title: Effectiveness of post-campaign, door-to-door, hang-up, and communication interventions to increase long-lasting, insecticidal bed net utilization in Togo (2011-2012): a cluster randomized, control trial.
abstract: BACKGROUND
  It is well established that insecticide-treated bed nets (ITNs), in particular long-lasting, insecticidal nets (LLINs), can be used as one of the primary interventions for effective malaria control. A consistent gap between net ownership and use has been observed, indicating that factors exist that prevent an owned mosquito net from being used. One approach used in the context of LLIN campaigns is a post-distribution, door-to-door visit of households with educational messages and to physically assist with hang-up of nets.
  
  
  METHODS
  A cluster randomized trial was conducted in the Plateaux Region of Togo to evaluate the effectiveness of different approaches to post-LLIN campaign home visits (number of visits and timing) by volunteers to enhance LLIN hang-up and utilization.
  
  
  RESULTS
  It was found that, in general, households that received intervention visits, particularly the most recent intervention visit, had levels of use that were typically 5 to 10% higher than the control households, while access did not differ among control and intervention households. Eight months post-campaign, ITN use by all individuals, children under five years and women of reproductive age was 11.3 to 14.4 percentage points greater in the study arm that received all three intervention visits than in the control communities. In households that received one or two additional door-to-door visits, the majority of respondents indicated that the volunteer provided new information during the visit regarding the use and importance of ITNs despite having received previous multiple visits.
  
  
  CONCLUSIONS
  The impact of the interventions appears to have been primarily through the delivery and reinforcement of key behaviour-change communication (BCC) messages regarding the importance of using an ITN and its care. Regardless of whether the respondents in fact received new information or had forgotten earlier information, this suggests that regular visits from community agents are useful in reinforcing key BCC messages.
authors.affiliation: HealthBridge, 1004-1 Nicholas Street, Ottawa, ON K1N 7B7, Canada. rdesrochers@healthbridge.ca.
authors.forename: Rachelle E
authors.initials: RE
authors.lastname: Desrochers
authors.forename: Kendra
authors.initials: K
authors.lastname: Siekmans
authors.forename: Peter R
authors.initials: PR
authors.lastname: Berti
authors.forename: Karen
authors.initials: K
authors.lastname: Bramhill
authors.forename: Sarah A W
authors.initials: SA
authors.lastname: Buchan
authors.forename: Guy K
authors.initials: GK
authors.lastname: Battah
authors.forename: Dodji
authors.initials: D
authors.lastname: Gbetoglo
authors.forename: Kokou
authors.initials: K
authors.lastname: Vignikin
authors.forename: Alice
authors.initials: A
authors.lastname: Sabino
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care; D005191:Family Characteristics; D005260:Female; D019538:Health Care Surveys; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006792:House Calls; D006801:Humans; D007223:Infant; D057148:Insecticide-Treated Bednets / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D009042:Motivation; D010349:Patient Compliance; D010565:Persuasive Communication; D015397:Program Evaluation; D018401:Sample Size; D012621:Seasons; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014037:Togo