Effects of Micro Architectural Environmental Interventions on Handwashing Compliance of Adolescents: A School-Based Intervention Trial.

ABSTRACT

PURPOSE: Aimed to explore more practical interventions for handwashing compliance (HWC) and protect the minor' health with the pandemic background, this study tested whether micro architectural interventions would promote HWC of adolescents through active experience. BACKGROUND: Despite the well-documented benefits of handwashing (HW), low compliance is common among adolescents. HW space in schools has always been treated as attached spaces of little matter, which is unfavorable to public health. According to environment behavior perspective, personal motivation of HWC may be motivated by active environment. METHOD: A school-based investigation and a 30-week environmental behavior experiment were conducted when students returned to school after the COVID-19 pandemic closure in 2020 in China to evaluate the effects of active environment interventions selected by previous survey on promoting adolescents' HW rate. Digital infrared counters were used to unobtrusively document their behavior. RESULTS: Results in summer revealed a positive effect on all intervention groups. The effects of combined interventions were higher than the effect of any single intervention. However, HW rates of all groups declined sharply in the coldest month and the between-group differences decreased. Significant correlations were found between HW rates and satisfaction with the intervention schemes. CONCLUSIONS: Findings suggest that architectural environmental intervention may potentially be a positive, friendly, and one-time investment mean to expand the HWC intervention scope from passive policies to positive experience, and HW space design for adolescents should be treated as a public health strategy.