A systematic review of hand-hygiene and environmental-disinfection interventions in settings with children

Abstract

Background: Helping adults and children develop better hygiene habits is an important public health focus. As infection causing bacteria can live on one's body and in the surrounding environment, more effective interventions should simultaneously encourage personal-hygiene (e.g. hand-hygiene) and environmental-disinfecting (e.g. cleaning surfaces). To inform the development of a future multi-faceted intervention to improve public health, a systematic literature review was conducted on behavior change interventions designed to increase hand-hygiene and environmental-disinfecting in settings likely to include children. Methods: The search was conducted over two comprehensive databases , Ebsco Medline and Web of Science, to locate intervention studies that aimed to increase hand-hygiene or environmental-disinfecting behavior in settings likely to include children. Located article titles and abstracts were independently assessed, and the full-texts of agreed articles were collaboratively assessed for inclusion. Of the 2893 titles assessed, 29 met the eligibility criteria. The extracted data describe the Behavior Change Techniques (version 1) that the interventions employed and the interventions' effectiveness. The techniques were then linked to their associated theoretical domains and to their capability-opportunity-motivation (i.e., COMB model) components, as described in the Behavior Change Wheel. Due to the heterogeneity of the studies' methods and measures, a meta-analysis was not conducted. Results: A total of 29 studies met the inclusion criteria. The majority of interventions were designed to increase hand-hygiene alone (N = 27), and the remaining two interventions were designed to increase both hand-hygiene and environmental-disinfecting. The most used techniques involved shaping knowledge (N = 22) and antecedents (N = 21). Interventions that included techniques targeting four or more theoretical domains and all the capabilityopportunity-motivation components were descriptively more effective. Conclusions: In alignment with previous findings, the current review encourages future interventions to target multiple theoretical domains, across all capability-opportunity-motivation components. The discussion urges interventionists to consider the appropriateness of interventions in their development, feasibility/pilot, evaluation, and implementation stages. Registration: Prospero ID-CRD42019133735.

Availability and factors influencing community level handwashing facility in Ethiopia: Implication for prevention of infectious diseases

“…Factors found to be influencing availability of basic handwashing facilities and consistent behaviour towards handwashing practice in the health care settings [ 14 ] and schools [ 8 ] have been explored in several studies. Existing community-based research to date has tended to focus on evaluation of sanitation and hygiene-related interventions rather than nationwide coverage and the associated factors [ 15 , 16 ]. As a result, despite the importance of community-level handwashing facility, there remains a paucity of evidence on the coverage and the influencing factors.…”

Hand hygiene knowledge, attitude, practice and hand microflora analysis of staff nurses in a rural tertiary care hospital

“…The hand-washing habits of nurses are debatable for many reasons, which include the cumbersome structure of intensive care units, the characteristics of the patients in intensive care, the heavy workload in such units, and an insufficiency of nurses. [ 3 4 ] Undeniably, with varied environmental factors and host factors, human skin is known to be immutably covered with microorganisms, both commensals and pathogens depending on topography. Either hospital surroundings or poor hygiene is one of the key factors of transient micro-flora on the hand which is dynamically responsible for cross-infections.…”

Data-driven versus theory-driven methods to understand health service implementation problems: A case study of childhood vaccination barriers

“…In our review, this covered a very wide range of issues: socio-economic issues such as having low income, societal issues like the in uence of media, health system issues like vaccine supply and cost, and individual access issues like distance and time. This was found to be a catch all category in many previous reviews of clinicians and patients using the TDF 12,[15][16][17][18][19] , so is not limited to the issue of vaccination barriers. For example, a review of barriers to low back pain guidelines found this domain was common to 4/5 clinician behaviours while many other domains were not covered at all 17 .…”