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Table 1

Questionnaire about RANAS psychosocial factors for handwashing behavior

Behavior determinantsSelected items
Risk factors 
Vulnerability In general, how high do you think is the risk that you get diarrhea? 
Severity
Health knowledge 
Imagine that you contracted diarrhea how severe would be the impact on your life in general?
Can you tell me what causes diarrhea? Could you please tell me for each following aspects whether it is a cause or not? E.g., Water contaminated by bacteria 
Attitudinal factors 
Belief about costs and benefits (effort)
Belief about costs and benefits (time consuming)
Belief about costs and benefits (expensive)
Belief about costs and benefits (distance) 
How effortful do you think is washing hands with soap and water?
How time consuming do you think it is to always wash hands with soap and water?

How expensive is it for you to always wash hands with soap and water?

Do you think that the handwashing facility is far away from your usual area of activity? 
Belief about costs and benefits (certain for prevention)
Feelings (like) 
How certain are you that always washing hands with soap and water prevents you and your family from getting diarrhea?
How much do you like always washing hands with soap and water? 
Normative factors 
Others’ behavior household
Others’ behavior village 
How many people of your household always wash hands with soap and water?
How many people of your village always wash hands with soap and water? 
Others’ approval


Personal importance (obligation) 
People who are important to you like your family members, friends, the chief of the village, NGO workers, or Pastor, how much they approve that you always wash hands with soap and water?
How strong do you feel a personal obligation to yourself to wash hands with soap and water? 
Ability factors 
Confidence in performance
Confidence in performance (difficult water)
Confidence in performance (difficult soap) 
How sure are you that you can wash hands with soap and water?
How difficult is to get as much drinking water as you need to always wash hands with soap and water?
How difficult is to get much soap as you need to always wash hands with soap and water? 
Confidence in continuation (distance) How confident are you that you can wash hands with soap and water, even if you have to walk some distance to reach the next handwashing facility? 
Self-regulation factors 
Barrier planning (water)
Barrier planning (soap)
Remembering (pay attention)

Remembering (forgetting last 24 h) 
Do you have a plan what to do so that you always have water for handwashing? Please specify.
Do you have a plan what to do so that you always have soap for handwashing? Please specify.
How much do you pay attention to always have enough soap at home to wash hands with soap and water?
When you think about the last 24 h: How often did it happen that you forgot to wash your hands with soap and water? 
Commitment (important)
Commitment (committed) 
How important is it for you to wash hands with soap and water?
How committed do you feel to wash hands with soap and water? 
Self-reported behavior 
Handwashing (before eating)
Handwashing (after using the toilet) 
Before you eat, how often do you wash your hands with soap and water?
After you defecated, how often do you wash your hands with soap and water? 
Behavior determinantsSelected items
Risk factors 
Vulnerability In general, how high do you think is the risk that you get diarrhea? 
Severity
Health knowledge 
Imagine that you contracted diarrhea how severe would be the impact on your life in general?
Can you tell me what causes diarrhea? Could you please tell me for each following aspects whether it is a cause or not? E.g., Water contaminated by bacteria 
Attitudinal factors 
Belief about costs and benefits (effort)
Belief about costs and benefits (time consuming)
Belief about costs and benefits (expensive)
Belief about costs and benefits (distance) 
How effortful do you think is washing hands with soap and water?
How time consuming do you think it is to always wash hands with soap and water?

How expensive is it for you to always wash hands with soap and water?

Do you think that the handwashing facility is far away from your usual area of activity? 
Belief about costs and benefits (certain for prevention)
Feelings (like) 
How certain are you that always washing hands with soap and water prevents you and your family from getting diarrhea?
How much do you like always washing hands with soap and water? 
Normative factors 
Others’ behavior household
Others’ behavior village 
How many people of your household always wash hands with soap and water?
How many people of your village always wash hands with soap and water? 
Others’ approval


Personal importance (obligation) 
People who are important to you like your family members, friends, the chief of the village, NGO workers, or Pastor, how much they approve that you always wash hands with soap and water?
How strong do you feel a personal obligation to yourself to wash hands with soap and water? 
Ability factors 
Confidence in performance
Confidence in performance (difficult water)
Confidence in performance (difficult soap) 
How sure are you that you can wash hands with soap and water?
How difficult is to get as much drinking water as you need to always wash hands with soap and water?
How difficult is to get much soap as you need to always wash hands with soap and water? 
Confidence in continuation (distance) How confident are you that you can wash hands with soap and water, even if you have to walk some distance to reach the next handwashing facility? 
Self-regulation factors 
Barrier planning (water)
Barrier planning (soap)
Remembering (pay attention)

Remembering (forgetting last 24 h) 
Do you have a plan what to do so that you always have water for handwashing? Please specify.
Do you have a plan what to do so that you always have soap for handwashing? Please specify.
How much do you pay attention to always have enough soap at home to wash hands with soap and water?
When you think about the last 24 h: How often did it happen that you forgot to wash your hands with soap and water? 
Commitment (important)
Commitment (committed) 
How important is it for you to wash hands with soap and water?
How committed do you feel to wash hands with soap and water? 
Self-reported behavior 
Handwashing (before eating)
Handwashing (after using the toilet) 
Before you eat, how often do you wash your hands with soap and water?
After you defecated, how often do you wash your hands with soap and water? 

Note. Response scales: 5-point response scale [from ‘not at all’ to ‘very much’; from ‘at no time’ to ‘almost each time’; from ‘never’ to ‘very often’; from ‘nobody’ to ‘almost all of them’], [yes; no; I don't know].

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