scholarly journals A Crossover Randomized Controlled Trial of Priming Interventions to Increase Hand Hygiene at Ward Entrances

2022 ◽  
Vol 9 ◽  
Author(s):  
Kelly Ann Schmidtke ◽  
Navneet Aujla ◽  
Tom Marshall ◽  
Abid Hussain ◽  
Gerard P. Hodgkinson ◽  
...  

BackgroundResearch conducted in the United States suggests that two primes (citrus smells and pictures of a person's eyes) can increase hand gel dispenser use on the day they are introduced in hospital. The current study, conducted at a hospital in the United Kingdom, evaluated the effectiveness of these primes, both in isolation and in combination, at the entry way to four separate wards, over a longer duration than the previous work.MethodsA crossover randomized controlled trial was conducted. Four wards were allocated for 6 weeks of observation to each of four conditions, including “control,” “olfactory,” “visual,” or “both” (i.e., “olfactory” and “visual” combined). It was hypothesized that hand hygiene compliance would be greater in all priming conditions relative to the control condition. The primary outcome was whether people used the gel dispenser when they entered the wards. After the trial, a follow up survey of staff at the same hospital assessed the barriers to, and facilitators of, hand hygiene compliance. The trial data were analyzed using regression techniques and the survey data were analyzed using descriptive statistics.ResultsThe total number of individuals observed in the trial was 9,811 (female = 61%), with similar numbers across conditions, including “control” N = 2,582, “olfactory” N = 2,700, “visual” N = 2,488, and “both” N = 2,141. None of the priming conditions consistently increased hand hygiene. The lowest percentage compliance was observed in the “both” condition (7.8%), and the highest was observed in the “visual” condition (12.7%). The survey was completed by 97 staff (female = 81%). “Environmental resources” and “social influences” were the greatest barriers to staff cleaning their hands.ConclusionsTaken together, the current findings suggest that the olfactory and visual priming interventions investigated do not influence hand hygiene consistently. To increase the likelihood of such interventions succeeding, future research should focus on prospectively determined mechanisms of action.

2020 ◽  
Vol 41 (10) ◽  
pp. 1169-1177
Author(s):  
Gwen R. Teesing ◽  
Vicki Erasmus ◽  
Daan Nieboer ◽  
Mariska Petrignani ◽  
Marion P.G Koopmans ◽  
...  

AbstractObjective:To assess the effect of a multimodal intervention on hand hygiene compliance (HHC) in nursing homes.Design, setting, and participants:HHC was evaluated using direct, unobtrusive observation in a cluster randomized controlled trial at publicly funded nursing homes in the Netherlands. In total, 103 nursing home organizations were invited to participate; 18 organizations comprising 33 nursing homes (n = 66 nursing home units) participated in the study. Nursing homes were randomized into a control group (no intervention, n = 30) or an intervention group (multimodal intervention, n = 36). The primary outcome measure was HHC of nurses. HHC was appraised at baseline and at 4, 7, and 12 months after baseline. Observers and nurses were blinded.Intervention:Audits regarding hand hygiene (HH) materials and personal hygiene rules, 3 live lessons, an e-learning program, posters, and a photo contest. We used a new method to teach the nurses the WHO-defined 5 moments of HH: Room In, Room Out, Before Clean, and After Dirty.Results:HHC increased in both arms. The increase after 12 months was larger for units in the intervention arm (from 12% to 36%) than for control units (from 13% to 21%) (odds ratio [OR], 2.10; confidence interval [CI], 1.35–3.28). The intervention arm exhibited a statistically significant increase in HHC at 4 of the 5 WHO-defined HH moments. At follow-up, HHC in the intervention arm remained statistically significantly higher (OR, 1.93; 95% CI, 1.59–2.34) for indications after an activity (from 37% to 39%) than for indications before an activity (from 14% to 27%).Conclusions:The HANDSOME intervention is successful in improving HHC in nursing homes.


2021 ◽  
Author(s):  
Nikkil Sudharsanan ◽  
Caterina Favaretti ◽  
Violetta Hachaturyan ◽  
Till Baernighausen ◽  
Alain Vandormael

Vaccination rates have stagnated in the United States and the United Kingdom leading to the continuing spread of COVID-19. Fear and concern over vaccine side-effects is one of the main drivers of hesitancy. Drawing from behavioral science and health communication theory, we conducted a randomized controlled trial among 8998 adults to determine whether the way COVID-19 vaccine side-effects are framed and presented to individuals can influence their willingness to take a vaccine. We presented participants information on a hypothetical future COVID-19 vaccine -- including information on its side-effect rate -- and then examined the effect of three side-effect framing strategies on individuals stated willingness to take this vaccine: adding a qualitative risk label next to the numerical risk, adding comparison risks, and for those presented with comparisons, framing the comparison in relative rather than absolute terms. Based on a pre-registered and published analysis plan, we found that adding a simple descriptive risk label (very low risk) next to the numerical side-effect increased participants' willingness to take the COVID-19 vaccine by 3.0 percentage points (p = 0.003). Providing a comparison to motor vehicle mortality increased COVID-19 vaccine willingness by 2.4 percentage points (p = 0.051). These effects were independent and additive: participants that received both a qualitative risk label and comparison to motor-vehicle mortality were 6.1 percentage points (p < 0.001) more likely to report willingness to take a vaccine compared to those who did not receive a label or comparison. Taken together, our results reveal that despite increasingly strong vaccination hesitancy and exposure to large amounts of vaccine misinformation, low-cost side-effect framing strategies can meaningfully affect vaccination intentions at a population level.


2016 ◽  
Vol 144 (12) ◽  
pp. 2552-2560 ◽  
Author(s):  
T. P. ZOMER ◽  
V. ERASMUS ◽  
C. W. LOOMAN ◽  
E. F. VAN BEECK ◽  
A. TJON-A-TSIEN ◽  
...  

SUMMARYGastrointestinal and respiratory infections in children attending daycare centres (DCCs) are common and compliance with hand hygiene (HH) guidelines to prevent infections is generally low. An intervention was developed to increase HH compliance and reduce infections in DCCs. The objective of this paper was to evaluate the effectiveness of this intervention on HH compliance. The intervention was evaluated in a two-arm cluster randomized controlled trial in 71 DCCs in The Netherlands. Thirty-six DCCs received the intervention including: (1) HH products; (2) training about HH guidelines; (3) two team training sessions aimed at goal setting and formulating HH improvement activities; and (4) reminders and cues for action (posters/stickers). Intervention DCCs were compared to 35 control DCCs that continued usual practice. HH compliance of caregivers and children was observed at baseline and at 1, 3 and 6 months follow-up. Using multilevel logistic regression, odds ratios (ORs) with 95% confidence intervals (CIs) were obtained for the intervention effect. Of 795 caregivers, 5042 HH opportunities for caregivers and 5606 opportunities for supervising children's HH were observed. At 1 month follow-up caregivers' compliance in intervention DCCs was 66%vs.43% in control DCCs (OR 6·33, 95% CI 3·71–10·80), and at 6 months 59%vs.44% (OR 4·13, 95% CI 2·33–7·32). No effect of the intervention was found on supervising children's HH (36%vs.32%; OR 0·64, 95% CI 0·18–2·33). In conclusion, HH compliance of caregivers increased due to the intervention, therefore dissemination of the intervention can be considered.


2020 ◽  
Vol 31 (2) ◽  
pp. 296-312
Author(s):  
Kelly Ann Schmidtke ◽  
Antony Elliott ◽  
Krishane Patel ◽  
Derek King ◽  
Ivo Vlaev

This article describes a randomized controlled trial to evaluate the effectiveness of intervention tools designed to help people save more or spend less money by enhancing their capabilities, motivations, and opportunities. The participants included 177 students from an English University who were randomly allocated to either the Control, Savings-Tool, or Savings+Habit-Tools group. Participants provided with the intervention tool(s) for 4 weeks were more likely to experience improvements in both their financial satisfaction and subjective perceptions than those in the Control group not asked to use either tool. The tools did not significantly affect financial behaviors or objective financial wellness. The discussion examines limitations of the study and discusses avenues for future research such as including a longer follow-up period.


2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Ephrem Tefera Solomon ◽  
Sirak Robele Gari ◽  
Helmut Kloos ◽  
Bezatu Mengistie Alemu

Abstract Background Handwashing with soap reduces diarrheal diseases burden considerably. However, the importance of handwashing in homes has received little attention in rural eastern Ethiopia. The effectiveness of handwashing may be reduced by lack of information on when and in what event hands must be washed, the frequency of handwashing, the individual who should wash his/her hands, and the procedure of handwashing. In these areas, indicators of adherence to handwashing are yet to be established. This study aimed at assessing the efficiency of handwashing on reducing diarrheal disease in children under 5 years old in rural kebeles of Dire Dawa, east Ethiopia. Methods Community-based cluster randomized controlled trial was conducted in rural kebeles of Dire Dawa for 4 months starting from October 2018 to January 2019. Selected clusters were randomized in intervention and control arms using draw method and data collectors conducted the baseline survey. Households assigned to the intervention group were given two bars of plain soap on a bi-monthly basis together with information promoting hand hygiene. Control households were allowed to continue their habitual handwashing practices. We compared the diarrheal incidences of the intervention and non-intervention households. Generalized estimation equations using Poisson family and log choice of the link was employed to calculate adjusted incidence rate ratio with its 95% confidence interval. Results We recorded a significant lesser diarrheal incidence in the handwashing arm than in the non-intervention arm (6.9 versus 13.8 episodes per 100 person weeks of observation). In all, there was a 41% reduction in diarrheal incidence in the intervention arm in relation to the non-intervention arm. Conclusion Handwashing with soap complemented with hand hygiene promotion significantly decreased diarrheal episodes in children under 5 years old in rural kebeles of Dire Dawa. We recommend the promotion and adaptation of washing hands using soap at recommended times to be an effective means of reducing childhood diarrhea morbidity in rural populations of Ethiopia towards achieving the Sustainable Development Goal 6. Trial registration PACTR, PACTR201807815961394. Registered 16 July 2018,


2021 ◽  
pp. 089826432110150
Author(s):  
Janet M. Boekhout ◽  
Esmee Volders ◽  
Catherine A. W. Bolman ◽  
Renate H. M. de Groot ◽  
Lilian Lechner

Objectives: This study explores the effects of the Active Plus intervention aiming to decrease loneliness among older adults (>65 years) with chronic diseases. Methods: A randomized controlled trial (RCT) was performed (N = 585; age: M = 74.5 years, SD = 6.4), assessing loneliness at baseline, 6 months and 12 months. Outcome measures in the multilevel linear regression analyses were total, social and emotional loneliness. Results: At 12 months, significant decreases in total ( B = −.37, p = .01) and social loneliness ( B = −.24, p = .02) were found. Age was a significant moderator for total and social loneliness; however, the intervention was effective only for participants aged 80 years and older. Discussion: The Active Plus intervention showed a significant decrease in total and social loneliness and was especially beneficial for the vulnerable age group of 80 years and older. A more comprehensive tool for measuring social activity and mobility impairments, and using a longer time frame to detect loneliness changes, may form interesting future research.


2015 ◽  
Vol 117 (2) ◽  
pp. 1-52
Author(s):  
Dennis J. Barr ◽  
Beth Boulay ◽  
Robert L. Selman ◽  
Rachel Mccormick ◽  
Ethan Lowenstein ◽  
...  

Background/Context Billions of dollars are spent annually on professional development (PD) for educators, yet few randomized controlled trials (RCT) have demonstrated the ultimate impact PD has on student learning. Further, while policymakers and others speak to the role schools should play in developing students’ civic awareness, RCTs of PD designed to foster civic learning are rare. This randomized controlled trial contributes to the knowledge base on the effectiveness of PD designed to integrate civic learning, ethical reflection, and historical thinking skills into high school humanities courses. Focus of Study The study examined the impact of a PD intervention in two areas: (a) teacher self-efficacy, burnout, and professional engagement and satisfaction; and (b) the academic, civic, social, and ethical competencies of 9th and 10th grade students in the teachers’ classes. Population/Participants/Subjects The study involved 113 teachers and 1,371 9th and 10th grade students in 60 high schools from eight metropolitan regions in the United States. Intervention/Program/Practice The intervention, Facing History and Ourselves, provides PD through a five-day seminar, curricular materials, and follow-up coaching and workshops to help teachers develop their capacities to implement an interdisciplinary historical case study unit using student-centered pedagogy. Research Design The study used a school-level, randomized, experimental design to investigate impacts of the intervention for teachers and their 9th and 10th grade students. Findings/Results Intervention teachers showed significantly greater self-efficacy in all eight assessed domains, more positive perceptions of professional support, satisfaction and growth, and greater personal accomplishment. Intervention students demonstrated stronger skills for analyzing evidence, agency, and cause and effect on a historical understanding performance measure; greater self-reported civic efficacy and tolerance for others with different views; and more positive perceptions of the classroom climate and the opportunities afforded for engaging with civic matters. Fidelity analysis found these causal effects despite the fact that roughly half of the intervention teachers did not fully implement the program. Conclusions/Recommendations Educators need evidence-based approaches for teaching complex social, civic, and political issues enabling students of diverse mindsets and backgrounds to engage constructively with one another while obtaining necessary skills and knowledge. These findings provide empirical support for a professional development approach that engages teachers in fostering academic and civic competencies critical to both participation in a democracy and success in college and career.


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