1921
Volume 99, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

We analyzed data from a cluster-randomized controlled trial conducted among 20 schools in Rajshahi, Bangladesh, to explore the role of social influence on handwashing with soap (HWWS) in a primary school setting. Using data collected through covert video cameras outside of school latrines, we used robust Poisson regression analysis to assess the impact of social influence—defined as the presence of another person near the handwashing location—on HWWS after a toileting event. In adjusted analyses, we found a 30% increase in HWWS when someone was present, as compared with when a child was alone (Prevalence ratio 1.30; 95% confidence interval: 1.14–1.47, < 0.001). The highest prevalence of HWWS was found when both child(ren) and adult(s) were present or when just children were present (64%). Our study supports the conclusion that the presence of another individual after a toileting event can positively impact HWWS in a primary school setting.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.17-0903
2018-07-30
2019-11-23
Loading full text...

Full text loading...

/deliver/fulltext/14761645/99/4/tpmd170903.html?itemId=/content/journals/10.4269/ajtmh.17-0903&mimeType=html&fmt=ahah

References

  1. Jarvis W, , 1994. Handwashing—the Semmelweis lesson forgotten? Lancet 344: 13111312. [Google Scholar]
  2. Curtis V, , 2003. Talking dirty: how to save a million lives. Int J Environ Health Res 13 (Suppl 1): S73S79. [Google Scholar]
  3. Willmott M, Nicholson A, Busse H, MacArthur GJ, Brookes S, Campbell R, , 2016. Effectiveness of hand hygiene interventions in reducing illness absence among children in educational settings: a systematic review and meta-analysis. Arch Dis Child 101: 4250. [Google Scholar]
  4. Maury E, Moussa N, Lakermi C, Barbut F, Offenstadt G, , 2006. Compliance of health care workers to hand hygiene: awareness of being observed is important. Intensive Care Med 32: 20882089. [Google Scholar]
  5. Pan S-C, Tien KL, Hung IC, Lin YJ, Sheng WH, Wang MJ, Chang SC, Kunin CM, Chen YC, , 2013. Compliance of health care workers with hand hygiene practices: independent advantages of overt and covert observers. PLoS One 8: e53746. [Google Scholar]
  6. Muto CA, Sistrom MG, Farr BM, , 2000. Hand hygiene rates unaffected by installation of dispensers of a rapidly acting hand antiseptic. Am J Infect Control 28: 273276. [Google Scholar]
  7. Judah G, Aunger R, Schmidt WP, Michie S, Granger S, Curtis V, , 2009. Experimental pretesting of hand-washing interventions in a natural setting. Am J Public Health 99 (Suppl 2): S405S411. [Google Scholar]
  8. Chittleborough CR, Nicholson AL, Basker E, Bell S, Campbell R, , 2012. Factors influencing hand washing behaviour in primary schools: process evaluation within a randomized controlled trial. Health Educ Res 27: 10551068. [Google Scholar]
  9. Pedersen DM, Keithly S, Brady K, , 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169170. [Google Scholar]
  10. Drankiewicz D, Dundes L, , 2003. Handwashing among female college students. Am J Infect Control 31: 6771. [Google Scholar]
  11. Pickering AJ, Blum AG, Breiman RF, Ram PK, Davis J, , 2014. Video surveillance captures student hand hygiene behavior, reactivity to observation, and peer influence in Kenyan primary schools. PLoS One 9: e92571. [Google Scholar]
  12. Grover E, Hossain MK, Uddin S, Venkatesh M, Ram PK, Dreibelbis R, , 2018. Comparing the behavioural impact of a nudge-based handwashing intervention to high-intensity hygiene education: a cluster-randomised trial in rural Bangladesh. Trop Med Int Health 23: 1025. [Google Scholar]
  13. Ram PK, 2010. Is structured observation a valid technique to measure handwashing behavior? Use of acceleration sensors embedded in soap to assess reactivity to structured observation. Am J Trop Med Hyg 83: 10701076. [Google Scholar]
  14. Hagel S, Reischke J, Kesselmeier M, Winning J, Gastmeier P, Brunkhorst FM, Scherag A, Pletz MW, , 2015. Quantifying the Hawthorne effect in hand hygiene compliance through comparing direct observation with automated hand hygiene monitoring. Infect Control Hosp Epidemiol 36: 957962. [Google Scholar]
  15. Dhar S, 2010. Observer bias in hand hygiene compliance reporting. Infect Control Hosp Epidemiol 31: 869870. [Google Scholar]
  16. Strickland B, Suben A, , 2012. Experimenter philosophy: the problem of experimenter bias in experimental philosophy. Rev Phil Psychol 3: 457467. [Google Scholar]
  17. Ercumen A, Arnold BF, Naser AM, Unicomb L, Colford JM, Jr. Luby SP, , 2017. Potential sources of bias in the use of Escherichia coli to measure waterborne diarrhoea risk in low-income settings. Trop Med Int Health 22: 211. [Google Scholar]
  18. Leontsini E, Winch PJ, , 2014. Increasing handwashing with soap: emotional drivers or social norms? Lancet Glob Health 2: e118e119. [Google Scholar]
  19. Cumbler E, Castillo L, Satorie L, Ford D, Hagman J, Hodge T, Price L, Wald H, , 2013. Culture change in infection control: applying psychological principles to improve hand hygiene. J Nurs Care Qual 28: 304311. [Google Scholar]
  20. Haberecht K, Schnuerer I, Gaertner B, John U, Freyer-Adam J, , 2015. The stability of social desirability: a latent change analysis. J Pers 83: 404412. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.17-0903
Loading
/content/journals/10.4269/ajtmh.17-0903
Loading

Data & Media loading...

  • Received : 20 Nov 2017
  • Accepted : 20 Jun 2018
  • Published online : 30 Jul 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error