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

Abstract

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. 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. 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)]. 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.