Research reveals simple solution to help address deadly problem

GREENSBORO, NC – During flu and cold season, one of the most frequent hygiene hints is hand washing.

Sounds simple, right? The problem is how to get people to follow that advice.

Research at The University of North Carolina at Greensboro reveals a practical solution, which has been published online in the American Journal of Public Health. The study will be published in the February issue of AJPH.

“There are simple changes to public environments, restrooms in particular, that can have a significant and positive impact on hand washing behavior,” said Dr. Eric W. Ford, a professor of healthcare in the Bryan School of Business and Economics at UNCG. “We found that the simple, visual cue of a paper towel being displayed increases both hand-washing rates and the use of soap.”

Here’s how the study was conducted:

Towel dispensers in public restrooms at UNCG were set to present a towel either with or without activation by users; the two modes were set to operate alternately for 10 weeks. Wireless sensors were used to record entry into bathrooms. Towel and soap consumption rates were checked weekly. There were 97,351 hand-washing opportunities across all restrooms.

The results: A visual cue can increase hand-washing compliance in public facilities. Towel use was 22.6 percent higher and soap use was 13.3 percent higher when the dispenser presented the towel without user activation than when activation was required.

“It’s so simple that it seems almost intuitive, but the most important study implication is that public facility managers can easily and inexpensively improve the public health of the communities that they serve,” said Ford.

It’s an important health issue, Ford said, noting that statistics on hospital infection rates show that in the U.S., deaths from flu-related causes have ranged from 3,000 to 49,000 over the years. (http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm).

The research grew out of UNCG's sustainability committee, which posed the question, “Does saving towels come at the expense of good hand hygiene?” The study was funded by the Bryan School and was conducted in the spring of 2012.

Ford was the study’s principal investigator. Brian Boyer, who was earning a master’s of public health during the study, managed data collection and entry from the sites. Colleagues who helped with the study design and analysis were Timothy R. Huerta of the Ohio State University College of Medicine and Nir Menachemi of the School of Public Health at the University of Alabama Birmingham.