Surveys of the Behavioral Determinants That May Influence People's Hand-hygiene and Environment Disinfecting in Different Countries
Conditions: Hygiene
Sponsor: University of Warwick

Hand-Hygiene/Surface Disinfecting Survey 
April 9 2020 
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Surveys of the behavioral determinants that may influence people’s hand-
hygiene and environment disinfecting in different countries 
 
Study Investigators 
 
 
 
Principle 
Investigator:  
Dr. Ken Drinkwater 
Psychology Department, Manchester Metropolitan University, 
Manchester, United Kingdom 
Phone: +44 (0)161 247 2599 
Email: k.drinkwater@mmu.ac.uk 
 
Co-
Investigator: 
Dr Kelly Ann Schmidtke 
Medical School, University of Warwick, Coventry, United Kingdom 
Ph. 07758933026 
Email: Kelly.A.Schmidtke@warwick.ac.uk  
 
Co-
Investigator:
 
 
Dr Leanne Staniford 
Psychology Department, Manchester Metropolitan University, 
Manchester, United Kingdom 
 
Co-
Investigator 
(if available):  
Unspecified masters student – If available 
The primary investigator will supervise the analysis and write up of the 
project the student’s dissertation and the projects publication in an 
academic press. If a student is not available, then this responsibility lies 
with the principle investigator 
 
Collaborating 
Organization:  
Spink Health 
The Hayloft/Haywards Heath Rd, Haywards Heath RH17 6QJ 
+44 (0)144 481 1099 
 
Collaborating 
Organization:  
Reckitt Benckiser (RB) 
103-105 Bath Road 
Slough, SL1 3UH 
+44 (0)1753 217800 
 
1. Abstract 
 
An anonymous online survey measure parents and teachers’ barriers and facilitators 
to influencing children’s hand-hygiene and their own surface cleaning. A pilot survey 
was conducted with participants from the United Kingdom and India, and its results 
informed what survey items are used in the final survey. The final survey will be 
conducted with participants from Australia, China, India, Indonesia, Saudi Arabia, 
South Africa, and the United Kingdom. The data collected will be completely 
anonymous and there are no sensitive questions. Participants can withdraw simply 
by closing their browser windows. The primary and secondary analyses focus on the 
hand-hygiene items, and aim to examine their internal validity. Secondary analyses 
will look at the surveys external validity. Exploratory analysis will compare 
participants’ responses across countries/regions, and individual differences. The 
survey results will inform a future school-based intervention and be written up for 
publication in an academic press acknowledging all collaborating organizations.   
 

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2. Introduction/Background 
 
As urbanization increases so do socially-acquired infections and antibiotic use.(1,2) 
This is a problem, because as antibiotic use become more prevalent so does 
antimicrobial resistance.(3,4) The slow pace at which new antibiotics emerge on 
market necessitates preserving the effectiveness of existing antibiotics.(5) The 
following attempts to do so are already in place: optimizing prescribing, educating 
the public, and increasing hygiene.(6) The present study focuses on the last effort: 
increasing hygiene.  
 
The World Health Organization describes hygiene as “practices that help to maintain 
health and prevent the spread of diseases.”(7) These practices include behaviors to 
disinfect one’s body and surrounding environment.(8) Improving community health 
may require a multifaceted intervention that targets hand-hygiene and environment-
disinfecting to stop reinfection cycles.(9) Interestingly, the cleanliness of the 
environment itself may play a role in people’s hygiene behaviors. For example clean 
scents encouraged people to clean their table scraps (10) and settings with no litter 
decrease people’s tendency to litter.(11) School have proven an effective delivery 
platform to increase community health.(12,13) Within these interventions children are 
often believed to be “agents of change” who carry lessons from school to the broader 
community.(14,15,16)  
 
To inform the development of future school-based interventions, the current study 
seeks to develop a survey to identify the most common reasons adults are not 
already positively influencing school children’s hand-hygiene. Identifying the most 
common reasons is important, because interventions that target uncommon or 
misinformed reasons are unlikely to yield practically significant improvements. The 
list of possible reasons includes the behavioral determinates described by the 
Theoretical Domains Framework (TDF;17). Specifically, the present study aims to 
assess adults’ tendencies to positively influence children’s hand-hygiene with 
regards to their: Knowledge, Skills, Memory, attention and decision processes, 
Behavioral regulation, Social/professional role and identity, Beliefs about capabilities, 
Beliefs about consequences (inclusive of Optimism and Reinforcement), Intentions 
(inclusive of Goals), Emotion, Environmental context and resources, and Social 
influences.  
 
In the current study, a survey will be designed to measure each TDF domain. In 
addition, because the cleanliness of the surrounding environment also influence 
cleaning behaviors, a sub-component of the survey will assess adults’ tendencies to 
disinfect surface areas where children play and learn. The survey will be rolled-out 
across several countries/regions. The primary and secondary analyses will to 
validate the internal and external features of the hand-hygiene survey component. 
Secondary analyses will look at the surveys external validity and internal validity 
across each country/region. Exploratory analysis will be used to compare 
participants’ responses across countries/regions, and individual differences. The 
results of this survey will be used to inform a future school-based intervention.   
  
 
 

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3. Aims of Study  
 
The current study aims to conduct and examine the validity of a survey that survey 
aims to assess the behavioral determinates that affect adults’ tendency to positively 
influence children’s hand-hygiene. We also look at determinants that affect surface 
cleaning.  
 
4. Objectives  
 
Objective 1. Roll-out a final draft surveys in the different countries/regions. 
 
Objective 2. Conduct a confirmatory factor analyses on the hand-hygiene component 
of the survey. 
 
Objective 3. Conduct regression analyses to determine whether participants’ 
responses on the hand-hygiene component of the survey predict their self-reported 
confidence.  
 
Objective 4. Compare participants’ responses across each domain, country, and 
individual difference. 
 
5. Hypothesis  
 
5a. Primary Hypothesis 
 
The primary hypothesis relates to Objective 2.  
 
The TDF determinates will describe the hand-hygiene data well.  
 
5b. Secondary Analysis 
 
The first secondary hypothesis relates to Objective 2.  
 
The TDF determinates will also describe the hand-hygiene data well across 
each country/region.  
 
The second secondary hypotheses relates to Objective 3.  
 
The TDF determinates will predict participants’ hand-hygiene related self-
reported confidence in influencing children’s hand hygiene well as a whole 
and across each country/region. 
 
 
 

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5c. Exploratory Analyses 
  
The exploratory analyses relate to Objective 4.  
 
Participants’ hand-hygiene responses across individual difference will be 
explored using averages and confidence intervals.   
 
Participants’ surface disinfecting responses will be assessed as a whole and 
then compared across countries and individual differences using averages 
and confidence intervals.   
 
6. Study Design  
 
An anonymous online survey will be used, because it can be rolled-out quickly to 
collect data from a large numbers of participants in different places. No IP address or 
other geolocation information will be collected.  
 
We will roll-out the final survey to a large adult participants in Australia, China, India, 
Indonesia, Saudi Arabia, South Africa, and the United Kingdom.  
 
7. Study Setting 
 
Participants from Australia, China, India, Indonesia, Saudi Arabia, South Africa, and 
the United Kingdom will complete the final survey online.  
 
8. Study Population  
 
The study population will include mums, dads, and teachers who have contact with 
children ages 5 to 10 years old.  
 
9. Eligibility Criteria  
 
Inclusion criteria  
 be over the age of 18; 
 be mums, dads or teachers likely to influence children 5-10 years old; and 
 reside in either Australia, China, India, Indonesia, Saudi Arabia, South Africa, 
or the United Kingdom.  
 
 
 

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10. Study Outcomes  
 
10a. Primary Outcome 
 
Participants’ responses to the survey items about their hand-hygiene influencing. 
 
10b. Secondary/Exploratory Outcomes 
 
Participants’ demographics.  
Participants’ self-reported confidence.  
Participants’ responses to the survey items about their surface disinfecting. 
 
11. Study Procedures  
 
The survey were designed by consulting the literature and area experts and informed 
by a previous unregistered pilot survey. The items are designed to measure 
participants’ demographics, hand-hygiene influencing, surface disinfecting, and self-
reported confidence as described below.  
 
Design. 
 
 Survey Section 1: Information/Consent Sheet. (1 item) 
 
Participants will be informed about the study and asked to give their informed 
consent before advancing. The information/consent sheet can be viewed in 
Appendix B.  
 
 Survey Section 2: Demographic items. (5 items) 
 
We will ask about participants’ individual differences, age and gender.  
 
Dem-Q1: How many years old are you?  
 
Response Option  
[drop down box if possible] 
 
17 or fewer years old 
 
18 – 30 years old 
 
31 – 40 years old 
 
40 – 50 years old 
 
50 – 60 years old 
 
61 – 70 years old 
 
70 or more years old 
 
An age-related demographic is 
necessary to confirm participants 
are of an acceptable age to take 
part in the survey, i.e. 18 or older.  
 
If a person says ‘17 or fewer’, they 
will not continue in the survey. 
 
 
 
 
 
 
 
 

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Dem-Q2: Are you employed as a full-time teacher for children from 5 to 10 
years old?  
 
Response Option 
 
Yes 
 
No 
 
A teacher-employment item is necessary to 
ensure we include the planned number of 
teachers in the final survey (see Table 2 on 
p. 10). 
 
 
Dem-Q3: Do you identify as a mum or dad of any children from 5 to 10 years 
old? 
 
Response Option 
 
No 
 
Yes, a mum 
 
Yes, a dad 
 
 
This parent item is necessary to ensure we 
include the planned number of mums and 
dads in the final survey. (see Table 2 on p. 
10). 
 
If a person says ‘NO’ and did not identify as 
a teacher in Q2, then they will not continue in 
the survey 
 
Dem-Q4: With which gender do you identify? 
 
Response Option 
 
Female 
 
Male 
 
Other/Prefer 
not to say 
This is a regularly collected demographic, that we 
collect here because we cannot and will not use Q3 
to infer participants genders. Further gender options, 
e.g. ‘binary’, are not included because these options 
do not translate well to all surveyed countries.  
 
 
 [If not teacher] Dem-Q5: Which one of the following best describes you?  
 
Response Option 
 
Work full-time  
 
Work part-time  
 
Retired  
 
Full-time Home-
maker / parent  
 
Student  
 
Unemployed 
 
Other 
 
The work-related item is desirable attribute to 
better understand the participants in the 
survey participants in the survey.   
 
 
 
 

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 Survey Section 3: Hand-hygiene influencing. 
 
Appendix A presents a list of the domains, their definitions, and survey items 
about hand-hygiene influencing. 
 
The hand hygiene items will appear in a random order.  
 
In the final survey, we aim to assess each of 11 behavioral determinates 
using at least 3 items that can be responded to with a 5-point Likert scales, 
where 1=strongly disagree and 5=strongly agree. Some items will be reverse 
scored to mitigate acquiescence bias. 
 
 Survey Section 4: Surface disinfecting.  
 
Appendix A presents a list of the domains, their definitions and survey items 
about hand-hygiene influencing. 
 
The surface cleaning items will appear in a random order.  
 
In the final survey, we aim to assess each of 11 behavioral determinates 
using at least 1 item that can be responded to with a 5-point Likert scales, 
where 1=strongly disagree and 5=strongly agree. Some items will be reverse 
scored to mitigate acquiescence bias. 
 
 Survey Section 5: Self-reported confidence (3 items).  
 
Appendix A also includes three self-confidence items.  
 
The first item regards participants’ confidence about how often their children 
clean their hands when they are present, 0% to 100% of the time. The second 
item regards participants’ confidence about how often their children clean their 
hands when they are not present, 0% to 100% of the time. The third item 
regards participants’ confidence about how often they clean their own hands, 
0% to 100% of the time.  
 
 
 

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Translation.  
 
After creating the initial items in the English language, the research team will 
ask OpinionHealth to translate them.1 The same process will occur for the 
information/consent sheet. The translation process will proceed as describe in 
Table 1.  
 
Table 1. Translation process 
 
Step 
Action 
1 
The research team will provide OpinionHealth with the initial items.  
 
2 
OpinionHealth will translate the items into the non-English language(s) 
 
3 
OpinionHealth will back-translate the items to English.  
 
4 
OpinionHealth will provide the research team with copies of the translated and 
back-translated items.  
 
5 
The research team will check to be sure that the items’ intended meanings have 
not been lost in translation. If items’ meaning are lost, the translation process will 
be repeated with those items.  
  
 
 
                                                        
1Opinion is a reputable survey company located in the United Kingdom experienced in conducting online 
surveys in line with all UK and EU regulations and Market Research Society's  Code of Conduct, e.g., GDPR. 
For more information, a link to Opinion Health’s website is provided here:  
http://opinionhealth.com/about_us  

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Active survey.  
 
OpinionHealth will to recruit participants according to a stratified fashion 
across countries and demographic characteristics, see Table 2. 
 
Table 2. Participants stratified characteristic  
 
Country 
Participants  
India 
375 mums   
375 dads   
75 teachers   
 
UK  
225 mums   
225 dads   
75 teachers   
 
China 
225 mums   
225 dads   
75 teachers   
 
Australia 
225 mums   
225 dads   
75 teachers   
 
South Africa 
225 mums   
225 dads   
75 teachers   
 
Indonesia 
225 mums   
225 dads   
75 teachers   
 
Saudi Arabia 
225 mums   
225 dads   
75 teachers   
 
The first screen of the online survey will inform participants of the study and 
request their informed consent to take part (see Appendix B). Those who give 
their informed consent will continue. Participants who complete the survey will 
be issued with payment to compensate them for their time in an amount equal 
to approximately 1 GBP in their home countries currency (varies depending 
on exchange rates), which they can redeem in the form of amazon gift 
vouchers or via their personal PayPal accounts. 
 
We will stop collecting survey responses in each country after the planned-
sample sizes are achieved or 30 days have passed since that country’s 
survey was activated, whichever comes first.  
 
 
 
 

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11a. Measurement tools used  
 
The survey will be designed in stage 1.  
Initial items are described above and in the Appendix A.  
 
11b. Data monitoring  
 
No identifiable information will be collected. 
 
The anonymous data will be transferred in password protected files between 
collaborators. All collaborating organizations are based in the United Kingdom  
 
The survey will be set up to ensure complete data collection, by reminding 
participants who forget to answer an item to do so before they advance in the 
survey. If participants do not wish to answer an item, they can withdraw by simply 
closing their browser window. Incomplete surveys will not be analyzed.  
 
12. Statistical Considerations and Data Analysis 
 
12a. Sample size and statistical power 
 
The sample-size is designed to support a factor analysis and regression analysis for 
the hand-hygiene component of the project. The surface cleaning component of the 
project will be analyzed using descriptive and exploratory methods.  
 
The planned sample size is given in Table 2.  
 
As per standard practice, each domain in the final survey will be captured by at least 
three items. In addition, a general rule of thumb recommends that collecting 
responses from 10 to 20 participants for each parameter in the hypothesized model 
(18) with at least 100 participants in each sub-group.(19,20) Our planned samples size 
meets these criteria, with the exception of teachers and this limitation will be noted in 
any published reports.  
 
The exploratory analyses do not have pre-specified hypotheses and so it is not 
possible to say how many participants would be required. Cohen (1998) 
recommends having at least 30 participants in each subgroup.(21) Our large sample 
size should entail having a sufficient number of participants for these exploratory 
analyses, and the precise number of participants in each will be specified in any 
publication.  
 
 
 
 

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12b. Statistical methods 
 
As a reminder, the sample-size is designed to support a factor analysis for the hand-
hygiene component of the project. The surface cleaning component of the project will 
only be analyzed using descriptive and exploratory methods.  
 
Software: The data will be analysed using the most recently available copies of 
SPSS and SPSS: AMOS.  
 
Descriptive: Frequencies, percentages, averages and confidence intervals will be 
used to describe the participants’ responses and demographics. 
 
Internal Consistency: Cronbach’s alphas will be calculated. Items will be removed as 
necessary to achieve an alpha coefficient of 0.70 or above within each domain; 
those coefficients as low as 0.65 will be tolerated if necessary to retain the planned 
model. 
 
Confirmatory Factor Analyses (CFA) - Objective 4: CFA will be performed to test 
whether the data from the items fit within the pre-determined components.  
 
The first models (the primary analyses) will be conducted with the data from all the 
countries and then additional models (the secondary analyses) will be conducted 
with each country.  
 
The models will be specified in AMOS and tested for goodness of fit using three 
indices: (a) absolute fit (based on a Chi-squared to degrees of freedom ratio, less 
than 2; 22), (b) parsimony (based on Root Mean Square Error of Approximation 
(RMSEA) of close to or less than 0.06), and comparative fit (based on an index 
‘close to’ 0.95; 23).  The models may be revised until the desired measures of fit are 
obtained.  
 
Figure will be created to describe the final models’ structure. An example of a figure 
like this with only 2 determinates appears below (Figure 2):  
 
Figure 2. Example of a CFA model 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Items                                                    Behavioral                               Overall confidence    
                                                            determinate               to influence hand-hygiene 

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Regression analyses - Objective 5: Multiple regression analysis will be conducted, 
overall and for each country. The predictors will be participants’ average responses 
to each behavioural determinate, and the outcome will be participants’ average 
responses to the confidence items. An alpha value of 0.05 will be used to assess 
each predictors’ contribution to the overall model.  
 
Exploratory Analyses - Objective 6: The participants’ individual differences will be 
compared using graphical analyses (bar charts with error bars) and statistical tests 
(e.g., ANOVAs). Their content is not further specified within this protocol.  
 
13. Collaborators 
 
This study is designed and will be conducted in collaboration with academic 
researchers, Reckitt Benckiser and Spink Health. Reckitt Benckiser (RB) is a British 
multinational consumer goods company that makes products like Dettol. Spink 
Health is a healthcare agency that creates and executes inspirational campaigns. All 
collaborators contributed to the protocol. Spink Health is charged with writing the 
corporate report back to RB, with the academic team acting as consultants. The 
academic team are charged with writing an academic report for publication in an 
academic press.  
 
14. Acknowledgment statement 
 
The funder and collaborators support will be acknowledged in reports/presentations 
with the following message: This research was funded by the Global Hygiene 
Council and designed in collaboration with Reckitt Benckiser Group plc and Spink 
Health. The analyses were conducted solely by academic team, and the views 
expressed in the article are those of the authors and do not necessarily represent the 
views of the funder. 
 
15. Ethical Considerations  
 
This study will be approved by the University’s ethical review board before data 
collection begins.   
 
Note that the study should be considered low risk to participants, as the survey data 
will be completely anonymously, the content is not sensitive and participants’ can 
easily withdraw by closing their browser window. 
 
 
 
 

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Appendix A. Survey items (finalized 09-Apr-2020) 
 
Domain 
Question 
Number 
Handwashing 
Surface 
Disinfection 
Parents 
Teachers 
Knowledge 
An awareness of the 
existence of something 
1 
H 
I know that my children should wash their hands with soap and water for at least 
20 seconds. 
I know that my pupils should wash their hands with soap and water for at least 20 seconds. 
2 
H 
(RS) I do not know when my children should wash their hands with soap and 
water. 
(RS) I do not know when my pupils should wash their hands with soap and water. 
3 
H 
(RS) I know that when my children's hands look clean, they are germ free. 
(RS) I know that when my pupils hands look clean, they are germ free. 
4 
SD 
(RS) I know that when surfaces look clean, there are no germs. 
(RS) I know that when surfaces look clean, there are no germs. 
5 
SD 
I know which surfaces I should disinfect in the home. 
I know which surfaces I should disinfect in the classroom 
Skills 
An ability or proficiency 
acquired through practice 
6 
H 
I am able to teach my children to wash their hands. 
I am able to teach my pupils to wash their hands. 
7 
H 
I am able to help my children develop good handwashing habits. 
I am able to help my pupils develop good handwashing habits. 
8 
H 
(RS) I am not able to teach my children to wash their hands. 
(RS) I am not able to teach my pupils to wash their hands. 
9 
SD 
I have the ability to disinfect surfaces in the home. 
I have the ability to disinfect surfaces in the classroom 
10 
SD 
(RS) I do not have the ability to disinfect some of the surfaces in the home. 
(RS) I do not have the ability to disinfect some of the surfaces in the classroom 
Memory, attention and 
decision processes 
The ability to retain 
information, focus 
selectively on aspects of the 
environment and choose 
between two or more 
alternatives 
11 
H 
I remind my children to wash their hands before eating. 
I remind my pupils to wash their hands before eating. 
12 
H 
(RS) I forget to remind my children to wash their hands. 
(RS) I forget to remind my pupils to wash their hands. 
13 
H 
(RS) There are many distractions that cause me to forget to remind my children to 
wash their hands. 
(RS) There are many distractions that cause me to forget to remind my pupils to wash their 
hands. 
14 
SD 
I remember to disinfect the surface areas in my home every day. 
I remember to disinfect the surface areas in the classroom every day. 
15 
SD 
(RS) I forget to disinfect the surface areas in my home. 
(RS) I forget to disinfect the surface areas in the classroom. 
Behavioural regulation 
Anything aimed at 
managing or changing 
objectively observed or 
measured actions 
16 
H 
I check that my children have washed their hands before they eat food to 
encourage their future hand hygiene. 
I check that my pupils have washed their hands before they eat food to encourage their future 
hand hygiene. 
17 
H 
(RS) I do not always check if my children wash their hands before eating food. 
(RS) I do not always check if my pupils wash their hands before eating food. 
18 
H 
(RS) I do not always check if my children wash their hand after going to the toilet. 
(RS) I do not always check if my pupils wash their hand after going to the toilet. 
19 
SD 
28. I keep track of whether I have disinfected surfaces in the home. 
28. I keep track of whether I have disinfected surfaces in the classroom. 
20 
SD 
29. (RS) I don't keep track of whether I have disinfected surfaces in my home. 
29. (RS) I don't keep track of whether I have disinfected surfaces in the classroom. 
Social/professional role 
and identity 
A coherent set of 
behaviours and displayed 
personal qualities of an 
individual in a social or 
work setting 
21 
H 
It is part of my role as a parent to teach my children to wash their hands. 
It is part of my role as a teacher to teach my pupils to wash their hands. 
22 
H 
(RS) It is not my role in society to teach my children to wash their hands. 
(RS) It is not my role in society to teach my pupils to wash their hands. 
23 
H 
(RS) It is not my role in society to tell my children to wash their hands. 
(RS) It is not my role in society to tell my pupils to wash their hands. 
24 
SD 
It is my role as a parent in society is to disinfect surfaces in my home 
It is my role as a teacher in society is to disinfect surfaces in my classroom 
25 
SD 
I feel a social responsibility to disinfect surfaces in my home.  
I feel a social responsibility to disinfect surfaces in the classroom  
Beliefs about capabilities 
Acceptance of the truth, 
reality, or validity about an 
ability, talent, or facility 
that a person can put to 
constructive use 
26 
H 
I believe my children would listen to me if I taught them to wash their hands 
I believe my pupils would listen to me if I taught them to wash their hands 
27 
H 
(RS) I do not believe I can control whether my children wash their hands. 
(RS) I do not believe I can control whether my pupils wash their hands. 
28 
H 
I  believe that I can tell my children to wash their hands with soap and water. 
I  believe that I can tell my pupils to wash their hands with soap and water. 
29 
SD 
I believe that I am capable of disinfecting surfaces in my home. 
I believe that I am capable of disinfecting surfaces in the classroom. 
30 
SD 
(RS) I believe that there is little I can do to disinfect surfaces in my home. 
(RS) I believe that there is little I can do to disinfect surfaces in the classroom 
Beliefs about 
consequences/ Optimism / 
Reinforcement 
(Belief) Acceptance of the truth, 
reality, or validity about outcomes of 
a behaviour in a given situation 
(Optimism) The confidence that 
things will happen for the best or 
that desired goals will be attained 
(Reinforcement) Increasing the 
probability of a response by 
arranging a dependent relationship, 
or contingency, between the 
response and a given stimulus 
31 
H 
I believe that telling my children to wash their hands with soap and water will 
protect them from falling ill. 
I believe that telling my pupils to wash their hands with soap and water will protect them from 
falling ill. 
32 
H 
(RS) I believe that children’s handwashing habits have little effect on whether they 
get ill. 
(RS) I believe that pupil's handwashing habits have little effect on whether they get ill. 
33 
H 
(RS)  I believe that teaching my children to wash their hands is not worthwhile. 
(RS)  I believe that teaching my pupils to wash their hands is not worthwhile. 
34 
SD 
I believe that if I disinfect my home, my children will all fall ill less often. 
I believe that if I disinfect the classroom my pupils will all fall ill less often. 
35 
SD 
(RS) I believe that disinfecting my home has no effect on how often my children 
get ill. 
(RS) I believe that disinfecting my classroom has no effect on how often my pupils get ill. 
36 
H 
I intend to keep reminding my children to wash their hands before eating. 
I intend to keep reminding my pupils to wash their hands before eating. 

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Intentions / Goals (referred 
to as: action plans in Dyson 
et al) 
(Intentions) A conscious 
decision to perform a behaviour 
or a resolve to act in a certain 
way 
(Goals) Mental representations 
of outcomes or end states that 
an individual wants to achieve 
37 
H 
I intend to keep reminding my children to wash their hands after going to the 
toilet.  
I intend to keep reminding my pupils to wash their hands after going to the toilet.  
38 
H 
(RS) I do not intend to teach my children to wash their hands. 
(RS) I do not intend to teach my pupils to wash their hands. 
39 
SD 
I intend to regularly disinfect surfaces in my home. 
I intend to regularly disinfect surfaces in the classroom. 
40 
SD 
(RS) I do not intend to regularly disinfect surfaces in my home. 
(RS) I do not intend to regularly disinfect surfaces in the classroom. 
Emotion 
A complex reaction pattern, involving 
experiential, behavioural, and 
physiological elements, by which the 
individual attempts to deal with a 
personally significant matter or event 
41 
H 
(RS) Teaching my children to wash their hands is frustrating. 
(RS) Teaching my pupils to wash their hands is frustrating. 
42 
H 
(RS) Reminding my children to wash their hands is tedious. 
(RS) Reminding my pupils to wash their hands is tedious. 
43 
H 
I enjoy praising my children for washing their hands. 
I enjoy praising my pupils for washing their hands. 
Environmental context and 
resources 
(Any circumstance of a 
person’s situation or 
environment that 
discourages or encourages 
the development of skills 
and abilities, independence, 
social competence, and 
adaptive behaviour) 
44 
H 
(RS) There is not enough time for my children to wash their hands. 
(RS) There is not enough time for my pupils to wash their hands. 
45 
H 
There are practical resources available in my home for my children to wash their 
hands. 
There are practical resources available in my school for my pupils to wash their hands. 
46 
H 
There are practical resources like running water, available in my home for my 
children to wash their hands. 
There are practical resources like running water, available in my school for my pupils to wash 
their hands. 
47 
SD 
(RS) I don't have the time to disinfect surfaces in my home. 
(RS) I don't have the time to disinfect surfaces in the classroom. 
48 
SD 
I have the materials in my home to disinfect surfaces in my home. 
I have the materials at my school to disinfect surfaces in the classroom. 
Social influences 
(Those interpersonal 
processes that can cause 
individuals to change their 
thoughts, feelings, or 
behaviours) 
49 
H 
People around me (such as my partner, family and friends) remind children to 
wash their hands. 
My colleagues remind pupils to wash their hands. 
50 
H 
Most people in my culture practice good handwashing habits. 
Most people in my culture practice good handwashing habits. 
51 
H 
(R5) It doesn't matter how clean my children's hands are if other people's children 
are not. 
(R5) It doesn't matter how clean my pupil's hands are if other children's are not. 
52 
SD 
People around me (such as my partner, family and friends) encourage me to 
disinfect my home. 
My colleagues encourage me to disinfect the classroom. 
53 
SD 
(RS) Few people around me (such as my partner, family and friends) disinfect 
surfaces in their homes. 
(RS) Few of my colleagues disinfect surfaces in the classroom. 
Self Confidence Questions 
  
Self 
confidence 
When your [children/pupils] can see you watching them, what percentage of the 
time do they wash their hands with soap and water after going to the toilet and 
before eating? [response options 0 - 100%] 
When your [children/pupils] can see you watching them, what percentage of the time do they 
wash their hands with soap and water after going to the toilet and before eating? [response 
options 0 - 100%] 
  
Self 
confidence 
When your [children/pupils] cannot see you watching them, what percentage of 
the time do they wash their hands with soap and water after going to the toilet 
and before eating?’[response options 0 - 100%] 
When your [children/pupils] cannot see you watching them, what percentage of the time do 
they wash their hands with soap and water after going to the toilet and before 
eating?’[response options 0 - 100%] 
 
 
Self-
confidence 
What percentage of the time do you wash your own hands with soap and water 
after going to the toilet and before eating? [response options 0-100%] 
 
 
 
 

Hand-Hygiene/Surface Disinfecting Survey 
April 9 2020 
15 
 
Appendix B. Information sheet 
  
 
 
Information/Consent Form 
Ethics Approval Date: 17-Feb-2020 
Version Number: 2.2, 23-Jan-2020 
 
A survey to understand what influence  
handwashing and surface disinfecting 
 
We invite you to take part in an anonymous survey to understand what influences 
adults disinfecting behaviours around the world. My name is Dr Ken Drinkwater, 
and I am a senior lecturer in the psychology department at Manchester 
Metropolitan University.  
 
Eligibility? To be eligible for this survey you should:  
 
be 18 years or older;  
 
identify as a female or male; and  
 
be either a teacher or parent of children between 5 and 10 years old.  
 
Do I have to take part? It is up to you to decide. You can withdraw at any time, 
for any reason, by closing your browser. However, we are only able to 
compensate you for your time if you complete the survey. 
 
What will I do? The survey may take about 20 minutes to complete. You will 
answer questions about factors that influence your hand-hygiene, surface 
cleaning behaviours, and demographics. There are no foreseen personal risks or 
benefits. 
 
Is the survey anonymous? Yes. Note that once your responses have been 
submitted, it will not be possible to withdraw your data because your individual 
responses cannot be identified. 
 
What will you do with the data? The anonymous data you provide may inform 
the design of a real-world intervention to increase hygiene; be published as an 
academic report; and/or be presented at academic workshops. 
 
This project has been reviewed and given favourable opinion to conduct by 
Manchester Metropolitan University’s ethics committee. If you have any 
questions, comments or concerns about this research you may contact the 
principle investigator (K.Drinkwater@mmu.ac.uk) or the faculty ethics contact 
(Prof Juliet Goldbart at j.goldbart@mmu.ac.uk). If you have any concerns 
regarding the personal data collected from you, our Data Protection Officer can 
be contacted using the legal@mmu.ac.uk e-mail address, by calling 0161 247 
3331 or in writing to: Data Protection Officer, Legal Services, All Saints Building, 

Hand-Hygiene/Surface Disinfecting Survey 
April 9 2020 
16 
 
Manchester Metropolitan University, Manchester, M15 6BH. You also have a 
right to lodge a complaint in respect of the processing of your personal data with 
the Information Commissioner’s Office as the supervisory authority. Please see: 
https://ico.org.uk/global/contact-us/ 
 
 
Thank you for considering participating in this project. 
 
To indicate your informed consent to participate, please click ‘yes’ below and 
then click forward. Otherwise, please exit the survey now. 
 
 
 
 

Hand-Hygiene/Surface Disinfecting Survey 
April 9 2020 
17 
 
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