Evidence-based tailoring of behavior-change campaigns: increasing fluoride-free water consumption in rural Ethiopia with persuasion

Appl Psychol Health Well Being. 2014 Mar;6(1):96-118. doi: 10.1111/aphw.12018. Epub 2013 Nov 11.

Abstract

Two hundred million people worldwide are at risk of developing dental and skeletal fluorosis due to excessive fluoride uptake from their water. Since medical treatment of the disease is difficult and mostly ineffective, preventing fluoride uptake is crucial. In the Ethiopian Rift Valley, a fluoride-removal community filter was installed. Despite having access to a fluoride filter, the community used the filter sparingly. During a baseline assessment, 173 face-to-face interviews were conducted to identify psychological factors that influence fluoride-free water consumption. Based on the results, two behavior-change campaigns were implemented: a traditional information intervention targeting perceived vulnerability, and an evidence-based persuasion intervention regarding perceived costs. The interventions were tailored to household characteristics. The campaigns were evaluated with a survey and analyzed in terms of their effectiveness in changing behavior and targeted psychological factors. While the intervention targeting perceived vulnerability showed no desirable effects, cost persuasion decreased the perceived costs and increased the consumption of fluoride-free water. This showed that altering subjective perceptions can change behavior even without changing objective circumstances. Moreover, interventions are more effective if they are based on evidence and tailored to specific households.

Keywords: Ethiopia; behavior-change campaigns; fluoride-removal filter; intervention; perceived costs; perceived vulnerability; persuasion; tailored interventions.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Child
  • Drinking Behavior*
  • Ethiopia
  • Evidence-Based Medicine
  • Female
  • Fluoride Poisoning / prevention & control*
  • Fluorides / analysis
  • Health Behavior*
  • Health Promotion / methods*
  • Humans
  • Male
  • Middle Aged
  • Persuasive Communication*
  • Rural Health
  • Treatment Outcome
  • Water / chemistry
  • Water Pollutants, Chemical
  • Water Supply
  • Young Adult

Substances

  • Water Pollutants, Chemical
  • Water
  • Fluorides