Men at a mosque

Ideas Addressing NORMS
The acceptability and standards for practice of a behavior dictated by religious, cultural, or other social networks, including workplace norms

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  • A 6-Week School Curriculum Improves Boys’ Attitudes and Behaviors Related to Gender-Based Violence in KenyaView Original Source

    The Big Idea: Gender-based violence contributes to lower use of health services. While gender-based violence can be prevented through girls’ and women’s empowerment, advocacy and home visitations, and it also needs to be addressed simultaneously with boys and men as GBV often occurs in the context of male peers who demonstrate negative attitudes toward women.

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  • A Change in Diet Brings a Change in Health for Kenyan FarmersView Original Source

    The Big Idea: Although women comprise a majority of child caregivers and farmers, women often lack access to new training and techniques offered through agriculture extension services. This can impact productivity as well as family’s food diversity. This program trained farmer’s self-help groups, reaching primarily women farmers in Kenya.

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  • A Disruptive Cue Improves Handwashing in School Children in ZambiaView Original Source

    The Big Idea: Behavioral economics holds great promise in changing patterns of behavior that influence human health, predicated on the idea of making a behavior as easy as possible to do. A study on handwashing in schools suggests that introducing a disruptive cue into the environment interrupted habitual neurological patterns to increase handwashing with soap.

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  • A Review of Evidence for Bystander Intervention to Prevent Sexual and Domestic Violence in UniversitiesView Original Source

    The Big Idea: Violence against women is a critical concern for public health. The growing evidence base for the bystander intervention approach to preventing sexual and domestic violence in university settings shows the potential to engage men, as well as women, positively in ending violence against women.

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  • A Spoonful of Sugar: Promoting WEE Through Edutainment ApproachesView Original Source

    The Big Idea:  Although financial inclusion among adults globally is improving, a gender gap remains in using financial services and products. This gender gap means that women, especially low-income women, are limited in financial security, financial decisions, or even expanding enterprises. Mobile banking options are helping to increase low-income women’s participation in formal savings services.

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  • Being Perceived as a "Real Woman" or Following One's Own Convictions: a Qualitative Study to Understand Individual, Family, and Community Influences on the Place of Childbirth in Busia, KenyaView Original Source

    The Big Idea: Many pregnant women may prefer to deliver their child at a health care facility rather at home with a traditional birth attendant, but do not feel able to choose this option because their female family members do not feel it is culturally appropriate. When designing strategies to increase uptake of deliveries in health care facilities, consider ways to help pregnant women, their families, and the community support the decision by incorporating traditional birth practices and modern delivery methods.

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  • Bringing Nigerian Health Clinics Back to Life in 72 HoursView Original Source

    The Big Idea:  Managers who are tasked with increasing family planning services in low resource areas are often faced with the reality that local health clinics may be run down, dirty, and may not have clean or modern equipment or have provisions for ensuring women’s exams are in a private setting. In addition to the poor facility experience, many women also report that the providers are not hospitable. A novel and economical intervention, which includes a 72-hour renovation of the clinic by engaging local community members, can dramatically increase uptake of services and improve quality of care.

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  • Building Support for Adolescent Sexuality and Reproductive Health Education and Responding to Resistance in Conservative Contexts: Cases from PakistanView Original Source

    The Big Idea: Well-designed, evidence-based sexuality education is an effective strategy to help young people delay first intercourse and use modern methods of contraception. However, school-based sexuality education often faces organized resistance from religious leaders and parent groups, among others. Building coalitions across communities, teachers, adolescent influencers, media, and religious leaders, gives programs better chance of success and scale-up.

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  • Changes in Couples’ Communication as a Result of Male-Involvement Family Planning InterventionView Original Source

    The Big Idea: Men are often the decision-makers about contraceptive use but programs usually focus on women. Men often lack the knowledge or skills to make informed decisions as a couple. By engaging men through peers, couples can make joint decisions on spacing births.

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  • Child-orientated Environmental Education Influences Adult Knowledge and Household BehaviourView Original Source

    The Big Idea:  Environmental education is frequently undertaken to change the attitudes and practices of participants, often aimed at children with the rationale that children influence the attitudes of their parents, who will consequently change their behavior.  This is the first rigorous study to demonstrate adults exhibiting greater knowledge of wetlands and improved reported household  water management behavior when their child has received wetland education in schools.

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  • Community Dialogues for Child Health: Results from a Qualitative Process in Three CountriesView Original Source

    The Big Idea: The availability of community-based services such as integrated community case management (iCCM) does not ensure utilization. Community dialogues with participatory discussions and learning for all community members contribute to improvements in timely care-seeking for sick children with diarrhea, pneumonia and malaria.

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  • Community Gender Norms Change as a Part of a Multilevel Approach to Sexual Health Among Married Women in Mumbai, IndiaView Original Source

    The Big Idea: Changing gender roles and expectations to support greater relational equity for women has been shown to reduce HIV risk by improving the dynamics of marital relationships that contribute to risk. This can be challenging in male-dominated cultures. This community intervention at multiple levels, with a variety of strategies, shows that it is possible to significantly improve men’s equitable attitudes.

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  • Effect of a Behaviour-Change Intervention on Handwashing with Soap in India (Superamma): A Cluster Randomized TrialView Original Source

    The Big Idea: In most countries, knowledge about the health benefits of handwashing with soap is high, but does not correspond to actual behavior change. Emotional, non-health messages focused around disgust were shown to be more effective, have a longer-lasting impact on handwashing behaviors, and have the potential to achieve sufficient scale for population-level impact.

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  • Effect of a Participatory Multisectoral Maternal and Newborn Intervention on Maternal Health Service Utilization and Newborn Care Practices: A Quasi-Experimental Study in Three Rural Ugandan Districts View Original Source

    The Big Idea: To improve newborn care practices, evidence-informed community-based strategies involve the training of community health workers, community mobilization and facility-based improvements. Improved newborn care practices are supported by combination of timely and appropriate services including facility delivery and home visits after childbirth.

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  • Effect of Community-based Behavior Change Management on Neonatal Mortality in Shivgarh, Uttar Pradesh, India: A Cluster-Randomized Controlled TrialView Original Source

    The Big Idea: Neonatal mortality reduction can be achieved with a simple, low-cost package of interventions that includes home visits to whole households by community health workers and consistent community engagement with newborn care stakeholders to change social norms, focusing on locally meaningful practices that community members believe are within their control to change, in this case prevention and management of hypothermia. 

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  • Effect of Participatory Women's Groups Facilitated by Accredited Social Health Activists on Birth Outcomes in Rural Eastern India: A Cluster-Randomised Controlled Trial View Original Source

    The Big Idea: This study tested a large-scale community-based strategy to improve newborn health through participatory women's groups facilitated by the government’s community health workers, Accredited Social Health Activists (ASHAs).

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  • Employer-Based Models to Increase Support for and Provision of LA/PMs in IndiaView Original Source

    The Big Idea: Offering family planning services through employers is one way to increase access to services. This program tested the feasibility of sustaining access to services through small and medium enterprises that employ both men and women in India.

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  • Ending Eclampsia, Nigeria: Engaging Community Women’s Groups for Improved Antenatal and Postnatal Care ServicesView Original Source

    The Big Idea: Program managers aiming to improve maternal and neonatal outcomes are familiar with complications such pre-eclampsia (PE) and eclampsia, and are tasked with determining the most effective prevention, early detection and care approaches. One promising initiative bridges the gap between health providers and the community by engaging leaders of women’s groups to empower pregnant women with the knowledge and skills to be engaged clients throughout the pregnancy continuum.

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  • Engaging Communities With a Simple Tool to Help Increase Immunization CoverageView Original Source

    The Big Idea: Most interventions aimed at raising vaccination coverage focus on improving services or on informing and motivating families. The use of a visual tool that engages communities to ensure that all children get vaccinations on schedule can increase demand for immunization within health services and among communities, identification of children requiring immunization, and thereby increase coverage.

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  • Essential Newborn Care Corps: Evaluation of Program to Rebrand Traditional Birth Attendants as Health Promoters in Sierra LeoneView Original Source

    The Big Idea: As efforts continue to increase the proportion of facility-based deliveries to increase maternal and newborn survival, traditional birth attendants are discouraged from performing home deliveries. Yet women continue to seek their advice and services.  Rebranding traditional birth attendants can fulfill important community health needs in the continuum of care.

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  • Evaluation of the Effects of Smart Couple Digital Health Tool in Kaduna, Nigeria View Original Source

    The Big Idea: Programs that increase demand for family planning services often address the information needs of women but usually fall short in preparing them to be active and engaged communicators during counseling, and often neglect to engage men as active partners. Mobile technology for women and men shows promise in prompting couple dialogue and increased use of contraceptives.

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  • Evaluation of the Responsible, Engaged, and Loving (REAL) Fathers Initiative on Physical Child Punishment and Intimate Partner Violence in Northern UgandaView Original Source

    The Big Idea: Intimate partner violence (IPV) is a significant risk factor for numerous health practices, including newborn care and exclusive breastfeeding. Reducing children’s exposure to violence is an evidence-based approach to preventing partner violence for mothers and in the next generation.

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  • Examining Diffusion to Understand the How of SASA!, A Violence Against Women and HIV Prevention Intervention in UgandaView Original Source

    The Big Idea: While we know which program interventions help to intimate partner violence, there is less information available about how the factors underlying the behaviors changed. This study applied explored how SASA!, a community mobilization approach for preventing HIV and violence against women, diffused within intervention communities and the factors that influenced the uptake of new ideas and behaviors around intimate partner relationships and violence.

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  • Exposure to Large-Scale Social and Behavior Change Communication Interventions Is Associated with Improvements in Infant and Young Child Feeding Practices in EthiopiaView Original Source

    The Big Idea: Given resource constraints, communication programmers often field questions about the numbers of channels and numbers of contacts needed to achieve change. This analysis of a program that aimed to improve infant and young child feeding in Ethiopia analyzed the dose response associated with significant behavior change. 

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  • Factors Affecting Adoption of Improved Rice Varieties among Rural Farm Households in Central NepalView Original Source

    The Big Idea: The use of improved high yielding crop varieties is an important behavior for many small holder farmers to increase productivity and improve food security. Yet farmers do not adopt many new agricultural technologies, such as improved seeds, to the extent desired or expected. This analysis explored the probability of smallholder farmers adopting new improved rice varieties from two regions of Central Nepal.

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  • Fertility Awareness for Community Transformation (FACT) EDEAN Results BriefView Original Source

    The Big Idea: Everyone enjoys a show! But can performances address the factors to facilitate behavior change?  This program tested the hypothesis that increased fertility awareness that leads to use of family planning methods, using community theater performances.

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  • Gamification of Nutrition: A Preliminary Study on the Impact of Gamification on Nutrition Knowledge, Attitude, and Behavior of Adolescents in NigeriaView Original Source

    The Big Idea: Many young people around the world are consuming larger amounts of sugar, salt and saturated fats and less from traditional diets such as fruits, vegetables and high fiber foods, which can result in obesity, diabetes and other health challenges. Gamifying nutrition education for adolescents can increase intake of fruits and vegetables.

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  • Gender-Transformative Bandebereho Couples' Intervention to Promote Male Engagement in Reproductive and Maternal Health and Violence Prevention in Rwanda: Findings from a Randomized Controlled TrialView Original Source

    The Big Idea: Many programs promote male engagement and involved fatherhood. This evaluation explored the how a discussion and education group with young fathers and their partners in Rwanda that addresses how gender inequalities are transformed through “everyday interactions in the home” impacted relationship power dynamics and women’s decision-making in their households.

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  • Grandmother’s Knowledge Positively Influences Maternal Knowledge and Infant and Young Child Feeding PracticesView Original Source

    The Big Idea: Programs often work with mothers to improve child nutrition. Engaging grandmothers, who are both caregivers of young children as well as influencers of mothers, is often important to improve infant and young child feeding practices.

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  • Hello Mama Via Papa: A Nigerian Father Gets the Message about Maternal and Newborn HealthView Original Source

    The Big Idea: Managers who oversee programs that help strengthen maternal, newborn and child health outcomes often directly target the mother.  A novel program in Nigeria targets fathers-to-be through mobile phones, providing them with simple, carefully timed text messages to share with their wives and to learn how to help care for her and the baby. 

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  • Impact of an Intensive Perinatal Handwashing Promotion Intervention on Maternal Handwashing Behavior in the Neonatal Period: Findings from a Randomized Controlled Trial in Rural Bangladesh View Original Source

    The Big Idea: Infections in the neonatal period cause up to on-quarter of neonatal mortality, including pneumonia, sepsis, and infections of the umbilical cord. Handwashing with soap could potentially reduce the risk of infection during the vulnerable neonatal period.

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  • Impact of Maternal Education about Complementary Feeding on Their Infants’ Nutritional Outcomes in Low- and Middle-income Households: A Community-based Randomized Interventional Study in Karachi, PakistanView Original Source

    The Big Idea: Improving young children's nutrition goes beyond food. A series of home visits by trained community health workers on breastfeeding and complementary feeding significantly changed behaviors and reduced malnutrition of their young children.

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  • Improving Coverage of Postnatal Care in Rural Ethiopia Using A Community-based, Collaborative Quality Improvement ApproachView Original Source

    The Big Idea: Newborns are most vulnerable during the first 48 hours after birth, a time when many mothers and newborns are confined by social norms to the home. Involving family members, neighbors and friends of pregnant women through family meetings and technology to notify community health workers of labor and birth is a scalable model that effectively increases the coverage of postnatal care

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  • Improving Teacher Quality: Lessons Learned from Grantees of the Partnership to Strengthen Innovation and Practice in Secondary EducationView Original Source

    The Big Idea: The quality of the teaching force is the single most influential school-based factor in promoting learning. Strengthening educational systems to deliver quality teaching requires answers questions such as how to motivate teachers in resource-constrained environments. This review of eight programs identifies a variety of intrinsic and extrinsic factors that lead to greater motivation and teaching quality.

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  • Increasing Contraceptive Use Among Young Married Couples in Bihar, India: Evidence from a Decade of Implementation of the PRACHAR ProjectView Original Source

    The Big Idea: In contexts of early marriage, early and rapid repeat pregnancies among young married women, and inequitable social and gender norms, a comprehensive intervention is required. This review of program data over more than a decade of implementation sheds light on the key elements to sustained social and behavior change, including use of a socioecological intervention model; a gender-synchronized approach that engages both male and female partners; and intensity of interventions calibrated to different moments in the life cycle of young people.

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  • Increasing Vaccination: Putting Psychological Science Into ActionView Original Source

    The Big Idea: Managers who seek to increase vaccination uptake, especially in low resource settings, can improve vaccine uptake by leveraging existing thoughts and feelings to facilitate action through a combination of facilitating action, reducing logistical barriers and regulating.

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  • Influence of Social Media on Alcohol Use in Adolescents and Young AdultsView Original Source

    The Big Idea: Promoting health behaviors among adolescents will increasingly require interacting with and changing perceived norms via social media. This work presents the rationale for understanding and navigating this complex pseudo-reality to effectively address norms among young people.

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  • Interventions to Reduce Discrimination and Stigma: The State of the Art View Original Source

    The Big Idea: Stigma and discrimination can limit access to services, reduce life expectancy, and increase risk of poverty. For many people, these consequences are worse than the illness itself.  Evidence-based approaches to address stigma and discrimination toward mental illness can be applied to other issues, such as HIV/AIDS.

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  • One Surprising Idea to Help Solve a Water Crisis: Arid Jordan Faces Refugee and Water Challenges, but These Women are Here to HelpView Original Source

    The Big Idea: For those who manage WASH programs in harsh desert environments where water resources are limited, one might assume that the environment and political conflicts over water are the key factors to address. But women (including female refugees) can play a critical role in reducing water consumption by identifying and repairing leaks in households in their own homes/residences and in their communities when trained as professional plumbers.

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  • Participation of Pregnant Women in a Community-Based Nutrition Program in Mumbai's Informal Settlements: Effect on Exclusive Breastfeeding PracticesView Original Source

    The Big Idea:  Promoting exclusive breastfeeding often requires addressing multiple factors and offering multiple strategies, but often the timing of these activities is not discussed. This study reviewed the impact of community based activities on exclusive breastfeeding, including the timing of women’s participation.

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  • Promoting Hygienic Weaning Food Handling Practices Through a Community-Based Programme: Intervention Implementation and Baseline Characteristics for a Cluster Randomised Controlled Trial in Rural GambiaView Original Source

    The Big Idea: The hygiene of complementary food for young children is a concern as contamination is often high, and may cause diarrhoea and other illnesses and infections. This program aimed to use lessons from effective programs in Nepal and India to design a lower-cost model for Gamia, translating formative research findings to determine critical control point corrective measures and motivational drives for behaviour change.

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  • Rural Sanitation in India: The Poo PartyView Original Source

    The Big Idea: Open Defecation Free (ODF) status requires use of a latrine, not only construction of latrines. Engaging women and youth in the movement against open defecation through creative and practical ways can renew stalled efforts in safe disposal of human feces.

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  • Saving for School with LockboxesView Original Source

    The Big Idea:  Commitment devices, which offer an opportunity to restrict future choices, have been shown to be effective in helping people save. However, severe restrictions can deter participation. This study assessed a program that offered different options to encourage students to save.

     

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  • Smallholder Farmers Gain Access to Inputs, Finance and Markets through Senegal's Millet "Hubs"View Original Source

    The Big Idea: As agricultural produce yields improve with greater inputs, farmers need new ways of aggregating and using proper storage and marketing to ensure that their produce and earnings last throughout the seasons.  Millet Business Service Hubs offer a collective solution to making services, training and loans available as needed by producers.

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  • Social Norms and Global Environmental Challenges: The Complex Interaction of Behaviors, Values, and PolicyView Original Source

    The Big Idea:  Government policies, including regulations, sanctions and incentives, are often needed when people’s behaviors do not meet the public good.  Policies are more cost-effective when they influence norms, so that behavior change is sustained even in the absence of external regulations or penalties.

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  • Tangible Benefits to Child Wellbeing Seen Among Households Participating In Savings And Internal Lending Communities (SILC)View Original Source

    The Big Idea: High quality HIV counseling and testing is essential for reducing HIV-related morbidity, mortality and transmission. HTC links individuals and families to antiretroviral therapy (ART), care and support, and HIV prevention, yet for individuals taking this step can be challenging. A strategic convergence of activities for caregivers who are already members of economic strengthening groups can improve HIV testing uptake for their own health and the health and survival of their children.

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  • Te'kponon Jikuagou - Addressing Unmet Need for Family Planning through Social Networks in BeninView Original Source

    The Big Idea: Too often programs work only with the usual suspects on birth spacing: couples, providers and leaders. This effective program found that engaging women’s existing social networks of relatives, friends and other influential individuals can tap into real influencers and accelerate the pace of diffusion for uptake of birth spacing practices.

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  • The Effectiveness of Multilevel Promotion of Exclusive Breastfeeding in Rural IndonesiaView Original Source

    The Big Idea: Exclusive breastfeeding is influenced by multiple factors at the institutional, social and individual levels. Addressing all of these levels simultaneously using locally tailored strategies can improve the duration and prevalence of exclusive breastfeeding.

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  • The Trick to Surviving a High-Stakes Pressure Job: Use a ChecklistView Original Source

    The Big Idea: Health care facility managers around the globe are keenly aware of the risk to clients due to infections with deadly bacteria through catheters and other procedures.   Drawing on humanities “oldest tool to combat blind spots and arrogance,” checklists have the power to dramatically reduce infections and injury or death for clients, when introduced through a human-centered approach.

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  • Transfers, Behavior Change Communication, and Intimate Partner Violence: Post-Program Evidence from Rural BangladeshView Original Source

    The Big Idea: Social transfer programs, cash and food, have been shown to reduce intimate partner violence (IPV). This study examined how communications activities related to cash or food transfers affected IPV after a program ended, suggesting sustained effects on women’s “threat points,” men’s social costs of violence, and household well-being.

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  • Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in NepalView Original Source

    The Big Idea: Research into food hygiene is often a neglected area of diarrhea and undernutrition prevention programs. While a number of studies have assessed risk factors and microbial contamination in food, few have developed or tested interventions to counter this problem in domestic settings. This trial assessed whether an intervention could improve multiple food hygiene behaviors in 4 villages in rural Nepal.

     

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  • Using a Community-Based Early Childhood Development Center as a Platform to Promote Production and Consumption Diversity Increases Children's Dietary Intake and Reduces Stunting in Malawi: A Cluster-Randomized TrialView Original Source

    The Big Idea: Early childhood development (ECD) platforms have the potential to deliver child development and nutrition interventions. This study explored the additional opportunity of utilizing this platform to deliver nutrition-sensitive agriculture support to families with young children.

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  • Using Peer Pressure to Cut Energy UseView Original Source

    The Big Idea: OPOWER’s neighborhood energy challenges have evolved into one of the largest behavior change experiments in the world by providing 18 million homes with energy-usage reports that include comparisons with neighbors’ usage.  Comparing individuals to their peers can lead to improvements in behavior, as individuals will often do what is recommended and practiced by the community so that they are judged positively.

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