People More Likely to Wash Hands if Shamed Into Doing So

People are more likely to wash their hands when they have been shamed into it, according to a study by the London School of Hygiene & Tropical Medicine.

The study, published in the American Journal of Public Health, looked at responses to electronic hygiene messages displayed in United Kingdom service station toilets.

A million people die every year from diarrheal disease and respiratory infection. Handwashing with soap is the cheapest and best way of controlling these diseases. It also prevents the spread of influenza and hospital-acquired infections such as Clostridium difficile.

"However, it’s difficult to know what kind of message is most effective at changing this everyday behavior, so it’s important to experimentally test what works best in a real setting," says Robert Aunger, leader of the study. "That way you can save money and make sure your program will be effective prior to rolling out any public health campaign at great expense.”

A quarter of a million people were counted using the toilets and their use of soap was monitored by online sensors. Only 32 percent of men washed their hands with soap while women were twice as good, with 64 percent washing their hands.

A variety of messages, ranging from “Water doesn’t kill germs, soap does,” to “Don’t be a dirty soap dodger,” were flashed onto LED screens at the entrance of the toilets and the effects of the messages on behavior were measured. “Is the person next to you washing with soap?” was best overall, showing how people respond to whether they thought others were watching. There were intriguing differences in behavior by gender, with women responding to reminders, while men tended to react best to messages that invoked disgust, for example ‘soap it off or eat it later’.

Gaby Judah, who ran the study, said, “Our findings are particularly important on Global Handwashing Day, when many agencies concerned with improving health worldwide by encouraging people to wash their hands with soap will be looking to use best practice.”

Global Handwashing Day is Oct. 15, 2009, and will involve more than 70 countries around the world, with the aim of improving handwashing practices.