How can a website change hand hygiene behaviour? Mediators of behaviour change in PRIMIT

Abstract

Background: The PRIMIT intervention succeeded in changing hand hygiene and reducing infection transmission in the home. The aims of these analyses were to describe what elements of the intervention were accessed most and to investigate mediators of behaviour change. Methods: The PRIMIT intervention consisted of 4 weekly web-based sessions plus tailored feedback. 19501 users were randomised to intervention access or a no access control group. Usage was objectively recorded by the website, and a Theory of Planned Behaviour based questionnaire administered online to assess attitudes and intentions towards hand-washing and hand-washing behaviour at baseline and 4 month follow-up. Findings: The intervention group reported greater increases in hand-washing, and also positive changes in attitudes and intentions towards hand hygiene. Visualisation analyses revealed variability in the usage of intervention components. Positive perceptions of the website were associated with greater usage and greater behaviour change. Discussion: Our analyses provide encouraging confirmation that brief exposure to appropriate behaviour change techniques targeting key influences on behaviour can be sufficient to change even a habitual behaviour such as hand-washing.