Haiti

Purpose of Study and Background

            After natural disaster, water supplies are often affected. In an area such as Haiti that struggles with incidence of endemic cholera, affected water supply potentiates risk of infection from diarrheal diseases, with cholera in particular. In low income areas, makeshift temporary living situations are overcrowded and worsen impact of communicable diseases because of lack of adequate access to water and close living situations. The above article studied the efficacy of health promotion programs in the wake of 2010 earthquake to increase use of hand washing. The overarching goal of the study was to determine the best method to disseminate that important health information and subsequent change in health practices.

 

Study Population and Setting

            This study interviewed in tent cities and neighborhoods in Port-au-Prince, and four rural areas close by. These face-to-face interviews were conducted after three humanitarian groups had implemented hand hygiene education. They sought out the persons that performed care and food preparation in the house, as these were likely the ones who would help with toileting of the sick and prepare meals for both well and sick. These persons would be most exposed to diarrheal disease and, subsequently, persons most like to spread the bacteria.

 

Type of Study and Methodology

            A random-route sampling method was used at twenty separate sites; every third house was interviewed. A total of 811 persons were interviewed via questionnaire that addressed perceptions of when it was most important to wash hands, perceptions of the handwashing promotional methods, and “behavioral factors” (p. 561). The behavioral factors sought to evaluate norms and values surrounding hand washing practice. The promotions evaluated included radio spots, radio programming, stickers, posters, megaphone, hygiene days, hygiene trainings, focus groups and other methods with a total of sixteen different modes of communication.

Results

Based upon the results of the interview, radio spots were the most influential promotional method. Incidentally, this mode was also able to reach 92% of the intended audience.

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Strengths, Weakness, and Limitations of Study

            The study is forthcoming with the results and methods of collecting data. There was no baseline data gathered prior to the health promotion implementations. Additionally, it would not have been ethical to create control groups in the emergency environment of post-earthquake disaster. It was also difficult to differentiate between certain promotional activities as they were all implemented in short succession of one another. There may have been bias in the study results as females where the primary focus as the main caregivers. Lastly, the study admits that self reported bias may interfere with accurate data collection, identifying observation of hand-washing practices to be the ideal method of data collection.

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Implications and Relation to Personal Professional Practice

            This study evaluated health promotion activity in the wake of disaster. “The study revealed that attitude, norm, ability, and self-regulation factors are more important in explaining handwashing behavior in an emergency situation than risk factors” (p. 569). The study states that focusing on appearance and how others will see or think of you, may be a stronger motivational factor than explaining health promoting behavior alone, with rationale.

            Applying this study to nursing practice, it seems important to evaluate a population’s norms of behavior along with physical barriers to implementing health promoting practices. The power of the media to influence perception seems to be even stronger than statistics of illness or explanation of methods.