mHealth Research Digest with Tim Bredrup

Hand washing can help prevent the spread of respiratory infections such as influenza, but successfully encouraging individuals to wash their hands more frequently remains challenging. Web based interventions are one potential method of increasing frequency of this healthy habit.   Recently, a group of psychologists from Germany and the United Kingdom evaluated whether a web-based intervention could affect the frequency of hand-washing in the home.  Potential mediators and moderators of outcome were also examined as a first step before testing effects of the intervention on infection rates in a controlled clinical trial for influenza-like illnesses and respiratory infection.

A total of 517 adults were recruited for the study, of which 324  were randomly assigned to a fully automated intervention comprising of 4 sessions of customized motivational messages and self-regulated support, while 179 were assigned to a no-intervention control group.  The participants were assessed by online questionnaires at the beginning of the study, at 4 weeks, and again at 12 weeks.

The study results indicated that “hand-washing rates in the intervention group were higher at 4 weeks than in the control group…and remained higher at 12 weeks. Hand-washing intentions and positive attitudes toward hand-washing increased more from baseline to 4 weeks in the intervention group than in the control group,” the researchers reported.  It was revealed through mediation analyses that the intervention had “positive indirect effects on change in hand-washing via intentions” and was “similarly effective for men and women, those of higher and lower socioeconomic status, and those with higher and lower levels of perceived risk,” as noted by the research team.

The team of psychologists concluded strong evidence now exists that web-based interventions could be an effective way to promote hand hygiene in the home.  It’s noteworthy to mention that at the time of this study the 2010 influenza pandemic was occurring, so participants had already been exposed to significant publicity about the importance of hand hygiene.  However, further research is needed to determine how actual infection rates would be affected by the intervention.

Authors: Lucy Yardley, PhD; Sascha Miller, MSc; Wolff Schlotz, PhD; Paul Little, MD, PhD, FRCGP

Institutions: University of Southampton, United Kingdom;  University of Regensburg, Germany

Original Abstract: Journal of Medical Internet Research