Table 2 Structure of the food hygiene intervention
Session | Purpose | Activity | Behavior change techniquea |
|---|---|---|---|
Group event 1 | Introduce 6 key feeding and food hygiene behaviors and present their importance for the health and well-being of the child | - Storytelling | - Information about health consequences |
- Picture matching game | - Instructions on how to perform the behavior | ||
|  | Encourage households to grow a diverse garden and maintain a clean kitchen and homestead compound along with the 6 key behaviors | - Women’s pledge to adopt the key behaviors and ‘ideal family’ practices - Announcement of ‘ideal family’ competition and indicators | - Goal setting (behaviors) - Commitment - Social incentive |
Household visit 1 | Physical rearrangement of kitchen or cooking area as a cue to perform the new behaviors | - Kitchen/cooking area makeover - Providing reminder materials (e.g., eye danglers, stickers) for kitchen | - Restructuring the physical environment - Adding objects to the environment |
Highlight the links between cleanliness of kitchen and 4 food hygiene behaviors | - Introduction to ‘clean kitchen’ indicators | - Instructions on how to perform the behavior - Goal setting (behaviors) | |
Group event 2 | Remind of the consequences of poor feeding and food hygiene behaviors for young children | - Sharing individual experiences with the group | - Review behavior goal(s) |
- Role play: child life game | - Instructions on how to perform the behavior | ||
- Recall of food hygiene key messages - Announcement of ‘clean kitchen’ competition | - Behavior practice/rehearsal - Social incentive | ||
Household visit 2 | Highlight the importance of diversified, nutritious, and safe food for women of child-bearing age and young children | - Discuss individual household experiences | - Review behavior goal(s) |
- Discuss the importance of a garden with vegetables and fruit in improving household’s dietary diversity | - Information about health consequences | ||
- Flip chart presentation on optimal feeding behaviors | - Instructions on how to perform the behavior | ||
- Demonstration of the hygienic preparation of a diverse food plate for women and young children (6–23 months) - Distribution of a complementary feeding mat | - Demonstration of the behavior - Adding objects to the environment | ||
- Observation of food hygiene activities against ‘ideal family’ and ‘clean kitchen’ indicators | - Feedback on behavior | ||
Group event 3 | Demonstrate transmission of germs and food contamination to emphasize the importance of clean utensils and handwashing | - Sharing individual experiences with the group | - Review behavior goal(s) - Feedback on behavior |
- A ‘disgust exercise’ using Glo Germ™. Glo Germ™ is a fluorescent liquid or gel visible only under ultraviolet light. It was used to simulate the distribution of germs on hands and utensils during food hygiene sessions. | - Information about health consequences - Instructions on how to perform the behavior | ||
Household visit 3 | Highlight the importance of proper storage of food and drinking water and thorough reheating of stored food | - Discuss individual household experiences - Flip chart presentation on food hygiene behaviors | - Review behavior goal(s) - Information about health consequences |
| Â | - Instructions on how to perform the behavior | ||
- Demonstration of proper time and temperature of safe proper reheating using food thermometer | - Demonstration of the behavior | ||
- Observation of food hygiene activities against ‘ideal family’ and ‘clean kitchen’ indicators | - Feedback on behavior | ||
Household visit 4 | Ask women to self-assess their food hygiene practices | - A ‘pile sorting exercise’ to rank the behaviors in order of ease to practice | - Graded tasks |
Encourage maintenance of practices in future | - Observation of food hygiene activities against ‘ideal family’ and ‘clean kitchen’ indicators | - Feedback on behavior | |
Group event 4 | Announce the ‘ideal family’ and the ‘clean kitchen’ winners | - Reward ceremony and distribution of ‘ideal family’ photos among ‘ideal family’ winners and handwashing soaps among ‘clean kitchen’ winners | - Social reward |
- Selection of peer leaders | - Social support | ||
- Public pledge to continue food hygiene practices | - Commitment |