Effect of behaviour change-intervention on hand washing practices and knowledge about hand washing among school students, Perambalur district, Tamil Nadu, India, 2014-2015

Abstract

Background: Diarrhoeal diseases among school children could be prevented by proper hand washing practices. Health education interventions will help in improving hand washing practices among school children. We conducted behavioural change intervention among middle school students, to compare adequate hand washing before and after intervention in rural area of Perambalur district, Tamilnadu, India. Methods & Materials: We did intervention study between November 2014 and April 2015 among 6th to 8th grade students in Ammapalayam block. We recruited 200 students, assuming proportion of hand washing with soap among the children is 17.5% and expecting proportion of hand washing with soap among the same children about 30%, after intervention, with one tail, level of significance of 5%, 90% power and 10% loss to follow up. We selected students through simple random sampling as matched pair. The intervention included oral and poster presentations, demonstration and competition on proper washing procedures to all students at first visit during the baseline survey. Outcomes were collected by semi-structured questionnaire at base line and at two follow up visits (one month and two months after the intervention). We compared the proportions before and after intervention by Mc-Nemars chi-square test. Results: At one month, proportion of adequate hand washing improved from 0% at baseline to 7% with Mc-Nemars chi-square=13.07, P-value=<0.001. Knowledge about importance of hand washing improved from 45% to 61% with Mc-Nemars chi-square=16, P-value<0.001. Knowledge about 6-steps in hand washing improved from 0% to 78.5% with Mc-Nemars chi-square=156, P-Value<0.001. At two month, proportion of adequate hand washing was improved to 5.5% with Mc-Nemars chi-square=10.08, P-Value<0.001. Knowledge about importance of hand washing was improved to 61% with Mc-Nemars chi-square= 138.69, P-Value<0.001 and knowledge about 6-steps in hand washing improved to 86% with Mc-Nemars chi-square= 171, P-Value<0.001. Conclusion: After intervention, there was an improvement in adequate hand washing, knowledge about importance of hand washing and knowledge about steps of hand washing at the end of one and two months. We recommend that same intervention may be done in schools to improve the knowledge and hand washing practices among school children.