Health Behavior Change During COVID-19 Pandemic

Study Overview
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Brief Summary
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This study aims at investigating handwashing behavior during COVID-19 pandemic. It was hypothesized that social-cognitive and emotional predictors as well as COVID-19 morbidity and mortality rates within the country would be associated with handwashing behavior in the general population of adults in 14 countries.

Detailed Description
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This observational study aims at testing the adherence to handwashing guidelines (the World Health Organization, WHO, 2020) at two measurement points, spanning 1 month. Adults from the general population in 14 countries (Poland, Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Portugal, Romania, Singapore, Switzerland) will provide self-report data on handwashing behavior and its social-cognitive predictors (perceived effectiveness of handwashing, risk perception, outcome expectancy, self-efficacy, intention, planning, and action control), anxiety, as well as COVID-19 morbidity and mortality rates within the country.

Official Title
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Health Behavior Change During COVID-19 Pandemic: the Focus on Handwashing

Conditions
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Health Behavior

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adults (from general population) who provided informed consent to participate Exclusion Criteria: younger than <18 years old

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Poland<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Australia<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Canada<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| China<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| France<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Gambia<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Germany<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Israel<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Italy<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Malaysia<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Portugal<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Romania<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Singapore<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|
| Switzerland<br>Adults, general population, N = 400 | Other: No intervention<br>* Observational data collection only, accounting for COVID-19 morbidity and mortality levels within each country<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Handwashing adherence | The 12-item self-report measure of adherence to handwashing guidelines across situations (e.g., after visiting public spaces, after touching garbage, etc.) based on the guidelines issued by the World Health Organization and the Centers for Disease Control and Prevention. The responses are provided on a 4-point scale, ranging from 1 (strongly disagree) to 4 (strongly agree). Higher scores indicate better outcomes (the higher level of adherence to handwashing guidelines). | 1 month | 
| Frequency of handwashing | The 1-item self-report measure of the frequency of handwashing (for at least 20 seconds, all surfaces of the hands) daily. The responses are provided on a 4-point scale, ranging from 1 (less than once) to 5 (more than 10 times). Higher scores indicate better outcomes (the higher frequency of handwashing). | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-efficacy | 4 self-efficacy questionnaire items; mean item score ranging from 1 to 4, higher scores indicate stronger self-efficacy | 1 month | 
| Risk perception | 3 questionnaire items to assess risk perception; mean item score ranging from 1 to 5, higher scores indicate higher risk perception | 1 month | 
| Outcome expectancy | 4 items assessing positive (1 item) and negative (1 items) outcome expectancies; mean item scores ranging from 1 to 4, higher scores indicate more positive outcome expectancies | 1 month | 
| Intention | 2 questionnaire items assessing intention to adhere to handwashing recommendations; mean item scores ranging from 1 to 4, higher scores indicate stronger intention to wash hands (for at least 20 seconds, all surfaces of the hands) | 1 month | 
| Planning | 2 questionnaire items assessing action planning (1 item) and coping planning (1 item); mean item scores ranging from 1 to 4, higher scores indicate a higher level of self-reported planning | 1 month | 
| Action control | 3 questionnaire items assessing a facet of action control, namely self-monitoring; mean item scores ranging from 1 to 4, higher scores indicate a higher level of self-reported monitoring of handwashing behavior | 1 month | 
| Perceived effectiveness of hand hygiene | 1 questionnaire item assessing perceptions of handwashing as an effective means of preventing coronavirus SARS-CoV-2 infection; item scores ranging from 1 to 4, higher scores indicate a higher level of perceived effectiveness of hand hygiene | 1 month | 
| Anxiety | 7-item self-report scale (Generalized Anxiety Disorder, GAD-7) scale to assess anxiety symptoms; mean item scores ranging from 1 to 4, higher scores indicate a higher level of generalized anxiety | 1 month | 
| Country-level COVID-19 morbidity and mortality rates | The daily cumulative numbers for COVID-19 morbidity and mortality in the study countries. Published daily as the Situation Report by World Health Organization, starting on 21 January 2020. Higher numbers indicate the higher cumulative COVID-19 morbidity and mortality rates in the country. | 60 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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General population, Adult, Handwashing, Social cognition, Anxiety, COVID-19