Chauhan Saurabh, Parashar Mamta, Khandekar Jyoti, Singh Mitasha
Department of Community Medicine, LHMC, New Delhi, India.
Department of Community Medicine, BSAMCH, New Delhi, India.
J Educ Health Promot. 2024 Aug 29;13:308. doi: 10.4103/jehp.jehp_1356_23. eCollection 2024.
Food handlers can serve as a medium for potential foodborne infections through contaminated hands, posing a public health hazard. Poor handwashing practices among them can be a source of foodborne illnesses through cross-contamination. Health education intervention using multiple channels is one of the most effective tools for improving hand hygiene behavior.
This study aimed to determine the change in hand hygiene knowledge, attitude, and practices (KAP) among study participants following the implementation of a health education intervention package.
A before-and-after intervention study on 111 food handlers of food establishments in a tertiary care hospital in Delhi was conducted in 2021-2022. A tool was prepared with a scoring system to rate the hand hygiene KAP of food handlers. Health education was given to all, and scores on the same tool were reassessed after 8 weeks using an interview schedule and observational checklist based on the World Health Organization (WHO)'s five keys and Food Safety and Standards Authority of India (FSSAI) guidelines. The intervention package included a health talk, audiovisual aids, and a demonstration of handwashing steps.
The mean scores of hand hygiene KAP improved significantly after the intervention with a difference of 5.24 ± 0.95 ( = 0.02), 3.14 ± 0.42 ( = 0.03), and 4.18 ± 1.97 ( = 0.03) out of total scores of 7, 5, and 15, respectively, with maximum improvement seen in practices of a duration of handwashing >20 seconds improving from 6.3% to 81.1% ( < 0.05) after the intervention and least improvement in use of towel or napkin to turn off tap improving from 2.7% to 4.5% after the intervention, respectively.
The study findings conclude that handwashing with soap and water and following the steps of handwashing are one of the most important practices to improve hand hygiene practices. It emphasizes the need to ensure the implementation of the existing guidelines for food establishments strictly in medical institutions. Thus, education on hand hygiene using a combination of channels in medical institutions should be meticulously planned and held at regular intervals to achieve the desired change.
食品从业人员可能通过受污染的双手成为潜在食源性感染的媒介，构成公共卫生危害。他们不良的洗手习惯可能通过交叉污染成为食源性疾病的源头。采用多种渠道的健康教育干预是改善手部卫生行为最有效的工具之一。
本研究旨在确定实施一套健康教育干预措施后，研究参与者手部卫生知识、态度和行为（KAP）的变化。
2021年至2022年，对德里一家三级护理医院食品经营场所的111名食品从业人员进行了一项干预前后的研究。准备了一个带有评分系统的工具，以评估食品从业人员的手部卫生KAP。对所有人进行了健康教育，并在8周后根据世界卫生组织（WHO）的五个要点和印度食品安全标准管理局（FSSAI）的指南，使用访谈提纲和观察清单对同一工具上的得分进行重新评估。干预措施包括一次健康讲座、视听辅助工具以及洗手步骤演示。
干预后，手部卫生KAP的平均得分显著提高，在满分分别为7分、5分和15分的情况下，得分分别提高了5.24±0.95（P = 0.02）、3.14±0.42（P = 0.03）和4.18±1.97（P = 0.03），其中洗手时间>20秒的行为改善最为明显，干预后从6.3%提高到81.1%（P<0.05），而使用毛巾或纸巾关闭水龙头的行为改善最少，干预后从2.7%提高到4.5%。
研究结果表明，用肥皂和水洗手并遵循洗手步骤是改善手部卫生行为的最重要做法之一。它强调了在医疗机构中严格确保食品经营场所现有指南得到执行的必要性。因此，医疗机构应精心规划并定期开展多种渠道相结合的手部卫生教育，以实现预期的改变。
