Effects of a handwashing intervention package on handwashing in preschool children

Young children who attend out‐of‐home care (e.g., preschool) are more susceptible to infections than children who do not attend out‐of‐home care. Previous research suggests handwashing is effective in reducing risk of infection and illness. However, research suggests that individuals do not routinely wash their hands using methods that healthcare agencies, such as the Centers for Disease Control and Prevention, have determined best practice. We evaluated the effects of a multicomponent handwashing intervention package on correct handwashing across groups of preschool children. Furthermore, we measured the degree to which their hands were clean using premeasures and postmeasures. Results suggest the intervention package was effective at increasing both correct handwashing and cleanliness of participants' hands.     

助推手卫生的行为干预策略

保持手卫生是感染防控的重要策略,但是如何提高其依从性成为预防传染性疾病和减少医疗机构获得性感染的一大挑战。以行为科学为基础的手卫生助推干预以更“隐性”的方式将洗手转变为一种可自动触发的行为习惯,弥补了以知识分享和健康宣教为主的传统手卫生干预策略的诸多局限性。基于影响机制的不同,手卫生助推干预策略可分为提供决策信息、优化决策选项、影响决策结构、提醒决策方向4个大类的框架体系。多模式助推策略的有效性也已在实践中得到印证,但目前还非常缺乏在中国社会文化情境下开展的助推洗手行为的干预研究,今后可尝试基于行为科学理论有针对性地在医院、学校和社区等公共场所开展此类干预研究和实践,为感染防控、疾病预防和改善公共健康做出相应的贡献。     

The effects of perceived social norms on handwashing behaviour in students

Handwashing is widely considered the most effective method of preventing the spread of infectious illness. Exploring the determinants of handwashing is vital to the development of interventions to increase this behaviour. A survey based on Social Norms Theory assessed handwashing frequency and perceptions of peer handwashing in 255 university students. Participants reported their own handwashing frequency, and how often they thought their peers washed their hands in particular circumstances, to determine whether misperceptions around handwashing exist, and whether these influence the behaviour of individuals. Gender was found to be a significant determinant of handwashing frequency as females reported washing their hands significantly more often than males. Participants also believed they washed their hands significantly more frequently than their peers. Perceived peer handwashing frequency was significantly correlated with participants’ own behaviour. This effect was seen in overall handwashing and in food, waste and illness-related hand washing. These results suggest perceived social norms around hand washing have a clear association with individual behaviour. Future research might test the effectiveness of a social norms intervention in other settings which carry an increased risk of infection spread.     

Exploring Socioeconomic Differences in Bedtime Behaviours and Sleep Duration in English Preschool Children

Children's sleep is critical for optimal health and development; yet sleep duration has decreased in recent decades, and many children do not have adequate sleep. Certain sleep behaviours (‘sleep hygiene’) are commonly recommended, and there is some evidence that they are associated with longer nighttime sleep. Parents of 84 British 3‐year‐old children were interviewed about their children's sleep and completed five‐night/four‐day sleep diaries documenting their children's sleep, from which daily sleep duration was estimated. Diaries were validated by actigraphy in a subgroup of children. Sleep hygiene behaviours (regular bedtime, reading at bedtime, falling asleep in bed) were associated with each other, and were more common in the high socioeconomic status compared to the low socioeconomic status group. Parents' reasons for not practicing sleep hygiene included difficulty, inability or inconvenience. Sleep hygiene behaviours were associated with significantly longer child sleep at night but not over 24 h. Longer daytime napping compensated for shorter nighttime sleep in children whose parents did not implement sleep hygiene behaviours. Parents may need to be advised that certain behaviours are associated with longer nighttime sleep and given practical advice on how to implement these behaviours. © 2014 The Authors. Infant and Child Development published by John Wiley & Sons, Ltd.     

A comparison of prompts and feedback for promoting handwashing in university restrooms

We compared the effects of prompts versus feedback on handwashing behavior across six restrooms at a large university. We evaluated the effects using two separate multiple baseline designs across three men's and three women's restrooms. Results indicate that feedback was more effective for increasing handwashing.     

Effects of an observer on conformity to handwashing norm

Women were observed after elimination in a public restroom to determine the effects of the presence or absence of an observer upon the likelihood of handwashing. 18 of 20 subjects in the presence of another and 3 of 19 who were not observed washed. The difference in frequency of handwashing between the two groups was clearly significant.     

EFFECTS OF AN ORAL HYGIENE PUNISHMENT PROCEDURE ON CHRONIC RUMINATION AND COLLATERAL BEHAVIORS IN MONOZYGOUS TWINS

This study investigated the suppressive effects of an oral hygiene punishment procedure on the ruminative behavior of profoundly retarded monozygous twins. Rumination, fingers in mouth/tongue out, appropriate behavior, and stereotyped behavior were measured before and during treatment with oral hygiene. Treatment was introduced for each meal in succession across the twins in a multiple-baseline design. Results showed that the rate of rumination of both twins was dramatically reduced to very low levels and stereotyped behavior increased spontaneously with the introduction of oral hygiene. Maintenance data showed that response reduction was maintained over a six-month period and, when compared to baseline levels, increased rates of socially appropriate behavior were evident in both children.     

A Review of Pediatric Nonpharmacological Sleep Interventions: Effects on Sleep,Secondary Outcomes,and Populations With Co-occurring Mental Health Conditions

Sleep problems are common in school-age children and linked to numerous negative outcomes. Sleep disturbances are particularly common in children with mental health disorders, such as attention-deficit/hyperactivity disorder, depression, and anxiety. Despite frequent use of nonpharmacological pediatric sleep interventions to treat common sleep problems, there is a paucity of research on whether these interventions are effective. Further, it is unclear whether by targeting sleep, these interventions lead to broader improvements in the domains of functioning that are commonly affected by poor sleep. The present review includes 20 studies that evaluated nonpharmacological sleep treatments for school-aged youth, including 5 studies specifically focused on youth with externalizing or internalizing problems. Multimodal approaches consisting of psychoeducation and sleep hygiene in combination with other components were effective at treating insomnia and general sleep problems in typically developing samples. The addition of behavioral parent training to sleep interventions was effective for youth with externalizing problems, whereas incorporating cognitive strategies into sleep interventions for youth with internalizing problems was found to be ineffective. A variety of secondary outcomes were examined, with the strongest support emerging for improvement in anxiety and behavioral problems. Implications for clinical practice and future research directions are discussed.     

“Dictating the Suitable Way of Life”: Mental Hygiene for Children and Workers in Socialist Mexico, 1934–1940

After the Mexican Revolution (1910–1920), an ambitious project of national reconstruction began in which education and health were two priorities in the consolidation of a new nation. In this context of social, cultural, and political transformation, mental hygiene was a field that made it possible to articulate the professional practice of psychiatrists with the project of the nation promoted by postrevolutionary governments. In Mexico, the mental hygiene movement was headed by the same doctors who professionalized the practice of psychiatry and made it a specialized field of knowledge. The first generation of psychiatrists managed to integrate mental hygiene into health and education policies during the socialist administration of president Lázaro Cárdenas; a phenomenon that made evident the articulation between mental hygiene, social medicine, and nationalist discourse. Discussion will focus on proposals made from the perspective of mental hygiene as a function of two social sectors regarded as priorities by the Cárdenas government: children and workers.     

THE GOOD TOOTHBRUSHING GAME: A SCHOOL-BASED DENTAL HYGIENE PROGRAM FOR INCREASING THE TOOTHBRUSHING EFFECTIVENESS OF CHILDREN

There has been a serious lack of experimentally verified, effective dental hygiene programs in the schools. In and of themselves, the instruction-alone programs which comprise children's dental education do not produce proper toothbrushing skills. In the present study, a school-based contingency dental hygiene program designed to increase the effectiveness of children's toothbrushing skills at home was implemented with grade one and two classes. Each class was divided into teams and participated in the “Good Toothbrushing Game.” Each day four children from each team had the cleanliness of their teeth assessed according to the Simplified Oral Hygiene Index (Greene & Vermillion, 1964). The team with the lowest mean oral hygiene score was declared the daily winner. Winning teams received stickers and had their names posted. A multiple baseline across classrooms single-subject group design (Hersen & Barlow, 1976, pp. 228–229) established that the good toothbrushing game greatly increased the effectiveness of children's oral hygiene skills. The treatment terminal level for the grade one scores was 2.0 as compared to a baseline terminal level of 5.0, and for the grade two's was 2.3 compared to 5.7 at the end of baseline. A 9-mo follow-up indicated that these results were maintained. The data strongly suggest that proper implementation of behavioral principles is essential to the success of oral hygiene programs.     

Teaching students with autism spectrum disorder to tolerate haircutting

We describe intervention with 2 adolescent male students who had autism spectrum disorder (ASD) and resisted haircutting performed by care providers at a residential school. The students were exposed to a graduated hierarchy of steps including the presence of hair clippers, and increased duration of hair clippers against their scalp and hair. Edible reinforcement was presented contingent on completion of a step without interfering behavior. Both students learned to tolerate all of the steps in the graduated hierarchy and a full haircut with maintenance at 2-, 4-, and 6-month follow-up. The study supports previous tolerance-training research with children and youth who have intellectual and developmental disabilities and resist personal care and hygiene routines.     

Sociodemographic,Cognitive, and Emotional Determinants of Two Health Behaviors during SARS-CoV-2 Outbreak: An Online Study among French-Speaking Belgian Responders during the Spring Lockdown

To contain the SARS-CoV-2 infection rate, health authorities have encouraged the population to enhance protective behaviors such as physical distancing and handwashing. Behavioral sciences emphasize the role of sociocognitive determinants to explain health behaviors, while largely ignoring emotional factors. In a large online study (N > 4000), we investigated the role of sociodemographic, cognitive, emotional, and social factors that can facilitate or hinder handwashing and limitation of social contacts. Data were collected from March 18 until April 19, 2020, which corresponds to the spring lockdown and the first peak of the pandemic in Belgium. Logistic regressions showed that sociodemographic factors (gender, age, level of education) and the dimensions of the Theory of Planned Behavior (intentions, attitudes, perceived behavioral control and subjective norms) had a strong impact on health behaviors, but that emotional factors explained an additional part of the variance. Being more attentive/determined and frightened/anxious, along with scoring higher on health anxiety were related to a higher frequency of handwashing. In contrast, being enthusiastic/happy was related to lower adherence to limiting social contacts. Our results suggest that the type of predictors and the direction of associations depend on the type of health behavior considered. The role of specific emotional factors in addition to more classical predictors is discussed. The study offers new perspectives regarding the factors that are associated with the adherence to behaviors recommended to adopt when faced with a pandemic.     

Chronic illness and COVID-19-related risk and protective behaviors

People with chronic illnesses are at increased risk of contracting COVID-19. Still, little is known about whether such an increased risk relates to COVID-19-related protective behaviors among those with chronic illness. This study compares the self-reported COVID-19 risky and protective behaviors—specifically physically distancing, handwashing, and having houseguests—of people (N = 936) (1) living with chronic illnesses or (2) cohabiting with someone with chronic illness to those who fall in neither category at the beginning of the COVID-19 pandemic (April 2020). Study results were mixed: people with a chronic illness were more likely to have had houseguests in the past 5 days and less likely to have increased their handwashing in response to the pandemic, but were also more likely to physical distance when outside the home. Those cohabiting with someone with a chronic illness were more likely to have had houseguests, but did not differ in other outcomes.     

A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study

The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment.     

Activities of daily living in children with developmental coordination disorder: dressing, personal hygiene, and eating skills

In order to understand how age, culture, and problems in motor coordination impact the performance of activities of daily living, we used focus groups and in-depth interviews with Australian and Canadian parents to examine activities of daily living of younger (5-7 years of age) and older (8-9 years of age) children with and without DCD. By comparison with their typically developing age group, children with DCD had more difficulty with dressing, personal hygiene, and eating skills. Difficulties with postural control and fine-motor skills were reported to contribute to poorer performance of activities of daily living. As expected, competence in the performance of activities of daily living improved in the older children with and without DCD and there were few differences in the performance of daily living tasks between typical children in Australia and Canada. Overall, the motor difficulties of children with DCD had a significant impact on performance of a wide range of daily activities.     

Facial imagery and personality development.

The empirical relationship between judgments obtained with a motorized facial-distortion mirror and relevant personality and rating measures was examined. Subjects were 88 school children. The findings indicated general trend differences between males and females in perceiving facial distortion shown in a mirror. Although not statistically significant, a relationship between teachers' ratings on hygiene, self-concept, sociability, and two scales of the High School Personality Questionnaire were noted.     

Consumer behaviour and the toilet: Research on expulsive and retentive personalities

During the last five decades, a number of studies have attempted to draw from psychoanalytic theory to examine the relationship between evacuation disorders and a person's character. According to Freud's original conceptualization, early or harsh toilet training leads children to develop an anal retentive personality, characterized by the tendency to control their bowels as well as their material possessions; by contrast, liberal toilet training leads children to develop an anal expulsive personality, characterized by the tendency to excessively relieve faeces, as well as be being careless, messy, and inclined to dispose of old products and buy new ones. Although toilet training may not be responsible, these sets of traits do cohere. To empirically examine these hypotheses, we studied the personality traits and consumption habits of people suffering from different bowel disorders. By means of semistructured interviews, we analysed the personality characteristics, sociodemographic backgrounds, and peculiar consumption habits of people suffering from constipation and diarrhoeic syndromes. The results show that constipated people tend to be obstinate, excessively concerned with hygiene, and inclined toward retaining possessions, whereas diarrhoeic people tend to be careless, disorganized, and disposed to share their possessions with others. We discuss the theoretical and practical implications of these results and indicate avenues for future research.     

IMMIGRATION AND ITS DISCONTENTS: TREATING CHILDREN IN THE PSYCHO-HYGIENE CLINIC IN MANDATE TEL AVIV

During the 1930s and 1940s hundreds of children were diagnosed in Tel Aviv's Psycho-Hygiene Clinic for Children as suffering mainly from organic retardation or neurosis. Those diagnosed as retarded or “educationally impaired” were sent either to special education institutions or to vocational schools and, in severe cases, to closed institutions. The children diagnosed as neurotic were usually treated individually at the clinic or in private clinics by mental health specialists and remained with their families. In most cases those diagnosed as retarded were children of Mizrahi origin whilst the children diagnosed as suffering from neurosis were of Ashkenazi origin. This paper argues that the diagnosis of so many children as problematic, as well as the relationship between their diagnosis and their ethnic origin, embodies two basic trends in yishuv society, especially prominent during the British Mandate: the labelling of the Mizrahim in general, and Mizrahi children in particular, as culturally and mentally inferior; and a high degree of intervention on the part of mental health specialists. The involvement of psychiatrists, psychoanalysts and specialists in fields such as mental hygiene and Psycho-Hygiene created a pathologization of social and economic problems, and by doing so obscured the harsh realities of immigration.     

Evolution of nurses’ social representations of hospital hygiene: From training to practice

Nurses’ social representations of hospital hygiene were analyzed. A cross-sectional method was used to compare and analyze the social representations of the concept domain of “hospital hygiene” across three independent groups of participants (n = 744). The groups included: (a) professional nurses (n = 114); (b) student nurses (n = 315); and (c) psychology students (n = 315). Comparisons were drawn: (a) between professionals and students; and (b) between student nurse cohorts at three different levels (years) of training. The results show an ongoing evolution of the social representations of hospital hygiene during training and in the course of professional practice. The representation of hospital hygiene is structured around the element “cleanliness” at the beginning of training and around “asepsis” at the end of training. An increased specialization of vocabulary pertaining specifically to hospital hygiene is also observed. A comparative analysis between students and professionals shows a lower number of common lexical associations in the student group. A discussion of how these results are related to other research in cognitive ergonomics and the analyses of dialogues involving professional interactions between experts and novices is provided.