Institute of Health Behaviors and Community Sciences, College of Public Health (LY Chang), National Taiwan University, Taipei, Taiwan.
Center for Policy, Outcomes, and Prevention (CJ Wang), Stanford University School of Medicine; Division of General Pediatrics (CJ Wang), Stanford University School of Medicine.
Acad Pediatr. 2022 Nov-Dec;22(8):1390-1398. doi: 10.1016/j.acap.2022.05.014. Epub 2022 Jul 18.
This study identified developmental patterns of handwashing habit formation during childhood and examined their associations with later COVID-19 preventive practices.
We used data from the Taiwan Birth Cohort Study, which included 11,254 adolescents with complete data on childhood handwashing behavior and age-15 COVID-19 survey items. Bias-adjusted 3-step latent class analysis was used to test study hypotheses.
The rates of handwashing and mask-wearing during the pandemic were 63.8% and 93.8%, respectively. Five distinct patterns of handwashing habit formation were identified: early formation (14.89%), delayed formation (17.73%), gradual formation (42.98%), inconsistent formation (9.78%), and nonformation (14.62%). Compared with adolescents with an early formation pattern of handwashing habits, those with other patterns exhibited lower odds ratios (ORs) of handwashing during COVID-19; these ORs were 0.67 (95% confidence interval [CI], 0.49-0.85), 0.60 (95% CI, 0.44-0.77), 0.29 (95% CI, 0.08-0.49), and 0.21 (95% CI, 0.01-0.40) for those with delayed formation, gradual formation, inconsistent formation, and nonformation patterns, respectively. Moreover, relative to that of adolescents with the early formation pattern, mask-wearing was less common among adolescents with gradual formation, inconsistent formation, and nonformation patterns, with ORs of 0.54 (95% CI, 0.16-0.92), 0.50 (95% CI, 0.03-0.96), and 0.26 (95% CI, 0.00-0.65), respectively.
The early formation of hygienic habits is associated with higher adherence to pandemic preventive practices among adolescents. Our findings suggest that interventions to promote hygienic behaviors can start as early as age 3 through the introduction of healthy habits such as handwashing.
本研究旨在确定儿童时期养成洗手习惯的发展模式，并探讨其与新冠疫情后预防措施的相关性。
本研究使用了来自台湾出生队列研究的数据，该研究纳入了 11254 名青少年，他们均完整报告了儿童时期的洗手行为以及 15 岁时新冠相关的调查项目。使用偏差校正的三步潜在类别分析检验研究假设。
疫情期间的洗手率和口罩佩戴率分别为 63.8%和 93.8%。发现了五种不同的洗手习惯形成模式：早期形成模式（14.89%）、延迟形成模式（17.73%）、逐渐形成模式（42.98%）、不一致形成模式（9.78%）和未形成模式（14.62%）。与具有早期洗手习惯形成模式的青少年相比，其他模式的青少年在新冠疫情期间洗手的比值比（OR）较低；延迟形成模式、逐渐形成模式、不一致形成模式和未形成模式的 OR 分别为 0.67（95%可信区间[CI]，0.49-0.85）、0.60（95%CI，0.44-0.77）、0.29（95%CI，0.08-0.49）和 0.21（95%CI，0.01-0.40）。此外，与具有早期形成模式的青少年相比，逐渐形成模式、不一致形成模式和未形成模式的青少年佩戴口罩的比例较低，OR 分别为 0.54（95%CI，0.16-0.92）、0.50（95%CI，0.03-0.96）和 0.26（95%CI，0.00-0.65）。
卫生习惯的早期形成与青少年对大流行预防措施的更高依从性相关。我们的研究结果表明，通过引入洗手等健康习惯，可以从 3 岁开始就对青少年进行促进卫生行为的干预。
