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. 2023 Jan 24;18(1):e0280686.
doi: 10.1371/journal.pone.0280686. eCollection 2023.

Hand hygiene of kindergarten children-Understanding the effect of live feedback on handwashing behaviour, self-efficacy, and motivation of young children: Protocol for a multi-arm cluster randomized controlled trial

Glenda Dangis  1 , Kirsi Terho  1   2 , Joanna Graichen  3 , Sebastian A Günther  3 , Riitta Rosio  1 , Sanna Salanterä  1   2 , Thorsten Staake  3 , Carlo Stingl  3 , Anni Pakarinen  1
Affiliations

Hand hygiene of kindergarten children-Understanding the effect of live feedback on handwashing behaviour, self-efficacy, and motivation of young children: Protocol for a multi-arm cluster randomized controlled trial

Glenda Dangis et al. PLoS One. .

Abstract

Early implementation of interventions at a young age fosters behaviour changes and helps to adopt behaviours that promote health. Digital technologies may help to promote the hand hygiene behaviour of children. However, there is a lack of digital feedback interventions focusing on the hand hygiene behaviour of preschool children in childhood education and care settings. This study protocol aims to describe a study that evaluates the effectiveness of a gamified live feedback intervention and explores underlying behavioural theories in achieving better hand hygiene behaviour of preschool children in early childhood education and care settings. This study will be a four-arm cluster randomized controlled trial with three phases and a twelve-month follow-up by country stratification. The sample size is 106 children of which one cluster will have a minimum number of 40 children. During the baseline phase, all groups will have automated monitoring systems installed. In the intervention phase, the control group will have no screen activity. The intervention groups will have feedback displays during the handwashing activity. Intervention A will receive instructions, and intervention B and C groups will receive instructions and a reward. In the post-intervention phase, all the groups will have no screen activity except intervention C which will receive instructions from the screen but no reward. The outcome measures will be hand hygiene behaviour, self-efficacy, and intrinsic motivation. Outcome measures will be collected at baseline, intervention, and post-intervention phases and a 12-month follow-up. The data will be analysed with quantitative and qualitative methods. The findings of the planned study will provide whether this gamified live feedback intervention can be recommended to be used in educational settings to improve the hand hygiene behaviour of preschool children to promote health. The trial is registered with ClinicalTrials.gov (registration number NCT05395988 https://clinicaltrials.gov/ct2/show/NCT05395988?term=NCT05395988&draw=2&rank=1).

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig 1
Fig 1. Schedule of enrolment, intervention, and assessments.
Fig 2
Fig 2. The design and data collection of the study.
Fig 3
Fig 3. Illustration of the reciprocity of the factors determining hand hygiene behavior.
Fig 4
Fig 4. The application of the SCT using the live feedback intervention.
Fig 5
Fig 5. Technical setup of the system.
Fig 6
Fig 6. The “How to handwash” content of the video on the screen display.
Fig 7
Fig 7. The animal animation as a reward.
Fig 8
Fig 8. Flowchart of the cluster randomization.
See this image and copyright information in PMC

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