TY - JOUR
T1 - Determinants of caregivers' use and adoption of household water chlorination
T2 - A qualitative study with peri-urban communities in the Peruvian Amazon
AU - Rothstein, Jessica D.
AU - Leontsini, Elli
AU - Olortegui, Maribel Paredes
AU - Yori, Pablo Peñataro
AU - Surkan, Pamela J.
AU - Kosek, Margaret
N1 - Publisher Copyright:
Copyright © 2015 by The American Society of Tropical Medicine and Hygiene.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - The gap between the efficacy and the effectiveness of household water treatment in reducing diarrhearelated morbidity indicates the need for a better understanding of the determinants of long-term behavior change. To explore the barriers to drinking water chlorination in the Peruvian Amazon, where diarrhea is endemic among under-5 children, we conducted qualitative research with 23 caregivers from peri-urban communities of Iquitos, Peru. Our inquiry drew on the Transtheoretical Model of behavior change and the Integrated Behavioral Model for Water, Sanitation, and Hygiene to identify the most relevant contextual, psychosocial, and technological determinants of initial action and longterm adoption of chlorination. Our findings suggest that the decision to try out this practice resulted from the combined effect of knowledge of chlorination benefits and product availability and affordability. Progress from action to adoption was influenced by caretakers' understanding of dosage, the packaging of chlorine products, knowledge and skills for multipurpose laundry bleach, the taste of treated water, and reinforcement. This analysis suggests that a focus on these determinants and the household domain may help to improve the sustainability of future intervention efforts.
AB - The gap between the efficacy and the effectiveness of household water treatment in reducing diarrhearelated morbidity indicates the need for a better understanding of the determinants of long-term behavior change. To explore the barriers to drinking water chlorination in the Peruvian Amazon, where diarrhea is endemic among under-5 children, we conducted qualitative research with 23 caregivers from peri-urban communities of Iquitos, Peru. Our inquiry drew on the Transtheoretical Model of behavior change and the Integrated Behavioral Model for Water, Sanitation, and Hygiene to identify the most relevant contextual, psychosocial, and technological determinants of initial action and longterm adoption of chlorination. Our findings suggest that the decision to try out this practice resulted from the combined effect of knowledge of chlorination benefits and product availability and affordability. Progress from action to adoption was influenced by caretakers' understanding of dosage, the packaging of chlorine products, knowledge and skills for multipurpose laundry bleach, the taste of treated water, and reinforcement. This analysis suggests that a focus on these determinants and the household domain may help to improve the sustainability of future intervention efforts.
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U2 - 10.4269/ajtmh.14-0654
DO - 10.4269/ajtmh.14-0654
M3 - Article
C2 - 26175028
AN - SCOPUS:84941636364
SN - 0002-9637
VL - 93
SP - 626
EP - 635
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 3
ER -