Public Health

Raising Eyebrows Gets Handwashing Results

Just because mom always taught you to wash up after doing your business doesn't mean you heed her sound advice. Now some British researchers have found the next best thing to mom looking over your shoulder in the bathroom may be prompting a stranger to do it for her.

Handwashing with soap.

What's it going to take to get you to wash with soap? iStockphoto.com hide caption

itoggle caption iStockphoto.com

The researchers found that provocative signs posted outside bathrooms to shame people into washing their hands with soap are much more effective than traditional gentle reminders. "The good old worthy health messages don't work anymore, no one's listening," says Val Curtis, a hygiene specialist at the London School of Hygiene And Tropical Medicine. "So we're trying to do things that are a little edgy, a little rude."

Indeed, "Is the person next to you washing with soap?" was the bathroom slogan that spurred the biggest bump in soap use, according to work done by Curtis and colleagues. For both men and women, the idea of someone watching and judging was the most powerful way to boost handwashing.

The study monitored a quarter of a million people using bathrooms at a busy rest stop—not with cameras in the loo, but with online sensors that recorded soap dispensing. People can't be trusted to tell the truth when asked if they washed their hands, says Curtis. "It's a waste of time, they just say 'yes.' "

Outside the bathrooms' entrance, with big arrows drawing attention to it, researchers posted an electronic display with different text-only messages ranging from the classic "Wash your hands with soap" to "Don't be a dirty soap-dodger."

Without any sign reminders, 65 percent of women and 32 percent of men washed their hands. Shaming messages boosted the figures by about 10 percentage points. The results appear in the current issue of the American Journal of Public Health.

Grossing men out affected their behavior the most. "Soap it off, or eat it later," was one of the most successful messages. "We all go yuck when we see nasty food or poo, and that helps keep us away from the things that would make us sick," Curtis explains.

Women, on the other hand, increased their sudsing the most after reading messages about germs: "Water doesn't kill germs, soap does." Men, apparently, aren't intimidated by germs—the same message hardly increased handwashing for them.

Curtis says she and her research team hope to use this information about what works to develop better handwashing campaigns around the globe. About 1 to 2 million kids die of a diarrheal disease every year, she says, and "we've shown that hand washing can be very effective, probably preventing about half of those deaths."

Thursday is Global Handwashing Day, and health and hygiene groups are holding a glamorous event in Leicester Square: the Golden POO Awards honoring short films, including "Dancing in the Loo" and "Are You Spreading Poo?" Organizers of the event hopes to raise awareness about how handwashing can prevent the spread of disease.

Curtis says one of the lessons of the study is that peer pressure really is powerful: "If you look around and see people handwashing, then you do it yourself."

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