Theorizing the dimensions of sustainable shift: Understanding adolescent girls' adoption of reusable menstrual pads

Unsustainable menstrual products pose significant environmental and health challenges, especially in developing nations. Although several factors influencing the transition to sustainable menstrual products are recognized, the dynamic interplay among these factors over time remains poorly understood. This study examines adolescent girls' transition from disposable to reusable cloth pads, applying Social Cognitive and Practice Theories to analyze individual and contextual factors influencing adoption. We conducted a longitudinal mixed-methods study with 320 girls aged 12-15 from rural public schools in Udupi, India. At baseline, 82.2% used disposable pads, and 34.7% lacked consumer literacy regarding pad composition and biodegradability. After an awareness session and the distribution of reusable pads, a significant shift occurred: 26.6% fully switched to reusable pads, and 42.2% partially switched. Switchers were driven by comfort, ease of maintenance, leak prevention, convenient disposal, and program influence. Non-switchers remained skeptical, prioritized convenience, and showed limited environmental awareness. Notably, adoption was not constrained by socioeconomic factors; rather, girls with toilets outside the house were more likely to switch, suggesting that situational autonomy influences adoption. Maintenance challenges, including stain removal and drying difficulties, persisted among users. Moving beyond prior research on switching intentions, this study reveals actual behavioral pathways and the interaction of emotional, cognitive, and material factors in sustainable habit formation. Findings from this exposed cohort suggest that sustained adoption is associated with intervention approaches that combine environmental education with practical support, address menstrual taboos, and engage families and communities to reduce structural barriers.