Correlates of School Children’s Handwashing: A Study in Tibetan Primary Schools

Abstract

Hand hygiene, including handwashing by children, has been reported to contribute to the prevention of various infectious conditions. This study aims to explore the correlates of handwashing behavior among 1690 fourth to sixth grade primary school students in 19 Tibetan primary schools (Golog, Qinghai, China). The theory of reasoned action (TRA) was applied. Data was collected by questionnaire. Structural equation modeling (SEM) analysis showed that students’ attitude (β = 0.22, 95% CI 0.13–0.31) and subjective norms in terms of compliance to teachers’, parents’ and peers’ suggestions to wash hands (β = 0.09, 95% CI 0.01–0.18) were directly associated with students’ handwashing behavior. Students’ knowledge (β = 0.04, 95% CI 0.03–0.07) had an indirect association with handwashing behavior, mediated by students’ attitudes and subjective norms. Subjective norms (β = 0.12, 95% CI 0.07–0.17) were also indirectly correlated with handwashing through students’ attitudes. Therefore, our study supported the theory of reasoned action through our findings that students’ attitude and knowledge, and also attitudes from teachers, parents and peers were correlated with student handwashing behavior. Students reported higher level of compliance to teachers than to their parents and classmates. Based on this information, we recommend teacher-involved participatory hygiene education to promote students’ handwashing behaviors in areas at high risk for infectious diseases that can be prevented by handwashing.

The knowledge, attitudes and practices of hand, foot, and mouth disease prevention strategies amongst parents and educators of children under 5 years amidst COVID-19 pandemic: A cross-sectional study

“…This is because most children in this age group have not yet developed the cognitive ability to consciously practise the recommended prevention measures. Sun et al ( 24 ) showed that teachers had significantly more influence over a primary school student's handwashing habits before meals, and after using toilets or touching dogs, compared with family and peers. This suggests that promoting handwashing behaviours amongst students through teacher-involved participatory hygiene education may assist in preventing infectious disease transmission.…”

Nongovernmental Organization Practitioners’ Perspectives on the Challenges and Solutions to Changing Handwashing Behavior in Older Children: A Qualitative Study

“…Social norms have been found to be a strong determinant of handwashing behavior, including among children. 62 , 79 – 82 A study in Bangladesh reported that children were more likely to practice HWWS after visiting the toilet when a peer monitor was present, 83 and a study in Kenya that found hand cleaning rates were higher when at least 1 other person was present at the handwashing station. 84 The evidence on using motivational drivers in HWWS interventions mostly results from interventions targeting adults.…”

The Impact of Blockchain Technology Effectiveness in Indonesia's Learning System

“…The theoretical foundation of this research is the Technology Acceptance Model (TAM), which was first developed to investigate how new technology adoption occurs [16], [17]. The Theory of Reasoned Action (TRA), which focuses on how individuals assess the value and benefits of blockchain technology, forms the basis of this model [18], [19]. Usability-related aspects are used to measure the extent to which the new technology can improve student performance, while ease-of-use aspects are used to evaluate how accessible the technology is.…”