Effectiveness of community health education program in improving handwashing with soap behavior among school-age children
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Published:
Jan 31, 2025
Keywords:
Behavior Change, Community Based Program, Handwashing with Soap, Health Education, School Age Children
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Abstract
Handwashing with soap behavior in school-age children is still a serious concern in efforts to prevent infectious diseases. This study aimed to assess the effectiveness of a community-based health education program in improving handwashing with soap behavior among elementary school students. The study used a quasi-experimental design with a pre-test and post-test approach on 150 students from three schools in rural areas. Data were collected through questionnaires and direct observation, then analyzed using descriptive and inferential statistics. The results showed a significant increase in knowledge (from 58.4 to 82.7) and frequency of HWWS behavior (from 40% to 85%) after the intervention. Inferential analysis also showed that age and location factors interacted with the effectiveness of the intervention. The implications of this study suggest that a community-based health education approach is an effective and sustainable strategy in promoting hygienic behavior in schools, and can be adapted for public health programs in other areas.
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Universitas Nurul Hasanah Kutacane, S. P., Mahendika, D. ., Tawil, M. R. ., Ningsih, W. ., & Rahagia, R. . (2025). Effectiveness of community health education program in improving handwashing with soap behavior among school-age children. Journal of Midwifery and Nursing, 7(1), 102-108. https://doi.org/10.35335/jmn.v7i1.5907
References
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Alzúa, M. L., Djebbari, H., & Pickering, A. J. (2020). A community-based program promotes sanitation. Economic Development and Cultural Change, 68(2), 357–390.
Amon-Tanoh, M. A., McCambridge, J., Blon, P. K., Kouamé, H. A., Nguipdop-Djomo, P., Biran, A., & Cousens, S. (2021). Effects of a social norm-based handwashing intervention including handwashing stations, and a handwashing station-only intervention on handwashing with soap in urban Côte d’Ivoire: a cluster randomised controlled trial. The Lancet Global Health, 9(12), e1707–e1718.
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Byford, T. (2014). Water, sanitation and hygiene standards for schools in low-cost settings. In International Journal of Environmental Studies. World Health Organization. https://doi.org/10.1080/00207233.2014.913878
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Mbakaya, B. C., Lee, P. H., & Lee, R. L. T. (2017). Hand hygiene intervention strategies to reduce diarrhoea and respiratory infections among schoolchildren in developing countries: A systematic review. International Journal of Environmental Research and Public Health, 14(4), 371. https://doi.org/10.3390/ijerph14040371
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Nachaiwieng, W., Sanit, S., Kongta, N., Saingamsook, J., Duangmano, S., Pornprasert, S., Somboon, P., & Yanola, J. (2024). The impact of an integrated intervention program combining drug therapy with water, sanitation, and hygiene (WASH) education on reinfection with intestinal parasitic infections among the Karen hill tribe in northern Thailand. Parasites & Vectors, 17, 544.
Of, M., Surgery, D., & Dentistry, P. H. (2018). EFFECTIVENESS OF TOOTH BRUSHING AND HAND WASHING MODULE IN 6-7 YEAR OLD SCHOOL CHILDREN IN URBAN AREAS OF BANGLORE-A NON-RANDOMISED STUDY Submitted By. Rajiv Gandhi University of Health Sciences (India).
Omari, R., Zotor, F., Baah-Tuahene, S., & Arthur, W. (2022). Handwashing knowledge, attitudes, and practices in Ghana. Journal of Preventive Medicine and Hygiene, 63(1), E59.
Oranga, J. O. (2022). The Role of Communication in Promoting Behavior Change: a Case of the ‘help a Child Reach 5’Handwashing Campaign in Kuria West, Migori County. University of Nairobi.
Organization, W. H., & Others. (2005). Epidemiology and management of common skin diseases in children in developing countries. In Geneva: World Health Organization. World Health Organization. http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Epidemiology+and+Management+of+Common+Skin+Diseases+in+Children+in+Developing+Countries#0%5Cnhttp://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Epidemiology+and+management+of+common+
Parminder, K., Kaur, M. H., & Bhupinder, K. (2019). A study to assess the effectiveness of child to child approach on knowledge and practices regarding hand washing among the primary school children of a selected school Faridkot, Punjab. Amarjeet Kaur Sandhu, 11(4), 461.
Pearson, R., Williams, M., & Kaminsky, J. (2024). Analysis of Factors Influencing Teacher and Student Water, Sanitation, and Hygiene Knowledge and Behaviors in Addis Ababa, Ethiopia. ACS ES&T Water.
Ross, I., Bick, S., Ayieko, P., Dreibelbis, R., Wolf, J., Freeman, M. C., Allen, E., Brauer, M., & Cumming, O. (2023). Effectiveness of handwashing with soap for preventing acute respiratory infections in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet, 401(10389), 1681–1690.
Snell-Johns, J., Mendez, J. L., & Smith, B. H. (2004). Evidence-Based Solutions for Overcoming Access Barriers, Decreasing Attrition, and Promoting Change With Underserved Families. Journal of Family Psychology, 18(1), 19–35. https://doi.org/10.1037/0893-3200.18.1.19
Tidwell, J. B., Gopalakrishnan, A., Unni, A., Sheth, E., Daryanani, A., Singh, S., & Sidibe, M. (2020). Impact of a teacher-led school handwashing program on children’s handwashing with soap at school and home in Bihar, India. PLoS One, 15(2), e0229655.
Vivas, A. P., Gelaye, B., Aboset, N., Kumie, A., Berhane, Y., & Williams, M. A. (2010). Knowledge, attitudes and practices (KAP) of hygiene among school children in Angolela, Ethiopia. Journal of Preventive Medicine and Hygiene, 51(2), 73–79.
Wolf, J., Johnston, R., Freeman, M. C., Ram, P. K., Slaymaker, T., Laurenz, E., & Prüss-Ustün, A. (2019). Handwashing with soap after potential faecal contact: Global, regional and country estimates. International Journal of Epidemiology, 48(4), 1204–1218. https://doi.org/10.1093/ije/dyy253
Yoo, H. J., & Song, E. (2021). Effects of personal hygiene habits on self-efficacy for preventing infection, infection-preventing hygiene behaviors, and product-purchasing behaviors. Sustainability (Switzerland), 13(17), 9483. https://doi.org/10.3390/su13179483
Akinsulie, O. C., Aliyu, V. A., Idris, I., Ajulo, S., Olukogbe, O., Ukauwa, C., & Akinsulie, J. M. (2024). The Implications of Handwashing and Skin Hygiene on Infectious Disease Dynamics: The African Scenario. Hygiene, 4(4), 483–499. https://doi.org/10.3390/hygiene4040036
Al-Wutayd, O., Mansour, A. E., Aldosary, A. H., Hamdan, H. Z., & Al-Batanony, M. A. (2021). Handwashing knowledge, attitudes, and practices during the COVID-19 pandemic in Saudi Arabia: A non-representative cross-sectional study. Scientific Reports, 11(1), 16769.
Alzúa, M. L., Djebbari, H., & Pickering, A. J. (2020). A community-based program promotes sanitation. Economic Development and Cultural Change, 68(2), 357–390.
Amon-Tanoh, M. A., McCambridge, J., Blon, P. K., Kouamé, H. A., Nguipdop-Djomo, P., Biran, A., & Cousens, S. (2021). Effects of a social norm-based handwashing intervention including handwashing stations, and a handwashing station-only intervention on handwashing with soap in urban Côte d’Ivoire: a cluster randomised controlled trial. The Lancet Global Health, 9(12), e1707–e1718.
Asteria, P. V., Yulianto, B., Suyatno, Sodiq, S., & Yohanes, B. (2020). The Establishment of Perceptions and Healthy Living Attitudes for Children Through Modern Fairytale Based on Covid-19. International Joint Conference on Arts and Humanities (IJCAH 2020), 1310–1316. https://doi.org/10.2991/assehr.k.201201.221
Beatson, R., Quach, J., Canterford, L., Farrow, P., Bagnall, C., Hockey, P., Phillips, E., Patton, G. C., Olsson, C. A., & Ride, J. (2023). Improving primary to secondary school transitions: A systematic review of school-based interventions to prepare and support student social-emotional and educational outcomes. Educational Research Review, 40, 100553.
Byford, T. (2014). Water, sanitation and hygiene standards for schools in low-cost settings. In International Journal of Environmental Studies. World Health Organization. https://doi.org/10.1080/00207233.2014.913878
Enright, G., Allman-Farinelli, M., & Redfern, J. (2020). Effectiveness of family-based behavior change interventions on obesity-related behavior change in children: a realist synthesis. International Journal of Environmental Research and Public Health, 17(11), 4099.
Forman, S. G., Olin, S. S., Hoagwood, K. E., Crowe, M., & Saka, N. (2009). Evidence-Based Interventions in Schools: Developers’ Views of Implementation Barriers and Facilitators. School Mental Health, 1(1), 26–36. https://doi.org/10.1007/s12310-008-9002-5
Fradianto, I., Andriyanto, A., Akbar, N., Yulanda, N. A., & Bahtiar, B. (2022). Improving Handwashing Behavior of School-Age Children Through a Game-Based Educational Program. ASEAN Journal of Community Engagement, 6(2), 324–334.
Hossain, M. (2012). A Study on Knowledge, Attitude and Practice about Personal Hygiene and Disease Awareness of East West University Students in Dhaka City. In Department of Pharmacy East West University Dhaka, Bangladesh. (Vol. 1, p. 94). East West University.
Kabir, A., Roy, S., Begum, K., Kabir, A. H., & Miah, M. S. (2021). Factors influencing sanitation and hygiene practices among students in a public university in Bangladesh. PLoS One, 16(9), e0257663.
Mbakaya, B. C., Lee, P. H., & Lee, R. L. T. (2017). Hand hygiene intervention strategies to reduce diarrhoea and respiratory infections among schoolchildren in developing countries: A systematic review. International Journal of Environmental Research and Public Health, 14(4), 371. https://doi.org/10.3390/ijerph14040371
Mendez, J. L., Carpenter, J. L., LaForett, D. R., & Cohen, J. S. (2009). Parental engagement and barriers to participation in a community-based preventive intervention. American Journal of Community Psychology, 44(1–2), 1–14. https://doi.org/10.1007/s10464-009-9252-x
Nachaiwieng, W., Sanit, S., Kongta, N., Saingamsook, J., Duangmano, S., Pornprasert, S., Somboon, P., & Yanola, J. (2024). The impact of an integrated intervention program combining drug therapy with water, sanitation, and hygiene (WASH) education on reinfection with intestinal parasitic infections among the Karen hill tribe in northern Thailand. Parasites & Vectors, 17, 544.
Of, M., Surgery, D., & Dentistry, P. H. (2018). EFFECTIVENESS OF TOOTH BRUSHING AND HAND WASHING MODULE IN 6-7 YEAR OLD SCHOOL CHILDREN IN URBAN AREAS OF BANGLORE-A NON-RANDOMISED STUDY Submitted By. Rajiv Gandhi University of Health Sciences (India).
Omari, R., Zotor, F., Baah-Tuahene, S., & Arthur, W. (2022). Handwashing knowledge, attitudes, and practices in Ghana. Journal of Preventive Medicine and Hygiene, 63(1), E59.
Oranga, J. O. (2022). The Role of Communication in Promoting Behavior Change: a Case of the ‘help a Child Reach 5’Handwashing Campaign in Kuria West, Migori County. University of Nairobi.
Organization, W. H., & Others. (2005). Epidemiology and management of common skin diseases in children in developing countries. In Geneva: World Health Organization. World Health Organization. http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Epidemiology+and+Management+of+Common+Skin+Diseases+in+Children+in+Developing+Countries#0%5Cnhttp://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Epidemiology+and+management+of+common+
Parminder, K., Kaur, M. H., & Bhupinder, K. (2019). A study to assess the effectiveness of child to child approach on knowledge and practices regarding hand washing among the primary school children of a selected school Faridkot, Punjab. Amarjeet Kaur Sandhu, 11(4), 461.
Pearson, R., Williams, M., & Kaminsky, J. (2024). Analysis of Factors Influencing Teacher and Student Water, Sanitation, and Hygiene Knowledge and Behaviors in Addis Ababa, Ethiopia. ACS ES&T Water.
Ross, I., Bick, S., Ayieko, P., Dreibelbis, R., Wolf, J., Freeman, M. C., Allen, E., Brauer, M., & Cumming, O. (2023). Effectiveness of handwashing with soap for preventing acute respiratory infections in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet, 401(10389), 1681–1690.
Snell-Johns, J., Mendez, J. L., & Smith, B. H. (2004). Evidence-Based Solutions for Overcoming Access Barriers, Decreasing Attrition, and Promoting Change With Underserved Families. Journal of Family Psychology, 18(1), 19–35. https://doi.org/10.1037/0893-3200.18.1.19
Tidwell, J. B., Gopalakrishnan, A., Unni, A., Sheth, E., Daryanani, A., Singh, S., & Sidibe, M. (2020). Impact of a teacher-led school handwashing program on children’s handwashing with soap at school and home in Bihar, India. PLoS One, 15(2), e0229655.
Vivas, A. P., Gelaye, B., Aboset, N., Kumie, A., Berhane, Y., & Williams, M. A. (2010). Knowledge, attitudes and practices (KAP) of hygiene among school children in Angolela, Ethiopia. Journal of Preventive Medicine and Hygiene, 51(2), 73–79.
Wolf, J., Johnston, R., Freeman, M. C., Ram, P. K., Slaymaker, T., Laurenz, E., & Prüss-Ustün, A. (2019). Handwashing with soap after potential faecal contact: Global, regional and country estimates. International Journal of Epidemiology, 48(4), 1204–1218. https://doi.org/10.1093/ije/dyy253
Yoo, H. J., & Song, E. (2021). Effects of personal hygiene habits on self-efficacy for preventing infection, infection-preventing hygiene behaviors, and product-purchasing behaviors. Sustainability (Switzerland), 13(17), 9483. https://doi.org/10.3390/su13179483
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