If you've spent any time on the Initial blog (and we sincerely hope you have) you’ll know by now that hygiene - and especially hand hygiene - is something of a recurring theme for us. Good hygiene practices are - by and large - the best way to prevent cross contamination (and the resulting illnesses and loss of productivity) in your workplace.
However, as much as we reiterate that good hand hygiene practices are the most effective means of preventing the spread of diseases, it seems that for many people that message simply isn't getting through.
A US study showed that one in ten bathroom users bypasses the hand basin altogether! Thorough hand washing - of 15 seconds or more - is being carried out by only five per cent of people after using the bathroom. The average recorded in the study was only six seconds, while only five per cent washed their hands for 15 seconds or longer.
Another study collected data on handwashing behaviour from 3,749 people using the bathrooms of bars, restaurants and other public places. Out of the total observed, only half the men in the study used soap while 15 per cent failed to wash their hands altogether. The figures for women were 78 per cent and seven per cent respectively. Closer to home, statistics released by Life Health Care South Africa in 2012 showed that sixty percent of all South Africans do not wash their hands with soap and water!
DID YOU KNOW: 15 October is Global Handwashing Day, an annual opportunity to raise awareness about the importance of proper handwashing habits to help prevent the spread of infection and reduce sickness.
I decided to do some research into the possible reasons behind why some people do - and others don’t - wash their hands, and to do so I turned to the Health Belief Model. The HBM is a psychological model that attempts to explain and predict health behaviors, by focusing on individuals’ attitudes and beliefs. It was first developed in the ‘50s by social psychologists Hochbaum, Rosenstock and Kegels whilst working in the U.S. Public Health Services, and was further developed by Rosenstock in the ‘80’s to help the HBM better fit the challenges of changing habitual unhealthy behaviors, such as being sedentary, smoking, or overeating. We could certainly add “failing to follow hand hygiene guidelines” to this list..
The HBM proposes that there are various concepts that motivate people to “act” (which for the purposes of this example is their willingness to follow good hand hygiene practices) including:
1. Perceived severity:
This is an individual’s interpretation of the severity and potential consequences of the illnesses they might contract by failing to wash their hands. For example, an employee may perceive that the flu is not medically serious, but if they perceive that there would be serious financial consequences as a result of being absent from work for several days, then they may perceive the flu to be a particularly serious condition.
2. Perceived susceptibility:
This is the individual's perception of the risk to themselves; for example do they perceive that that failing to wash their hands after using the bathroom will result in illness for themselves.
The combination of perceived severity and perceived susceptibility is referred to as perceived threat. The health belief model predicts that a higher perceived threat leads to a higher likelihood of engaging in health-promoting behaviors, such as hand washing.
3. Perceived benefits:
These are the individual’s perception of the perceived benefits of taking action; if an individual believes that hand washing will reduce their susceptibility to diarrhea, colds, flu etc (or decrease the seriousness of these illnesses) then they are more likely to engage hand washing practices.
4. Perceived barriers:
These refer to an individual's assessment of the obstacles to behavior change. For example a lack of available soap, clean basins and hand drying solutions may be seen as barriers to handwashing.
5. Cues to action:
The HBM also posits that a cue - such as handwashing posters or information leaflets - is required to trigger engagement in a behaviour. The intensity of the cues required to spur an individual to action vary based on perceived susceptibility, seriousness, benefits, and barriers.
this was the component added to the model in the 80’s, and refers to an individual’s belief in their ability to successfully undertake the behaviour. Developers of the model recognized that confidence in one's own ability to effect change in outcomes was a key component of health behavior change.
The HBM is certainly food for thought for those office managers who feel that simply eliminating barriers to good hygiene practices (such as lack of soap, dirty basins etc) is enough to drive adoption of these practices. Read more about the reasons why you should make hand hygiene a habit.
The model implies that for a large proportion of the population, only eliminating barriers isn’t enough. To effect meaningful change in the hygiene habits of your organisation will require a multifaceted strategy that includes providing information on consequences and risks (so that colleagues can weigh up for themselves the perceived threat of hygiene non-compliance), cues to action such as posters and the elimination of perceived barriers.
Training around effective hygiene practices can bolster colleagues feelings of self-efficacy and combined with the above, this can all lead to long term improvements in the wellness of an organisation.
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