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Experimental pretesting of hand-washing interventions in a natural setting

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  • Judah, G.
  • Aunger, R.
  • Schmidt, W.-P.
  • Michie, S.
  • Granger, S.
  • Curtis, V.

Abstract

Objectives. We pretested interventions derived from different domains of behavior change theory to determine their effectiveness at increasing hand washing with soap in a natural setting. Methods. We installed wireless devices in highway service station restrooms to record entry and soap use. Two text-only messages for each of 7 psychological domains were compared for their effect on soap-use rates. We collected data on nearly 200000 restroom uses. Results. The knowledge activation domain was most effective for women, with a relative increase in soap use of 9.4% compared with the control condition (P=.001). For men, disgust was the most effective, increasing soap use by 9.8% (P=.001). Disgust was not significantly better than the control condition for women, nor was knowledge activation for men. Messages based on social norms and social status were effective for both genders. Conclusions. Our data show that unobtrusive observation of behavior in a natural setting can help identify the most effective interventions for changing behaviors of public health importance. The gender differences we found suggest that public health interventions should target men and women differently.

Suggested Citation

  • Judah, G. & Aunger, R. & Schmidt, W.-P. & Michie, S. & Granger, S. & Curtis, V., 2009. "Experimental pretesting of hand-washing interventions in a natural setting," American Journal of Public Health, American Public Health Association, vol. 99(S2), pages 405-411.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2009.164160_1
    DOI: 10.2105/AJPH.2009.164160
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    1. Kiatkawsin, Kiattipoom & Han, Heesup, 2017. "Young travelers' intention to behave pro-environmentally: Merging the value-belief-norm theory and the expectancy theory," Tourism Management, Elsevier, vol. 59(C), pages 76-88.
    2. Peter D. Lunn & Cameron A. Belton & Ciarán Lavin & Féidhlim P. McGowan & Shane Timmons & Deirdre A. Robertson, 2020. "Using behavioral science to help fight the Coronavirus," Journal of Behavioral Public Administration, Center for Experimental and Behavioral Public Administration, vol. 3(1).
    3. Levine, David I. & Riggs, William & Steffen, Kelsey, 2017. "Rapid prototyping a school-based health program in the developing world," Development Engineering, Elsevier, vol. 2(C), pages 68-81.
    4. Sophie Rutter & Catherine Stones & Jane Wood & Colin Macduff & Margarita Gomez-Escalada, 2020. "Effectiveness and Efficiency of Persuasive Space Graphics (PSG) in Motivating UK Primary School Children’s Hand Hygiene," IJERPH, MDPI, vol. 17(7), pages 1-27, March.
    5. Tzikas, Alexandros & Koulierakis, George, 2023. "A systematic review of nudges on hand hygiene against the spread of COVID-19," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 105(C).
    6. Dolan, P. & Hallsworth, M. & Halpern, D. & King, D. & Metcalfe, R. & Vlaev, I., 2012. "Influencing behaviour: The mindspace way," Journal of Economic Psychology, Elsevier, vol. 33(1), pages 264-277.
    7. Aaron Lawson & Marie Vaganay-Miller, 2019. "The Effectiveness of a Poster Intervention on Hand Hygiene Practice and Compliance When Using Public Restrooms in a University Setting," IJERPH, MDPI, vol. 16(24), pages 1-12, December.
    8. Marzena Tomaszewska & Beata Bilska & Danuta Kołożyn-Krajewska, 2020. "Do Polish Consumers Take Proper Care of Hygiene while Shopping and Preparing Meals at Home in the Context of Wasting Food?," IJERPH, MDPI, vol. 17(6), pages 1-21, March.
    9. Karen File & Thomas Valente & Mary-Louise McLaws, 2018. "Hygiene and Health: Who Do Mothers in Vanuatu Communicate with about Health?," IJERPH, MDPI, vol. 15(3), pages 1-14, March.
    10. Michalek, Gabriela & Schwarze, Reimund, 2020. "The strategic use of nudging and behavioural approaches in public health policy during the coronavirus crisis," UFZ Discussion Papers 6/2020, Helmholtz Centre for Environmental Research (UFZ), Division of Social Sciences (ÖKUS).
    11. Bruno Cardinale Lagomarsino & Matías Gutman & Lucía Freira & María Laura Lanzalot & Maximiliano Lauletta & Leandro E. Malchik & Felipe Montaño Campos & Bianca Pacini & Martín A. Rossi & Christian Vale, 2017. "Peer Pressure: Experimental Evidence From Restroom Behavior," Economic Inquiry, Western Economic Association International, vol. 55(3), pages 1579-1584, July.
    12. Liu, Jenny X. & Vallin, Janelli & Chiu, Calvin & Cabrera, F. Abigail & Hunter, Lauren A. & Rao, Aarthi & Njau, Prosper & McCoy, Sandra I., 2023. "Designing for two: How enhancing human-centered design with behavioral nudges unlocked breakthroughs to promote young women's psychological safety and access to reproductive care in Tanzania," Social Science & Medicine, Elsevier, vol. 320(C).
    13. Verma, Vivek Kumar & Chandra, Bibhas & Kumar, Sumit, 2019. "Values and ascribed responsibility to predict consumers' attitude and concern towards green hotel visit intention," Journal of Business Research, Elsevier, vol. 96(C), pages 206-216.
    14. Hattaya Chutiphimon & Apinya Thipsunate & Atigun Cherdchim & Bootsarakam Boonyaphak & Panat Vithayasirikul & Patiphan Choothong & Swit Vichathai & Pitchayanont Ngamchaliew & Polathep Vichitkunakorn, 2020. "Effectiveness of Innovation Media for Improving Physical Distancing Compliance during the COVID-19 Pandemic: A Quasi-Experiment in Thailand," IJERPH, MDPI, vol. 17(22), pages 1-10, November.
    15. Bruno Cardinale Lagomarsino & Matías Gutman & Lucía Freira & María Laura Lanzalot & Maximiliano Lauletta & Leandro Malchik & Felipe Montaño Campos & Bianca Pacini & Martín Rossi & Christian Valencia, 2015. "Peer Pressure and Externalities: Evidence from a field experiment," Working Papers 125, Universidad de San Andres, Departamento de Economia, revised Dec 2015.
    16. Brewis, Alexandra & Wutich, Amber & du Bray, Margaret V. & Maupin, Jonathan & Schuster, Roseanne C. & Gervais, Matthew M., 2019. "Community hygiene norm violators are consistently stigmatized: Evidence from four global sites and implications for sanitation interventions," Social Science & Medicine, Elsevier, vol. 220(C), pages 12-21.

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