Effectiveness and Efficiency of Persuasive Space Graphics (PSG) in Motivating UK Primary School Children's Hand Hygiene.

Sophie Rutter,Colin Macduff,Jane Wood,Margarita Gomez-Escalada,Catherine Stones

doi:10.3390/ijerph17072351

Abstract

Good hand hygiene is necessary to control and prevent infections, but many children do not adequately wash their hands. While there are classroom communications targeted at children, the toilet space, the location of many hand hygiene activities, is neglected. This paper describes an initial evaluation of “123” persuasive space graphics (images and messages integrated within an architectural environment that encourage specific actions). The effectiveness (whether hand hygiene improves) and efficiency (the ease with which a setting can adopt and implement an intervention) is evaluated in three UK schools and one museum. Five evaluations (participant demographic, handwashing frequency, handwashing quality, design persuasiveness, stakeholder views) were conducted. In the school settings, persuasive space graphics increased the quality and frequency of handwashing. In the museum setting, frequency of handwashing slightly increased. In all settings children found the graphics persuasive, and stakeholders also believed them to be effective. Stakeholders considered persuasive space graphics a low-cost and time-efficient way to communicate. It can be concluded that persuasive space graphics are effective in increasing hand hygiene, particularly in school settings where children have a longer exposure to the graphics. Persuasive space graphics are also an efficient low-cost means of communicating hand hygiene.

Highlights

Infection prevention and control is a key strategy for tackling antimicrobial resistance in the UK’s five-year action plan [1] and twenty-year vision [2]
During the second post-installation period at School 3, children had removed designs from the toilets and soap consumption remained close to pre-persuasive space graphics (PSG) levels, suggesting that the increase in handwashing frequency was not maintained when the PSG were absent
It should be noted though that the increase in frequency of handwashing that can be attributed to the presence of the PSG is less than in the school settings

Summary

Introduction

Infection prevention and control is a key strategy for tackling antimicrobial resistance in the UK’s five-year action plan [1] and twenty-year vision [2]. It is estimated though that in the UK only 52% of people (19% in the world) wash their hands with soap after using toilet facilities [4] It is, vital that the importance of hand hygiene is effectively communicated and that this communication results in long lasting change [4]. Sickness in children raises the risk of infection within households Parents need to take leave to care for sick children, and there is an increase in general practitioner visits [5]. Another reason for promoting hand hygiene to children is

Methods

Results

Discussion

Conclusion