Agata Slota | Palladium - Apr 17 2020
Handwashing Campaigns Aren't Always Effective, but Behavioural Science Can Help

Photo Credit: Melissa Jeanty

Why is it that despite knowing that germs spread more easily when we don’t wash our hands, so many of us still don’t bother? A study in the UK showed that only 32% of men and 64% of women washed their hands after leaving a bathroom (even though 99% claimed they had), and only 19% of the world’s population is estimated to wash their hands with soap after using the bathroom or changing a baby.

Hand washing is one of the most cost-effective means of preventing the spread of infectious disease, and yet knowing how germs spread doesn’t seem to change many people’s hand hygiene habits. Educational campaigns explaining the health benefits of clean hands have proven largely ineffective, in particular when it comes to sustained change.

In the midst of the current pandemic, appeals to hand washing are more prominent than ever. Will the fear of COVID-19 finally change people’s behaviour? We do know that during outbreaks of cholera and flu, health appeals tend to be more convincing. And yet, an international study found that during the 2009 swine flu, only 53% of people washed their hands more frequently than usual.

What we don’t know is how many people are concerned enough about contracting COVID to change their hand washing habits. After all, other behavioural changes to “flatten the curve”, such as physical distancing and the use of face masks, have had to be imposed by force and the rule of law in many countries. Less conspicuous behaviours are much more difficult to track and enforce.

So, what can be done to improve the success of hand washing programs, once the basics of access to soap and water are taken care of? Behaviour change in social contexts is complex, but there are lessons to be learned from the field of cognitive psychology and social campaigns across the globe. Here are three approaches to try.

Think of our loved ones

Recent research suggests that we’re more likely to make small sacrifices if they are on behalf of others. This means that messages that focus on how a new, inconvenient behaviour benefits others could be more persuasive than highlighting the benefits to ourselves. It is also known that simple, well-placed reminders can be effective in promoting action.

In this case, messages shouldn’t simply direct people to wash their hands, but explicitly link handwashing with a concern for others, especially family and friends. “Wash your hands, protect your family” on a bathroom poster could be much more powerful than “Clean hands keep you healthy.”

Apply peer pressure

Peer-pressure and the presence of others have repeatedly been shown to improve hand hygiene. In contexts where hand washing is believed to be the ‘right thing' to do, we are much more likely to wash our hands if someone else is nearby or if we are reminded of others’ potential disapproval.

In a study carried out in a public bathroom in the UK, signs that read “‘Is the person next to you washing with soap?’ resulted in a 12.1% increase in hand-washing ratio among men and a 10.9% increase among women.” Even creating the impression that hand washing is common or widely expected can encourage the behaviour.

Using the power of social norms is still an option while social distancing. A reminder that others would disapprove of us not washing our hands can be effective without anyone round.

Inspire a commitment

‘Public commitments’ have been repeatedly proven effective in changing behaviours. When we share with others that we will make a change in our lives, we are much more likely to go through with that plan. Not surprisingly, such a nudge works best when the change can be observed by others, but even behind closed doors, expressed commitments are effective.

Commitments can even lead to sustained change. When we pledge that we’ll take an action, and then follow through, we begin to experience a change in how we see ourselves (e.g., “I’m a person who washes their hands all the time”). Because of our inherent desire for self-consistency, this makes us want to continue washing our hands long after the original pledge, even if the self-image we are trying to maintain was originally someone else’s idea.

In practice, a handwashing campaign could encourage people to share posts on social media that declare “I wash my hands to help stop the spread of COVID.” Or where in-person or video conference meetings are held, leaders could ask attendees to stand or otherwise indicate if they are willing to commit to washing their hands.

For any behaviour change initiative, the same caveats apply: every context is different, and interventions need to be tested (even if very quickly and on a small scale) to check their applicability to local conditions, customs, and constraints. But thinking like a behavioural scientist could go a long way toward consistently better hygiene habits and slowing the spread of COVID-19.

Agata Slota is an expert in communication and behaviour, which she applies to social change and governance programs across Europe, the Middle East, and Africa. Contact to learn more.