Table 3 Intervention function table
From: Designing integrated interventions to improve nutrition and WASH behaviors in Kenya
Determinant(s) (COM-B) | Theoretical domains framework | Intervention function | Behavior change techniques | Intervention activity | Desired outcome |
|---|---|---|---|---|---|
Section A: “clean compound” package | |||||
Physical opportunity | Environmental context and resources | Environmental restructuring | Adding object to the environment | Feces scooper | Reduced instance of observed feces in the compound/in child play area |
Reflective motivation | Intentions/belief about capabilities | Enablement | Behavioral contract, action planning | Pledge card | Households improve or adopt key clean compound behaviors selected during the initial counseling session. |
Physical opportunity | Environmental context and resources | Environmental restructuring/training | Adding objects to the environment (demonstration of the behavior, rehearsal/practice of the behavior) | Nail clippers | Reduced child exposure to harmful pathogens transmitted by way of the fecal–oral route |
Automatic motivation | Emotion | Modeling | Incompatible beliefs, information about health consequences | Clean compound family storybook | Reduced instance of observed feces in the compound/in child play area |
Reflective motivation | (Social/professional role and identity) | Persuasion | |||
Physical opportunity automatic motivation | Environmental context and resources | Environmental restructuring | Prompts/cues, restructuring the physical environment | Handwashing station with soap delivery | Increased caregiver handwashing with soap after latrine use and after child feces disposal; increased handwashing with soap of CU2 after defecation |
Section B: “mealtime” package | |||||
Psychological capability | Behavioral regulation | Enablement | Action planning, self-monitoring | Dietary diversity tracking card | Increased consumption of diverse and appropriate hygienic complementary foods for children under 2; increased consumption of diverse foods for whole family |
Reflective motivation | Intentions/belief about capabilities | Enablement | Behavioral contract, action planning | Pledge card | Households improve or adopt key mealtime behaviors selected during the initial counseling session. |
Psychological capability | Skills | Training | Instructions on how to perform a behavior/ demonstration of the behavior | Feeding bowl counseling card | Increased consumption of diverse and appropriate, hygienic complementary foods for children under 2; increased consumption of diverse foods for pregnant and lactating women; increased caregiver use of responsive feeding techniques |
Physical opportunity | Environmental context and resources | Environmental restructuring | Adding objects to the environment, prompts/cues | Feeding bowl and slotted spoon | Increased consumption of diverse and appropriate, hygienic complementary foods for children under 2; increased consumption of diverse foods for pregnant and lactating women; increased caregiver use of responsive feeding techniques |
Psychological capability | Skills | Training | Behavioral practice/rehearsal, demonstration of the behavior | Community cooking/feeding demonstration | Increased consumption of diverse and appropriate, hygienic complementary foods for children under 2; increased consumption of diverse foods for pregnant and lactating women; increased caregiver use of responsive feeding techniques |
Section C: “food hygiene” package | |||||
Physical opportunity | Environmental context and resources | Environmental restructuring | Restructuring the physical environment | Handwashing station with soap delivery | Increased caregiver handwashing with soap and handwashing of children under 2’s hands before feeding and eating |
Automatic motivation | Reinforcement | Environmental restructuring | Prompts/cues | ||
Psychological capability | Memory, attention and decision processes | Education/training | Prompts/cues, demonstration of the behavior | Food hygiene graphic card | Increased caregiver handwashing with soap before food preparation; reduced contamination of household foods |
Reflective motivation | Intentions/belief about capabilities | Enablement | Behavioral contract, action planning | Pledge card | Households improve or adopt key food hygiene behaviors selected during the initial counseling session. |
Physical opportunity | Environmental context and resources | Environmental restructuring | Restructuring the physical environment | Handwashing station with soap delivery | Increased caregiver handwashing with soap before food preparation |
Automatic motivation | Reinforcement | Prompts/cues | |||
Physical opportunity | Environmental context and resources | Environmental restructuring | Adding object to the environment | Mesh food cover | Reduced fecal contamination of household foods |
Social opportunity | Social influences (social norms) | Interpersonal influences, cultural expectations | Restructure the social environment | Roles and responsibilities/maize exercise | Increased caregiver recognition of potential inputs to improve children’s health |
Reflective motivation | Social role | Education; Modeling | |||
Automatic motivation | Emotion | Modeling | Demonstration | ||
Reflective motivation | Intentions/belief about capabilities; social role | Enablement; Modeling | Behavioral contract, Action planning; goal setting | Public pledge with peer group | Households improve or adopt key food hygiene behaviors selected during the initial counseling session |
Capability (physical and psychological) | Knowledge, physical skills | Education; training | Demonstration; instruction | Feeding demonstration | Increased caregiver knowledge of optimal porridge thickness and potential porridge additions; increased acceptability of porridge thickness; |
Reflective motivation | Beliefs about consequences, optimism | Education; modeling | Feedback on outcome of behavior | Increased caregiver understanding that children could eat thick porridge without choking | |
Psychological capability | Knowledge | Education, | Information on health consequences, | Skits delivering intervention messages | Increased caregiver knowledge of ideal WASH/IYCF behaviors associated with their intervention package |
Reflective motivation | Social role | Modeling | Demonstration of the behavior | ||
Physical opportunity | Environmental context and resources | Environmental restructuring | Restructuring the physical environment | Hardware demonstrations | Increased caregiver use of intervention hardware as intended |
Capability (physical and psychological) | Knowledge | Education; training | Prompts/cues | ||
Psychological capability | Knowledge | Education; training | Demonstration; instruction | Household counseling | Increased capacity and motivation of caregivers to practice ideal WASH/IYCF behaviors |
Social opportunity | Social Influence | Modeling, enablement | Social support; goal setting; problem solving; reviewing behavioral goals | ||