title: Behavioral Reactivity Associated With Electronic Monitoring of Environmental Health Interventions--A Cluster Randomized Trial with Water Filters and Cookstoves.
abstract: Subject reactivity--when research participants change their behavior in response to being observed--has been documented showing the effect of human observers. Electronics sensors are increasingly used to monitor environmental health interventions, but the effect of sensors on behavior has not been assessed. We conducted a cluster randomized controlled trial in Rwanda among 170 households (70 blinded to the presence of the sensor, 100 open) testing whether awareness of an electronic monitor would result in a difference in weekly use of household water filters and improved cookstoves over a four-week surveillance period. A 63% increase in number of uses of the water filter per week between the groups was observed in week 1, an average of 4.4 times in the open group and 2.83 times in the blind group, declining in week 4 to an insignificant 55% difference of 2.82 uses in the open, and 1.93 in the blind. There were no significant differences in the number of stove uses per week between the two groups. For both filters and stoves, use decreased in both groups over four-week installation periods. This study suggests behavioral monitoring should attempt to account for reactivity to awareness of electronic monitors that persists for weeks or more.
authors.affiliation: Department of Mechanical Engineering, Portland State University , Portland, Oregon 97201, United States.
authors.forename: Evan A
authors.initials: EA
authors.lastname: Thomas
authors.affiliation: Department of Mechanical Engineering, Portland State University , Portland, Oregon 97201, United States.
authors.forename: Sarita
authors.initials: S
authors.lastname: Tellez-Sanchez
authors.affiliation: School of Electrical and Computer Engineering, Georgia Institute of Technology , Atlanta, Georgia 30332, United States.
authors.forename: Carson
authors.initials: C
authors.lastname: Wick
authors.affiliation: London School of Hygiene and Tropical Medicine , London, United Kingdom.
authors.forename: Miles
authors.initials: M
authors.lastname: Kirby
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University , Atlanta Georgia 30322 United States.
authors.forename: Laura
authors.initials: L
authors.lastname: Zambrano
authors.affiliation: London School of Hygiene and Tropical Medicine , London, United Kingdom.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Abadie Rosa
authors.affiliation: London School of Hygiene and Tropical Medicine , London, United Kingdom.|Department of Epidemiology, Rollins School of Public Health, Emory University , Atlanta Georgia 30322 United States.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Clasen
authors.affiliation: School of Public Health, Oregon Health & Science University , Portland Oregon United States.
authors.forename: Corey
authors.initials: C
authors.lastname: Nagel
mesh_terms: D001294:Attitude to Health; D004581:Electronics / Q000295:instrumentation; D004782:Environmental Health / Q000379:methods*; D005191:Family Characteristics; D005260:Female; D006794:Household Articles; D006801:Humans; D007223:Infant; D008297:Male; D012432:Rwanda; D018508:Water Purification / Q000295:instrumentation* / Q000379:methods