Effect of Installation of Alcohol Gel Dispensers and Behavioral Nudges on Behavioral Drivers for Hand Hygiene: A Quasi-Experimental Study at a Tertiary Hospital during the COVID-19 Pandemic

Dispensers-Nudges and COVID-19 Hand Hygiene Beliefs

  • Sommanas Naknual Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Nanta Kliangkird Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Tippawan Liabsuetrakul Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Wit Wichaidit Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Keywords: COVID-19, hand hygiene, health beliefs, nudges, social norms

Abstract

Objective: To compare the level of hand hygiene behavioral drivers before and after installation of alcohol gel dispensers and behavioral nudges among outpatients and visitors at a tertiary hospital in Thailand during the coronavirus disease 2019 (COVID-19) pandemic.
Material and Methods: A quasi-experimental study was conducted among outpatients and visitors in June 2020. We installed 12 alcohol gel dispensers with signs serving as behavioral nudges at a tertiary hospital in the Internal Medicine Outpatient Department (OPD), Surgery OPD, and the Pharmacy. We trained enumerators to interview outpatients and visitors regarding their behavioral drivers (beliefs about COVID-19 and hand hygiene based on the health belief model, plus handwashing social norms). We analyzed data using descriptive statistics.
Results: Enumerators recruited 206 participants in the pre-intervention phase (refusal rate = 37.6%) and 219 participants in the post-intervention phase (refusal rate = 32.2%). There were significant differences between the pre-intervention and post-intervention phases with regard to self-efficacy for hand hygiene (92.0% vs. 100%, respectively), perceived lack of barriers to hand hygiene with alcohol (93.2% vs. 98.2%, respectively), and the proportion of participants who reported that hand hygiene had become a habit (7.5 vs. 18.8%, respectively). Reports of other domains of health beliefs (perceived severity of COVID-19, perceived benefits of handwashing) were homogeneous in both periods.
Conclusion: We found differences in perceived lack of barriers and reported habit of hand hygiene but while self-efficacy was homogeneous in both periods. Issues regarding selection bias, construct validity, and generalizability may limit the usefulness of the study data. Caveats should be considered in the interpretation of the study findings.

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Published
2021-09-10
How to Cite
1.
Naknual S, Kliangkird N, Liabsuetrakul T, Wichaidit W. Effect of Installation of Alcohol Gel Dispensers and Behavioral Nudges on Behavioral Drivers for Hand Hygiene: A Quasi-Experimental Study at a Tertiary Hospital during the COVID-19 Pandemic: Dispensers-Nudges and COVID-19 Hand Hygiene Beliefs. PSU Med J [Internet]. 2021Sep.10 [cited 2021Sep.18];. Available from: https://he01.tci-thaijo.org/index.php/PSUMJ/article/view/245328
Section
Original Articles