Pre-testing - Pilot project ideas with a small group of the population. It can be useful to do pre-testing when ideas are still quite rough so that there is still time to implement the adaptations. Take time to learn from the population about how they interpret the messages or activities, whether anything is unclear, whether the messages and activities seem relevant to them and how the project materials and the approach used makes them feel. Adjust materials and project activities based on this feedback.

Develop an implementation guide and train and learn from staff - It is important that your staff know how to carry out each of the activities being proposed during the project. We recommend developing a draft manual to guide the implementation of each component. This should include information on what materials are needed for each activity, how long the activity will take, when it should happen, who it should be delivered by and detailed step-by-step instructions for how it should be done. Train staff on each component of the project and about safety measures at this time. Take time to learn from them about how the project might need to be adapted to make it more feasible for them to carry out. Incorporate this feedback and finalise the project manual.

Develop a monitoring and evaluation strategy - Consider whether your implementation, staffing or budgeting needs to be adjusted to allow effective and safe monitoring and evaluations processes. Plan for how data will be used to iteratively adjust and improve the project. Given the changing nature of outbreak response it is useful to assume that on a monthly basis (at least) you may need to make revisions to the project (normally these will be relatively small). In order to do this, establish means of generating ongoing community feedback. Organise weekly meetings with the implementation teams to learn more about what is working well and what is challenging and collectively decide on any programme adjustments.

Brief overview of the three step process for hygiene programme design

How to incorporate guidelines, theory and evidence throughout the programme design process

Step 1: Selecting target behaviours, populations and settings

Step 2: Learning from populations about behavioural barriers & enablers

Step 3: Identifying appropriate behavioural techniques and delivery channels

Bringing theory, evidence, formative research, BCTs and delivery channels together to design an intervention