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• W3203845191 abstract "Abstract Background Open defecation due to a lack of access to sanitation facilities remains a public health issue in the United States. People experiencing homelessness face barriers to accessing sanitation facilities, and are often forced to practice open defecation on streets and sidewalks. Exposed feces may contain harmful pathogens posing a significant threat to public health, especially among unhoused persons living near open defecation sites. The City of San Francisco’s Department of Public Works implemented the Pit Stop Program to provide the unhoused and the general public with improved access to sanitation with the goal of reducing fecal contamination on streets and sidewalks. The objective of this study was to assess the impact of these public restroom interventions on reports of exposed feces in San Francisco, California. Methods We evaluated the impact of various public restroom interventions implemented from January 1, 2014 to January 1, 2020 on reports of exposed feces, captured through a 311 municipal service. Publicly available 311 reports of exposed feces were spatially and temporally matched to 31 Pit Stop restroom interventions in ten San Francisco neighborhoods. We conducted an interrupted time-series analysis to compare pre- versus post-intervention rates of feces reports near the restrooms. Results Feces reports declined by 12.47 reports per week after the installation of 13 Pit Stop restrooms ( p- value = 0.0002). The rate of reports per week declined from the six-month pre-intervention period to the post-intervention period (slope change=-0.024 [95% CI=-0.033, -0.014]). Reports also declined after new restroom installations in the Mission and Golden Gate Park, and after the provision of attendants in the Mission, Castro/Upper Market, and Financial District/South Beach. Conclusions Increased access to public toilets and the addition of restroom attendants reduced fecal contamination in San Francisco, especially in neighborhoods with people experiencing homelessness. Programs that improve access to public restrooms should be evaluated at the neighborhood level in order to tailor sanitation interventions to neighborhood-specific needs." @default.
• W3203845191 created "2021-10-11" @default.
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• W3203845191 date "2021-09-29" @default.
• W3203845191 modified "2023-09-25" @default.
• W3203845191 title "Somewhere to go: Assessing the impact of public restroom interventions on reports of open defecation in San Francisco, California from 2014 to 2020" @default.
• W3203845191 doi "https://doi.org/10.21203/rs.3.rs-936620/v1" @default.
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