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      Effectiveness and Efficiency of Persuasive Space Graphics (PSG) in Motivating UK Primary School Children’s Hand Hygiene

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          Abstract

          Good hand hygiene is necessary to control and prevent infections, but many children do not adequately wash their hands. While there are classroom communications targeted at children, the toilet space, the location of many hand hygiene activities, is neglected. This paper describes an initial evaluation of “123” persuasive space graphics (images and messages integrated within an architectural environment that encourage specific actions). The effectiveness (whether hand hygiene improves) and efficiency (the ease with which a setting can adopt and implement an intervention) is evaluated in three UK schools and one museum. Five evaluations (participant demographic, handwashing frequency, handwashing quality, design persuasiveness, stakeholder views) were conducted. In the school settings, persuasive space graphics increased the quality and frequency of handwashing. In the museum setting, frequency of handwashing slightly increased. In all settings children found the graphics persuasive, and stakeholders also believed them to be effective. Stakeholders considered persuasive space graphics a low-cost and time-efficient way to communicate. It can be concluded that persuasive space graphics are effective in increasing hand hygiene, particularly in school settings where children have a longer exposure to the graphics. Persuasive space graphics are also an efficient low-cost means of communicating hand hygiene.

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          Most cited references30

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          Designing for dissemination among public health researchers: findings from a national survey in the United States.

          We have described the practice of designing for dissemination among researchers in the United States with the intent of identifying gaps and areas for improvement.
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            Hygiene: new hopes, new horizons

            Summary Although promotion of safe hygiene is the single most cost-effective means of preventing infectious disease, investment in hygiene is low both in the health and in the water and sanitation sectors. Evidence shows the benefit of improved hygiene, especially for improved handwashing and safe stool disposal. A growing understanding of what drives hygiene behaviour and creative partnerships are providing fresh approaches to change behaviour. However, some important gaps in our knowledge exist. For example, almost no trials of the effectiveness of interventions to improve food hygiene in developing countries are available. We also need to figure out how best to make safe hygiene practices matters of daily routine that are sustained by social norms on a mass scale. Full and active involvement of the health sector in getting safe hygiene to all homes, schools, and institutions will bring major gains to public health.
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              Experimental pretesting of hand-washing interventions in a natural setting.

              We pretested interventions derived from different domains of behavior change theory to determine their effectiveness at increasing hand washing with soap in a natural setting. We installed wireless devices in highway service station restrooms to record entry and soap use. Two text-only messages for each of 7 psychological domains were compared for their effect on soap-use rates. We collected data on nearly 200 000 restroom uses. The knowledge activation domain was most effective for women, with a relative increase in soap use of 9.4% compared with the control condition (P = .001). For men, disgust was the most effective, increasing soap use by 9.8% (P = .001). Disgust was not significantly better than the control condition for women, nor was knowledge activation for men. Messages based on social norms and social status were effective for both genders. Our data show that unobtrusive observation of behavior in a natural setting can help identify the most effective interventions for changing behaviors of public health importance. The gender differences we found suggest that public health interventions should target men and women differently.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                31 March 2020
                April 2020
                : 17
                : 7
                : 2351
                Affiliations
                [1 ]Information School, the University of Sheffield, Sheffield S1 4DP, UK
                [2 ]School of Design, University of Leeds, Leeds LS2 9JT, UK; j.wood@ 123456mihealth.info
                [3 ]School of Design, Glasgow School of Art, Glasgow G3 6RQ, UK; c.macduff@ 123456gsa.ac.uk
                [4 ]School of Clinical and Applied Sciences, Leeds Beckett University, Leeds LS1 3HE, UK; m.gomez-escalada@ 123456leedsbeckett.ac.uk
                Author notes
                Author information
                https://orcid.org/0000-0002-3249-5269
                Article
                ijerph-17-02351
                10.3390/ijerph17072351
                7177326
                32244287
                5aef59ee-fe64-4418-9f3a-d97ff5bcb2d5
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 19 February 2020
                : 27 March 2020
                Categories
                Article

                Public health
                handwashing,hand hygiene,children,schools,measures,data collection tools,research methods
                Public health
                handwashing, hand hygiene, children, schools, measures, data collection tools, research methods

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