Maryann Delea

Maryann Delea
The Carter Center

PhD MPH

About

27
Publications
3,750
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352
Citations
Introduction
I combine social and behavioral theory with rigorous epidemiological methods to examine the manner in which humans interact with their physical and psychosocial environments, and the effects these interactions have on health and development outcomes. My current research interests include: evaluating intervention techniques and novel measurement approaches that may further enhance the integration of WASH and NTD programming; improving the conceptualization and measurement of intermediate and behavioral outcomes within the context of causal chain analyses, including collective efficacy, agency, and social norms; and employing a social constructs framework to improve intervention design, targeting, and evaluation.

Publications

Publications (27)
Article
Full-text available
Background Efforts are underway to scale-up the facial cleanliness and environmental improvement (F&E) components of the World Health Organization’s SAFE strategy for elimination of trachoma as a public health problem. Improving understanding of the F&E intervention landscape could inform advancements prior to scale-up, and lead to more effective a...
Article
Full-text available
Impact evaluations of water, sanitation, and hygiene interventions have demonstrated lower than expected health gains, in some cases due to low uptake and sustained adoption of interventions at a community level. These findings represent common challenges for public health and development programmes relying on collective action. One possible explan...
Article
Full-text available
Background Unimproved water, sanitation, and hygiene (WASH) behaviors are key drivers of infectious disease transmission and influencers of mental well-being. While WASH is seen as a critical enabler of health, important knowledge gaps related to the content and delivery of effective, holistic WASH programming exist. Corresponding impacts of WASH o...
Article
Full-text available
Behaviors related to water, sanitation, and hygiene (WASH) are key drivers of infectious disease transmission, and experiences of WASH are potential influencers of mental well-being. Important knowledge gaps exist related to the content and delivery of effective WASH programs and their associated health impacts, particularly within the contexts of...
Preprint
Full-text available
Background Behaviors related to water, sanitation, and hygiene (WASH) are key drivers of infectious disease transmission, and experiences of WASH are potential influencers of mental well-being. Important knowledge gaps exist related to the content and delivery of effective WASH programs and their associated health impacts, particularly within the c...
Article
Full-text available
Background Inconsistent toilet usage is a continuing challenge in India. Despite the impact of social expectations on toilet usage, few programs and studies have developed theoretically grounded norm-centric behavior change interventions to increase toilet use in low-income settings. Objective The objective of this paper is to detail the rationale...
Article
Collective agency refers to a group’s or network’s perceived ability to come together, establish common goals or shared interests, and take action to attain those goals/interests. Group-based interventions that intend to relocate power, information, and resources to community groups may, in turn, enhance the personal agency of group members as well...
Article
Full-text available
Background Descriptive norms messaging interventions are used to motivate people to adopt or maintain desirable behaviors. Such interventions provide people with information that describes an undesirable behavior as uncommon or a desirable behavior as prevalent within a relevant social group. Descriptive norms messaging interventions have shown pro...
Article
Full-text available
Social sanctions can be effective for sustaining beneficial norms by harnessing the power of social pressure and peer monitoring. Yet, field evidence regarding how norms might be linked to perceived risk of sanction is limited. In this study, we focused on communities located in peri-urban areas of Tamil Nadu, India, and examined how people’s perce...
Preprint
BACKGROUND Inconsistent toilet usage is a continuing challenge in India. Despite the impact of social expectations on toilet usage, few programs and studies have developed theoretically grounded norm-centric behavior change interventions to increase toilet use in low-income settings. OBJECTIVE The objective of this paper is to detail the rationale...
Article
Full-text available
People often form perceptions about how prevalent a behavior is in a social group. However, these perceptions can be inaccurate and biased. While persistent undesirable practices in low-income countries have drawn global attention, evidence regarding people's perception of how prevalent these practices are is scarce. Among those harmful practices,...
Preprint
Social sanctions can be effective in sustaining beneficial norms by harnessing the power of social pressure and peer monitoring. Previous laboratory experiments showed people perceived the deviator as more punishable when the socially desirable behaviors were more prevalent. Yet, there is limited field evidence on whether this relationship is obser...
Preprint
Full-text available
Introduction: Inconsistent toilet usage is a continuing challenge in India. Despite the impact of social expectations on toilet usage, few programs and studies have developed theoretically grounded norms-centric behavior change interventions to increase toilet use in low-income settings. This protocol details the rationale and design of an ex-ante,...
Preprint
People often form perceptions about how prevalent a behavior is in a social group. However, these perceptions can be inaccurate and biased. While persistent undesirable practices in low-income countries have drawn global attention, evidence regarding people’s perception of how prevalent these practices are is scarce. Among those harmful practices,...
Article
Full-text available
Personal hygiene practices, including facewashing and handwashing, reduce transmission of pathogens, but are difficult to measure. Using color theory principles, we developed and tested a novel metric that generates quantitative measures of facial and hand cleanliness, proxy indicators of personal hygiene practices. In this cross-sectional study, c...
Preprint
Full-text available
Background Descriptive norms messaging interventions are used to motivate people to adopt or maintain desirable behaviors. Such interventions provide people with information that describes an undesirable behavior as uncommon or a desirable behavior as prevalent within a relevant social group. Descriptive norms messaging interventions have shown pro...
Preprint
Full-text available
Background Descriptive norms messaging interventions are used to motivate people to adopt or maintain desirable behaviors. Such interventions provide people with information that describes an undesirable behavior as uncommon or a desirable behavior as prevalent within a relevant social group. Descriptive norms messaging interventions have shown pro...
Article
Full-text available
Community-level action may be required to achieve the levels of sanitation uptake necessary for health gains. Evidence suggests that collective action is influenced by collective efficacy (CE)-a group's belief in its abilities to organize and execute action to achieve common goals. The extent to which it is necessary to fully contextualize existing...
Article
Full-text available
Objective Discrete choice experiments (DCEs) are stated preference methods that allow for the quantification of preferences by presenting respondents with hypothetical choices. We conducted image‐based DCEs to assess preferences for latrine use (stratified by gender) and construction (among men only) in Amhara, Ethiopia. Methods Preference was qua...
Article
Full-text available
Background: Health improvements realized through sanitation are likely achieved through high levels of facilities utilization by all household members. However, measurements of sanitation often rely on either the presence of latrines, which does not guarantee use, or respondent-reported utilization of sanitation facilities, which is prone to respo...
Article
Despite considerable investment, sustainability of rural water resources remains a critical challenge in Ethiopia. Evidence suggests social capital – the networks, norms, and trust that facilitate cooperative behaviors – influences a community’s ability to manage communal water resources. In turn, strong community governance of water resources may...
Article
Full-text available
Introduction Government efforts to address massive shortfalls in rural water and sanitation in India have centred on construction of community water sources and toilets for selected households. However, deficiencies with water quality and quantity at the household level and community coverage and actual use of toilets have led Gram Vikas, a local n...
Article
In January 2008, an intentionally unvaccinated 7-year-old boy who was unknowingly infected with measles returned from Switzerland, resulting in the largest outbreak in San Diego, California, since 1991. We investigated the outbreak with the objective of understanding the effect of intentional undervaccination on measles transmission and its potenti...
Conference Paper
Background: In January 2008, an unvaccinated child with a personal belief exemption (PBE) returned to the U.S. from Switzerland, where a measles outbreak was ongoing. While infectious, he attended a school with a high PBE rate and was seen in four different healthcare settings. The local health department received measles serology results one week...

Projects

Projects (5)
Project
RISE aims to provide research-based evidence that a localised, water sensitive approach to revitalising informal settlements can deliver sustainable, cost-effective health and environmental improvements, paving the way for further deployments in the region and globally. Working with communities, governments, local leaders and partner institutions, RISE is co-designing location-specific solutions that integrate green infrastructure, such as constructed wetlands, to strengthen the whole-of-life water and sanitation cycle. Working across 24 settlements in Fiji and Indonesia, RISE aims to enable these communities to: • Recycle their own wastewater (both blackwater and greywater); • Harvest rainwater; • Create green space for water cleansing and food cultivation; • Restore natural waterways to encourage diversity; and, • Reduce vulnerability to flooding and climate change.
Project
The three-year Longitudinal Evaluation of Norms and Networks Study (LENNS) was designed by the University of Pennsylvania's Social Norms Group to elucidate the social determinants of toilet use and open defecation, with a focus on norms and social networks.
Project
Andilaye - Amharic for "togetherness" - is a cluster-randomized trial evaluating the impact of a demand-side sanitation and hygiene intervention on sustained behavior change and mental well-being in rural and peri-urban Amhara, Ethiopia