The beliefs may be about how beneficial the new behaviour would be, or how good or bad it would feel to perform it. Beliefs can be ‘false’ and might include elements that are inconsistent with the facts. Perception is highly selective and people often favour ‘evidence’ that confirms their beliefs and reaffirms their actions. All the beliefs that form an attitude need to be in favour of the desired behaviour for a person to act. Attitudes are developed individually, but originate in the culture, traditions or values considered to be acceptable or normal in a given context. Attitudes can change over time or they can persist, even if they prove to be misconceptions.

Attitudes and beliefs can contain emotional and cognitive aspects. For example, an attitude towards toilet use consists of feelings or emotions about using or not using a toilet (such as comfort, shame or disgust) as well as cognitive beliefs about how safe the toilet is for women or children to use and how costly it would be to construct. An attitude might also be formed by beliefs, such as women and men should not use the same toilet or that using a toilet will lead to infertility. To plan successful HP activities, a good understanding should be developed of existing beliefs (both emotional and cognitive); useful methods include Focus Group Discussions T.14, KAP Surveys T.24 or RANAS F.20 surveys. 

Past experience, such as poor treatment from an agency can also shape attitudes to WASH and therefore what people are prepared to engage with. The way that a programme is carried out is often as important as the programme itself.