Abstract
Aim
The occurrence of high fluoride concentrations in the ground- and surface water all over the world leads to the risk of developing dental and skeletal fluorosis. In Ethiopia, 8 million people depend on water sources with excessive fluoride. In four project areas in the Ethiopian Rift Valley, fluoride removal household filters based on bone char media have been implemented. This study examines possible predictors of consuming filtered water derived from various behavior change theories.
Subject and methods
In a complete cross-sectional survey, 160 filter users were interviewed through structured face-to-face interviews. A logistic regression was carried out to reveal factors predicting consumption of filtered water.
Results
The results show that the consumption of fluoride-free water is mainly related to people’s pride in offering filtered water to guests (status norm) and the feeling of being able to produce enough water with the filter (perceived behavioral control). Moreover, the study showed that the more filter users like the taste of filtered water and the more expensive they perceive the filter media, the more likely users will exclusively consume filtered water (attitudinal beliefs). Furthermore, perceiving the act of filling as a matter of habit (perceived habit) enhances filtered water consumption.
Conclusion
Based on the results, possible intervention strategies to change the influential psychological factors and, hence, increase the consumption of treated water can be designed.
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References
Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Dec Proc 50:179–211
Amini M, Mueller K, Abbaspour KC, Möller KN, Sarr M, Johnson CA (2008) Statistical modeling of global geogenic fluoride contamination in groundwaters. Envirol Sci Technol 42(10):3662–3668
Armitage CJ (2005) Can the theory of planned behavior predict the maintenance of physical activity? Health Psychol 24:235–245F
Bandura A (2004) Health promotion by social cognitive means. Health Educ Behav 31:143–164
Becker MH, Maiman LA, Kirscht JP, Haefner DP, Drachman RH (1977) The health belief model and prediction of dietary compliance: a field experiment. J Health Soc Behav 18:348–366
Cialdini RB (2001) Influence: science and practice, 4th edn. Allyn and Bacon, Boston
Cialdini RB, Reno RR, Kallgren CA (1990) A focus theory of normative conduct: recycling the concept of norms to reduce littering in public places. J Pers Soc Psychol 58:1015–1026
Conner M, Armitage CJ (1998) Extending the theory of planned behavior: a review and avenues of further research. J Appl Soc Psychol 28:1429–1464
Dahlstrand U, Biel A (1997) Pro-environmental habits: propensity levels in behavioral change. J Appl Soc Psychol 27:588–601
De Young R (1993) Changing behavior and making it stick: the conceptualization and management of conservation behavior. Environ Behav 25:485–505
Dwyer WO, Leeming FC, Cobern MK, Porter BE, Jackson JM (1993) Critical review of behavioral interventions to preserve the environment: research since 1980. Environ Behav 25:275–321
Fox J, Monette G (1992) Generalized collinearity diagnostics. J Am Stat Ass 87:178–183
Gerrard M, Gibbons FX, Bushman BJ (1996) Relation between perceived vulnerability to HIV and precautionary sexual behavior. Psychol Bull 119:390–409
Gollwitzer PM (1999) Implementation intentions: strong effects of simple plans. Am Psychol 54:493–503
Harland P, Staats H, Wilke HAM (2007) Situational and personality factors as direct or personal norm mediated predictors of pro-environmental behavior: questions derived from norm-activation theory. Basic Appl Soc Psychol 29:323–334
Heckhausen H (1991) Motivation and action. Springer Verlag, Berlin
Heri S, Mosler HJ (2008) Factors affecting the diffusion of solar water disinfection: a field study in Bolivia. Health Educ Behav 35:541–560
Holm K, Kremers SPJ, de Vries H (2003) Why do Danish adolescents take up smoking? Eur J Public Health 13:67–74
Kloos H, Tekle-Haimanot R (1999) Distribution of fluoride and fluorosis in Ethiopia and prospects for control. Trop Med Int Health 4:355–364
Kraemer SM, Mosler HJ (2010) Persuasion factors influencing the decision to use sustainable household water treatment. Int J Environ Health Res 20:61–79
Krebs R (2002) Anleitung zur Herstellung von MC-Fragen und MC-Prüfungen [Instructions for preparing MC-questions and MC-exams]. http://www.fnl.ch/LOBs/LOs_Public/MC_Anleitung.pdf. Cited 6 March 2010
Lichtenstein DR, Ridgway NM, Netemeyer RG (1993) Price perception and consumer shopping behavior: a field study. J Marketing Res 30:234–245
Maddux JE, Rogers RW (1983) Protection motivation and self-efficacy: a revised theory of fear appeals and attitude change. J Exp Soc Psychol 19:469–479
Malde MK, Scheidegger R, Julshamn K, Bader HP (2011) Substance flow analysis: a case study of fluoride exposure through food and beverages in young children living in Ethiopia. Environ Health Perspect 119:579–584
Mosler HJ, Tobias R (2007) Umweltpsychologische Interventionsformen neu gedacht [Environmental psychological forms of interventions re-thought]. Umweltpsychologie 11:35–54
Mosler HJ, Blöchliger OR, Inauen J (2010) Personal, social, and situational factors influencing the consumption of drinking water from arsenic-safe deep tubewells in Bangladesh. J Environ Manage 91:1316–1323
Orbell S, Blair C, Sherlock K, Conner M (2001) The theory of planned behavior and ecstasy use: roles for habit and perceived control over taking versus obtaining substances. J Appl Soc Psychol 31:31–47
Orbell S, Lidierth CJ, Geeraert N, Uller C, Uskul AK, Kyriakaki M (2009) Social-cognitive beliefs, alcohol, and tobacco use: a prospective community study of change following a ban on smoking in public places. Health Psychol 28:753–661
Park HS, Smith SW (2007) Distinctivness and influence of subjective norms, personal descriptive and injunctive norms, and societal descriptive and injunctive norms on behavioral intent: a case of two behaviors critical to organ donation. Hum Comm Res 33:194–218
Prochaska JO, DiClemente CC (1982) Transtheoretical therapy: toward a more integrative model of change. Psychother-Theor Res 19:276–288
Schwartz SH (1977) Normative influence on altruism. In: Berkowitz L (ed) Advances in experimental social psychology. Academic, New York, pp 221–279
Smith JR, Terry DJ, Manstead ASR, Louis WR, Kotterman D, Wolfs J (2008) The attitude-behavior relationship in consumer conduct: the role of norms, past behavior, and self-identity. J Soc Psychol 148:311–333
Tekle-Haimanot R (2005) Study of fluoride and fluorosis in Ethiopia with recommendations on appropriate defluoridation technologies. Consultancy report, UNICEF-Ethiopia, University of Addis Ababa, Faculty of Medicine, Ethiopia
Tekle-Haimanot R, Melaku Z, Kloos H, Reimann C, Fantaye W, Zerihun L, Bjorvatn K (2006) The geographic distribution of fluoride in surface and groundwater in Ethiopia with an emphasis on the Rift Valley. Sci Total Environ 367:182–190
Tobias R (2009) Changing behavior by memory aids: a social psychological model of prospective memory and habit development tested with dynamic field data. Psychol Rev 116:408–438
Verplanken B, Aarts H (1999) Habit, attitude, and planned behaviour: Is habit an empty construct or an interesting case of goal-directed automaticity? Eur Rev Soc Psychol 10:101–134
Verplanken B, Orbell S (2003) Reflections on past behavior: a self-report index of habit strength. J Appl Soc Psychol 33:1313–1330
Wondwossen F, Åstrøm AN, Bjorvatn K, Bårdsen A (2006) Sociodemographic and behavioural correlates of severe dental fluorosis. Int J Paediatr Dent 16:95–103
Acknowledgements
This study is part of the Water Resource Quality (WRQ) project at EAWAG. Most of all, we would like to extend thanks to Esayas Samuel, Tesfaye Edosa, and Feyisa Lemma from the Oromia Self Help Organization (OSHO)for their professional input, valuable contribution, and great collaboration during the field work. Further, we want to name the Swiss National Science Foundation (SNF) and the Swiss Agency for Development and Cooperation (DEZA) as the project’s financial support. Finally, our acknowledgment also goes to the Swiss Interchurch Aid (HEKS), which provided the project with the household filters.
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The authors declare that they have no conflict of interest.
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Huber, A.C., Bhend, S. & Mosler, HJ. Determinants of exclusive consumption of fluoride-free water: a cross-sectional household study in rural Ethiopia. J Public Health 20, 269–278 (2012). https://doi.org/10.1007/s10389-011-0445-z
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DOI: https://doi.org/10.1007/s10389-011-0445-z