Online-only: Posters motivate college men to wash hands
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* Natalie McGill

Men still have some catching up to do with women when it comes to regular bathroom hand-washing, but a new study in January’s Human Communication Research journal shows a simple visual boost may be all that is needed.

The study, conducted over a year and a half at a Michigan State University men’s restroom, showed that bathroom visitors were more likely to wash hands after seeing a hand-washing poster than students in restrooms without one. Researchers waited in bathrooms to observe the hand-washing.

The study focused on men instead of women because there is more room for improvement in hand-washing among men. Seventy-seven percent of men in the U.S. regularly wash their hands after leaving a bathroom, compared to 93 percent of women, according to the Centers for Disease Control and Prevention.

The study used posters to promote hand-washing. Two posters were used that differed slightly, but each resulted in more hand-washing among the 252 men in the study, meaning the presence of a hand-washing poster alone was enough to change behavior, said Maria Lapinski, PhD, a study author and associate dean for research at Michigan State University’s College of Communication Arts and Sciences. The posters used a humorous rivalry between colleges to deliver its message, she said.

The first poster image was of five men facing a urinal — four wearing backwards Michigan State University hats and one in a cap from rival school University of Michigan — with the text “Four out of five college students wash their hands every time they use the bathroom.” Eighty-one percent of men who saw a poster washed their hands.

The second poster was the opposite — four men in backwards University of Michigan hats and one in a Michigan State University cap. The text below said, “One out of five college students wash their hands every time they use the bathroom.” Eighty-eight percent of men who saw a poster washed their hands. Among those who did not see a hand-washing poster, 70 percent of men washed their hands, the study said.

The fact the posters centered on a rivalry between the two state universities also influenced behavior, Lapinski said.

“From there, I think that humor combined with simple guidance on what people are supposed to do ultimately prompted people to act,” Lapinski told The Nation’s Health.

However, just because the men washed their hands does not mean they washed them properly, the study said. Bathroom observers judged the hand-washing according to CDC recommendations. Those recommendations include covering the palms with soap and using a towel to turn off the faucet instead of a bare hand.

From a public health perspective, hand-washing makes a difference in places such as college campuses, said Elaine Larson, PhD, RN, FAAN, a consultant to the World Health Organization on hand hygiene and an associate dean of research at Columbia University’s School of Nursing. Living on a campus and interacting with multiple people means a better chance for an infection to spread among students whose immune systems may already be weakened from factors such as lack of sleep, she said.

People become more aware of hand-washing during the flu season, but in general the practice is so habitual that people do not put much stake in it, Larson said. The amount of time spent washing is not as important as the attention paid to washing all hand surfaces, such as the fingertips, which collect more germs than other parts of the hand, she said. Experts recommend washing your hands for at least 20 seconds.

“If you’re actually conscious of covering all the surfaces of your hand it will cost you at least 10 seconds,” Larson told The Nation’s Health. “You can wash your hands for 10 seconds and still not touch the right areas.”

For more information on the study, visit [http://onlinelibrary.wiley.com/doi/10.1111/j.1468-2958.2012.01441.x/full](http://onlinelibrary.wiley.com/doi/10.1111/j.1468-2958.2012.01441.x/full). For more hand-washing tips, visit APHA’s Get Ready campaign at [http://www.getreadyforflu.org/handwashing.htm](http://www.getreadyforflu.org/handwashing.htm).

*   Copyright The Nation’s Health, American Public Health Association