TY - JOUR
T1 - Formative Research for the Development of the CHoBI7 Cholera Rapid Response Program for Cholera Hotspots in Bangladesh
AU - Zohura, Fatema
AU - Thomas, Elizabeth D.
AU - Masud, Jahed
AU - Bhuyian, Md Sazzadul Islam
AU - Parvin, Tahmina
AU - Monira, Shirajum
AU - Faruque, Abu S.G.
AU - Alam, Munirul
AU - George, Christine Marie
N1 - Funding Information:
This study was funded by Fogarty International Center. We thank the study participants and the following individuals for their support with the implementation of this study: Abul Khair Mohammad Shamsuzzaman, Be-Nazir Ahmed, Fosiul Alam Nizame, Khobair Hossain, Jahed Masud, Ismat Minhaj Uddin, Rafiqul Islam, Maynul Hasan, SM. Arifur Rahman, Abdullah Al Morshed, Zakir Hossain, Kabir Hossain, Amal Sarker, Abul Bashar Sikder, Abdul Matin, Sadia Afrin Ananya, Lubna Tani, Farhana Ahmed, Tahera Taznen, Marufa Akter, Akhi Sultana, Nasrin Akter, Laki Das, Abdul Karim, Shirin Akter, Khan Ali Afsar and Wasim Ahmed Asif. We also thank hospital staff for their support. icddr,b acknowledges the governments of Bangladesh, Canada, Sweden, and United Kingdom for providing core/unrestricted support.
Funding Information:
This study was funded Fogarty International Center, grant number R21TW010997.
Publisher Copyright:
© 2022 by the authors.
PY - 2022/10
Y1 - 2022/10
N2 - Cholera is a severe form of acute watery diarrhea that if left untreated can result in death. Globally, there are 2.9 million cholera cases annually. Individuals living in close proximity to cholera cases are at a higher risk for developing cholera compared to the general population. Targeted water, sanitation, and hygiene (WASH) interventions have the potential to reduce cholera transmission in cholera hotspots around cholera cases. The objective of this study was to expand the scope of the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) program, focused on cholera patient households, for delivery in cholera hotspots in urban slums in Dhaka, Bangladesh. Thirty-one semi-structured interviews were conducted in cholera hotspots around cholera patients, and three intervention planning workshops were conducted to inform modifications needed to the CHoBI7 program. After exploratory interviews, a two-phase, iterative pilot study was conducted for 9 months to test the developed CHoBI7 Cholera Rapid Response program among 180 participants to further inform modifications to intervention content and delivery. Findings from pilot participant interviews highlighted the need to adapt intervention content for delivery at the compound—rather than household—level, given an environment with multiple households sharing a water source, toilets, and kitchen facilities. This was addressed by conducting a “ring session” for intervention delivery in cholera hotspots for households to discuss how to improve their shared facilities together and encourage a compound-level commitment to promoted WASH behaviors and placement of soapy water bottles in shared spaces. Based on the low number of soapy water bottles observed in communal spaces during the first iteration of the pilot, we also added context-specific examples using the narratives of families in mobile messages to encourage WASH behavioral recommendations. Formative research identified important considerations for the modifications needed to tailor the CHoBI7 program for delivery in cholera hotspots in urban Bangladesh.
AB - Cholera is a severe form of acute watery diarrhea that if left untreated can result in death. Globally, there are 2.9 million cholera cases annually. Individuals living in close proximity to cholera cases are at a higher risk for developing cholera compared to the general population. Targeted water, sanitation, and hygiene (WASH) interventions have the potential to reduce cholera transmission in cholera hotspots around cholera cases. The objective of this study was to expand the scope of the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) program, focused on cholera patient households, for delivery in cholera hotspots in urban slums in Dhaka, Bangladesh. Thirty-one semi-structured interviews were conducted in cholera hotspots around cholera patients, and three intervention planning workshops were conducted to inform modifications needed to the CHoBI7 program. After exploratory interviews, a two-phase, iterative pilot study was conducted for 9 months to test the developed CHoBI7 Cholera Rapid Response program among 180 participants to further inform modifications to intervention content and delivery. Findings from pilot participant interviews highlighted the need to adapt intervention content for delivery at the compound—rather than household—level, given an environment with multiple households sharing a water source, toilets, and kitchen facilities. This was addressed by conducting a “ring session” for intervention delivery in cholera hotspots for households to discuss how to improve their shared facilities together and encourage a compound-level commitment to promoted WASH behaviors and placement of soapy water bottles in shared spaces. Based on the low number of soapy water bottles observed in communal spaces during the first iteration of the pilot, we also added context-specific examples using the narratives of families in mobile messages to encourage WASH behavioral recommendations. Formative research identified important considerations for the modifications needed to tailor the CHoBI7 program for delivery in cholera hotspots in urban Bangladesh.
KW - Bangladesh
KW - WASH
KW - behavior change
KW - cholera and diarrhea
KW - handwashing with soap
KW - mHealth
KW - water treatment
UR - http://www.scopus.com/inward/record.url?scp=85140714107&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85140714107&partnerID=8YFLogxK
U2 - 10.3390/ijerph192013352
DO - 10.3390/ijerph192013352
M3 - Article
C2 - 36293930
AN - SCOPUS:85140714107
SN - 1661-7827
VL - 19
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 20
M1 - 13352
ER -