title: Achieving long-term use of solar water disinfection in Zimbabwe.
abstract: OBJECTIVE
  To use a psychological theory of behavioural change to measure and interpret the effectiveness of different promotional strategies for achieving long-term usage of a household water treatment and safe storage (HWTS) system in peri-urban Zimbabwe.
  
  
  METHODS
  Solar disinfection (SODIS) was introduced into five peri-urban communities near Harare, Zimbabwe. Six different interventions were developed and were applied in four communities in different combinations, with the fifth remaining as a control area where no interventions were implemented.
  
  
  METHODS
  Throughout the 26 months of the study nine longitudinal panel surveys were conducted in which SODIS usage was estimated using three separate metrics: reported, calculated, and observed. A total of 1551 people were interviewed.
  
  
  RESULTS
  The three indicators of SODIS usage broadly agreed with one another. By any measure, the most effective intervention was household visits by trained promoters in combination with persuasion. Households which received household visits maintained SODIS usage rates of 65% or more, even six months after the cessation of all promotional activities. Households receiving other interventions were significantly less effective. Interventions like prompts or public commitment after the application of household visits were effective at maintaining good practices once these were established.
  
  
  CONCLUSIONS
  Household promotion in combination with persuasion appears more effective than other approaches, especially when followed with interventions targeting the maintenance of the new behaviour. With this intervention it is possible that around 65% of the households continue to use solar water disinfection (SODIS) more than two years after the initial promotion, and six months after the end of all interventions.
authors.affiliation: Eawag, Swiss Federal Institute for Aquatic Science and Technology, Überlandstrasse 133, 8600 Zürich, Switzerland. mosler@eawag.ch
authors.forename: H-J
authors.initials: HJ
authors.lastname: Mosler
authors.forename: S M
authors.initials: SM
authors.lastname: Kraemer
authors.forename: R B
authors.initials: RB
authors.lastname: Johnston
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004203:Disinfection / Q000379:methods*; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011582:Psychological Theory; D036301:Qualitative Research; D013472:Sunlight; D013997:Time Factors; D014504:Urban Health; D018508:Water Purification / Q000379:methods* / Q000706:statistics & numerical data*; D014881:Water Supply / Q000592:standards*; D055815:Young Adult; D015030:Zimbabwe