# Association between receiving the Aksi Bergizi Social Behavioral Change Communication (SBCC) intervention and hygiene behaviors among secondary school students in Padang, Indonesia

## TL;DR

A study in Indonesia found that a hygiene promotion program significantly improved handwashing with soap among secondary school students, but had no effect on nail hygiene.

## Contribution

This study provides the first systematic assessment of the Aksi Bergizi SBCC intervention's impact on hygiene behaviors in Indonesian secondary school students.

## Key findings

- Students in target schools were significantly more likely to use soap when washing hands before eating and after using the toilet.
- There was no significant difference in nail hygiene behaviors between students in target and non-target schools.
- All students reported brushing their teeth at least twice per day, with no observable difference in oral hygiene.

## Abstract

The Government of Indonesia and UNICEF introduced the Aksi Bergizi Social Behavioral Change Communication (SBCC) intervention to promote healthy eating and hygiene behaviors among adolescents. However, no systematic assessment of the program’s effect has been made. This study aims to assess the association between exposure to the Aksi Bergizi nutrition promotion program and hand, oral, and nail hygiene behaviors among secondary school students in Padang, Indonesia.

We conducted a school-based cross-sectional study in Padang Municipality, Indonesia, collecting data from 253 students attending Aksi Bergizi target schools and 253 students from non-target schools using a self-administered questionnaire. We compared hygiene behaviors between students in the two groups using descriptive statistics and multivariable logistic regression with adjustment for demographic and socioeconomic characteristics.

All students reported brushing their teeth at least twice per day, so there was no observable difference regarding oral hygiene. However, we found that students in target schools were significantly more likely than those in non-target schools to always use soap when washing their hands both before eating (75% vs. 21%; Adjusted odds ratio (OR) = 6.03; 95% confidence interval (CI) [3.96–9.19]) and after using the toilet (74% vs. 21%; Adjusted OR = 5.74, 95% CI [3.78–8.72]). However, there was no statistically significant difference with regard to nail hygiene, i.e., cutting nails at least once per week.

We found differences between target and non-target schools regarding self-reported handwashing but no differences in nail-clipping. The findings of this study have implications for stakeholders in infectious diseases and nutrition. Future studies should consider ways to reduce social desirability bias and increase the generalizability of the study findings.