title: A quasi-experimental evaluation of an interpersonal communication intervention to increase insecticide-treated net use among children in Zambia.
abstract: BACKGROUND
  This paper presents results from an evaluation of the effect of a community health worker (CHW) -based, interpersonal communication campaign (IPC) for increasing insecticide-treated mosquito net (ITN) use among children in Luangwa District, Zambia, an area with near universal coverage of ITNs and moderate to low malaria parasite prevalence.
  
  
  METHODS
  A quasi-experimental community randomized control trial was conducted from 2008 to 2010. CHWs were the unit of randomization. Cross-sectional data were collected from houses in both 2008 and 2010 using simple random sampling of a complete household enumeration of the district. A difference-in -differences approach was used to analyse the data.
  
  
  RESULTS
  ITN use among children <5 years old in households with ≥1 ITN increased overall from 54% in 2008 to 81% in 2010 (χ(2) = 96.3, p <0.01); however, there was no difference in increase between the treatment and control arms in 2010 (p >0.05). ITN use also increased among children five to 14 years old from 37% in 2008 to 68% in 2010. There was no indication that the CHW-based intervention activities had a significant effect on increasing ITN use in this context, over and above what is already being done to disseminate information on the importance of using an ITN to prevent malaria infection.
  
  
  CONCLUSIONS
  ITN use increased dramatically in the district between 2008 and 2010. It is likely that IPC activities in general may have contributed to the observed increase in ITN use, as the increased observed in this study was far higher than the increase observed between 2008 and 2010 malaria indicator survey (MIS) estimates. Contamination across control communities, coupled with linear settlement patterns and subsequent behavioural norms related to communication in the area, likely contributed to the observed increase in net use and null effect in this study.
authors.affiliation: Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, USA. keating@tulane.edu
authors.forename: Joseph
authors.initials: J
authors.lastname: Keating
authors.forename: Paul
authors.initials: P
authors.lastname: Hutchinson
authors.forename: John M
authors.initials: JM
authors.lastname: Miller
authors.forename: Adam
authors.initials: A
authors.lastname: Bennett
authors.forename: David A
authors.initials: DA
authors.lastname: Larsen
authors.forename: Busiku
authors.initials: B
authors.lastname: Hamainza
authors.forename: Cynthia
authors.initials: C
authors.lastname: Changufu
authors.forename: Nicholas
authors.initials: N
authors.lastname: Shiliya
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Eisele
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D002675:Child, Preschool; D003142:Communication; D003150:Community Health Workers; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D057148:Insecticide-Treated Bednets / Q000706:statistics & numerical data*; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D009032:Mosquito Control / Q000379:methods*; D015024:Zambia