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Graichen J, Stingl C, Pakarinen A, Rosio R, Terho K, Günther SA, Salanterä S, Staake T. Improving hand hygiene of young children with a digital intervention: a cluster-randomised controlled field trial. Sci Rep 2024; 14:6157. [PMID: 38486036 PMCID: PMC10940613 DOI: 10.1038/s41598-024-56233-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
Contagious diseases that affect young children place a great burden on them and their families. Proper hand hygiene is an important measure to reduce the disease burden, however, its implementation in day care centres is challenging. This paper introduces a digital intervention to support independent and good handwashing among young children. The intervention leverages animated instructions triggered by water and soap use, together with a symbolic reward shown to children on a screen during and immediately after handwashing. We tested the intervention in a pre-registered, cluster-randomised controlled field trial in 4 day care centres in Finland and Germany with 162 children over 42 days. The intervention increased soaping time, used as a proxy for handwashing quality, by 5.30 s (+ 62%, p < 0.001). The effect occurs immediately at the onset of the intervention and is maintained throughout the intervention phase.
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Affiliation(s)
- Joanna Graichen
- Department of Information Systems and Applied Computer Sciences, University of Bamberg, Bamberg, Germany.
| | - Carlo Stingl
- Department of Information Systems and Applied Computer Sciences, University of Bamberg, Bamberg, Germany
| | - Anni Pakarinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Rosio
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Kirsi Terho
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Sebastian A Günther
- Department of Information Systems and Applied Computer Sciences, University of Bamberg, Bamberg, Germany
| | - Sanna Salanterä
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Thorsten Staake
- Department of Information Systems and Applied Computer Sciences, University of Bamberg, Bamberg, Germany
- Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland
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Andhikaputra G, Sapkota A, Lin YK, Chan TC, Gao C, Deng LW, Wang YC. The impact of temperature and precipitation on all-infectious-, bacterial-, and viral-diarrheal disease in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 862:160850. [PMID: 36526204 DOI: 10.1016/j.scitotenv.2022.160850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND The ongoing climate change will elevate the incidence of diarrheal in 2030-2050 in Asia, including Taiwan. This study investigated associations between meteorological factors (temperature, precipitation) and burden of age-cause-specific diarrheal diseases in six regions of Taiwan using 13 years of (2004-2016) population-based data. METHODS Weekly cause-specific diarrheal and meteorological data were obtained from 2004 to 2016. We used distributed lag non-linear model to assess age (under five, all age) and cause-specific (viral, bacterial) diarrheal disease burden associated with extreme high (99th percentile) and low (5th percentile) of climate variables up to lag 8 weeks in six regions of Taiwan. Random-effects meta-analysis was used to pool these region-specific estimates. RESULTS Extreme low temperature (15.30 °C) was associated with risks of all-infectious and viral diarrhea, with the highest risk for all-infectious diarrheal found at lag 8 weeks among all age [Relative Risk (RR): 1.44; 95 % Confidence Interval (95 % CI): 1.24-1.67]. The highest risk of viral diarrheal infection was observed at lag 2 weeks regardless the age. Extreme high temperature (30.18 °C) was associated with risk of bacterial diarrheal among all age (RR: 1.07; 95 % CI: 1.02-1.13) at lag 8 weeks. Likewise, extreme high precipitation (290 mm) was associated with all infectious diarrheal, with the highest risk observed for bacterial diarrheal among population under five years (RR: 2.77; 95 % CI: 1.60-4.79) at lag 8 weeks. Extreme low precipitation (0 mm) was associated with viral diarrheal in all age at lag 1 week (RR: 1.08; 95 % CI: 1.01-1.15)]. CONCLUSION In Taiwan, extreme low temperature is associated with an increased burden of viral diarrheal, while extreme high temperature and precipitation elevated burden of bacterial diarrheal. This distinction in cause-specific and climate-hazard specific diarrheal disease burden underscore the importance of incorporating differences in public health preparedness measures designed to enhance community resilience against climate change.
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Affiliation(s)
- Gerry Andhikaputra
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Amir Sapkota
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, United States of America
| | - Yu-Kai Lin
- Department of Health and Welfare, University of Taipei College of City Management, 101 Zhongcheng Road Sec. 2, Taipei 111, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, 128 Academia Road, Section 2, Taipei, Taiwan; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chuansi Gao
- Division of Ergonomics and Aerosol Technology, Faculty of Engineering, Lund University, Lund 223 62, Sweden
| | - Li-Wen Deng
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan; Research Center for Environmental Changes, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei 11529, Taiwan.
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Gillebaart M, Ybema JF, de Ridder DTD. Make it a habit: how habit strength, goal importance and self-control predict hand washing behaviour over time during the COVID-19 pandemic. Psychol Health 2022; 37:1528-1546. [PMID: 35137657 DOI: 10.1080/08870446.2022.2036740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Hand washing has been at the core of recommendations and guidelines that aim to curb infectious diseases in general, and COVID-19 in particular. As hand washing comes down to an individual's behaviour, we aimed to study how individual psychological variables influence hand washing over time during the COVID-19 pandemic. DESIGN Over the course of 20 weeks, participants answered questions about their hand washing behaviour, goal importance, habit strength and self-control. Participants from an experimental and a control condition completed a baseline and final measurement, and the experimental condition was invited to bi-weekly measurements through reminders. MAIN OUTCOME MEASURE Hand washing behaviour over the past 14 days was assessed by self-report at baseline and final measurement, and additionally repeatedly over the course of 20 weeks in the experimental condition. RESULTS Hand washing behaviour decreased over time, but this decrease was buffered by habit strength and goal importance. The decrease was smaller in the experimental condition that received reminders every 2 weeks. CONCLUSION Sending personal reminders on hand washing behaviour contributes to hand washing behaviour. Moreover, taking habit strength and goal importance, and to a lesser extent self-control into account is important when designing interventions to promote hand washing behaviour.
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Affiliation(s)
- Marleen Gillebaart
- Social, Health, and Organisational Psychology, Utrecht University, Utrecht, The Netherlands
| | - Jan Fekke Ybema
- Social, Health, and Organisational Psychology, Utrecht University, Utrecht, The Netherlands
| | - Denise T D de Ridder
- Social, Health, and Organisational Psychology, Utrecht University, Utrecht, The Netherlands
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Sobel DM, Stricker LW. Parent–child interaction during a home STEM activity and children’s handwashing behaviors. Front Psychol 2022; 13:992710. [DOI: 10.3389/fpsyg.2022.992710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
Abstract
We examined correlations between a home-based STEM activity illustrating the importance of soap use during handwashing and children’s (4-to 7-year-olds, N = 81, 42 girls, 39 boys) use of soap when washing their hands. Parents and children either participated in or watched the activity. Children reflected on the activity immediately afterward and a week later. Parent–child interaction during participation related to the frequency of unprompted soap use during handwashing, controlling for performance on other, related cognitive measures. Children whose parents were more goal-directed, and set goals for the interaction, were less likely to use soap spontaneously when handwashing in the subsequent week. The amount of causal knowledge children generated when they reflected on the experience immediately afterward also influenced whether children used soap when washing their hands. Reducing the autonomy children believe they have during a STEM-based activity potentially leads them to not engage in a behavior related to the activity on their own. Overall, these data suggest that parent–child interaction during STEM activities can influence the ways children encode and engage with those activities in their everyday lives. Given that the ways children wash their hands might mitigate the spread of disease, interventions that focus on providing children with the belief that STEM activities are for them might be broadly beneficial to society.
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Mattison CP, Calderwood LE, Marsh ZA, Wikswo ME, Balachandran N, Kambhampati AK, Gleason ME, Lawinger H, Mirza SA. Childcare and School Acute Gastroenteritis Outbreaks: 2009-2020. Pediatrics 2022; 150:e2021056002. [PMID: 36278284 PMCID: PMC10061552 DOI: 10.1542/peds.2021-056002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVES Acute gastroenteritis (AGE) outbreaks commonly occur in congregate settings, including schools and childcare facilities. These outbreaks disrupt institutions, causing absences and temporary facility closures. This study analyzed the epidemiology of school and childcare AGE outbreaks in the United States. METHODS We analyzed AGE outbreaks occurring in kindergarten to grade 12 schools and childcare facilities reported via the National Outbreak Reporting System in the United States from 2009 to 2019 and compared this information to 2020 data. Outbreak and case characteristics were compared using the Kruskal-Wallis rank sum test, χ2 goodness-of-fit test, and Fisher exact test. RESULTS From 2009 to 2019, there were 2623 school, 1972 childcare, and 38 school and childcare outbreaks. School outbreaks were larger (median, 29 cases) than childcare outbreaks (median, 10 cases). Childcare outbreaks were longer (median, 15 days) than school outbreaks (median, 9 days). Norovirus (2383 outbreaks; 110 190 illnesses) and Shigella spp. (756 outbreaks; 9123 illnesses) were the most reported etiologies. Norovirus was the leading etiology in schools; norovirus and Shigella spp. were dominant etiologies in childcare centers. Most (85.7%) outbreaks were spread via person-to-person contact. In 2020, 123 outbreaks were reported, 85% in the first quarter. CONCLUSIONS Schools and childcare centers are common AGE outbreak settings in the United States. Most outbreaks were caused by norovirus and Shigella spp. and spread via person-to-person transmission. Fewer outbreaks were reported in 2020 from the COVID-19 pandemic. Prevention and control efforts should focus on interrupting transmission, including environmental disinfection, proper handwashing, safe diapering, and exclusion of ill persons.
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Affiliation(s)
- Claire P. Mattison
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
- Cherokee Nation Assurance, Arlington, Virginia
| | - Laura E. Calderwood
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
- Cherokee Nation Assurance, Arlington, Virginia
| | - Zachary A. Marsh
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E. Wikswo
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Neha Balachandran
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
- Cherokee Nation Assurance, Arlington, Virginia
| | - Anita K. Kambhampati
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - Michelle E. Gleason
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah Lawinger
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sara A. Mirza
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
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Ofori SK, Hung YW, Schwind JS, Muniz-Rodriguez K, Kakou RJ, Alade SE, Diallo K, Sullivan KL, Cowling BJ, Fung ICH. The use of digital technology to improve and monitor handwashing among children 12 years or younger in educational settings: a scoping review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:547-564. [PMID: 32579032 DOI: 10.1080/09603123.2020.1784398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Our scoping review aimed to identify and describe the application of digital technology in hand hygiene research among children in educational settings. We searched for articles in PubMed, IEEE Xplore, and Web of Science. Original hand hygiene research with a form of digital technology used among children ≤12 years in educational settings was eligible for inclusion. Twelve studies met the eligibility criteria and the data were extracted by two teams of independent co-authors for narrative synthesis. Ten studies used digital technology as an intervention tool and two for monitoring purposes. Three main digital technologies were identified including computer games (n = 2), videos (n = 8), and video cameras (n = 2). Digital technologies found in our scoping review were reported to be effective in hand hygiene studies over short temporal periods especially when used in combination with other measures. Future research may demonstrate the effectiveness of digital technology in helping children develop sustainable handwashing behaviors.
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Affiliation(s)
- Sylvia K Ofori
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Yuen Wai Hung
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Jessica S Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kamalich Muniz-Rodriguez
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Reece J Kakou
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Sunmisola E Alade
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kadiatou Diallo
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kelly L Sullivan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - I C H Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Establishing Healthy Personal Hygiene Habits with Young Children in Australia: A Cross-Sectional Mixed Methods Study. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Abstract
Effective and consistent engagement in personal hygiene practices is important for preventing the acquisition and transmission of communicable diseases in childhood. This study aimed to investigate trends in adherence to recommended hygiene practices and identify factors contributing to difficulties in establishing good hygiene habits with young children (0–4 years) in Australia. A self-selected community sample of parents (N = 426) completed an online survey assessing children's adherence to recommended hygiene practices and barriers and enablers of establishing good personal hygiene habits. Parents reported interest in receiving information/tips on children's personal hygiene (yes/no) and nominated topics of interest. Less than half of children in any age group consistently (always/almost always) covered coughs and sneezes, washed hands after toileting, or washed hands before meals or when dirty. Children's non-compliance (i.e. resistance, refusal) was the most commonly reported barrier to establishing good personal hygiene habits, while children's compliance (i.e. cooperative behaviour, following or complying with caregivers’ instructions) was the most commonly cited enabler. Despite low levels of adherence, less than half (41.2%) of parents wanted information/tips on children's hygiene. Results suggest a disconnect between parents’ knowledge about recommended hygiene practices and actual behaviour. Development and testing of approaches to behaviour change that incorporate evidence-based strategies to manage children's resistance and support parents to encourage the development of healthy hygiene habits is warranted.
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Yayan EH, Demırel Öner P, Coşkun Şımşek D, Zengın M. Hand Microbial Flora of Hospitalized Children at the Beginning of Hospitalization and Before Discharge: A Cross-Sectional Study. Ethiop J Health Sci 2021; 30:875-880. [PMID: 33883831 PMCID: PMC8047244 DOI: 10.4314/ejhs.v30i6.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Hospital infections in pediatric units increase the length of hospital stay and the use of antibiotics, and this causes exposure to more procedures. This study was aimed to determine the microorganisms represented in the hand flora of pediatric patients at the beginning of hospitalization and before discharge. Methods The study was designed as a prospective cross-sectional study. This prospective study was performed with 124 pediatric patients. After completion of the admission procedures, an initial sample was taken from the hands of the hospitalized patients. Another sample was taken from the patients just before discharging. Results Growth of coagulase-negative staphylococcus (CNS) was observed in the culture samples of 28 patients. Cultures from 23 patients showed different microorganisms such as Staphylococcus aureus, Escherichia coli, and S. epidermis. Examination of final discharge cultures showed CNS in 43 patients, S. aureus in 5 patients, E. coli in 8 patients, Acinetobacter baumannii in 11 patients, and Kocuria rhizophila, K. kristinae, Candida spp., Pseudomonas spp., and Enterococcus in 1 patient. Conclusion The cultures from samples obtained at discharge showed the presence of antibiotic-resistant pathogenic microorganisms causing healthcare associated infection.
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Affiliation(s)
- Emriye Hilal Yayan
- Department of Child Health and Diseases Nursing, Nursing Faculty, İnönü University, Malatya, Turkey. orcid.org/0000-0003-0075-4171
| | - Pınar Demırel Öner
- Elazığ Fethi Sekin City Hospital, Elazığ, Turkey orcid.org/0000-0001-9592-5986
| | - Didem Coşkun Şımşek
- Department of Child Health and Diseases Nursing, Health Sciences Faculty, Fırat University, Elazığ, Turkey orcid.org/0000-0003-0364-5667
| | - Mürşide Zengın
- Department of Child Health and Diseases Nursing, Health Sciences Faculty, Adıyaman University, Adıyaman, Turkey. https://orcid.org/0000-0003-1453-6028
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Lawson A, Cameron R, Vaganay-Miller M. An Evaluation of the Hand Hygiene Behaviour and Compliance of the General Public When Using Public Restrooms in Northern Ireland (NI) during the Initial Weeks of the Novel Coronavirus (COVID-19) Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6385. [PMID: 34204779 PMCID: PMC8296206 DOI: 10.3390/ijerph18126385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The ongoing novel coronavirus (COVID-19) global pandemic has resulted in significant levels of morbidity and mortality worldwide, particularly among the elderly and immuno-suppressed groups. Although adequate hand hygiene (HH) behaviour and compliance is widely accepted as being the most effective self-protective measure in preventing the spread of diseases like COVID-19, previous research suggests that normal hand hygiene compliance is poor, but generally improves during a disease pandemic. This research aimed to evaluate the hand hygiene behaviour and compliance of the general public in the initial weeks of the COVID-19 pandemic in Northern Ireland (NI). METHODS This cross-sectional study involved the use of infrared-imaging cameras to observe the hand hygiene behaviour and compliance of the general public when using one set of male and female public restrooms. RESULTS The findings of this study indicated that the level of hand hygiene compliance of the general public was poor in the initial weeks, with 82.93% overall not washing their hands adequately. CONCLUSIONS Inadequate HH behaviour and compliance may have added significantly to the rapid rate of spread of COVID-19 in the initial weeks of the pandemic in NI. Current public health campaigns do not appear, based on this study, to have the desired impact and may need to be reviewed or re-enforced in order to achieve the levels of hand hygiene compliance required to slow the spread of COVID-19 and other communicable diseases in the future.
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Affiliation(s)
- Aaron Lawson
- Belfast School of Architecture and the Built Environment, Ulster University, Newtownabbey BT37 0QB, UK; (R.C.); (M.V.-M.)
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Herr RM, Diehl K, Schneider S, Osenbruegge N, Memmer N, Sachse S, Hoffmann S, Wachtler B, Herke M, Pischke CR, Novelli A, Hilger-Kolb J. Which Meso-Level Characteristics of Early Childhood Education and Care Centers Are Associated with Health, Health Behavior, and Well-Being of Young Children? Findings of a Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4973. [PMID: 34067043 PMCID: PMC8125417 DOI: 10.3390/ijerph18094973] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 12/26/2022]
Abstract
Characteristics of early childhood education and care (ECEC) centers might be relevant for children's health. This scoping review aims to provide an overview of the association between meso-level characteristics (MLCs) of ECEC centers with children's health, health behavior, and wellbeing. Five databases were searched for quantitative and qualitative research articles published in English or German since 1 January 2000 on health, health behavior, and wellbeing of children aged 0 to 6 years considering MLCs of ECEC centers. Two authors screened 10,396 potentially eligible manuscripts and identified 117 papers, including 3077 examinations of the association between MLCs and children's health indicators (Kappas > 0.91). Five categories of MLCs were identified: (1) structural characteristics, (2) equipment/furnishings, (3) location, (4) facilities/environment, (5) culture/activities/policies/practices, and 6) staff. Only very few studies found an association of MLCs with body weight/obesity, and general health and wellbeing. Especially physical activity and mental health were related to MLCs. In general, the location (rural vs. urban, neighborhood status) seemed to be a relevant health aspect. MLCs of ECEC centers appeared relevant for child health indicators to different degrees. Future research should focus on these associations, in detail, to identify concrete ECEC indicators that can support health promotion in early childhood.
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Affiliation(s)
- Raphael M. Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (K.D.); (S.S.); (N.O.); (N.M.); (J.H.-K.)
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (K.D.); (S.S.); (N.O.); (N.M.); (J.H.-K.)
| | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (K.D.); (S.S.); (N.O.); (N.M.); (J.H.-K.)
| | - Nina Osenbruegge
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (K.D.); (S.S.); (N.O.); (N.M.); (J.H.-K.)
| | - Nicole Memmer
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (K.D.); (S.S.); (N.O.); (N.M.); (J.H.-K.)
| | - Steffi Sachse
- Institute of Psychology, University of Education Heidelberg, 69120 Heidelberg, Germany;
| | - Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, 01968 Senftenberg, Germany;
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany;
| | - Max Herke
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany;
| | - Claudia R. Pischke
- Institute of Medical Sociology, Center for Health and Society, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany;
| | - Anna Novelli
- Chair of Health Economics, Technical University of Munich, 80992 Munich, Germany;
| | - Jennifer Hilger-Kolb
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany; (K.D.); (S.S.); (N.O.); (N.M.); (J.H.-K.)
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Azor-Martinez E, Garcia-Fernandez L, Strizzi JM, Cantarero-Vallejo MD, Jimenez-Lorente CP, Balaguer-Martinez JV, Torres-Alegre P, Yui-Hifume R, Sanchez-Forte M, Gimenez-Sanchez F. Effectiveness of a hand hygiene program to reduce acute gastroenteritis at child care centers: A cluster randomized trial. Am J Infect Control 2020; 48:1315-1321. [PMID: 32303373 DOI: 10.1016/j.ajic.2020.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 12/15/2022]
Abstract
We aimed to assess the effectiveness of an educational and hand hygiene program in daycare centers (DCCs) and homes on acute gastroenteritis (AGE) incidence in children attending DCCs. METHODS A randomized, controlled, and open study of 911 children aged 0-3 years attending 24 DCCs in Almería (Spain) with an 8-month follow-up was employed. Two intervention groups of DCCs families performed educational and hand hygiene measures, 1 with soap and water (soap and water group; n = 274), another with hand sanitizer (hand sanitizer group [HSG]; n = 339), and the control group (CG; n = 298) followed usual handwashing procedures. We compared AGE episode rates with Poisson regression model. RESULTS seven hundred fourteen AGE episodes were registered, significant differences between HSG and CG children were found during December and January. A multivariate model was applied and the adjusted incidence rate ratios by rotavirus vaccination found significant differences when children were previously vaccinated, the children in the soap and water group had a higher risk of AGE episodes (incidence rate ratio: 1.28, 95% confidence interval:1.0-1.64), compared with those in the HSG. CONCLUSIONS This study demonstrated that hand hygiene programs that included hand sanitizer were most effective in the winter months. Further, the largest reduction of AGE episodes occurred in the children that followed hand hygiene programs including hand sanitizer and educational measures for DCC staff, parents, and children, and were vaccinated for rotavirus.
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Suen LKP, Cheung JPL. Effectiveness of "Hand Hygiene Fun Month" for Kindergarten Children: A Pilot Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197264. [PMID: 33020447 PMCID: PMC7579510 DOI: 10.3390/ijerph17197264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/27/2020] [Accepted: 10/01/2020] [Indexed: 05/10/2023]
Abstract
Early childhood is a formative period during which healthy habits are developed, including proper hand hygiene practices. The aim of this quasi-experimental study was to determine the effectiveness of a 4-week series of educational sessions that consider the cognitive developmental stage of children on increasing their knowledge and promoting hand hygiene practices. The intervention group (n = 33) observed the hand hygiene program, whereas another group served as the waitlist control (n = 20). Creative activities were planned for the illustration of hand hygiene concepts in terms of "right moments", "right steps", and "right duration". Hand sanitizer coverage was evaluated using a hand scanner. After the intervention, the experimental group had higher knowledge level toward hand hygiene than the control group (p < 0.001). Significant improvements in hand hygiene performance at the left palm and dorsum (p < 0.05), right palm (p < 0.05), and overall hand coverage (p < 0.05) were observed in the experimental group. The study demonstrated that the knowledge and proper hand hygiene (HH) practice of children can be positively influenced by the use of an age-appropriate education program. The results of this study have implications for school health educators and parents for promoting HH practices among children at home and at the school level.
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Does a Playful Intervention Promote Hand Hygiene? Compliance and Educator's Beliefs about Hand Hygiene at a Daycare Center. J Pediatr Nurs 2020; 51:e64-e68. [PMID: 31492509 DOI: 10.1016/j.pedn.2019.08.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Our purpose was to analyze hand hygiene compliance before and after a playful intervention, and caregivers' beliefs, perception of self-efficacy, and barriers to hand hygiene at a daycare center in Brazil. DESIGN AND METHODS This a quasi-experimental study was conducted from January to July 2017 in a daycare center that provides full-time education for children aged zero to four years from low-income families. The playful intervention with 24 caregivers included an emoji card game to address their beliefs and perception of self-efficacy and a product that reveals dirty areas on washed hands. For 126 children aged two to four years we used a story told through puppets, card games, songs, and a practice of washing hands colored with tempera paint. RESULTS The results showed that the playful intervention with children and caregivers increased hand hygiene compliance from 13.3% to 41.4% with a significant statistical difference (p < 0.001) after the intervention. The caregiver's perception of self-efficacy for hand hygiene was higher after bathroom use (59.8%) and lower after playing outdoors (28.6%). CONCLUSIONS Playful interventions performed by nurses promote hand hygiene compliance among children and caregivers at daycare centers. PRACTICE IMPLICATIONS Practice implications include that health education provided by pediatric nurses is essential in promoting health and preventing the dissemination of infectious diseases to children and caregivers at daycare centers.
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Biezen R, Grando D, Mazza D, Brijnath B. Visibility and transmission: complexities around promoting hand hygiene in young children - a qualitative study. BMC Public Health 2019; 19:398. [PMID: 30975108 PMCID: PMC6460784 DOI: 10.1186/s12889-019-6729-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 03/31/2019] [Indexed: 11/19/2022] Open
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.
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Affiliation(s)
- Ruby Biezen
- Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia.
| | - Danilla Grando
- School of Science, RMIT University, Building 223, Level 1, Bundoora Campus, Plenty Road, Bundoora, VIC, 3083, Australia
| | - Danielle Mazza
- Department of General Practice, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Bianca Brijnath
- National Ageing Research Institute LTD, 34-54 Poplar Road, Parkville, VIC, 3052, Australia
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Azor-Martinez E, Yui-Hifume R, Muñoz-Vico FJ, Jimenez-Noguera E, Strizzi JM, Martinez-Martinez I, Garcia-Fernandez L, Seijas-Vazquez ML, Torres-Alegre P, Fernández-Campos MA, Gimenez-Sanchez F. Effectiveness of a Hand Hygiene Program at Child Care Centers: A Cluster Randomized Trial. Pediatrics 2018; 142:peds.2018-1245. [PMID: 30297500 DOI: 10.1542/peds.2018-1245] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Respiratory infections (RIs) are an important cause of morbidity and excessive antibiotic prescriptions in children attending day care centers (DCCs). We aimed to assess the effectiveness of an educational and hand hygiene program in DCCs and homes in reducing RI incidence and antibiotic prescriptions in children. METHODS A cluster, randomized, controlled, and open study of 911 children aged 0 to 3 years attending 24 DCCs in Almería (Spain) with an 8-month follow-up. Two intervention groups of DCC families performed educational and hand hygiene measures, 1 with soap and water (SWG; n = 274), another with hand sanitizer (HSG; n = 339), and the control group (CG; n = 298) followed usual hand-washing procedures. RI episode rates were compared through multilevel Poisson regression models. The percentage of days missed were compared with Poisson exact tests. RESULTS There were 5211 RI episodes registered. Children in the HSG had less risk of RI episodes (incidence rate ratio [IRR]: 0.77; 95% confidence interval [CI]: 0.68-0.88) and antibiotic prescriptions (IRR: 0.69; 95% CI: 0.57-0.84) compared with the those in the CG. Children in the SWG had a higher risk of RI episodes (IRR: 1.21; 95% CI: 1.06-1.39) and antibiotic prescriptions (IRR: 1.31; 95% CI: 1.08-1.56) than those in the HSG. Pupils missed 5186 DCC days because of RIs, and the percentage of days absent was significantly lower in the HSG compared with the CG (P < .001) and the SWG (P < .001). CONCLUSIONS Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents, reduce absent days, RIs, and antibiotic prescriptions for these infections in children at DCCs.
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Affiliation(s)
| | | | | | | | | | | | - Llenalia Garcia-Fernandez
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Seplin Soluciones Estadísticas, Granada, Spain; and
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Arıkan D, Gürarslan Baş N, Kurudirek F, Baştopcu A, Uslu H. The Effect of Therapeutic Clowning on Handwashing Technique and Microbial Colonization in Preschool Children. J Nurs Scholarsh 2018; 50:441-450. [PMID: 29764000 DOI: 10.1111/jnu.12392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE This study aimed to determine the effect of therapeutic clowning on handwashing technique and microbial colonization in preschool children. DESIGN This randomized controlled trial was conducted using pre-test and post-test experimental and control groups. METHODS The study was conducted between March and June 2016 in two kindergartens in eastern Turkey. The study was completed with a total of 195 students, including 90 students in the experimental group and 105 students in the control group. A questionnaire was used for data collection. This questionnaire included sections about the subjects' descriptive characteristics and the results of the bacterial cultures of their hand swabs. For the collection of these swabs, the subjects were informed in advance, and samples were collected at predetermined times. The swabs were analyzed to determine the bacterial colonization of the subjects' hands. Clowns and video activities were used as intervention tools in the study. FINDINGS In the post-test, the microbial growth was ≤103 in 68.9% and >103 in 31.1% of the subjects in the experimental group. In contrast, the growth was ≤103 in 34.3% and >103 in 65.7% of the control group subjects. The difference in the post-test microbial growths of the two groups was statistically significant (p < .000). CONCLUSIONS The hygienic handwashing technique taught in the therapeutic clowning and videos reduced the bacterial colonization on the preschool children's hands by 50%. Moreover, this method was effective in reducing the growth rate of coliform bacteria that indicate undesirable, poor hygiene of the hands. CLINICAL RELEVANCE Considering these results, we recommend that pediatric healthcare professionals use entertaining methods such as those involving clowns to teach and guide children regarding hygienic handwashing techniques.
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Affiliation(s)
- Duygu Arıkan
- Professor, Atatürk University Faculty of Nursing, Department of Child Health and Diseases Nursing, Erzurum, Turkey
| | - Nazan Gürarslan Baş
- Assistant Professor, Munzur University High School of Health, Department of Nursing, Tunceli, Turkey
| | - Fatma Kurudirek
- Assistant Professor, Atatürk University Faculty of Nursing, Department of Child Health and Diseases Nursing, Erzurum, Turkey
| | - Ayşe Baştopcu
- Research Asistant, Atatürk University, Faculty of Medicine Clinical Microbiology, Department of Medical Microbiology, Erzurum, Turkey
| | - Hakan Uslu
- Professor, Atatürk University, Faculty of Medicine Clinical Microbiology, Department of Medical Microbiology, Erzurum, Turkey
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