IRCT20230814059147N2 IRCT 2026-07-06 Office of Research Innovation and Commercialization (ORIC) National University of Medical Sciences Effectiveness of a Multi-Component School-Based Educational Intervention on Improving Water, Sanitation, and Hygiene (WASH) Practices among Primary School Children in Rawalpindi SWIFT Trial Effectiveness of a Multi-Component School-Based Educational Intervention on Improving Water, Sanitation, and Hygiene (WASH) Practices among Primary School Children in Rawalpindi: A Randomized Controlled Trial 2025-11-01 anticipated 188 Complete https://irct.ir/trial/91402 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: A simple cluster randomization method with a 1:1 allocation ratio was used, with the school serving as the unit of randomization to minimize contamination between students within the same institution. Eligible public primary schools from the selected peri-urban areas of Rawalpindi were assigned unique identification numbers, and an independent researcher generated the random allocation sequence using a computer-generated random number function in Microsoft Excel. No stratification was applied because all participating schools had comparable geographical and administrative characteristics. Allocation concealment was maintained until completion of baseline data collection by restricting access to the allocation sequence to the independent researcher. Owing to the nature of the intervention, blinding of participants and school staff was not feasible; however, outcome assessors remained blinded to group allocation during data collection to minimize observer bias, Blinding description: Owing to the nature of the multi-component school-based intervention, blinding of participants, teachers, and intervention providers was not feasible. However, outcome assessors were blinded to group allocation during baseline, post-intervention, and follow-up data collection to minimize observer bias. Thus, the study employed an assessor-blinded (single-blind) design. 2-3 Condition 1: Poor hand hygiene (inadequate handwashing practices) among primary school children. Condition 2: Acute upper respiratory infection,. Intervention 1: Intervention group: Participants in the intervention group received a 4-week multi-component school-based Water, Sanitation and Hygiene (WASH) intervention comprising four integrated components: (1) four weekly 45-minute interactive hygiene education sessions delivered by trained investigators using age-appropriate presentations, demonstrations, storytelling, discussions, and practical handwashing exercises; (2) continuous provision of commercially available hand soap at designated school handwashing stations throughout the intervention period; (3) environmental behavioural nudges, including painted footprints leading from toilets to handwashing stations and mirrors installed above the stations to encourage handwashing with soap; and (4) establishment of student-led WASH committees supervised by teachers to reinforce hygiene practices, promote peer support, monitor soap availability, and encourage maintenance of handwashing facilities. Intervention 2: Control group: Participants in the control group continued their routine educational activities according to the standard government primary school curriculum throughout the 4-week study period. No additional WASH-specific intervention, including interactive hygiene education sessions, continuous soap provision, environmental behavioural nudges (painted footprints and mirrors), or student-led WASH committees, was introduced. Schools maintained their usual water, sanitation, and hygiene facilities and practices without modification. Yes - There is a plan to make this available What will be shared: De-identified Individual Participant Dataset (IPD) and Study Documents De-identified individual participant data underlying the published results, including the study protocol, statistical analysis plan, data dictionary, informed consent forms, and study instruments (WASH KAP questionnaire and Structured Non-Intrusive Observation checklist), will be made available upon reasonable request to the corresponding investigator. Data will be shared after publication of the primary study findings for researchers with a methodologically sound proposal, following approval by the principal investigator and institutional ethics requirements. Participant confidentiality will be protected by removing all personal identifiers. When: By December 2026 To whom: All the people related to public health Conditions: For public health issues related to hand hygiene Where to obtain: by emailing the Dr Paaras Suleman : Dr Paaras Suleman sulemanpaaras@gmail.com 0334-3931815 How to obtain: Researchers requesting access to study data or documents should submit a written request to the corresponding investigator describing the research objectives, intended use of the data, and analysis plan. Requests will be reviewed by the principal investigator and, where required, the institutional ethics committee to ensure scientific merit and protection of participant confidentiality. Approved applicants may be required to sign a data-sharing agreement before receiving de-identified data and study documents. Data will normally be made available within 4–8 weeks of approval. Comments: