Appiah-Brempong Emmanuel, Appiah-Brempong Miriam
Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Civil Engineering, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Health Psychol Behav Med. 2024 Aug 18;12(1):2391932. doi: 10.1080/21642850.2024.2391932. eCollection 2024.
Handwashing with soap remains the single most cost-effective strategy for reducing the spread of infectious diseases. From our scoping search, no study was identified which examined the predictors of children's handwashing behaviour within the context of the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB) combined. This paper contributes to bridging this gap in literature. We sought to examine variables emanating from the HBM and TPB which could potentially predict handwashing behaviour; determine whether behavioural intention will potentially predict behaviour; and identify school children's motivation for proper handwashing behaviour.
Data were collected from 717 school children recruited from four basic schools. A structured questionnaire was used for data collection. Data were analysed using multi-variable linear regression models.
Participants' knowledge of hand hygiene failed to predict behavioural intention and handwashing behaviour. As regards participants' perception of severity, there was an association with behavioural intention in a crude model, but this was not so in an adjusted model. Also, perception of severity was not associated with handwashing behaviour. Attitude to handwashing (β = 0.120, 95% CI [0.00, 0.24] = 0.046), possession of handwashing skills (β = 0.037, 95% CI [0.01, 0.07] = 0.008), and subjective norms (β = 0.263, 95% CI [0.20, 0.33] < 0.001) were among the psychosocial variables that showed potential for predicting both behavioural intention and behaviour. The TPB's intention-behaviour relationship was corroborated by our results. Among others, motivation for adherence to proper handwashing behaviour included the desire to make hands smell better.
Interventions targeting the handwashing behaviour of school children should consider strategies that move beyond mere knowledge improvement, but rather target attitude and skill enhancement strategies implemented in partnership with 'significant others' such as teachers, and adult peers.
用肥皂洗手仍然是减少传染病传播最具成本效益的单一策略。通过我们的范围搜索，未发现有研究在健康信念模型（HBM）和计划行为理论（TPB）相结合的背景下考察儿童洗手行为的预测因素。本文有助于填补这一文献空白。我们试图研究源自HBM和TPB的可能预测洗手行为的变量；确定行为意图是否可能预测行为；并确定学童正确洗手行为的动机。
从四所小学招募了717名学童收集数据。使用结构化问卷收集数据。采用多变量线性回归模型分析数据。
参与者的手卫生知识未能预测行为意图和洗手行为。关于参与者对严重性的认知，在一个简单模型中与行为意图有关联，但在调整模型中并非如此。此外，对严重性的认知与洗手行为无关。洗手态度（β = 0.120，95%可信区间[0.00, 0.24] = 0.046）、拥有洗手技能（β = 0.037，95%可信区间[0.01, 0.07] = 0.008）和主观规范（β = 0.263，95%可信区间[0.20, 0.33] < 0.001）是显示出预测行为意图和行为潜力的心理社会变量。我们的结果证实了TPB的意图 - 行为关系。除其他外，坚持正确洗手行为的动机包括希望让手闻起来更好。
针对学童洗手行为的干预措施应考虑超越单纯知识提升的策略，而是针对与教师和成年同龄人等“重要他人”合作实施的态度和技能提升策略。
