11– 15 Some hygiene promotion trials in household or community settings have improved handwashing and reduced hand contamination among adults.
Experiment with hygiene products by trial and error.
We outline the analytic approaches we will use to investigate these relationships, by capitalizing on the longitudinal design and randomized interventions of the Sanitation Hygiene Infant Nutrition Efficacy trial in Zimbabwe.
The class-by-class outline in the 2003 MBSR instructor's manual [ 33] was followed with the addition of assigning the chapter Sleep and Sleep Stress from Full Catastrophe Living [ 12] in week 2. To standardize knowledge of sleep hygiene in the MVP trial, a 10-minute presentation was given at the first MBSR class and booklets developed at the National Institutes of Health [ 34] distributed.
The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial is a cluster-randomized trial testing the independent and combined effects of improved water, sanitation, and hygiene (WASH) and improved infant feeding on child stunting and anemia at 18 months of age [ 9].
Automated audits of hand hygiene have recently been trialled [ 25- 27], but these are limited to monitoring compliance to the 5 moments rather than the quality of application as intended via the 6 steps.
The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial is designed to test the independent and combined effects of 2 village health worker (VHW delivered intervention packages to improve water, sanitation, and hygiene (WASH) and infant feeding behaviors with the aim of improving length and hemoglobin concentration (or reducing stunting and anemia respectively) at 18 months of age.
Current major projects include the SHINE (Sanitation, Hygiene, and Infant Nutrition Efficacy) Trial in Zimbabwe, Mycotoxins and Infant Growth (Zimbabwe and Tanzania), Implementation Science for Scaling up Nutrition (Tanzania), and a project in Kenya and Ethiopia to translate the new global recommendation for calcium supplementation in pregnancy into policies and programs in Kenya and Ethiopia.
Formative research was conducted in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial districts (Chirumanzu and Shurugwi) and a neighboring district (Gweru) in central Zimbabwe.
A key hypothesis of the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial is that a subclinical intestinal pathology, termed environmental enteric dysfunction (EED), underlies child stunting [ 1].
