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1.
Jarvis W, 1994. Handwashing—the Semmelweis lesson forgotten? Lancet 344: 1311–1312.
-
2.
Curtis V, 2003. Talking dirty: how to save a million lives. Int J Environ Health Res 13 (Suppl 1): S73–S79.
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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: 42–50.
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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: 2088–2089.
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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.
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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: 273–276.
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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): S405–S411.
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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: 1055–1068.
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9.
Pedersen DM, Keithly S, Brady K, 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169–170.
-
10.
Drankiewicz D, Dundes L, 2003. Handwashing among female college students. Am J Infect Control 31: 67–71.
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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.
-
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: 10–25.
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13.
Ram PK et al. 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: 1070–1076.
-
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: 957–962.
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15.
Dhar S et al. 2010. Observer bias in hand hygiene compliance reporting. Infect Control Hosp Epidemiol 31: 869–870.
-
16.
Strickland B, Suben A, 2012. Experimenter philosophy: the problem of experimenter bias in experimental philosophy. Rev Phil Psychol 3: 457–467.
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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: 2–11.
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Leontsini E, Winch PJ, 2014. Increasing handwashing with soap: emotional drivers or social norms? Lancet Glob Health 2: e118–e119.
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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: 404–412.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1670 | 1496 | 436 |
| Full Text Views | 990 | 19 | 5 |
| PDF Downloads | 219 | 15 | 5 |
Social Influence on Handwashing with Soap: Results from a Cluster Randomized Controlled Trial in Bangladesh
Elise Grover
Elise Grover
Department of Civil Engineering and Environmental Science, Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma;
Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, Colorado;
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Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, Colorado;
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Mohammed Kamal Hossain
Mohammed Kamal Hossain
Save the Children, Bangladesh, Dhaka, Bangladesh;
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Saker Uddin
Saker Uddin
Save the Children, Bangladesh, Dhaka, Bangladesh;
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Mohini Venkatesh
Mohini Venkatesh
Save the Children, USA, Washington, District of Columbia;
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Pavani K. Ram
Pavani K. Ram
Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York;
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Robert Dreibelbis
Robert Dreibelbis
Department of Civil Engineering and Environmental Science, Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma;
Department of Disease Control, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Department of Disease Control, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
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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, P < 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.
Author Notes
Authors’ addresses: Elise Grover, Department of Civil Engineering and Environmental Science, Center for Applied Social Research, University of Oklahoma, Norman, OK, and Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, CO, E-mail: elise.grover@ucdenver.edu. Mohammed Kamal Hossain and Saker Uddin, Save the Children, Bangladesh, Dhaka, Bangladesh, E-mails: kamal.hossain@savethechildren.org and sakeruddin@gmail.com. Mohini Venkatesh, Save the Children, USA, Washington, DC, E-mail: mvenkatesh@savechildren.org. Pavani K. Ram, Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, E-mail: pkram@buffalo.edu. Robert Dreibelbis, Department of Civil Engineering and Environmental Science, Center for Applied Social Research, University of Oklahoma, Norman, OK, and Department of Disease Control, Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mail: robert.dreibelbis@lshtm.ac.uk.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Jarvis W, 1994. Handwashing—the Semmelweis lesson forgotten? Lancet 344: 1311–1312.
-
2.
Curtis V, 2003. Talking dirty: how to save a million lives. Int J Environ Health Res 13 (Suppl 1): S73–S79.
-
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: 42–50.
-
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: 2088–2089.
-
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.
-
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: 273–276.
-
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): S405–S411.
-
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: 1055–1068.
-
9.
Pedersen DM, Keithly S, Brady K, 1986. Effects of an observer on conformity to handwashing norm. Percept Mot Skills 62: 169–170.
-
10.
Drankiewicz D, Dundes L, 2003. Handwashing among female college students. Am J Infect Control 31: 67–71.
-
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.
-
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: 10–25.
-
13.
Ram PK et al. 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: 1070–1076.
-
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: 957–962.
-
15.
Dhar S et al. 2010. Observer bias in hand hygiene compliance reporting. Infect Control Hosp Epidemiol 31: 869–870.
-
16.
Strickland B, Suben A, 2012. Experimenter philosophy: the problem of experimenter bias in experimental philosophy. Rev Phil Psychol 3: 457–467.
-
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: 2–11.
-
18.
Leontsini E, Winch PJ, 2014. Increasing handwashing with soap: emotional drivers or social norms? Lancet Glob Health 2: e118–e119.
-
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: 304–311.
-
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: 404–412.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1670 | 1496 | 436 |
| Full Text Views | 990 | 19 | 5 |
| PDF Downloads | 219 | 15 | 5 |