Comparative efficacy of a simplified handwashing program for improvement in hand hygiene and reduction of school absenteeism among children with intellectual disability

Regina Lai Tong Lee, Man Cynthia Leung, Wah Kun Tong, Hong Chen, Hong Lee

Research output: Journal article publicationJournal articleAcademic researchpeer-review

19 Citations (Scopus)


Background: Infectious diseases are common among schoolchildren as a result of their poor hand hygiene, especially in those who have developmental disabilities. Methods: A quasi-experimental study using a pre- to post-test design with a control group was used to test the feasibility and sustainability of simplified 5-step handwashing techniques to measure the hand hygiene outcome for students with mild intellectual disability. Sickness-related school absenteeism was compared. Results: The intervention group experienced a significant increase in the rating of their handwashing quality in both hands from pre- to post-test: left dorsum (+1.05, P <.001); right dorsum (+1.00, P <.001); left palm (+0.98, P <.001); and right palm (+1.09, P <.001). The pre- to post-test difference in the intervention group (+1.03, P <.001) was significantly greater than the difference in the control group (+0.34, P =.001). There were no differences between the post-test and the sustainability assessment in the intervention group. The intervention school experienced a significantly lower absenteeism rate (0.0167) than the control group in the same year (0.028, P =.04).Students in this study showed better performance in simplified handwashing techniques and experienced lower absenteeism than those using usual practice in special education school settings. Conclusion: The simplified 5-step hand hygiene technique has been proven effective in reducing the spread of infectious diseases.
Original languageEnglish
Pages (from-to)907-912
Number of pages6
JournalAmerican Journal of Infection Control
Issue number9
Publication statusPublished - 1 Sep 2015


  • Multidimensional strategies

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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