Introduction
Aims
Method
PRIMIT Intervention Design
Motivation |
Messages to increase perceived risk |
- Information about health consequences of infection, for self and vulnerable family members (for seasonal and potential pandemic flu) |
- Detailed explanation of how infection transmitted by hand |
Messages to increase positive attitudes towards target behavior (i.e. engaging in hand hygiene at least ten times a day with soap or gel) |
- Information and evidence for the efficacy of reducing viral load by hand hygiene |
- Information that soap or antibiotic gel and frequent handwashing (at least ten times a day) necessary to stop infection |
If-then planning to support implementation of intentions |
User required to record current handwashing occasions and frequency (see above for example of interactive digital plan) |
- Further explanation of virus transmission from surfaces to face using various locations and events, to increase perceived risk in these situations |
- User presented with record of current behavior and asked to choose when to wash hands more often |
- Tailored feedback provided: positive feedback if planned to wash hands more or encouraged to return to plan and reconsider if no plans to increase in handwashing frequency made |
- Personalised plan presented to user with suggestion to print it out, place it somewhere prominent and ask others for help keeping it |
Optional information |
- Information about and endorsement by the medical team and references to key research papers (to enhance credibility) |
- Information about health consequences of pandemic flu (how it differs from seasonal and health implications) to increase perceived risk |
Tailored content |
- Tailored to provide advice relevant to household membership (collected at start of session one): children under 16, related adults, unrelated adults (to promote perceived self-relevance) |
Recruitment and Procedures
Measures
Baseline
M (SD) | 4-week
M (SD) | 16-week
M (SD) | Baseline to 16-week follow-up change | Effect size: Hedge’s g
av
| |
---|---|---|---|---|---|
Current behavior | 3.8 (1.1) | 4.3 (0.9) | 4.3 (0.9) |
t
(6034) = 36.8, p < .001 | 0.43 |
Intention | 4.0 (1.1) | 6.0 (1.5) | 4.2 (0.8) |
t
(6034) = 38.1, p < .001 | 0.47 |
Attitude | 4.1 (0.5) | 4.2 (0.5) |
t
(6025) = 3.03, p = .002 | 0.05 | |
Perceived behavioral control | 6.2 (1.4) | 6.4 (1.2) |
t
(5923) = 7.10, p < .001 | 0.11 | |
Perceived risk | 5.1 (1.6) | 5.9 (1.4) |
t
(5942) = 34.8, p < .001 | 0.48 | |
Subjective norms | 5.0 (1.6) | 5.5 (1.6) |
t
(5945) = 26.6, p < .001 | 0.35 |
Analysis
Results
Did Changes in Theory of Planned Behavior Cognitions Accompany Changes in Hand Hygiene?
What Is the Required Threshold of Usage for Behavior Changes in Hand Hygiene?
How Did the Intervention Impact and Usage Differ across Different Population Subgroups?
Behavior (M, SD) | Behavior (M
adj, SE) | ||||
---|---|---|---|---|---|
Baseline | Follow-up | Baseline | Follow-up | ||
Age | Below/equal to 60 | 3.93 (1.12) | 4.34 (0.88) | 3.92 (0.01) | 4.36 (0.02) |
Above 60 | 3.90 (1.12) | 4.38 (0.89) | 3,92 (0.01) | 4.36 (0.02) | |
Gender | Male | 3.64 (1.16) | 4.20 (0.96) | 3.89 (0.01) | 4.31 (0.01) |
Female | 4.14 (1.02) | 4.49 (0.80) | 3.94 (0.01) | 4.40 (0.01) | |
Education | Below/equal to 9 years | 3.94 (1.10) | 4.40 (1.10) | 3.91 (0.01) | 4.38 (0.02) |
More than 9 years | 3.88 (1.14) | 4.29 (1.05) | 3.94 (0.01) | 4.33 (0.01) |