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WASH Benefits Bangladesh trial: system for monitoring coverage and quality in an efficacy trial

Overview of attention for article published in Trials, July 2018
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (59th percentile)

Mentioned by

5 tweeters


11 Dimensions

Readers on

62 Mendeley
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WASH Benefits Bangladesh trial: system for monitoring coverage and quality in an efficacy trial
Published in
Trials, July 2018
DOI 10.1186/s13063-018-2708-2
Pubmed ID

Mahbubur Rahman, Sania Ashraf, Leanne Unicomb, A. K. M. Mainuddin, Sarker Masud Parvez, Farzana Begum, Kishor Kumar Das, Abu Mohd. Naser, Faruqe Hussain, Thomas Clasen, Stephen P. Luby, Elli Leontsini, Peter J. Winch


Researchers typically report more on the impact of public health interventions and less on the degree to which interventions were followed implementation fidelity. We developed and measured fidelity indicators for the WASH Benefits Bangladesh study, a large-scale efficacy trial, in order to identify gaps between intended and actual implementation. Community health workers (CHWs) delivered individual and combined water, sanitation, handwashing (WSH) and child nutrition interventions to 4169 enrolled households in geographically matched clusters. Households received free enabling technologies (insulated water storage container; sani-scoop, potty, double-pit, pour-flush latrine; handwashing station, soapy-water storage bottle), and supplies (chlorine tablets, lipid-based nutrient supplements, laundry detergent sachets) integrated with parallel behavior-change promotion. Behavioral objectives were drinking treated, safely stored water, safe feces disposal, handwashing with soap at key times, and age-appropriate nutrition behaviors. We administered monthly surveys and spot-checks to households from randomly selected clusters for 6 months early in the trial. If any fidelity measures fell below set benchmarks, a rapid response mechanism was triggered. In the first 3 months, functional water seals were detected in 33% (14/42) of latrines in the sanitation only arm; 35% (14/40) for the combined WSH arm; and 60% (34/57) for the combined WSH and Nutrition arm, all falling below the pre-set benchmark of 80%. Other fidelity indicators met the 65 to 80% uptake benchmarks. Rapid qualitative investigations determined that households concurrently used their own latrines with broken water seals in parallel with those provided by the trial. In consultation with the households, we closed pre-existing latrines without water seals, increased the CHWs' visit frequency to encourage correct maintenance of latrines with water seals, and discouraged water-seal removal or breakage. At the sixth assessment, 86% (51/59) of households were in sanitation only; 92% (72/78) in the combined WSH; and 93% (71/76) in the combined WSH and Nutrition arms had latrines with functional water seals. An intensive implementation fidelity monitoring and rapid response system proved beneficial for this efficacy trial. To implement a routine program at scale requires further research into an adaptation of fidelity monitoring that supports program effectiveness. WASH Benefits Bangladesh: ClinicalTrials.gov, ID: NCT01590095 . Registered on 30 April 2012.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 62 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 62 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 9 15%
Student > Master 9 15%
Student > Ph. D. Student 8 13%
Other 5 8%
Librarian 3 5%
Other 8 13%
Unknown 20 32%
Readers by discipline Count As %
Social Sciences 9 15%
Medicine and Dentistry 7 11%
Psychology 4 6%
Engineering 4 6%
Economics, Econometrics and Finance 3 5%
Other 11 18%
Unknown 24 39%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 July 2018.
All research outputs
of 13,266,991 outputs
Outputs from Trials
of 3,328 outputs
Outputs of similar age
of 218,797 outputs
Outputs of similar age from Trials
of 2 outputs
Altmetric has tracked 13,266,991 research outputs across all sources so far. This one is in the 49th percentile – i.e., 49% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,328 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.7. This one is in the 49th percentile – i.e., 49% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 218,797 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 59% of its contemporaries.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them