Hygiene perception changes during the influenza A H1N1 pandemic in Germany: incorporating the results of two cross-sectional telephone surveys 2008–2009

Background: The federal campaign Wir gegen Viren [Us against viruses] promoted hygiene in Germany during the influenza A H1N1 pandemic in 2009. The intervention aimed to encourage people to protect themselves against respiratory infections by simple means of hygiene behaviour. Quantitative research was carried out to outline changes in hygiene perception of the population over time, and to find out whether the potential hygiene perception changes were consistent to the federal campaign about hygiene or not. Methods: To determine changes in the hygiene perception of the population, two cross-sectional telephone surveys were held, each one with n = 2006 participants. The initial survey was carried out before the influenza A H1N1 pandemic in calendar week 49–51 in 2008 and the second in week 48 in 2009 directly after the peak of the pandemic in Germany. The questionnaire contained indicators about perceived hand hygiene efficacy, preference for coughing into the sleeve, propensity for presenteeism while showing symptoms of a cold and acceptance of hygiene masks. Results: The proportion of people who perceive the efficacy of hand washing as “very good” increased significantly from 50.9% in 2008 to 61.1% in 2009. The proportion of people who perceive coughing into the sleeve as the best way to cough increased even more dramatically from 4.8% in 2008 to 38.3% in 2009. In contrast the propensity for presenteeism decreased significantly: The proportion of people who state that they always report to work while they show symptoms of a cold decreased from 50.8% in 2008 to 40.9% in 2009. Acceptance of hygiene masks has not changed significantly from 2008 to 2009. Conclusions: The results revealed changes in hygiene perception during influenza A H1N1 pandemic in Germany. The changes we found are in accordance with the hygiene recommendations given by the federal campaign Wir gegen Viren [Us against viruses]. Results can constitute a practical benchmark for future research about hygiene perception and hygiene promotion for adults. A pivotal question is: does the increase in hygiene perception persist after the pandemic has ceased

Mit Wasser und Seife gegen die Grippe

Pharmazeutische Maßnahmen wie die Impfung und die antivirale Prophylaxe sind nur 2 Bausteine zum Infektionsschutz der Bevölkerung. Ein dritter, entscheidender Baustein sind einfache, nicht-pharmazeutische Maßnahmen wie die Händehygiene. In einer qualitativen Studie wird zunächst ermittelt, wie das Händewaschen aktuell in der Bevölkerung verankert ist. Darauf aufbauend werden 7 Hypothesen formuliert, die Bedarf für weitere Forschung zur Förderung der Händehygiene aufzeigen. Das Potenzial für derartige Forschung liegt beispielsweise in der Konzeption und Evaluation von Informationskampagnen zur Händehygiene. Die 7 Hypothesen lauten: Hypothese 1 Gesundheitstipps haben eine höhere Chance auf Verhaltensänderung, wenn sie dem Rezipienten die persönliche Betroffenheit verständlich und erlebbar machen. Hypothese 2 Hygiene dient hauptsächlich dem Wohlgefühl und der Gesellschaftsfähigkeit. Hypothese 3 Eine emotionale Verbindung zwischen Hygiene und Gesundheit besteht durch das Ekelgefühl. Hypothese 4 Das Händewaschen wird vorwiegend rituell und nach gefühltem Bedarf durchgeführt. Hypothese 5 Der Ansteckungsweg von Grippe/Atemwegsinfektionen ist bisher nur so weit bewusst, wie er beobachtbar ist, also in Bezug auf Husten, Niesen und dabei entstehende Tröpfchen. Hypothese 6 Das Bewusstmachen des Übertragungswegs „Hand“ steigert die Motivation zum Händewaschen. Hypothese 7 In der Pandemie erhöht sich der Informationsbedarf und die Bereitschaft zum persönlichen Infektionsschutz.Medical interventions like vaccination and antiviral prophylaxis are only two ways of protecting the population from infectious diseases. A third and decisive method is to apply non-pharmaceutical interventions like hand hygiene. A qualitative study identified the role hand washing actually plays in the daily life of the population. Based on the results, seven hypotheses are proposed which point to the need for further research about promotion of hand hygiene, e.g. the conception and evaluation of hand washing advertising campaigns. Hypothesis 1 Health tips are more likely to be followed if they communicate clearly and understandably the personal relevance of the information to the recipients. Hypothesis 2 For many, hygiene serves above all to make them feel good and more comfortable around others. Hypothesis 3 The feeling of disgust is an emotional connection between health and hygiene. Hypothesis 4 People mainly wash their hands ritually and when they actually feel the need to clean their hands. Hypothesis 5 As far as most people are aware, the means of transmission of influenza and other respiratory diseases are only the ones they can observe, namely coughing, sneezing, and the resulting visible droplets. Hypothesis 6 People are more motivated to wash their hands after learning that infections can be spread via the hands. Hypothesis 7 A pandemic situation increases the population’s demand for information and people’s willingness to protect themselves from infection