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BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Care | Research article

Visibility and transmission: complexities around promoting hand hygiene in young children – a qualitative study

Authors: Ruby Biezen, Danilla Grando, Danielle Mazza, Bianca Brijnath

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

Effective hand hygiene practice can reduce transmission of diseases such as respiratory tract infections (RTIs) and gastrointestinal infections, especially in young children. While hand hygiene has been widely promoted within Australia, primary care providers’ (PCPs) and parents’ understanding of hand hygiene importance, and their views on hand hygiene in reducing transmission of diseases in the community are unclear. Therefore, the aim of this study was to explore the views of PCPs and parents of young children on their knowledge and practice of hand hygiene in disease transmission.

Methods

Using a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs and five focus groups with parents (n = 50) between June 2014 and July 2015 in Melbourne, Australia. Data were thematically analysed.

Results

Participants agreed that hand hygiene practice was important in reducing disease transmissions. However, barriers such as variations of hand hygiene habits, relating visibility to transmission; concerns around young children being obsessed with washing hands; children already being ‘too clean’ and the need to build their immunity through exposure to dirt; and scepticism that hand hygiene practice was achievable in young children, all hindered participants’ motivation to develop good hand hygiene behaviour in young children.

Conclusion

Despite the established benefits of hand hygiene, sustained efforts are needed to ensure its uptake in routine care. To overcome the barriers identified in this study a multifaceted intervention is needed that includes teaching young children good hand hygiene habits, PCPs prompting parents and young children to practice hand hygiene when coming for an RTI consultation, reassuring parents that effective hand hygiene practice will not lead to abnormal psychological behaviour in their children, and community health promotion education campaigns.
Literature
1.
Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer WL, Altaf A, et al. Effect of handwashing on child health: a randomised controlled trial. Lancet. 2005;366:225–33.CrossRef
2.
Azor-Martínez E, Gonzalez-Jimenez Y, Seijas-Vazquez ML, Cobos-Carrascosa E, Santisteban-Martínez J, Martínez-López JM, et al. The impact of common infections on school absenteeism during an academic year. Am J Infect Control. 2014;42(6):632–7.CrossRef
3.
Hubner N-O, Hubner C, Wodny M, Kampf G, Kramer A. Effectiveness of alcohol-based hand disinfectants in a public adminstration: impact on health and work performance related to acute respiratory symptoms and diarrhoea. BMC Infect Dis. 2010;10:250.CrossRef
4.
Aiello AE, Coulborn RM, Vanessa P, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. 2008;98(8):1372–81.CrossRef
5.
Chen Y, Kirk MD. Incidence of acute respiratory infections in Australia. Epidemiol Infect. 2013;142(7):1355–61.CrossRef
6.
Chen Y, Williams E, Kirk M. Risk factors for acute respiratory infection in the Australian community. PLoS One. 2014;9(7):e101440.CrossRef
7.
Sacri A, GSerres G, Quach C, Boulianne N, Valiquette L, Skowronski D. Transmission of acute gastroenteritis and respiratory illness from children to parents. Pediatr Infect Dis J. 2014;33:583–8.CrossRef
8.
Warren-Gash C, Fragaszy E, Hayward AC. Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review. Influenza Other Respir Viruses. 2013;7(5):738–49.CrossRef
9.
Ponka A, Poussa T, Loasmaa M. The effect of enhanced hygiene practices on absences due to infectious diseases among children in day care centers in Helsinki. Infection. 2004;32:2–7.CrossRef
10.
Julian TR, Pickering AJ, Leckie JO, Boehm AB. Enterococcus spp on fomites and hands indicate increased risk of respiratory illness in child care centers. Am J Infect Control. 2013;41(8):728–33.CrossRef
11.
Lau CH, Springston EE, Sohn M-W, Mason I, Gadola E, Damitz M, et al. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study. BMC Pediatr. 2012;12(1):52.CrossRef
12.
Sandora TJ, Shih MC, Goldmann DA. Reducing absenteeism from gastrointestinal and respiratory illness in elementary school students: a randomized, controlled trial of an infection-control intervention. Pediatrics. 2008;121:e1555–e62.CrossRef
13.
Priest P, McKenzie JE, Audas R, Poore M, Brunton C, Reeves L. Hand sanitiser provision for reducing illness absences in primary school children: a cluster randomised trial. PLoS Med. 2014;11(8):e1001700.CrossRef
14.
Sandora TJ, Taveras EM, Shih MC, Resnick EA, Lee GM, Ross-Degnan D, et al. A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home. Pediatrics. 2005;116:587–94.CrossRef
15.
Tamimi A, Maxwell S, Edmonds S, Gerba C. Impact of the use of an alcohol-based hand sanitizer in the home on reduction in probability of infection by respiratory and enteric viruses. Epidemiol Infect. 2015;143:3335–41.CrossRef
16.
Nicholson J, Naeeni M, Hoptroff M, Matheson J, Roberts A, Taylor D, et al. An investigation of the effects of a hand washing intervention on health outcomes and school absence using a randomised trial in Indian urban communities. Tropical Med Int Health. 2014;19(3):284–92.CrossRef
17.
Randle J, Metcalfe J, Webb H, Luckett JCA, Nerlich B, Vaughan N, et al. Impact of an educational intervention upon the hand hygiene compliance of children. J Hosp Infect. 2013;85(3):220–5.CrossRef
18.
Stewardson AJ, Sax H, Gayet-Ageron A, Touveneau S, Longtin Y, Zingg W, et al. Enhanced performance feedback and patient participation to improve hand hygiene compliance of health-care workers in the setting of established multimodal promotion: a single-Centre, cluster randomised controlled trial. Lancet Infect Dis. 2016;16(12):1345–55.CrossRef
19.
White C, Statile A, Conway P, Shoettker P, Solan L, Unaka N, et al. Utilizing improvement science methods to improve physician compliance with proper hand hygiene. Pediatrics. 2012;129(4):e1042–e50.CrossRef
20.
Snow M, White GL, Kim HS. Inexpensive and time-efficient hand hygiene interventions increase elementary school children’s hand hygiene rates. J Sch Health. 2008;78(4):230–3.CrossRef
21.
Rosen L, Zucker D, Bordy D, Engelhard D, Manor O. The effect of a handwashing intervention on preschool educator beliefs, attitudes, knowledge and self-efficacy. Health Educ Res. 2009;24(4):686–98.CrossRef
22.
Martín-Madrazo C, Soto-Díaz S, Cañada-Dorado A, Salinero-Fort MA, Medina-Fernández M, de Santa Pau E, et al. Cluster randomized trial to evaluate the effect of a multimodal hand hygiene improvement strategy in primary care. Infect Control Hosp Epidemiol. 2012;33(7):681–8.CrossRef
23.
Morton JL, Schultz AA. Healthy hands: use of alcohol gel as an adjunct to handwashing in elementary school children. J Sch Nurs. 2004;20(3):161–7.CrossRef
24.
Chittleborough CR, Nicholson AL, Basker E, Bell S, Campbell R. Factors influencing hand washing behaviour in primary schools: process evaluation within a randomized controlled trial. Health Educ Res. 2012;27(6):1055–68.CrossRef
25.
Barroso V, Caceres W, Loftus P, Evans KH, Shieh L. Hand hygiene of medical students and resident physicians: predictors of attitudes and behaviour. Postgrad Med J. 2016;92(1091):497–500.CrossRef
26.
27.
Biezen R, Grando D, Mazza D, Brijnath B. Why do we not want to recommend influenza vaccination to young children? A qualitative study of Australian parents and primary care providers. Vaccine. 2018;36:859–65.CrossRef
28.
29.
Braun V, CLarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
30.
31.
Alfahan A, Alhabib S, Abdulmajeed I, Rahman S, Bamuhair S. In the era of corona virus: health care professionals’ knowledge, attitudes, and practice of hand hygiene in Saudi primary care centers: a cross-sectional study. J Community Hosp Intern Med Perspect. 2016;6(4). https://​doi.​org/​10.​3402/​jchimp.​v6.​32151.CrossRef
32.
Whitby M, Pessoa-Silva CL, McLaws ML, Allegranzi B, Sax H, Larson E, et al. Behavioural considerations for hand hygiene practices: the basic building blocks. J Hosp Infect. 2007;65:1–8.CrossRef
33.
Borg MA, Benbachir M, Cookson BD, Redjeb SB, Elnasser Z, Rasslan O, et al. Self-protection as a driver for hand hygiene among healthcare workers. Infect Control Hosp Epidemiol. 2009;30:578–80.CrossRef
34.
Ainsworth B, Steele M, Stuart B, Joseph J, Miller S, Morrison L, et al. Using an analysis of behavior change to inform effective digital intervention design: how did the PRIMIT website change hand hygiene behavior across 8993 users? Ann Behav Med. 2017;(3):423.CrossRef
35.
Hinds AL, Woody EZ, Schmidt LA, Van Ameringen M, Szechtman H. In the wake of a possible mistake: security motivation, checking behavior, and OCD. J Behav Ther Exp Psychiatry. 2015;49, Part B:133–40.CrossRef
36.
Hinds AL, Woody EZ, Van Ameringen M, Schmidt LA, Szechtman H. When too much is not enough: obsessive-compulsive disorder as a pathology of stopping, rather than starting. PLoS One. 2012;7(1):e30586.CrossRef
37.
van Beeck AHE, Zomer TP, van Beeck EF, Richardus JH, Voeten HACM, Erasmus V. Children’s hand hygiene behaviour and available facilities: an observational study in Dutch day care centres. Eur J Pub Health. 2016;26(2):297–300.CrossRef
38.
Song IH, Kim S-A, Park W-S. Family factors associated with children’s handwashing hygiene behavior. J Child Health Care. 2012;17(2):164–73.CrossRef
39.
Veitch C, Hollins J, Worley P, Mitchell G. General practice research. Problems and solutions in participant recruitment and retention. Aust Fam Physician. 2001;30:399–406.PubMed
40.
Metadata
Title
Visibility and transmission: complexities around promoting hand hygiene in young children – a qualitative study
Authors
Ruby Biezen
Danilla Grando
Danielle Mazza
Bianca Brijnath
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-6729-x

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