Proper Hand-Washing Techniques in Public Restrooms - Differences in Gender, Race, Signage, and Time of Day - Study

Oct 15, 2026

Uploaded by Grenda

This study evaluates hand-washing behaviors in public restrooms with and without reminder signs, analyzing compliance differences by gender, race, signage, and time of day. Observations were collected from male and female adults entering restrooms at two public shopping malls in a Midwestern city in October 2001, totaling 599 observations. Full CDC guideline compliance occurred in 31.7% of cases, while 68% did not wash or washed less effectively. Differences were significant by gender and race, but not by signage or time of day.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

Participants and Setting

Methods and Compliance Levels

Hand-Washing Sign Categories

Key Findings

Proper Hand-Washing Techniques in Public Restrooms: Differences in Gender, Race, Signage, and Time of Day Andrea Kinnison, Randal R. Cottrell, and Keith A. King ABSTRACT The purpose of this study was to evaluate hand washing behaviors in public restrooms with and without reminder signs. Gender, race, signage, and time of day were examined to determine if there were differences in hand washing compliance based on these variables. Participants included male and female adults entering restrooms at two public shopping malls in a midwestern city. The total number of observations made was 599. Of those observed, full handwashing compliance (based on CDC guidelines) was accomplished by 190 (31.7%) individuals. Sixty-eight percent either did not wash their hands or washed them in a less effective way. Significant differences were noted in handwashing compliance based on gender and race. Females and non-Caucasians were more likely to wash their hands than were males and Caucasians. No significant differences in hand washing were noted based on signage or time of day. The most common way to spread infections is via the hands (Coignard et al., 1998) . Thus, hand washing is one of the most effective tools for preventing the spread of infection. Semmelweiss, a physician and epidemiologist, first noted the importance of hand washing in the 1800s (Timmreck, 1998) . In the United States, however, hand washing rates range from 60%-78%(“Did you wash,” 1996) . The transmission of disease through the fecal-oral route poses a serious public health problem. Eshericia coli 0157:H7, cholera, typhoid fever, salmonella, cryptosporidiosis, the common cold, shigella, and Hepatitis A are just a few examples of diseases that could be caused by improper hand washing (Timmreck, 1998) . Fecal oral disease transmission occurs when microorganisms found in the feces enter the mouth through food, water, or not washing hands after using the toilet. Key preventive strategies include hygiene education and proper hand washing (Benenson, 1995) . Low hand washing rates have been attributed to lack of knowledge about the importance of hand washing and lack of motivation (Centers for Disease Control and Prevention [CDC], 1985) . No published study to date has examined whether handwashing differs based on gender, race, and time of day. Previous studies have not examined handwashing signs to determine their effectiveness. Several studies have examined hand washing campaigns among day care centers. These campaigns include education, activities and handwashing signs (Munger & Harris, 1989) . The present study examined whether hand washing behaviors differ based on these variables. In addition, the effect of hand washing signs in public restrooms on hand washing was investigated. Previous hand washing reports in the literature had limited observations to only one gender and no studies examining different races could be found. By studying race, gender, the effectiveness of reminder signs, and time variables this study sought information to better direct future hand washing programs and campaigns. Identifying gender or racial differences could provide preliminary evidence to help health educators better focus future hand washing programs in adult populations. Results from this study could also help determine if hand washing signs Andrea Kinnison, MEd, is with the Department of Public Health at the University of Toledo, Toledo, OH 43606. Randal R. Cottrell, DEd, CHES, is a professor, and Keith A. King, PhD, CHES, is an assistant professor at the University of Cincinnati, P.O. Box 210002, Cincinnati, OH 45221. Andrea Kinnison, Randal R. Cottrell, and Keith A. King are effective, and if funds should be spent purchasing signs. Examining handwashing rates based on time of day may reveal if people are more likely to wash hands at or around the lunch hour. METHODS Participants The participants of this study were male and female adults entering the restroo

FAQs

What was the study designed to evaluate?

The study evaluated hand-washing behaviors in public restrooms with and without reminder signs and tested whether compliance differed by gender, race, signage, and time of day.

How was full hand-washing compliance defined?

Full compliance was defined using CDC guidelines as washing both hands with soap, rubbing to produce lather for 15 seconds.

Did reminder signage or time of day affect hand washing?

No significant differences were found based on signage or time of day in the study results described in the abstract.

Oct 15, 2026

Uploaded by Grenda