A program to improve the hand hygiene compliance of Hong Kong preschoolers with an insight into their absenteeism

Pui Lai OR, Patricia T.Y. CHING, Wai Yee Joanne CHUNG

Research output: Contribution to journalArticlespeer-review

7 Citations (Scopus)


Background: Hand hygiene prevents cross-infection and is the most effective defense against contagious diseases. Preschoolers, without proper hand hygiene skills, are a vulnerable group to such diseases. The aim of this study was to evaluate whether hand hygiene compliance training of preschoolers in Hong Kong improves their hand hygiene knowledge and performance, and whether the training reduces their absenteeism resulting from influenza symptoms.

Methods: This was a quasi-experimental study with a pretest-posttest design. A total of 110 preschoolers participated in a program consisting of 4 training sessions on hand hygiene. Before and after the program, their hand hygiene knowledge was assessed by 10 true or false questions, and their handwashing skills were assessed by photos of their hands taken before and after handwashing. Before handwashing, a fluorescent stain gel was used to cover their hands. To determine whether a causal relationship existed between compliance and absenteeism, the preschoolers’ absenteeism data were collected during a period of 3 months for analysis.

Results: Significant differences were found in hand hygiene knowledge on handwashing steps, duration, and after playing with toys. Percentage increases were recorded for 8 questions. There was significant improvement in hand hygiene performance on the fronts and the backs of fingers, thumbs, and fingertips (P < .05). The findings showed a decrease in absence rates with influenza symptoms for the month before (31%), during (30%), and after (25%) the completion of the program in all participating schools.

Discussion: After the training program, the participants’ hand hygiene knowledge and performance considerably improved. They washed their hands more thoroughly and there was a significant reduction in absences owing to influenza.

Conclusions: Good cooperation between schools and families is found to be important in helping students build positive attitudes and habits, even in performing simple routines like hand hygiene. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)498-503
JournalAmerican Journal of Infection Control
Issue number5
Early online date04 Jan 2019
Publication statusPublished - May 2019


Or, P. P. L., Ching, P. T. Y., & Chung, J. W. Y. (2019). A program to improve the hand hygiene compliance of Hong Kong preschoolers with an insight into their absenteeism. American Journal of Infection Control, 47(5), 498-503. doi: 10.1016/j.ajic.2018.11.014


  • Health habit
  • Hand hygiene knowledge
  • Influenza symptoms


Dive into the research topics of 'A program to improve the hand hygiene compliance of Hong Kong preschoolers with an insight into their absenteeism'. Together they form a unique fingerprint.