Effect of a theory-based hand hygiene educational intervention for enhancing behavioural outcomes in Ghanaian schools: a cluster-randomised controlled trial

Int J Public Health. 2020 Jan;65(1):99-109. doi: 10.1007/s00038-019-01310-4. Epub 2019 Nov 7.

Abstract

Objectives: The study sought to determine whether a hand hygiene educational intervention underpinned by educational and psychosocial theories is effective in enhancing behavioural intention and proper handwashing practices among school children.

Methods: The study was a cluster-randomised controlled trial, with schools constituting the clusters. At baseline, 717 pupils organised in four clusters were recruited. Techniques for data collection included a structured observation. The Student's t test was used for data analysis.

Results: At follow-up, a statistically significant difference was observed between the study arms with regard to intention to wash hands with soap [after toilet use (p = 0.032, d = 0.5); before meals (p = 0.020, d = 0.2)]. Similarly, a statistically significant difference was identified between the study arms with regard to the practice of handwashing with soap (HWWS) [after toilet use (p = 0.005); before meals (p = 0.012)].

Conclusions: A theory-driven hand hygiene educational intervention involving school children can have a medium to a very large effect size, with respect to the practice of HWWS, and a low to a medium effect size with respect to behavioural intention.

Keywords: Education; Hand hygiene; Intention; Practice; School; Theory based.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Female
  • Ghana
  • Hand Disinfection / methods
  • Hand Disinfection / standards
  • Hand Hygiene / methods*
  • Hand Hygiene / standards
  • Health Behavior
  • Health Education / organization & administration*
  • Humans
  • Intention
  • Male
  • School Health Services / organization & administration*
  • Soaps

Substances

  • Soaps