Social Influences on Hand Hygiene


Objective: Adherence to hand hygiene by medical professionals and the general public worldwide has been uniformly low. The purpose of this study was to determine whether the hand-hygiene behavior of eighth graders could be influenced through an intervention consisting of a presentation of scientific data, a visual germ demonstration, and a demonstration and explanation of how to hand wash and sanitize properly. Additionally, the study investigated whether there was a measurable change in students’ self-reported attitudes and behaviors.

Methods: A quasi-experimental design measured attitudes, behavior, and consumption of sanitizer pre- and post-intervention on a convenient sample consisting of the entire eighth grade of a Massachusetts public middle school.

Results: The post-intervention use of hand-sanitizing wipes showed significant increase (p = .034) over the pre-intervention baseline. Of the respondents, 47.8% said they had changed their hand-hygiene behavior and 44.9% said they had changed their attitude to hand hygiene. There were strong and significant correlations between changing behavior and changing attitudes (r = .71, p < .001); between changing one’s behavior and talking about the topic to others (r = .365, p = .002); and between changing one’s attitude and talking about the topic to others (r = .35, p = .003).

Conclusion: The study supports the hypothesis that hand-hygiene training intended to change attitudes and behavior needs to include multiple modes of learning that are both experiential and intellectual. To be maximally effective and have a high adoption rate, hand-hygiene training also has to fit within a social context that makes it an expected practice. The author suggests that learned patterns of behavior, such as appropriate hand hygiene, may be significantly easier to set during childhood and adolescence rather than in the adult population.

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