Background:
Illness-related absences have been shown to lead to negative educational and economicoutcomes. Both hand washing and hand sanitizer interventions have been shown to beeffective in reducing illness-related absences. However, while the importance of handhygiene in schools is clear, the role of instruction in use is less obvious. The purpose of thisstudy was to compare absenteeism rates among elementary students given access to handhygiene facilities versus students given both access and short repetitive instruction in use,particularly during influenza season when illness-related absences are at a peak.
Methods:
A hand hygiene intervention was implemented from October to May during the 2009/2010academic year, including peak flu season, in two Chicago Public Elementary Schools amongstudents grades pre-kindergarten to eighth grade (ages 4-14). Classrooms were systematicallyassigned to an intervention or control group by grade (cluster design). Hand hygiene facilities(sanitizer and soap) were made available to all students. Students in the intervention groupalso received short repetitive instruction in hand hygiene every 2 months. Only absences as aresult of respiratory or gastrointestinal illness were used to establish illness-relatedabsenteeism rates. Percent absent days were calculated and bivariate analyses were performedto compare percent absent days among students given access to hand hygiene facilities versusstudents given both access and instruction. Prior to the intervention, teachers’ perceptions ofstudents’ hand hygiene were also evaluated. Teacher perceptions were analysed to describeattitudes and beliefs.
Results:
Data were collected and analysed for 773 students reporting 1,886 absences during the studyperiod (1.73% of total school days). Both the percent total absent days and percent illnessrelatedabsent days were significantly lower in the group receiving short instruction duringflu season (P = 0.002, P < 0.001, respectively). This difference peaked in during influenza(when intervention began) and declined in the following months. Teachers (n = 23) agreedthat hand hygiene is not performed properly among students and reported time constraints asa barrier to frequent hand washing.
Conclusions:
Adding hand hygiene instruction to existing hand hygiene practices improved attendance atpublic elementary schools during the flu season. Standardized and brief repetitive instructionin hand hygiene holds potential to significantly reduce absenteeism.