Hand Hygiene of Kindergarten Children

Study Overview
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Brief Summary
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Randomized controlled trial to further assess the impact of a digital intervention on hand hygiene of young children. Children in intervention kindergartens will see live instructions and feedback on their hand washing activity in reals-time / while washing hands. Aim of the study is to better understand behavior change of young children.

Official Title
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Hand Hygiene of Kindergarten Children: Understanding the Effect of Live Feedback on Hand Washing Behavior, Self-Efficacy and Motivation of Young Children

Conditions
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Hand Hygiene, Hand Washing

Intervention / Treatment
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* Device: Digital hand washing instructions
* Device: Digital hand washing reward


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: children attending kindergarten Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 7 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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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control group<br>The control group receives no screen next to the sink. | |
| Experimental: Instruction group<br>The reward group receives a screen next to each sink in kindergarten. On the screen, hand washing instructions are shown during hand washing. After a defined time period, the screen is removed. | Device: Digital hand washing instructions<br>* Tablet displaying animated hand washing instructions<br>|
| Experimental: Reward group<br>The reward group receives a screen next to each sink in kindergarten. On the screen, hand washing instructions are shown during hand washing. If hands are washed correctly (time and soap usage), a reward (animal animation) is shown on the screen. After a defined time period, the screen is removed. | Device: Digital hand washing reward<br>* Tablet displaying animated hand washing instructions and animated animals as reward<br>|
| Experimental: Reward plus instruction-only group<br>The reward plus instruction group receives a screen next to each sink in kindergarten. On the screen, hand washing instructions are shown during hand washing. If hands are washed correctly (time and soap usage), a reward (animal animation) is shown on the screen. After a defined time period, the screen only shows instructions, the reward is not shown anymore. After a defined time period, the screen is removed. | Device: Digital hand washing instructions<br>* Tablet displaying animated hand washing instructions<br>Device: Digital hand washing reward<br>* Tablet displaying animated hand washing instructions and animated animals as reward<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Handwashing motivation of children (measured as soaping time by digital system). | Motivation of children, measured as soaping time (activity level) by digital system. Activity level is used as a proxy for motivation. | up to 3 months | 
| Handwashing motivation of children (investigated with observation questionnaire for children in kindergarten) | Motivation of children, investigated with observation questionnaire (covering different steps of handwashing) of children while washing hands in kindergarten. In the observation questionnaire, each step of handwashing is rated on a scale (with highest number meaning highest compliance to handwashing instructions). Activity level (as measured by observation questionnaire) is used as a proxy for motivation. | up to 3 months | 
| Self-efficacy of children (investigated with interviews with children) | Self-efficacy of children is measured in interviews with the children. The interview questionnaires for the children are based on Bandura's concept of self-efficacy. The scale that is used in the interview questionnaires is specially developed for our experiment. | up to 3 months | 
| Self-efficacy of children (investigated with interviews with staff) | Self-efficacy of children is measured in interviews with the kindergarten staff. The interview questionnaires for the staff (for evaluating children's self-efficacy) are based on Bandura's concept of self-efficacy. The scale that is used in the interview questionnaires is specially developed for our experiment. | up to 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sickness days of children (as recorded by kindergarten management) | Sickness days of children, recorded by kindergarten management on a daily basis. | Up to one year |