Scientific American reports on a multiyear PLoS Medicine study, published on Monday, which "followed a nationwide public health campaign to increase zinc use for childhood diarrhea in Bangladesh."

"A 10-day course of zinc tablets ... promises to not only treat children who have diarrhea, but also to help protect them from future bouts with the condition (the most common side effect of the zinc being nausea). The challenge lies in getting parents and caretakers to give the treatment to their children - and health care providers to embrace it," Scientific American writes.

The study "found that in the first two years of a public health campaign that used television, radio, outdoor ads, and other communication, awareness of the treatment peaked after about 10 months. Those in the urban areas outside of slums had the highest awareness (90 percent). Levels were lower in townships (74 percent), urban slums (66 percent) and rural areas (50 percent)." The study's lead author Peter Larson, of the Center for International Child Health at the BC Children's Hospital in Canada said, "We didn't expect to see awareness go up as quickly as it did."

About 23 months after the start of the campaign, "however, some 25 percent of urban, non-slum caretakers who had children with a current case of diarrhea were using zinc (along with 20 percent of those in towns and urban slums and 10 percent in rural areas)." Larson said he was "somewhat discouraged" by the adoption findings.

"Studying how - and why - people change their behavior has helped other public health campaigns, including malaria, with the wider use of bed nets. Larson notes that, after advertising, it is important to promote the image of individuals making the decision for themselves. It also comes down to involving the stakeholders, such as mid-level government officials and physician groups, who ultimately play a large role in a program's success," according to the publication (Harmon, 11/3).

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