (CDC), Morbidity Mortality Weekly Report Recommendations and Reports (2002) Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA, Hand Hygiene Task Force, October 25, 2002/51(RR16): 1-44.
Chapin, J. (2009) Designing a Handwashing Station for Rural Vietnamese Households, presentation, Water and Sanitation Program, World Bank, Washington, DC.
Coombes, Y. and Devine, J. (2009) Introducing FOAM : A Framework to Analyze Handwashing Behavior and Design Effective Handwashing Promotion Programs, working paper, Water and Sanitation Program, Washington, DC.
Curtis, V., Danquah, L. and Aunger, R. (2009) ‘Planned, motivated and habitual hygiene behavior: An eleven country review’, Health Education Research 24: 655-73.
Delisio, K. (2009) Behavioral Determinants of Handwashing among Peruvian Caregivers: Analysis of Baseline Data from The Water and Sanitation Program (WSP)'s Scaling Up Handwashing Behavior Change Initiative (Master's Thesis , John Hopkins University).
Indochina Research (Vietnam) (2007) Vietnam National Handwashing Initiative Consumer Research, Baseline Survey Final Report, Ho Chi Minh City: Indochina Research Limited.
Kane, M. (2009) Rapport Etude Lavage des Mains Au Savon Senegal, unpublished study, Water and Sanitation Program, World Bank, Washington, DC.
Luby, S., Halder, A., Tronchet, C., Akhter, S., Bhuiya, A. and Johnson, R. (2009) ‘Household characteristics associated with handwashing with soap in rural Bangladesh’, American Journal of Tropical Medicine and Hygiene 81: 882-7.
Pittet, D. (2000) ‘Improving compliance with hand hygiene in hospitals’, Infection Control and Hospital Epidemiology 21: 381-6.
Scott, B., Curtis, V. and Rabie, T. (2003) ‘Protecting children from diarrhea and acute respiratory infections: The role of handwashing promotion in water and sanitation programmes’, WHO Regional Health Forum 7: 42-7.
Scott, B., Curtis, V., Rabie, T. and Garbrah-Aidoo, N. (2007) ‘Health in our hands but not in our heads: Understanding hygiene motivation in Ghana’, Health Policy and Planning 22: 225-33.
Verplanken, B. and Orbell, S. (2003) ‘Reflections on past behavior: A self-report index of habit strength’, Journal of Applied Social Psychology 33: 1313-30.
Verplanken, B. and Wood, W. (2006) ‘Interventions to Break and Create Consumer Habits’, Journal of Public Policy & Marketing 25: 90-103.
Biran, A., Tabyshalieva, A. and Salmorbeka, Z. (2005) Formative Research for Hygiene Promotion in Kyrgyzstan, Oxford University Press, Oxford, UK.
Cairncross, S., Shordt, K., Zacharia, S. and Kumari Govindan, B. (2005) ‘What causes sustainable changes in hygiene behavior? A cross-sectional study from Kerala India’, Social Science and Medicine 61: 2212-20.
Cardosi, J., Curtis, V. and Scott, B. (2007) The Handwashing Handbook: A Guide for Developing a Hygiene Promotion Program to Increase Handwashing With Soap. Water and Sanitation Program, World Bank, Washington, DC.
Center for Diseases Control and Prevention (CDC), Morbidity Mortality Weekly Report Recommendations and Reports (2002) Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA, Hand Hygiene Task Force, October 25, 2002/51(RR16): 1-44.
Chapin, J. (2009) Designing a Handwashing Station for Rural Vietnamese Households, presentation, Water and Sanitation Program, World Bank, Washington, DC.
Coombes, Y. and Devine, J. (2009) Introducing FOAM : A Framework to Analyze Handwashing Behavior and Design Effective Handwashing Promotion Programs, working paper, Water and Sanitation Program, Washington, DC.
Curtis, V., Danquah, L. and Aunger, R. (2009) ‘Planned, motivated and habitual hygiene behavior: An eleven country review’, Health Education Research 24: 655-73.
Delisio, K. (2009) Behavioral Determinants of Handwashing among Peruvian Caregivers: Analysis of Baseline Data from The Water and Sanitation Program (WSP)'s Scaling Up Handwashing Behavior Change Initiative (Master's Thesis , John Hopkins University).
Indochina Research (Vietnam) (2007) Vietnam National Handwashing Initiative Consumer Research, Baseline Survey Final Report, Ho Chi Minh City: Indochina Research Limited.
Kane, M. (2009) Rapport Etude Lavage des Mains Au Savon Senegal, unpublished study, Water and Sanitation Program, World Bank, Washington, DC.
Luby, S., Halder, A., Tronchet, C., Akhter, S., Bhuiya, A. and Johnson, R. (2009) ‘Household characteristics associated with handwashing with soap in rural Bangladesh’, American Journal of Tropical Medicine and Hygiene 81: 882-7.
Pittet, D. (2000) ‘Improving compliance with hand hygiene in hospitals’, Infection Control and Hospital Epidemiology 21: 381-6.
Scott, B., Curtis, V. and Rabie, T. (2003) ‘Protecting children from diarrhea and acute respiratory infections: The role of handwashing promotion in water and sanitation programmes’, WHO Regional Health Forum 7: 42-7.
Scott, B., Curtis, V., Rabie, T. and Garbrah-Aidoo, N. (2007) ‘Health in our hands but not in our heads: Understanding hygiene motivation in Ghana’, Health Policy and Planning 22: 225-33.
Verplanken, B. and Orbell, S. (2003) ‘Reflections on past behavior: A self-report index of habit strength’, Journal of Applied Social Psychology 33: 1313-30.
Verplanken, B. and Wood, W. (2006) ‘Interventions to Break and Create Consumer Habits’, Journal of Public Policy & Marketing 25: 90-103.
Biran, A., Tabyshalieva, A. and Salmorbeka, Z. (2005) Formative Research for Hygiene Promotion in Kyrgyzstan, Oxford University Press, Oxford, UK.
Cairncross, S., Shordt, K., Zacharia, S. and Kumari Govindan, B. (2005) ‘What causes sustainable changes in hygiene behavior? A cross-sectional study from Kerala India’, Social Science and Medicine 61: 2212-20.
Cardosi, J., Curtis, V. and Scott, B. (2007) The Handwashing Handbook: A Guide for Developing a Hygiene Promotion Program to Increase Handwashing With Soap. Water and Sanitation Program, World Bank, Washington, DC.
Center for Diseases Control and Prevention (CDC), Morbidity Mortality Weekly Report Recommendations and Reports (2002) Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA, Hand Hygiene Task Force, October 25, 2002/51(RR16): 1-44.
Chapin, J. (2009) Designing a Handwashing Station for Rural Vietnamese Households, presentation, Water and Sanitation Program, World Bank, Washington, DC.
Coombes, Y. and Devine, J. (2009) Introducing FOAM : A Framework to Analyze Handwashing Behavior and Design Effective Handwashing Promotion Programs, working paper, Water and Sanitation Program, Washington, DC.
Curtis, V., Danquah, L. and Aunger, R. (2009) ‘Planned, motivated and habitual hygiene behavior: An eleven country review’, Health Education Research 24: 655-73.
Delisio, K. (2009) Behavioral Determinants of Handwashing among Peruvian Caregivers: Analysis of Baseline Data from The Water and Sanitation Program (WSP)'s Scaling Up Handwashing Behavior Change Initiative (Master's Thesis , John Hopkins University).
Indochina Research (Vietnam) (2007) Vietnam National Handwashing Initiative Consumer Research, Baseline Survey Final Report, Ho Chi Minh City: Indochina Research Limited.
Kane, M. (2009) Rapport Etude Lavage des Mains Au Savon Senegal, unpublished study, Water and Sanitation Program, World Bank, Washington, DC.
Luby, S., Halder, A., Tronchet, C., Akhter, S., Bhuiya, A. and Johnson, R. (2009) ‘Household characteristics associated with handwashing with soap in rural Bangladesh’, American Journal of Tropical Medicine and Hygiene 81: 882-7.
Pittet, D. (2000) ‘Improving compliance with hand hygiene in hospitals’, Infection Control and Hospital Epidemiology 21: 381-6.
Scott, B., Curtis, V. and Rabie, T. (2003) ‘Protecting children from diarrhea and acute respiratory infections: The role of handwashing promotion in water and sanitation programmes’, WHO Regional Health Forum 7: 42-7.
Scott, B., Curtis, V., Rabie, T. and Garbrah-Aidoo, N. (2007) ‘Health in our hands but not in our heads: Understanding hygiene motivation in Ghana’, Health Policy and Planning 22: 225-33.
Verplanken, B. and Orbell, S. (2003) ‘Reflections on past behavior: A self-report index of habit strength’, Journal of Applied Social Psychology 33: 1313-30.
Verplanken, B. and Wood, W. (2006) ‘Interventions to Break and Create Consumer Habits’, Journal of Public Policy & Marketing 25: 90-103.
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