Getting undergraduates to do what’s good for them may be more about what they think is disgusting than what they think is smart, research at DU indicates.
Moreover, if the message offers an easy way to avoid what’s disgusting, many students will change their ways.
The 2007 study that led to these conclusions focused on getting students to wash their hands more often, particularly after using the bathroom.
Fear of spreading germs or getting sick by not washing didn’t mean much to students, focus group research suggested. What got their attention was the knowledge that they might be walking around with “gross things” on their hands if they didn’t wash.
The findings are generating interest. Universities including UC Santa Barbara, Wyoming, Colorado State and CU–Colorado Springs are seeking to borrow DU’s techniques in hopes of improving student hand washing behavior on their campuses. And with publication this month in the international professional journal Communication in Healthcare, even more schools may be joining suit.
“We tried gross messages, germ messages and you’ll-get-sick messages. And the only ones that stuck was gross,” says Assistant Director of Health Promotions Katie Dunker, one of a team of five who conducted the pilot study. “We found that the ‘gross factor’ is what works, and we were able to increase hand washing behavior by a lot.”
In fall quarter 2007, researchers posted messages in the bathrooms of two DU undergraduate residence halls. The messages said things like, “Poo on you, wash your hands” or “You just peed, wash your hands,” and contained vivid graphics and photos. The messages resulted in increased hand washing among females by 26 percentage points and among males by 8 percentage points.
Observations in two control dorms over the same four-week period showed hand washing dipped 2 percentage points among females and 21.5 percentage points among males.
The study’s lead author, Renee Botta, associate professor in the Department of Mass Communications and Journalism Studies, theorizes that the severe drop in hand washing among males might have been that the habit they brought to campus fell away the longer they were away from home and the more they were pressed by studies. Then, too, males may require a secondary message beyond the “gross ones” that motivated women.
“That’s the next research piece,” she says.
What was clear, she adds, was that the grossness campaign brought positive results not only in the study but also in a campus emergency that broke out last April. A week before the study was to be expanded to the entire University, a Norovirus outbreak made 63 students ill over a four-day period. Hand washing was identified as an important way to prevent the disease from spreading.
The University administration urged widespread posting of messages, Botta says. “Luckily, we had messages that had already been tested with the dorm students. Those were the messages that [we] ended up putting out.”
Did the messages stop Norovirus?
“My impression is it helped,” Botta says.
Dunker agrees, as does Kelly Fenson-Hood, health promotion and marketing coordinator at the Health and Counseling Center and a co-researcher on the project. The messages promoted hand washing, which was an important weapon in reducing the spread of the virus.
Botta thinks the lessons of the hand washing campaign could be applied to other campus messages or alerts, although she stresses that every situation is different.
“The relevance of the message is really, really important,” she says. “You can threaten that they’ll get the flu or promise a flu-free winter, but if they don’t really care about that, your message is gonna fall flat.” The keys are “relevance of the message and self-efficacy — look how easy it is to avert [the threat].”
The study is titled “Using a relevant threat, EPPM and interpersonal communication to increase hand washing behaviours on campus.” Authors are Botta, Dunker, Fenson-Hood, Stephanie Maltarich and Dr. Louise McDonald. The study appears in the fall edition of the Journal of Communication in Healthcare.
* * * * *
How to Wash Your Hands
Effective hand washing, health and counseling officials say, requires 20 seconds of vigorous scrubbing with hot water and soap to remove harmful bacteria and the oils they cling to. Botta suggests singing the ABCs or saying them backward to judge how long 20 seconds are.
Also:
A study by the London School of Hygiene and Tropical Medicine, reported in October, found fecal bacteria on the hands of 28 percent of 409 London commuters tested.