Judah Gaby, Aunger Robert, Schmidt Wolf-Peter, Michie Susan, Granger Stewart, Curtis Val
London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK.
Am J Public Health. 2009 Oct;99 Suppl 2(Suppl 2):S405-11. doi: 10.2105/AJPH.2009.164160.
We pretested interventions derived from different domains of behavior change theory to determine their effectiveness at increasing hand washing with soap in a natural setting.
We installed wireless devices in highway service station restrooms to record entry and soap use. Two text-only messages for each of 7 psychological domains were compared for their effect on soap-use rates. We collected data on nearly 200 000 restroom uses.
The knowledge activation domain was most effective for women, with a relative increase in soap use of 9.4% compared with the control condition (P = .001). For men, disgust was the most effective, increasing soap use by 9.8% (P = .001). Disgust was not significantly better than the control condition for women, nor was knowledge activation for men. Messages based on social norms and social status were effective for both genders.
Our data show that unobtrusive observation of behavior in a natural setting can help identify the most effective interventions for changing behaviors of public health importance. The gender differences we found suggest that public health interventions should target men and women differently.
我们对源自行为改变理论不同领域的干预措施进行了预测试，以确定它们在自然环境中增加用肥皂洗手行为的有效性。
我们在高速公路服务站的卫生间安装了无线设备，以记录进入情况和肥皂使用情况。对7个心理领域中的每一个领域的两条纯文本信息对肥皂使用率的影响进行了比较。我们收集了近20万次卫生间使用的数据。
知识激活领域对女性最有效，与对照条件相比，肥皂使用量相对增加了9.4%（P = 0.001）。对男性而言，厌恶情绪领域最有效，肥皂使用量增加了9.8%（P = 0.001）。厌恶情绪领域对女性而言并不显著优于对照条件，知识激活领域对男性而言也是如此。基于社会规范和社会地位的信息对两性都有效。
我们的数据表明，在自然环境中对行为进行不干扰的观察有助于确定改变具有公共卫生重要性的行为的最有效干预措施。我们发现的性别差异表明，公共卫生干预措施应针对男性和女性采取不同的方式。
