Skip to main content
Top
Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | Coronavirus | Research

Application of the Capability, Opportunity, Motivation and Behavior (COM-B) model to identify predictors of two self-reported hand hygiene behaviors (handwashing and hand sanitizer use) to prevent COVID-19 infection among U.S. adults, Fall 2020

Authors: Laura G. Brown, E. Rickamer Hoover, Bethlehem N. Besrat, Claire Burns-Lynch, Rebekah Frankson, Shantrice L. Jones, Amanda G. Garcia-Williams

Published in: BMC Public Health | Issue 1/2022

Login to get access

Abstract

Background

Handwashing with soap and water is an important way to prevent transmission of viruses and bacteria and worldwide it is estimated handwashing can prevent 1 in 5 viral respiratory infections. Frequent handwashing is associated with a decreased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Using a hand sanitizer with at least 60% alcohol when handwashing is not feasible can also help prevent the transmission of viruses and bacteria.

Objective

Since early 2020, the public has been encouraged to handwash frequently with soap and water and use alcohol-based hand sanitizer when soap and water are not available to reduce COVID-19 transmission. This study’s objectives were to assess U.S. adults’ perceptions of components of the Capability, Opportunity, Motivation and Behavior (COM-B) Model in relation to these two hand hygiene behaviors and to identify relationships between these components and hand hygiene behaviors.

Methods

Items assessing capability, opportunity, motivation, and hand hygiene behaviors were included in FallStyles, a survey completed by 3,625 adults in the fall of 2020 through an online panel representative of the U.S. population. We calculated composite capability, opportunity, and motivation measures and descriptive statistics for all measures. Finally, we conducted multiple logistic regressions to identify predictors of handwashing and hand sanitizer use.

Results

Most respondents reported frequently washing hands with soap and water (89%) and using alcohol-based hand sanitizer (72%) to prevent coronavirus. For capability, over 90% of respondents said that neither behavior takes a lot of effort, but fewer agreed that they knew when, or how, they should engage in handwashing (67%; 74%) and hand sanitizer use (62%; 64%). For opportunity, over 95% of respondents said lack of time didn’t make it hard to engage in either behavior; fewer said visual cues reminded them to engage in the behaviors (handwashing: 30%; sanitizer use: 48%). For motivation, the majority believed the two behaviors were good ways to prevent coronavirus illness (handwashing: 76%; sanitizer use: 59%). Regressions indicated that capability, opportunity, and particularly motivation were positively associated with both hand hygiene behaviors.

Conclusions

The COM-B model was a helpful framework for increasing understanding of hand hygiene behavior; it identified capability, opportunity, and motivation as predictors of both handwashing and hand sanitizer use.
Footnotes
1
45 C.F.R. part 46, 21 C.F.R. part 56; 42 U.S.C. Section 241(d); 5 U.S.C. Section 552a; 44 U.S.C. Section 3501 et seq.
 
Literature
2.
go back to reference Doung-ngern P, Suphanchaimat R, Panjangampatthana A, Janekrongtham C, Ruampoom D, Daochaeng N, Eungkanit N, Pisitpayat N, Srisong N, Yasopa O, Plernprom P, Promduangsi P, Kumphon P, Suangtho P, Watakulsin P, Chaiya S, Kripattanapong S, Chantian T, Bloss E, Namwat C, Limmathurotsakul D. Case-control study of use of personal protective measures and risk for SARS-CoV 2 infection Thailand. Emerg Infect Dis. 2020;26(11):2607–16. https://doi.org/10.3201/eid2611.203003.CrossRef Doung-ngern P, Suphanchaimat R, Panjangampatthana A, Janekrongtham C, Ruampoom D, Daochaeng N, Eungkanit N, Pisitpayat N, Srisong N, Yasopa O, Plernprom P, Promduangsi P, Kumphon P, Suangtho P, Watakulsin P, Chaiya S, Kripattanapong S, Chantian T, Bloss E, Namwat C, Limmathurotsakul D. Case-control study of use of personal protective measures and risk for SARS-CoV 2 infection Thailand. Emerg Infect Dis. 2020;26(11):2607–16. https://​doi.​org/​10.​3201/​eid2611.​203003.CrossRef
10.
go back to reference Czeisler M, Garcia-Williams A, Molinari N, Gharpure R, Li Y, Barrett C, Robbins R, Facer-Childs E, Barger L, Czeisler C, Rajaratnam S, Howard M. Demographic characteristics, experiences, and beliefs associated with hand hygiene among adults during the COVID-19 pandemic — United States, June 24–30, 2020. MMWR. 2020;69:1485–91. https://doi.org/10.15585/mmwr.mm6941a3.CrossRef Czeisler M, Garcia-Williams A, Molinari N, Gharpure R, Li Y, Barrett C, Robbins R, Facer-Childs E, Barger L, Czeisler C, Rajaratnam S, Howard M. Demographic characteristics, experiences, and beliefs associated with hand hygiene among adults during the COVID-19 pandemic — United States, June 24–30, 2020. MMWR. 2020;69:1485–91. https://​doi.​org/​10.​15585/​mmwr.​mm6941a3.CrossRef
11.
go back to reference Haston J, Miller G, Berendes D, Andujar A, Marshall B, Cope J, Huner C, Robinson B, Hill V, Garcia-Williams A. Characteristics associated with adults remembering to wash hands in multiple situations before and during the COVID-19 pandemic — United States, October 2019 and June 2020. MMWR. 2020;69:1443–9. https://doi.org/10.15585/mmwr.mm6940a2.CrossRef Haston J, Miller G, Berendes D, Andujar A, Marshall B, Cope J, Huner C, Robinson B, Hill V, Garcia-Williams A. Characteristics associated with adults remembering to wash hands in multiple situations before and during the COVID-19 pandemic — United States, October 2019 and June 2020. MMWR. 2020;69:1443–9. https://​doi.​org/​10.​15585/​mmwr.​mm6940a2.CrossRef
13.
go back to reference Hsing J, Jasmin M, Barrero-Castillero A, Jani S, Pulendran U, Lin B, Thomas-Uribe M, Wang C. Influence of health beliefs on adherence to COVID-19 preventative practices: International social media–based survey study. J Med Internet Res. 2020;23(2):e23720. https://doi.org/10.2196/23720.CrossRef Hsing J, Jasmin M, Barrero-Castillero A, Jani S, Pulendran U, Lin B, Thomas-Uribe M, Wang C. Influence of health beliefs on adherence to COVID-19 preventative practices: International social media–based survey study. J Med Internet Res. 2020;23(2):e23720. https://​doi.​org/​10.​2196/​23720.CrossRef
14.
17.
go back to reference Moran C, Campbell D, Campbell T, Roach P, Bourassa L, Collins Z, Stasiewicz M, McLane P. Predictors of attitudes and adherence to COVID-19 public health guidelines in Western countries: a rapid review of the emerging literature. J Pub Health. 2021;43(4):1–15. https://doi.org/10.1093/pubmed/fdab070.CrossRef Moran C, Campbell D, Campbell T, Roach P, Bourassa L, Collins Z, Stasiewicz M, McLane P. Predictors of attitudes and adherence to COVID-19 public health guidelines in Western countries: a rapid review of the emerging literature. J Pub Health. 2021;43(4):1–15. https://​doi.​org/​10.​1093/​pubmed/​fdab070.CrossRef
22.
go back to reference Miller J, Hartman T, Levita L, Martinez A, Mason L, McBride O, McKay R, Murphy J, Shevlin M, Stocks T, Bennett K, Bentall R. Capability, opportunity, and motivation to enact hygienic practices in the early stages of the COVID-19 outbreak in the United Kingdom. Br J Health Psychol. 2020;25(4):856–64. https://doi.org/10.1111/bjhp.12426.CrossRef Miller J, Hartman T, Levita L, Martinez A, Mason L, McBride O, McKay R, Murphy J, Shevlin M, Stocks T, Bennett K, Bentall R. Capability, opportunity, and motivation to enact hygienic practices in the early stages of the COVID-19 outbreak in the United Kingdom. Br J Health Psychol. 2020;25(4):856–64. https://​doi.​org/​10.​1111/​bjhp.​12426.CrossRef
24.
28.
29.
go back to reference DiClemente R, Crosby R, Kegler M. 2009. (Eds.). (2009). Emerging theories in health promotion practice and research (2nd ed.). Jossey-Bass/Wiley. DiClemente R, Crosby R, Kegler M. 2009. (Eds.). (2009). Emerging theories in health promotion practice and research (2nd ed.). Jossey-Bass/Wiley.
30.
go back to reference National Cancer Institute. Theory at a Glance: Application to Health Promotion and Health Behavior (Second Edition). Niu Z, Qin Z, Hu P, Wang T. 2021. Health Beliefs, trust in media sources, health literacy, and preventive behaviors among high-risk Chinese for COVID-19 Health Communication. 2005;1–9. https://doi.org/10.1080/10410236.2021.1880684. National Cancer Institute. Theory at a Glance: Application to Health Promotion and Health Behavior (Second Edition). Niu Z, Qin Z, Hu P, Wang T. 2021. Health Beliefs, trust in media sources, health literacy, and preventive behaviors among high-risk Chinese for COVID-19 Health Communication. 2005;1–9. https://​doi.​org/​10.​1080/​10410236.​2021.​1880684.
32.
go back to reference Michie S, Atkins L, West R. 2014. The Behavior Change Wheel: A guide to designing interventions. Silverback Publishing Great Britain. Michie S, Atkins L, West R. 2014. The Behavior Change Wheel: A guide to designing interventions. Silverback Publishing Great Britain.
40.
go back to reference Dreibelbis R, Winch PJ, Leontsini E, Hulland K, Ram P, Leanne Unicomb L, Luby S. The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings. BMC Pub Health. 2013;13:1015. https://doi.org/10.1186/1471-2458-13-1015.CrossRef Dreibelbis R, Winch PJ, Leontsini E, Hulland K, Ram P, Leanne Unicomb L, Luby S. The Integrated Behavioural Model for Water, Sanitation, and Hygiene: a systematic review of behavioural models and a framework for designing and evaluating behaviour change interventions in infrastructure-restricted settings. BMC Pub Health. 2013;13:1015. https://​doi.​org/​10.​1186/​1471-2458-13-1015.CrossRef
44.
go back to reference Prasetyo Y, Castillo A, Salonga L, Sia J, Seneta J. Factors affecting perceived effectiveness of COVID-19 prevention measures among Filipinos during Enhanced Community Quarantine in Luzon, Philippines: integrating protection motivation theory and extended theory of planned behavior. Int J Infect Dis. 2020;99:312–23. https://doi.org/10.1016/j.ijid.2020.07.074.CrossRef Prasetyo Y, Castillo A, Salonga L, Sia J, Seneta J. Factors affecting perceived effectiveness of COVID-19 prevention measures among Filipinos during Enhanced Community Quarantine in Luzon, Philippines: integrating protection motivation theory and extended theory of planned behavior. Int J Infect Dis. 2020;99:312–23. https://​doi.​org/​10.​1016/​j.​ijid.​2020.​07.​074.CrossRef
Metadata
Title
Application of the Capability, Opportunity, Motivation and Behavior (COM-B) model to identify predictors of two self-reported hand hygiene behaviors (handwashing and hand sanitizer use) to prevent COVID-19 infection among U.S. adults, Fall 2020
Authors
Laura G. Brown
E. Rickamer Hoover
Bethlehem N. Besrat
Claire Burns-Lynch
Rebekah Frankson
Shantrice L. Jones
Amanda G. Garcia-Williams
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-14809-y

Other articles of this Issue 1/2022

BMC Public Health 1/2022 Go to the issue