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    <title>Dataset for: Results of a cluster-randomised controlled equivalence trial of the Surprise Soap hand washing intervention among older children living in a refugee settlement in Sudan</title>
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    <abstract>Increasing handwashing with soap (HWWS) among older children in emergency settings can have a large public health impact, however, evidence on what works is limited. One promising approach is the ‘Surprise Soap’ intervention in which a novel soap with an embedded toy is delivered to children in a short, participatory household session. This dataset contains the results of a cluster-randomised controlled equivalence trial to evaluate the Surprise Soap intervention against a standard intervention in a complex emergency setting.</abstract>
    <date>2023-07-19</date>
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    <collection_method>Methods: A cluster-randomised controlled equivalence trial was conducted in Naivasha refugee settlement, Sudan. Blinding was not possible. 203 randomly selected households, with at least one child aged 5-12, were randomised to receive the Surprise Soap intervention (n=101) or a standard intervention comprising a short household session with health messaging and plain soap distribution (n=102). The primary outcome was the proportion of pre-specified potential HWWS events observed for children aged 5-12, accompanied by HWWS, at baseline, four-, twelve-, and sixteen-weeks post intervention delivery. 

Results: 200 households were included in the analyses: 101 intervention and 99 control. No difference in intervention effectiveness was observed at any follow-up (four-weeks: adjusted RR=1.2, 95% CI 0.8–1.7; twelve-weeks: RR=0.8, 95% CI 0.5–1.1; sixteen-weeks: RR=1.0, 95% CI 0.7–1.4). However, we observed increased HWWS in both arms at four-weeks (27 and 23 percentage point increase in the intervention and control arm, respectively) that was sustained at sixteen-weeks.

Conclusions:  Our results may indicate that HWWS interventions that directly target children at the household level, provide soap, and instruct children how and when to practice HWWS are important public health interventions in emergencies. Applying contextual knowledge to decisions on Surprise Soap implementation is recommended; in emergencies where soap access and exposure to handwashing promotion are low, there appears to be no marginal benefits that justify additional costs compared to the standard intervention.</collection_method>
    <grant>50680</grant>
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        <title>Surprise Soap - Registration</title>
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        <title>A cluster-randomised controlled equivalence trial of the Surprise Soap handwashing intervention among older children living in a refugee settlement in Sudan.</title>
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