Innovative Method to Teach Tots About Personal Cleanliness

Swine flu reminded us how important washing our hands can be. Studies show that simple handwashing can decrease communicable gastrointestinal diseases by 50 percent and communicable respiratory diseases by 20 percent. Now, with schools at special risk for swine flu, a TelAvivUniversity researcher is bringing that message to educators and researchers.

Dr. Laura Rosen worked on a program to educate boys and girls ― and their teachers ― on the good sense of handwashing. And she’s had astounding success: using a combination of teacher education and teaching tools such as puppet shows and songs, she has increased the practice of handwashing before lunch in participating schools from 25 percent to about 60 percent. Her findings were published in the March 2009 issue of Health Education Research.

Rosen, of Tel Aviv University’s School of Public Health, studied 40 pre-schools and kindergartens in the Jerusalem area and discovered that teachers were often unaware of the direct connection between handwashing and health. “There was no connection being made between hygiene and illness,” she said, “so basic hygiene wasn’t being taught.”

Some of the practices in the pre-schools and kindergartens, such as the use of communal cups and common towels, indicated the need for education on disease transmission. Many of the educators lacked knowledge of how illness can be transferred. “We mostly wanted to get the message through to the educators,” says Rosen. “The teachers had a really important role ― whether the kids were washing their hands or not depended on the teachers,” who needed to provide an example for their charges.

To change the teachers’ behavior, Rosen and her fellow researchers used a multi-pronged approach that focused on the children as well. “You need to work on attitude,” she explains. “We ran seminars for teachers and taught them about the transmission of diseases.”

The next step for Rosen was to give the schools the tools they needed to put the theory into practice. “It was essential to give teachers the tools to change their students’ behaviour,” she said. “Some places didn’t even have soap. If you have a population that knows how important it is to wash hands, but doesn’t have soap, they aren’t in a very good situation. We also wanted to cut back on the sharing of cups, so we gave them individual cups.”

Rosen and her fellow researchers communicated the importance of handwashing to the educators with the use of a petri dish experiment. They asked educators to put their hands in three dishes: the first without washing their hands, the second after washing with water, and the third after washing with water and soap. By seeing colors that highlighted the bacteria, the educators could see the effects of handwashing for themselves, says Rosen.

Rosen first decided to tackle the issue when she became frustrated with the frequent illnesses of her own young children. “As a mother, I couldn’t figure out what was happening,” she said. “I was looking for ways to keep my family healthy.” Her research was conducted when she was a PhD student at HebrewUniversity. “The major lesson is that hygiene and the transmission of illness are ongoing concerns,” she concludes. “And children have better things to do than to be sick all the time.”