No abstract

Context Effective handwashing can prevent the spread of germs, including Covid-19. However, young children can lack a fundamental understanding of germ transfer. A Germ’s Journey educational resources were designed to support young children in learning about germs and handwashing. These resources include a book, website, song, online games and glo-gel activities that are informed by a behaviour change model. Research gap Prior research has not evaluated the impacts of these resources on behavioural outcomes. Purpose of the study Two intervention studies evaluated the impacts of these resources on both knowledge and behavioural outcomes. Method In Study 1, children (n = 225) were recruited from four schools and randomly assigned by classrooms to participate in a multicomponent intervention (vs. control). In Study 2, children (n = 104) were recruited from a museum and randomly assigned to participate in a song intervention (vs. control). Trained observers recorded participants’ engagement in six handwashing behaviours and their understanding of germs. These behavioural and knowledge outcomes were analysed using regression and related analyses. Results In Study 1, significant improvements were observed between baseline and follow up in the intervention group for both behavioural scores (Est = 0.48, SE = 0.14, t = 3.30, p = 0.001) and knowledge scores (Est = 2.14, SE = 0.52, z = 4.11, p < 0.001), whereas these improvements were not observed in the control group (ts < 1). In Study 2, the intervention group had significantly higher behavioural scores compared to the control group (Est. = -0.71, SE = 0.34, t = -2.07, p = 0.04). Conclusion This research demonstrates that specifically designed hand hygiene educational resources can improve handwashing practice and understanding in young children, and could lead to the reduction of the transmission of disease within this group.

Objective: Using a participatory action research (PAR) model, this paper reports on findings from a mixed-methods study which aimed to discover whether specifically developed health education resources ( A Germ’s Journey) aid children’s understanding of health-hygiene principles, and how these findings can inform the future development of culturally relevant resources to teach children in low- and middle-income countries about the association between bacteria, handwashing and disease. Design: Educational health-hygiene workshops were conducted at 13 case study sites ( n = 651) in collaboration with local organisations in Ahmedabad, India. During Phase 1 of the study, children’s and teacher–trainer workshops were conducted using UK resources. Following suggestions from local teachers, a Gujarati book was co-created and in Phase 2, workshops (using the Gujarati book) were delivered. Methods: Data were collected from children using quasi-experimental methods, using pre-workshop questions, follow-up questions, observations and baseline and post-workshop assessments. Data were collected from teachers using questionnaires. Results: Following teacher–trainer workshops during Phase 1 of the study, 100% of teachers stated that they would use the resources with their pupils in the future. Two months after participating in the workshops, 60%–73% of children knew how germs can cause illness, and 76%–80% knew how to remove germs from hands. When assessed during Phase 2 of the study, 54% of children scored higher after the intervention, showing an increased understanding of microbiology after using the resources. Conclusion: The results indicate that children had an improved understanding of the causes of bacterial disease and the health implications of not using adequate health-hygiene practices. Recommendations for the future development of resources include the use of a PAR model of research, co-creation with end users, and working alongside local organisations and participants in order to access ‘hard-to-reach’ areas.

No abstract

No abstract