On the Role of Habit in Self-Reported and Observed Hand Hygiene Behavior.

Abstract

The present contribution tests the main ideas that (a) hand hygiene behavior is associated with habit, and (b) this association is robust when deliberative constructs (i.e. knowledge and intention) are controlled for, indicating an automatic component in hand hygiene behavior. Two correlational studies using different operationalisations of hand hygiene behavior are reported. In Study 1, hand hygiene was assessed in the context of food preparation; data were measured using the Day Reconstruction Method in a sample of the general population. Study 2 considered hand hygiene compliance of healthcare workers applying video observation by body cameras and additionally self-reported behavior. In both studies, habit was assessed using the Self-Report Behavioral Automaticity Index. Both studies found the expected positive association between habit and hand hygiene (0.271<r<0.570). Habit was further analyzed in combination with knowledge and intention (Study 2), and emerged as a significant predictor of observed hand hygiene, while knowledge and intention were marginally significant. No significant interactions were found. The present work provides evidence that hand hygiene behavior is reliably related to habit. The findings speak to the notion that addressing the automatic route to hand hygiene behavior when designing interventions can be fruitful.