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Changes in Hand Hygiene Knowledge, Attitudes, and Practices Among Primary School Students: Insights from a Promotion Program in Guatemala

Author

Listed:
  • Michelle Marie Pieters

    (Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala)

  • Natalie Fahsen

    (Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala)

  • Christina Craig

    (Centers for Disease Control and Prevention, Atlanta, GA 30329, USA)

  • Kelsey McDavid

    (Centers for Disease Control and Prevention, Atlanta, GA 30329, USA)

  • Kanako Ishida

    (Centers for Disease Control and Prevention, Atlanta, GA 30329, USA)

  • Christiana Hug

    (Centers for Disease Control and Prevention, Atlanta, GA 30329, USA)

  • Denisse Vega Ocasio

    (Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
    Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA)

  • Celia Cordón-Rosales

    (Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala)

  • Matthew J. Lozier

    (Centers for Disease Control and Prevention, Atlanta, GA 30329, USA)

Abstract

School-aged children are vulnerable to infectious diseases due to their developing immune systems and frequent social interactions. The COVID-19 pandemic underscored the importance of non-pharmaceutical interventions, like hand hygiene (HH). This study evaluated the changes achieved through a school-based intervention to Guatemalan primary school students’ HH knowledge, attitudes, and self-reported practices while collecting teacher feedback to inform future efforts. The intervention included handwashing festivals, environmental nudges, and the regular delivery of soap and alcohol-based hand rub (ABHR). Knowledge, attitudes, and practices (KAP) surveys were conducted pre- and post-intervention with 109 and 144 students, respectively. Six teachers participated in interviews to provide perspectives. Significant improvements were observed in students’ knowledge of HH’s role in preventing disease (pre: 84.4%; post: 96.5; p < 0.01) and recognition of critical moments (pre: 84.4%; post: 92.4%; p < 0.05). Self-reported practices also improved, with more students reporting washing their hands for 20 s or more (pre: 68.8%; post: 79.9%; p < 0.05). Fewer students reported liking ABHR after the intervention (pre: 89%; post: 78.5%; p < 0.05). Teachers reported increased HH practices and provided feedback to enhance interventions. These findings highlight the effectiveness of school-based interventions and emphasize the importance of addressing knowledge gaps and incorporating teacher insights for sustained public health benefits.

Suggested Citation

  • Michelle Marie Pieters & Natalie Fahsen & Christina Craig & Kelsey McDavid & Kanako Ishida & Christiana Hug & Denisse Vega Ocasio & Celia Cordón-Rosales & Matthew J. Lozier, 2025. "Changes in Hand Hygiene Knowledge, Attitudes, and Practices Among Primary School Students: Insights from a Promotion Program in Guatemala," IJERPH, MDPI, vol. 22(3), pages 1-14, March.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:3:p:424-:d:1611925
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    References listed on IDEAS

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    1. Michelle M. Pieters & Natalie Fahsen & Christina Craig & Ramiro Quezada & Caroline Q. Pratt & Andrea Gomez & Travis W. Brown & Alexandra Kossik & Kelsey McDavid & Denisse Vega Ocasio & Matthew J. Lozi, 2023. "Assessment of Water, Sanitation, and Hygiene Conditions in Public Elementary Schools in Quetzaltenango, Guatemala, in the Context of the COVID-19 Pandemic," IJERPH, MDPI, vol. 20(20), pages 1-11, October.
    2. Robert Dreibelbis & Anne Kroeger & Kamal Hossain & Mohini Venkatesh & Pavani K. Ram, 2016. "Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh," IJERPH, MDPI, vol. 13(1), pages 1-7, January.
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