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Trop Med Int Health. 2012 May;17(5):604-12. doi: 10.1111/j.1365-3156.2012.02966.x. Epub 2012 Mar 5.

Prevalence and associated psychosocial factors of increased hand hygiene practice during the influenza A/H1N1 pandemic: findings and prevention implications from a national survey in Taiwan.

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Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.



To investigate increased hand hygiene practice in response to the pandemic influenza A/H1N1 (pH1N1) and its associated psychosocial factors in the Taiwanese general population.


A national telephone survey using random digit dialing was conducted on October 28-30, 2009 in Taiwan, resulting in a final sample of 1079 participants aged 15 or older.


Seventy-seven per cent reported that they increased hand hygiene practice during the pH1N1 epidemic. Multivariate logistic regression analysis showed that increased hand hygiene practice was associated with health beliefs that pH1N1 was more transmissible than avian influenza (OR = 1.42); that pH1N1 was slightly more severe in Taiwan compared with other countries (OR = 1.59); that handwashing was very effective in preventing pH1N1 (OR = 3.12), and that handwashing after contact with possibly pH1N1-contaminated objects/surfaces was not very difficult (OR = 2.14) or not difficult at all (OR = 2.49).


These findings suggest that future campaigns to promote preventive health behaviour in the public should consider communicating evidence-based information concerning the effectiveness of the recommended preventive behaviour, comparing the emerging epidemic with prior local outbreaks, and not overplaying the seriousness of the disease with fear tactics.

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