Hand Hygiene Behavior Research Articles

The effect of education given to secondary school students on hand hygiene behaviors: a Quasi experimental study.

This study aimed to examine the effect of the hand hygiene education on middle school students' behavioral scores related to hand hygiene practices. The research adheres to a quasi-experimental design suitable for the pre-test Posttest model with a control group. The population of the study consists of a total of 1159 students, comprising 5th, 6th, 7th, and 8th graders. During the first semester of the 2021-2022 academic year, face-to-face education was conducted at a middle school located in Ankara. Two face-to-face training sessions were conducted to increase awareness of hand hygiene. The groups indicate homogeneity in terms of demographic characteristics. The mean hand hygiene behavior score was 56.45 ± 8.03 before the education in the intervention group, which increased to 59.79 ± 7.62 after the education. In the control group, the mean score was 55.98 ± 7.89 before the education and 57.15 ± 7.63 after the education. It was found that after the educational program, there was a statistically significant increase in hand hygiene behavior scores of the groups. The research findings indicate a beneficial impact of hand hygiene education on students' average behavioral scores. To foster lasting behavioral changes from a young age, it is advisable to implement hygiene education in schools periodically, including targeted interventions for middle school students.

Observation of Food Handlers’ Hand Hygiene Behavior During Production at a Sandwich-making Factory

Effective hand hygiene is essential during food production to reduce the risk of microbiological contamination. Improper hand hygiene by food handlers can be a major contributing factor in the spread of foodborne illnesses. Self-reported behavior does not equate to actual behavior as it has the limitation of biases. Therefore, observational data are more effective at assessing the actual behavior of food handlers. Covert observation utilizing closed-circuit television (CCTV) cameras can yield reliable data. This study utilized covert observation to assess hand hygiene compliance from CCTV footage of food handlers in a sandwich-making facility. An electronic observation checklist, based upon the company’s hand-hygiene protocol, was used to capture observed hand hygiene practices. A total of 588 occasions that required hand hygiene practices by food handlers (n = 12) were observed during the production of ready-to-eat (RTE) sandwiches over 16 h during two shifts. Food handlers did not wash their hands on 32% of occasions which required food hygiene practices. Of those occasions where there was an attempt to implement hand hygiene practices (n = 401), only 1% of behaviors were compliant with the company hand hygiene protocol. Observations indicated that 95% of attempts did not adhere to the recommended handwashing duration (≥20 s). Soap was not used in 4% of attempts, and hands were not wetted prior to applying soap in 16% of attempts. Additionally, 62% of attempts did not use hand sanitizer after handwashing and drying. Food handlers were observed attempting hand hygiene practices significantly more frequently (p < 0.001) when entering (89% of occasions) than exiting (8% of occasions) the production area. Findings indicate that appropriate interventions are needed to improve hand hygiene compliance of food handlers to ensure food is produced safely within the food manufacturing sector.

Becoming Hand Hygiene Heroes: implementation of an infection prevention and control campaign for patient and family hospital safety

BackgroundThe COVID-19 pandemic highlighted that hand hygiene is key in preventing healthcare-associated infections. Patients and families are understudied targets for infection prevention and control practices. Previous campaigns to change hand hygiene behavior have been effective, but often face systemic challenges with implementation. MethodsThe “Hand Hygiene Heroes” educational campaign was developed to improve patient and family hand hygiene at two tertiary care pediatric and obstetrics hospitals. Its multiple phases included visual materials, tailored activities for nine hospital units, and long-term evaluation during a two-year period. Hand hygiene rates among patients/families and healthcare workers were measured at baseline and throughout the campaign via direct observation. ResultsOverall, hand hygiene significantly increased for both patients/families (OR 1.82, p 0.041) and healthcare workers (OR 2.15, p <0.001) after campaign initiation. However, individual units had varying degrees of sustainment on follow-up evaluations. DiscussionDuration of intervention, activity simplicity, active participation, and resource availability may affect success of campaign initiatives. Positive prognostic factors included mixed leadership support from administration and front-line workers, pre-determined sustainability plans, and tailored activities by target audience. ConclusionsImplementation of hospital educational campaigns can be resource-intensive but can positively impact patient and family hand hygiene.

Prevalence and factors associated with sub-optimal hand and oral hygiene behaviour among adolescents in Central America

Prevalence and factors associated with sub-optimal hand and oral hygiene behaviour among adolescents in Central America

Predictors of hand hygiene attitudes among Saudi healthcare workers of the intensive care unit in Saudi Arabia

Healthcare-associated infections present a challenge to healthcare systems, particularly critical care units. Hand hygiene emerges as a crucial element in infection control, acting as a vital link between healthcare workers, patients, and pathogens. Positive attitudes, motivated by a genuine concern for patient safety, are recognized as major predictors of hand hygiene compliance among healthcare workers. This study aims to assess the attitudes of ICU staff toward hand hygiene and identify factors that influence these attitudes. A cross-sectional survey of intensive care unit staff in seven large Saudi hospitals was conducted using an anonymous, self-reporting questionnaire to examine the attitudes of ICU personnel about hand hygiene and determine the factors that impact these attitudes. A regression analysis was used to determine the determinants of hand hygiene attitudes. Of the 600 respondents, 93% rated their hand hygiene knowledge as good, and 71% received hand hygiene training from their hospital. Most respondents (78%) had previously experienced healthcare-associated infections. The majority reported a favorable overall attitude toward hand hygiene (M = 4.15, SD = 0.85). Attitudes toward hand hygiene were significantly associated with perceived knowledge (β = 0.32, p < 0.001), prior hand hygiene training (β = 0.13, p < 0.05), and years of experience (β = − 0.10, p < 0.05). Healthcare workers in the ICU have a generally positive attitude toward hand hygiene. Such attitudes were correlated with hand hygiene knowledge, prior training, and job experience. The study’s findings can help to inform health promotion initiatives and campaigns aimed at achieving long-term improvements in hand hygiene behaviors.

Evaluating the tolerability and acceptability of a locally produced alcohol-based handrub and hand hygiene behaviour among health workers in Sierra Leone: a longitudinal hospital-based intervention study

BackgroundAlcohol-based handrub (ABHR) is the gold standard for hand hygiene (HH) and is a cornerstone of infection prevention and control (IPC) strategies. However, several factors influence the efficient use of ABHR by health workers. This study evaluated the tolerability and acceptability of a locally produced ABHR product and HH behaviour among health workers.MethodsA longitudinal hospital-based intervention study was conducted in accordance with the WHO’s standardized protocol for evaluating ABHR tolerability and acceptability (Method 1). Sixty health workers across 4 hospitals in Sierra Leone were observed over a 30-day period at three separate visits (days 1, 3–5, and 30) by trained observers. The outcomes of interest included skin tolerability and product acceptabilityevaluated using subjective and objective measures.ResultsObjective and subjective evaluations demonstrated strong skin tolerability and high acceptability with the product. At all three visits, the skin tolerability score assessed by trained observers was < 2 in ≥ 97% of participants, exceeding the WHO benchmark score (BMS = < 2 in ≥ 75%). Participants’ self-evaluations of overall skin integrity were 97% (visit 2) and 98% (visit 3) for scores > 4 (BMS = > 4 in ≥ 75%). The primary acceptability criteria increased up to 95% (colour) and 88% (smell) at visit 3 (BMS = > 4 in ≥ 50%). Despite high acceptability, the product’s drying effect remained low at 52% and 58% during visits 2 and 3, respectively (BMS = > 4 in ≥ 75%). There were positive HH behaviours (n = 53, 88%), with more than half (n = 38, 63%) of them exhibiting HH at almost every HH moment. The mean ABHR was notably high (76.1 ml, SD ± 35), especially among nurses (mean = 80.1 ml) and doctors (mean = 74.0 ml).ConclusionThe WHO-formulated, locally produced ABHR was well tolerated and accepted by health workers. These findings support the continuous utilization of evidence-based, cost-effective hand hygiene interventions in resource-limited settings. High handrub consumption and frequent HH practices were noticeable HH behaviours. Further research is recommended to optimize product formulations for skin dryness and investigate the association between ABHR consumption and hand hygiene compliance.

Perilaku Hand Hygiene dalam Pencegahan Covid-19 pada Perawat

Health workers are on the front line, especially as nurses who are always next to patients 1 x 24 hours. We must take precautions by means of hand hygiene before and after carrying out nursing care, where the COVID-19 outbreak is spreading very quickly resulting in an increase in the number of patients in the whole world. To reduce and prevent the transmission of this virus, we as nurses in providing nursing care must carry out hand hygiene and comply with WHO's 5 moments of hand hygiene, namely before touching a patient, before a clean or aseptic procedure, after exposure to or risk of body fluids. This study aims to determine the analysis of hand hygiene behavior in preventing COVID-19 among nurses at the Labuang Baji Regional General Hospital, Makassar City. The research design used is a quantitative research design with a crosssectional approach. The sample determination was carried out using a random sampling research method with a sample size of 83 respondents. The relationship test was carried out using the chi-square statistical test with a significance level (ρ) ≤ 0.05. The research results showed that the level of knowledge of nurses in the good category was 27 people (32.5%); the attitude of nurses in the positive category was 59 people (71.1%); there is no relationship between knowledge and hand hygiene behavior (p=0.786); and there is no relationship between attitude and hand hygiene behavior (p=0.372). The conclusion of this research is that there is no influence of nurses' knowledge and attitudes about hand hygiene on COVID-19 prevention measures at the Labuang Baji Regional General Hospital, Makassar City. It is recommended for future researchers to improve the implementation of hand hygiene among nurses in the motivation and work of PPI.

Exploring determinants of hand hygiene among nursing students: A theory of planned behavior approach

BackgroundThis study aims to assess the hand hygiene behavior of nursing students and identify the factors influencing this behavior through the “Scale for Assessment Hand Washing Behavior in the Frame of Theory of Planned Behaviour (SAHBTPB)”.MethodsThis descriptive and cross-sectional study was undertaken at the nursing departments of the university’s faculty of health sciences in İzmir, Turkey between 2021 and 2022. A total of 240 nursing students were recruited as participants for this study. Data were collected with the SAHBTPB. The data was analyzed using descriptive statistics, the Chi-square test, and correlation analysis in the SPSS 21.0 program (p < .05).ResultsParticipation rate was 74.76%. The mean age of the students was 20.59 ± 1.59 years and 69.9% were woman. The nursing students’ total mean score of SAHBTPB was 147.5 ± 14.0 (min = 94; max = 176). There was a positively significant association between the total score and students’ gender, graduate level, and hand hygiene education status. There was no significant difference in scale total score mean based on the existence of dermatological problems on the students’ hands or their frequency of hand hygiene (p > .05).ConclusionThe mean scores of nursing students on the SAHBTPB were found to be at a good level. The sub-dimension “intention” was identified as an effective factor in predicting the hand hygiene behavior of the students. The findings have the potential to positively impact nursing education by increasing awareness among students and offering valuable insights for nurses and educators.

Application of Health Education Program based on Intelligent Recommendation Algorithm in the Development of School-age Children's Hand Hygiene Behavior

The cultivation of hand hygiene behavior among school-age children is an important way to prevent the spread of diseases and ensure children’s health. However, traditional health education methods lack personalized programs tailored to each child, which cannot effectively improve their hand hygiene awareness and behavior. In response to this issue, the study combines multi-objective particle swarm optimization algorithm to provide personalized hand hygiene behavior development recommendations for school-age children, improving their hand hygiene awareness and behavioral level. The study adopted multi-objective particle swarm optimization algorithm and convolutional neural network, combined with the personalized needs of school-age children and the goal of cultivating hand hygiene behavior, and proposed a health education plan based on intelligent recommendation algorithm. Through deep learning, match the hand hygiene needs of school-age children with corresponding health education plans to achieve personalized recommendations. The average accuracy of the health education recommendation plan for hand hygiene behavior cultivation of school-age children based on multi-objective particle swarm optimization algorithm reaches 99.07%. Meanwhile, after introducing convolutional neural networks, the feature matching error between the recommended scheme and school-age children ranges from 10-1 to 10-2. After testing, the designed algorithm performs more stably and has less fluctuations under different sparsity conditions. Health education solutions based on intelligent recommendation algorithms can provide personalized solutions for school-age children, effectively cultivate their hand hygiene behavior, and meet various health needs.

Assessment of Intestinal Parasitic Infection and Personal Hygiene Practice Among School Children in A Primary School in A Village in Jakarta, Indonesia

Background: Intestinal parasitic infections (IPI) are still among developing countries' most prevalent parasitic infections. IPI is closely linked to nutrition, personal hygiene, environmental sanitation, income, climate, and education. Aims/Objectives: To assess the IPI and personal hygiene status among school children in the flood-prone area in Jakarta, Indonesia. Methodology: A cross-sectional study was conducted in a government primary school in South Jakarta, Indonesia, involving 157 students. A structured questionnaire was developed to assess the personal hygiene behavior of the students. A physical examination of the nail fingers was conducted as well. Feces samples were collected from each student and examined using direct smear techniques to identify intestinal parasite infection. Results: The prevalence of IPI was 38.2% in single and mixed infections. Intestinal parasites recorded in this study were Blastocystis hominis, Giardia lamblia, Trichuris trichiura, hookworm eggs, and non-pathogen protozoa Entamoeba coli. There is no significant difference between the prevalence of IPI with footwear usage, nail-cutting once a week (p=0.718), handwashing before the meal (p=0.688), handwashing after defecations (p=0.618); however, there is a significant difference between nail cleanliness and IPI (p=0.003). Conclusions: The prevalence of IPI in these school children was high and required interventions like health education and action on nail and hand hygiene behavior from school personnel or teachers.

Hand hygiene perceptions, preferences, and practices among hospital staff in the Dominican Republic in the context of COVID-19: a qualitative study

Proper hand hygiene (HH), which includes sanitizing with alcohol-based hand rub (ABHR) (or handwashing with soap and water if ABHR is unavailable), is key for preventing healthcare-associated infections (HCAI), including COVID-19. Understanding drivers of HH is key to improving adherence. This study aims to explore drivers and barriers to HH practice at two hospitals in the Dominican Republic in the context of the COVID-19 pandemic to inform development of HH behaviour change interventions. We conducted in-depth interviews with 20 hospital staff during September 2021. We used the COM-B (capability, opportunity, motivation, behaviour) model to explore HH experiences and preferences. Interviews were recorded, transcribed, coded, and analysed using a thematic approach. A total of 11 parent codes and 27 sub-codes were identified, and 1145 coded segments were analysed. Use of handwashing with soap and water and/or sanitizing with ABHR was reported by all participants; handwashing was generally preferred. Participants expressed knowledge of proper HH methods (capability), but inconsistent supplies and lack of time presented HH challenges (opportunity). Interviewees described practicing HH to protect themselves and their families from COVID-19 and other infections (reflective motivation) or out of habit (automatic motivation). By understanding and addressing underlying factors affecting HH, hospitals can decrease the risk of HCAIs. Our findings suggest that interventions implemented to improve HH in these hospitals should target motivation and opportunity. These findings informed a multimodal intervention to increase ABHR access and implement message-tested communications campaigns; end-point assessments will provide insights into the intervention's impact.

The Influence of Perceived Subjective Norms on Nurses' Hand Hygiene Behavior: Intention as an Intervening Variable

The Influence of Perceived Subjective Norms on Nurses' Hand Hygiene Behavior: Intention as an Intervening Variable

Good Hand Hygiene Practices: Increasing Public Awareness through Policy and Public Campaigns

This descriptive quantitative research evaluates compliance with and perceptions of hand hygiene practices among healthcare workers in hospitals in the city of Prabumulih and in the district of Muara Enim. Employing a simple random sample, 115 healthcare professionals were surveyed using a questionnaire based on the Health Belief Model (HBM) administered via Google Forms. The study primarily focuses on various perceptions including susceptibility, severity, benefits, barriers, cues to action, and self-efficacy towards hand hygiene. Statistical analyses, both descriptive to outline the general tendencies and inferential to explore the interconnections between different HBM constructs, aim to provide insights into the factors influencing hand hygiene practices. This research underscores the critical gaps between knowledge and actual hand hygiene behavior, particularly evident among healthcare students, highlighting the need for targeted educational strategies to enhance compliance and reduce disease transmission effectively.

Clinical Outcome and Factors with Dietary Behaviors in Pregnant Women with Listeria monocytogenes: A Hospital-Based Case-Control Study in Shanghai.

Listeriosis is a globally rare foodborne disease that causes fetal-placental infection, leading to adverse pregnancy outcome, while limited research among pregnant women is available in China. This study was therefore aimed at analyzing the incidence, clinical manifestations, and clinical outcome of listeriosis among pregnant women and its associated dietary behavior risk factors in prevention. A hospital-based case-control study had been conducted from January 2017 to December 2021. Clinical data, laboratory information, and questionnaires including dietary behaviors and personal hygiene were collected within 2 days after case diagnosis. There were 48 pregnant women, including 12 cases and 36 controls, with an average age of 31.19 ± 3.75 years. The incidence of admission-based listeriosis among pregnant women was 1.6058 per 10,000. The 12 strains were divided into 3 serotypes: 1/2a(83.33%), 1/2b(8.33%), and 4b(8.33%). Among the cases, 5 cases (41.67%) resulted in abortion, 3 cases (25%) induced preterm labor, and 4 cases (33.33%) had full-term deliveries after treatment. There were 7 live births in the case group, among which 6 were admitted to the neonatal intensive care unit (NICU), while 1 case had a healthy fetal outcome. All patients in the control group gave birth to live fetuses. Epidemiological investigation revealed that pregnant women dining at restaurants three or more times per week might increase the risk of having Listeria infection. There were no significant differences in dietary consumed behaviors, hand hygiene, and refrigerator usage behaviors between case and control groups. The study suggested that dining at restaurants might be associated with Listeria infection among pregnant women. Therefore, it is essential to enhance education on listeriosis serious consequences and promote healthy dietary and hygiene habits among pregnant women.

Evaluation of Social-Cognitive Determinants of Patients’ Hand Hygiene Decisions and the Role of Mental Health in a Cross-Sectional and a Longitudinal Study of German Patients

Patients’ effective hand hygiene helps to reduce healthcare-associated infections and prevents the spread of nosocomial infections and communicable diseases, such as COVID-19. Accordingly, this study aimed to describe effective hand hygiene decisions based on the Health Action Process Approach (HAPA) and whether this pattern is invariant for mental health. Data were collected cross-sectionally from patients who had previously been admitted to a hospital (Nstudy 1 = 279; study 1) and longitudinally from psychosomatic rehabilitation patients (Nstudy 1 = 1073; study 2). The fit of the HAPA framework and changes in hand hygiene decisions regarding compliance, social-cognitive variables of the HAPA, and mental health status were examined. The results revealed that the trimmed HAPA framework fitted the data well (χ2 = 27.1, df = 12, p &lt; 0.01, CMIN/df = 2.26, CFI = 0.97, RMSEA = 0.08). According to multi-group structural equation modeling, the HAPA model with hand hygiene behavior was found to be invariant regarding mental health. To conclude, the trimmed HAPA framework was revealed to be a generic framework for explaining social-cognitive processes relating to hand hygiene decisions. Therefore, helping individuals to perform hand hygiene recommendations requires intention formation and bridging the intention–behavior gap. This can be undertaken by promoting planning and self-efficacy. All processes appear generic to participants with and without mental health challenges.

Nurses' knowledge and attitudes towards hand hygiene in Aceh, Indonesia: A correlational study among surgical nurses

This study aims to thoroughly examine nurses' knowledge and attitudes about hand hygiene and investigate how these factors are related. Conducted in a hospital environment, the research aims to gather detailed information to help develop better hand hygiene practices among nurses. Healthcare-associated infections (HAIs) pose a global issue, impacting numerous people each year. However, consistent hand hygiene can greatly reduce these infections. Nurses are vital in preventing HAIs, and this study looks at the hand hygiene behaviors of thirty-three surgical nurses. The research involved collecting data through three questionnaires and analyzing it with the Pearson correlation test. The results revealed that the average knowledge score of the nurses was 11.6, and their average attitude score was 16.33. There was a strong correlation (r=0.688) between the nurses' knowledge and their attitudes towards hand hygiene practices. Moreover, a significant positive correlation (ρ-value of 0.000) was observed, indicating a meaningful relationship between knowledge levels and attitudes towards hand hygiene. The findings suggest that enhancing knowledge about hand hygiene results in a more positive attitude towards its practices. The role of the hospital ward manager is crucial in maintaining proper hand hygiene among staff. As a role model, supervisor, and evaluator, the ward manager significantly influences awareness and adherence to good hand hygiene practices. Additionally, the hospital should provide adequate support and resources to enable staff to perform hand hygiene effectively.

Prevalence and determinants of hand hygiene behavior among Indian population: a systematic review and meta-analysis

Despite a global call to action, many deaths occur yearly in developing nations from contagious diseases due to poor sanitation and hygiene. Although hand hygiene (HH) behavior was critical in preventing the COVID-19 pandemic, the sustainability of such practices is still questionable. Therefore, the current systematic review and meta-analysis investigated the prevalence and determinants of HH behavior among the Indian population (PROSPERO registration ID: CRD42022344961). Systematic searches on electronic databases, including ScienceDirect, Scopus, Web of Science, JSTOR, PubMed, and Google Scholar, targeted qualitative and quantitative studies that report HH behaviors in India. Pooled effect sizes were calculated with the inverse-variance method using random-effects models, acknowledging the study heterogeneity. Out of 1053 studies, 15 studies that met eligibility criteria were included in the qualitative synthesis. Among them, five studies were included in the meta-analyses. The overall prevalence of HH before food was 55% (95% CI = 31–78), and after the toilet was 84% (95% CI = 65–96). Subgroup analysis showed that before-food HH prevalence pre- and post-COVID-19 was 61% and 36%, respectively, whereas after-toilet HH prevalence was 91% and 74%, respectively. Meta-regression revealed statistically non-significant results for COVID-19 status. While it could not adequately explain the heterogeneity of the ‘before-food prevalence’ studies (Adj. R2 = − 34.80%), it did account for more than 19% in ‘after-toilet prevalence’ (Adj. R2 = 19.72%). This systematic review highlights various demographic, psychosocial, and environmental determinants of HH behavior. The results offer the potential for a deeper comprehension of the key factors influencing HH in India and could find implications for developing viable interventions. This aids in planning efficient promotional campaigns to enhance personal hygiene and control infectious diseases in the nation.

Digital health literacy, behavior and knowledge of adolescents for hand hygiene during the COVID-19 pandemic.

to investigate factors associated with digital health literacy, hand hygiene knowledge and behavior among Brazilian adolescents during the COVID-19 pandemic. cross-sectional study with 473 adolescents aged 15 to 19. Data were collected virtually between June and August 2021 through a questionnaire on sociodemographic characteristics, digital health literacy, knowledge and behavior regarding hand hygiene. Variables were adjusted using multiple linear regression models with normal response. the average digital health literacy score was 29.89 ±5.30; for hand hygiene knowledge and behavior was 13.1 ±1.5 and 11.1±2.7, respectively. Higher knowledge and behavior scores for hand hygiene were associated with having completed high school, compared to those attending college, among those who attend health courses, seek information about the pandemic and in scientific articles. Higher digital health literacy scores in adolescents who did not wear masks when playing sports (p= 0.017). There was an association between digital health literacy and knowledge (p = 0.000) and behavior (p = 0.000) regarding hand hygiene. there is an association between higher digital health literacy scores and hand hygiene knowledge and behavior.

Evaluating hand hygiene knowledge, attitudes, and practices among healthcare workers in post-pandemic H1N1 influenza control: a cross-sectional study from China.

This study evaluates the knowledge, attitudes, and practices (KAP) of hand hygiene among healthcare workers, crucial for preventing healthcare-associated infections (HAIs) in medical facilities. This cross-sectional study assessed hand hygiene KAP among healthcare workers across various settings in Hubei, China utilizing a stratified random sampling approach from, December 25, 2023-to-April 25, 2024. A bilingual electronic survey, adapted from validated tools, was disseminated via email and social media to ensure a broad reach. Participants included diverse healthcare professionals who met specific inclusion criteria. Responses were analyzed using R software, employing descriptive and inferential statistics to identify key predictors of hand hygiene behavior and to confirm the reliability of the survey instrument. The survey of 2,265 healthcare workers revealed that 77% demonstrated comprehensive knowledge of hand hygiene, 80% exhibited positive attitudes, and 94% practiced effective hand hygiene. Notable findings include a significant understanding of hand hygiene's role in preventing respiratory illnesses (58%) and HAIs (41% agreed, 39% unsure). High compliance in practices like washing hands for at least 20 s was evident (84%), though gaps in confidence about hand hygiene techniques were noted (33% confident, 56% unsure). Binary logistic regression analysis indicated that younger healthcare workers (21-30 years) were more likely to exhibit both knowledge (OR = 7.4, 95% CI = 1.44-136, p = 0.059) and positive attitudes (OR = 4.48, 95% CI = 1.73-11.8, p < 0.001) compared to other age groups. Significant associations were found between higher income levels and positive attitudes toward hand hygiene (OR for ≥80,000 = 3.19, 95% CI = 2.05-5.02, p < 0.001), and between knowledge and practices, suggesting that well-informed individuals are more likely to adhere to recommended practices. The findings reveal robust hand hygiene knowledge but uncover critical confidence gaps among healthcare workers, urging immediate, targeted educational interventions to fortify adherence and prevent infection outbreaks.

Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic

Only a few studies have examined the long-term trends of hand and oral hygiene, especially among adolescents. To investigate the 15-year trends in frequency of handwashing and toothbrushing and examine the factors associated with hand and oral hygiene, particularly during the COVID-19 pandemic. This cross-sectional study, performed from January 1, 2008, to December 31, 2022, used general population-based data from 963 644 individuals in a national representative survey (Korea Youth Risk Behavior Web-based Survey [KYRBS]). COVID-19 pandemic. Trends in hand and oral hygiene practices were measured by how frequently adolescents washed their hands and whether they fulfilled the recommended guidelines for toothbrushing. An interrupted time series analysis using linear and logistic regression models was performed to assess any associations with the COVID-19 pandemic. Hand and oral hygiene behaviors before and during the pandemic in each sociodemographic subgroup were also compared. In the 963 644 adolescents (495 697 [51.4%] male; mean [range] age, 15.01 [12-18] years) who participated in the KYRBS from 2008 to 2022, a 73.3% (95% CI, 59.4%-97.4%; P < .001) immediate increase was seen in overall hand hygiene behavior at the onset of the COVID-19 pandemic compared with the prepandemic period, with a sustained decrease thereafter (β = -0.018; 95% CI, -0.022 to -0.015; P < .001). Meanwhile, no immediate increase was observed in terms of overall oral hygiene behavior (0.1%; 95% CI, -0.9% to 1.1%; P = .82); however, there was a sustained decrease during the pandemic (β = -0.018; 95% CI, -0.020 to -0.016; P < .001). Older age, female sex, nonsmoking status, alcohol use, low household economic level, and poor school performance were significantly associated with poor hand hygiene during the pandemic. In this cross-sectional study of South Korean adolescents, an increase in the prevalence of hand hygiene was observed during the early pandemic; however, this prevalence decreased over time. Meanwhile, the decrease in the prevalence of oral hygiene was more pronounced during the pandemic. This study recommends stronger guidelines for adolescent health coaches, such as teachers or public health advisers, regarding hygiene behaviors, even after the COVID-19 pandemic ends.