Centre for Rural and Remote Health, James Cook University, Mount Isa, QLD 4825, Australia.
School of Demography, The Australian National University, Canberra, ACT 2601, Australia.
Int J Environ Res Public Health. 2021 May 7;18(9):4984. doi: 10.3390/ijerph18094984.
While appropriate hand hygiene practices (HHP) are protective against infections, the paucity of evidence on global estimates and determinants of HHP in adolescents limits effective design and planning of intervention to improve HHP in young people. We examined the prevalence and correlates of HHP in adolescents. We used nationally representative data from the Global School-based Student Health Survey (2003-2017) from 92 countries. HHP were categorized as "appropriate", "inappropriate" and "lacking" based on the information about "hand washing before eating", "hand washing after using the toilet", and "hand washing with soap". Multinomial logistic regression analyses were used to assess the role of socio-demographic, health, lifestyle, school, and family-related variables in HHP. Among 354,422 adolescents (13-17 years), only 30.3% were found to practice appropriate hand hygiene. Multivariable models suggest that sedentary behavior (adjusted relative risk ratio (ARRR) 1.41, 95% CI 1.31-1.51)), and bullying victimization (ARRR 1.20, 95% CI 1.10-1.30) promoted inappropriate HHP. In contrast, parental supervision (ARRR 0.55, 95% CI 0.50-0.59) and parental bonding (ARRR 0.81, 95% CI 0.75-0.87) were protective against inappropriate HHP. From a policy perspective, hand hygiene promotion policies and programs should focus on both school (bullying, exercise) and family-level factors (parental supervision and parental bonding) factors.
虽然适当的手部卫生习惯（HHp）可以预防感染，但由于缺乏全球青少年 HHp 估计和决定因素的证据，限制了有效设计和规划干预措施以改善年轻人的 HHp。我们研究了青少年 HHp 的流行情况和相关因素。我们使用了来自 92 个国家的全球学校学生健康调查（2003-2017 年）的全国代表性数据。根据“进食前洗手”、“使用厕所后洗手”和“用肥皂洗手”的信息，将 HHp 分为“适当”、“不适当”和“缺乏”。使用多项逻辑回归分析评估社会人口统计学、健康、生活方式、学校和家庭相关变量在 HHp 中的作用。在 354422 名青少年（13-17 岁）中，只有 30.3%的人被认为有适当的手部卫生习惯。多变量模型表明，久坐行为（调整后的相对风险比（ARRr）1.41，95%置信区间（CI）1.31-1.51）和欺凌受害（ARRr 1.20，95%CI 1.10-1.30）促进了不适当的 HHp。相比之下，父母监督（ARRr 0.55，95%CI 0.50-0.59）和父母纽带（ARRr 0.81，95%CI 0.75-0.87）对不适当的 HHp 具有保护作用。从政策角度来看，手部卫生促进政策和计划应同时关注学校（欺凌、锻炼）和家庭层面的因素（父母监督和父母纽带）。
