Demographic Characteristics, Experiences, and Beliefs Associated with Hand Hygiene Among Adults During the COVID-19 Pandemic — United States, June 24–30, 2020
Authors: Mark É. Czeisler, Amanda G. Garcia-Williams, Noelle-Angelique Molinari, Radhika Gharpure, Yiman Li, Catherine E. Barrett, Rebecca Robbins, Elise R. Facer-Childs, Laura K. Barger, Charles A. Czeisler, Shantha M.W. Rajaratnam, Mark E. Howard
Journal: MMWR Morbidity and Mortality Weekly Report (2020)

Frequent hand hygiene, including handwashing with soap and water or using a hand sanitizer containing ≥60% alcohol when soap and water are not readily available, is one of several critical prevention measures recommended to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 .*Previous studies identified demographic factors associated with handwashing among U.S. adults during the COVID-19 pandemic (1,2); however, demographic factors associated with hand sanitizing and experiences and beliefs associated with hand hygiene have not been well characterized.To evaluate these factors, an Internet-based survey was conducted among U.S. adults aged ≥18 years during June 24-30, 2020.Overall, 85.2% of respondents reported always or often engaging in hand hygiene following contact with hightouch public surfaces such as shopping carts, gas pumps, and automatic teller machines (ATMs).† Respondents who were male (versus female) and of younger age reported lower handwashing and hand sanitizing rates, as did respondents who reported lower concern about their own infection with SARS-CoV-2 § and respondents without personal experience with COVID-19.Focused health promotion efforts to increase hand hygiene adherence should include increasing visibility and accessibility of handwashing and hand sanitizing materials in public settings, along with targeted communication to males and younger adults with focused messages that address COVID-19 risk perception.* https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.† Respondents were provided with the following examples as high-touch public surfaces: shopping carts, gas pumps, and ATMs.§ For this question, respondents were asked to rate on a scale from "Not at all" to "Extremely" the extent to which they were concerned about the following statement regarding COVID-19 and infection control measures: "My own risk of infection with COVID-19."FIGURE 1. Adjusted odds ratios* , † for washing hands after contact with high-touch public surfaces, § by select respondent characteristics ¶, ** , † †, § § -United States, June 24-30, 2020 5 6 4 3 2 1 0 Adjusted odds ratio Lower odds Higher odds Gender (ref: Female) Male Age group, yrs (ref: 18-24) 25-44 45-64 ≥65 Race/Ethnicity (ref: White, non-Hispanic ) Black, non-Hispanic Asian, non-Hispanic Other race or multiple races, non-Hispanic Hispanic, any race or races 2019 Household income, USD (ref: <$25,000) $25,000-$49,999 $50,000-$99,999 ≥$100,000 U.S. Census region (ref: Midwest) Northeast South West Rural/Urban classi cation (ref: Rural) Urban Knew someone with positive test results for SARS-Cov-2 (ref: No) Yes Knew someone hospitalized for or who died from COVID-19 (ref: No) Yes Level of concern of own risk for SARS-CoV-2 infection (ref: Not at all) Slightly Moderately Very Extremely Abbreviations: COVID-19 = coronavirus disease 2019; ref = referent; USD = U.S. dollars.* Adjusted odds ratios were estimated using an ordered logit model of handwashing on the variables listed in the column with a proportional odds assumption.† 95% confidence intervals indicated with error bars.§ Frequency of handwashing was assessed on a 5-point Likert scale from "Never" to "Always" using the following question: "In the last week, how frequently did you wash your hands with soap and water after touching high-touch surfaces in public." ¶ The non-Hispanic, other race, or multiple races category includes respondents who identified as not Hispanic and as more than one race or as American Indian or Alaska Native, Native Hawaiian or Pacific Islander, or Other.** Region classification was determined using the U.S. Census Bureau's Census Regions and Divisions of the United States.https://www2.census.gov/geo/pdfs/mapsdata/maps/reference/us_regdiv.pdf.† † Rural/urban residence was classified as urban or rural based on self-reported ZIP codes according to the Federal Office of Rural Health Policy definition of rurality.https://www.hrsa.gov/rural-health/about-us/definition/datafiles.html.§ § For this question, respondents were asked to rate on a scale from "Not at all" to "Extremely" the extent to which they were concerned about the following statement regarding COVID-19 and infection control measures: "My own risk of infection with COVID-19."