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Evaluating a handwashing with soap program in Australian remote Aboriginal communities: a pre and post intervention study design

McDonald, Elizabeth L., Cunningham, Teresa E. and Slavin, Nicola (2015). Evaluating a handwashing with soap program in Australian remote Aboriginal communities: a pre and post intervention study design. BMC Public Health,15(Article No. 1188).

Document type: Journal Article
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Title Evaluating a handwashing with soap program in Australian remote Aboriginal communities: a pre and post intervention study design
Author McDonald, Elizabeth L.
Cunningham, Teresa E.
Slavin, Nicola
Journal Name BMC Public Health
Publication Date 2015
Volume Number 15
Issue Number Article No. 1188
ISSN 1471-2458   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84948687488
Total Pages 12
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
The No Germs on Me (NGoM) Social Marketing Campaign to promote handwashing with soap to reduce high rates of infection among children living in remote Australian Aboriginal communities has been ongoing since 2007. Recently three new television commercials were developed as an extension of the NGoM program. This paper reports on the mass media component of this program, trialling an evaluation design informed by the Theory of Planned Behaviour (TPB).

A survey questionnaire taking an ecological approach and based on the principals and constructs of the TPB was developed. Surveys were completed in six discrete Aboriginal communities immediately before and on completion of four weeks intensive televising of the three new commercials.


Across the six communities access in the home to a television that worked ranged from 49 to 83 % (n = 415). Seventy-seven per cent (n = 319) of participants reported having seen one or more of the new commercials. Levels of acceptability and comprehension of the content of the commercials was high (97 % n = 308). Seventy-five per cent (n = 651) of participants reported they would buy more soap, toilet paper and facial tissues if these were not so expensive in their communities. For TPB constructs demonstrated to have good internal reliability the findings were mixed and these need to be interpreted with caution due to limitations in the study design.

Cultural, social-economic and physical barriers in remote communities make it challenging to promote adults and children wash their hands with soap and maintain clean faces such that these behaviours become habit. Low levels of access to a television in the home illustrate the extreme level of disadvantage experienced in these communities. Highlighting that social marketing programs have the potential to increase disadvantage if expensive items such as television sets are needed to gain access to information. This trial of a theory informed evaluation design allowed for new and rich information to be obtained about community members’ beliefs, attitudes and intentions towards teaching and assisting children so safe hygiene behaviours become habit. Findings will support an evidence-based approach is taken to plan future NGoM program activities.

Keywords Hygiene
Australian Aboriginal
Theory of planned behaviour
Behaviour change
Social marketing
Health promotion
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Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License

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