Evaluating brief motivational and self-regulatory hand hygiene interventions: a cross-over longitudinal design

BMC Public Health

Ralf Schwarzer²  Nina Knoll¹  Sonia Lippke³  Pempa Lhakhang¹ 

[1] Health Psychology Division, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany;Department of Psychology, University of Social Sciences and Humanities, ul, Ostrowskiego 30b, Wroclaw, 53-238, Poland;Jacobs University Bremen gGmbH, Campus Ring 1, Bremen, 28759, Germany

关键词: Young adults;    Planning;    Self-efficacy;    Intention;    Handwashing;    Self-regulation;    Motivation;   

Others  :  1122795
DOI  :  10.1186/s12889-015-1453-7

 received in 2014-10-02, accepted in 2015-01-20,  发布年份 2015

【 摘 要 】

Background

Frequent handwashing can prevent infections, but non-compliance to hand hygiene is pervasive. Few theory- and evidence-based interventions to improve regular handwashing are available. Therefore, two intervention modules, a motivational and a self-regulatory one, were designed and evaluated.

Methods

In a longitudinal study, 205 young adults, aged 18 to 26 years, were randomized into two intervention groups. The Mot-SelfR group received first a motivational intervention (Mot; risk perception and outcome expectancies) followed by a self-regulatory intervention (SelfR; perceived self-efficacy and planning) 17 days later. The SelfR-Mot group received the same two intervention modules in the opposite order. Follow-up data were assessed 17 and 34 days after the baseline.

Results

Both intervention sequences led to an increase in handwashing frequency, intention, self-efficacy, and planning. Also, overall gains were found for the self-regulatory module (increased planning and self-efficacy levels) and the motivational module (intention). Within groups, the self-regulatory module appeared to be more effective than the motivational module, independent of sequence.

Conclusions

Self-regulatory interventions can help individuals to exhibit more handwashing. Sequencing may be important as a motivation module (Mot) first helps to set the goal and a self-regulatory module (SelfR) then helps to translate this goal into actual behavior, but further research is needed to evaluate mechanisms.

【 授权许可】

   
2015 Lhakhang et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Cannon MJ, Davis KF: Washing our hands of the congenital cytomegalovirus disease epidemic. BMC Public Health 2005, 5:70. BioMed Central Full Text
• [2]Ciofi degli Atti M, E Tozzi A, Ciliento G, Pomponi M, Rinaldi S, Raponi M: Healthcare workers’ and parents’ perceptions of measures for improving adherence to hand hygiene. BMC Public Health 2011, 11:466. BioMed Central Full Text
• [3]Judah G, Aunger R, Schmidt WP, Michie S, Granger S, Curtis V: Experimental pretesting of hand-washing interventions in a natural setting. Am J Public Health 2009, 99(Suppl 2):S405-11.
• [4]Vujcic J, Ram PK, Campbell D, Carroll K. Periodic overview of handwashing literature: Practical guidance for implementers based on selected peer-reviewed and grey literature published. Available at: http://www.globalhandwashing.org/sites/default/files/HW Research Summary July-December 2012_0.pdf.
• [5]Mariwah S, Hampshire K, Kasim A: The impact of gender and physical environment on the handwashing behaviour of university students in Ghana. TM & IH 2012, 17(4):447-54.
• [6]Gupta MD, Engelman R, Levy J, Luchsinger G, Merrick T, et al. The State of World Population 2014: The Power of 1.8 Billion. UNFPA 2014. ISBN: 978-0-89714-972-3. Available at: http://www.unfpa.org/swp.
• [7]Mackert M, Liang MC, Champlin S: “Think the sink:” preliminary evaluation of a handwashing promotion campaign-brief report. Am J Infect Control 2013, 41(3):275-7.
• [8]Larson E: Monitoring hand hygiene: meaningless, harmful, or helpful? Am J Infect Control 2013, 41(5 Suppl):S42-5.
• [9]Davis OL, Fante RM, Jacobi LL: The effectiveness of sign prompts to increase hand washing behaviors in restrooms. N Am J Psychol 2013, 15(3):565-76.
• [10]Thumma J, Aiello AE, Foxman B: The association between handwashing practices and illness symptoms among college students living in a university dormitory. Am J Infect Control 2009, 37(1):70-2.
• [11]Lippke S, Ziegelmann JP: Theory-based health behavior change: developing, testing, and applying theories for evidence-based interventions. Appl Psychol Int Rev 2008, 57:698-716.
• [12]Latham JR, Magiorakos AP, Monnet DL, Aspevall O, Blacky A, Borg M, et al.: The role and utilisation of public health evaluations in Europe: a case study of national hand hygiene campaigns. BMC Public Health 2014, 14:131. BioMed Central Full Text
• [13]Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, Eccles M, Cane J, Wood CE: The behaviour change techniques taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behaviour change Interventions. Ann Behav Med 2013, 46(1):81-95.
• [14]Michie S, West R: Behaviour change theory and evidence: a presentation to Government. Health Psychol Rev 2013, 7(1):1-22.
• [15]Schwarzer R, Antoniuk A, Gholami M: A brief intervention changing oral self-care, self-efficacy, and self-monitoring. Br J Health Psychol 2015, 20:56-67.
• [16]Schwarzer R: Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Appl Psychol:Int Rev 2008, 57(1):1-29.
• [17]Lhakhang P, Godinho C, Knoll N, Schwarzer R. A brief intervention increases fruit and vegetable intake: A comparison of two intervention sequences. Appetite. 2014:103–110. doi:10.1016/j.appet.2014.07.014.
• [18]Schwarzer R, Luszczynska A. Health Action Process Approach. In: Conner, M and Norman, P, editors. Predicting health behaviours. 3rd edition. Oxford University Press. 2015. In press.
• [19]Bandura A: Self-efficacy: the exercise of control. Freeman, New York; 1997.
• [20]van der Meer EWC, Boot CRL, Twisk JWR, et al.: Hands4U: the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema -a randomised controlled trial among healthcare workers. Occup Environ Med 2014, 71:492-9.
• [21]Fishbein M, Ajzen I: Predicting and changing behavior: the reasoned action approach. Psychology Press, New York, NY; 2010.
• [22]Webb TL, Sheeran P: Does changing behavioral intentions engender behaviour change? A meta-analysis of the experimental evidence. Psychol Bull 2006, 132(2):249-68.
• [23]Sheeran P: Intention-behavior relations: a conceptual and empirical review. Eur Rev Soc Psycho 2002, 12:1-30.
• [24]Sniehotta FF, Scholz U, Schwarzer R: Bridging the intention-behaviour gap: planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol & Health 2005, 20(2):143-60.
• [25]Kwasnicka D, Presseau J, White M, Sniehotta F: Does planning how to cope with anticipated barriers facilitate health-related behavior change? A systematic review. Health Psychol Rev 2013, 7:129-45.
• [26]Hagger MS, Luszczynska A: Implementation intention and action planning interventions in health contexts: State of the research and proposals for the way forward. Appl Psychol Health Well-Being 2014, 6:1-47.
• [27]Suppliet J, Hankonen N, Jallinoja P: Is trust in health information related to better hand hygiene among military conscripts? MBH 2014, 2(1):82-8.
• [28]Pincock T, Bernstein P, Warthman S, Holst E: Bundling hand hygiene interventions and measurement to decrease health care-associated infections. Am J Infect Control 2012, 40(Suppl 1):S18-27.
• [29]Lhakhang P, Gholami M, Knoll N, Schwarzer R. Comparing a motivational and a self-regulatory intervention to adopt an oral self-care regimen: A two-sequential randomized crossover trial. PHM. 2014. doi:10.1080/13548506.2014.951368.
• [30]Curtis V, Schmidt W, Luby S, Florez R, Touré O, Biran A: Hygiene: new hopes, new horizons. Lancet Infect Dis 2011, 11(4):312-21.
• [31]Huis A, van Achterberg T, de Bruin M, Grol R, Schoonhoven L, Hulscher M: A systematic review of hand hygiene improvement strategies: a behavioural approach. Implement Sci 2012, 7:92. BioMed Central Full Text
• [32]Kellar PA: How can the impact of implementation intentions as a behaviour change intervention be improved? Eur Rev Appl Psychol 2014, 64(1):35-41.
• [33]Luby SP, Agboatwalla M, Feikin DR: Effect of handwashing on child health: a randomised controlled trial. Lancet 2005, 366(9481):225-33.
• [34]Wieber F, Odenthal G, Gollwitzer PM: Self-efficacy feelings moderate implementation intention effects. Self Identity 2010, 9:177-94.
• [35]Luszczynska A, Schwarzer R, Lippke S, Mazurkiewicz M: Self-efficacy as a moderator of the planning-behaviour relationship in interventions designed to promote physical activity. Psychol & Health 2011, 26(2):151-66.
• [36]Schwarzer R, Richert J, Kreausukon P, Remme L, Wiedemann AU, Reuter T: Translating intentions into nutrition behaviors via planning requires self-efficacy: evidence from Thailand and Germany. Int J Psychol 2010, 45:260-8.