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Table 2 Structure of the food hygiene intervention

From: Design, delivery, and determinants of uptake: findings from a food hygiene behavior change intervention in rural Bangladesh

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
  - 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
  1. aBehavior change techniques taxonomy (v1) [31] was used to label the intervention activities