Stanton 1987 BGD.

Methods	Cluster RCT
Participants	Number: 1923 families, 1350 with children aged < 6 years (after 0.8% emigrated) Inclusion criteria: families with children aged < 6 years
Interventions	Intervention (25 slums): educational intervention emphasizing 3 messages: proper hand washing before food preparation, defecation away from the house and in a proper site, and suitable disposal of waste and faeces. The intervention was delivered in the community over 8 weeks through small group discussions, larger demonstrations, community wide planning and action meeting, posters, games, pictorial stories, flexi flans (flannel board with movable characters). Control (26 slums): community health workers continued to provide the primary healthcare services.
Outcomes	Diarrhoea incidence in 6 months following intervention and 1 year following intervention. Diarrhoea: ≥ 3 unformed stools in any 24‐hour period during the 2‐week interval. stipulated that a child could have a maximum of 1 episode in any 1 recall period, and that a new episode began only after a round without diarrhoea (or in the first round) and ended with the next diarrhoea‐free round. Nutritional status (weight for age, height for age, weight for height) (Stanton 1988) Hygiene behaviour change: hand washing before serving food, child defecate in living area, garbage and faeces seen in living area, child observed to put garbage in mouth.
Notes	Location: Dhaka slums, Bangladesh Length of study: 18 months (October 1984 to March 1986). Publication status: journal
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Use of a random number table.
Allocation concealment (selection bias)	Unclear risk	No detail on how allocation was concealed.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "This study was not performed in a double‐blinded fashion."
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "This study was not performed in a double‐blinded fashion."
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Similar attrition in both groups. Quote: "equivalent percentages of intervention and control communities immigrated (19% in intervention vs. 23% in control) or emigrated (38% in intervention vs. 37% in control)" but unclear number of children who provided full histories of diarrhoea.
Selective reporting (reporting bias)	Low risk	Report on all outcomes.
Other bias	Unclear risk	—
Similarity of baseline outcome measurements	Unclear risk	NA
Similarity of baseline characteristics	Unclear risk	NA
Adequate allocation of intervention concealment during the study	Unclear risk	NA
Adequate protection against contamination	Unclear risk	NA
Confounders adequately adjusted for in analysis/design	Unclear risk	NA
Recruitment bias	Low risk	Participants were recruited in clusters prior to randomization.
Baseline imbalance	Low risk	Similar baseline characteristics and matched at design stage. Quote: "grouped the ordered communities into 25 adjacent pairs and one remaining community…within each stratum (pair), one community was assigned to intervention and one to control."
Loss of clusters	Unclear risk	No mention of loss of clusters, although did not present the single control slum that was not matched.
Incorrect analysis	High risk	Although reported on analysis using cluster as individuals, did not present data and quote unadjusted data as final.