Making a song and dance about hand hygiene

By Kathryn Lim* and Dr Holly Seale^
Monday, 27 August, 2018

Making a song and dance about hand hygiene

Healthcare organisations around the globe are creating entertaining videos to promote hand hygiene and sharing their efforts on YouTube. But how effective is this medium at educating on this important topic? A UNSW study pursued the answer.

Healthcare-associated infections, and the ability of hand hygiene to help prevent the spread of infectious diseases, is far from your usual topic of entertainment. However, since the advent of YouTube we have seen more and more videos dedicated to promoting hand hygiene using song and dance.

Is it out of sheer frustration that our infection prevention and control (IPC) experts are turning their back on traditional posters and in-house education sessions and adopting a new approach to ‘promote’ hand hygiene to their colleagues?

Given the volume of YouTube followers (just behind Facebook with 1.8 billion monthly users), have these IPC experts stumbled onto a new strategy that could influence both healthcare professionals and consumer behaviour?

Entertainment and hand hygiene promotion

Entertainment-education is a communication strategy that harnesses the power of entertainment in order to deliver an educational message that brings about behavioural and social change in its audience. This strategy has been used to deliver public health messages across a range of topics, including reproductive health, family planning and HIV prevention.

YouTube has emerged as a platform for hosting health-related entertainment-education content, and is being harnessed to promote health-related messages across networks and communities on a local and global scale. Increasingly, individuals and organisations have used YouTube to promote infection control in unique and creative ways, despite a limited understanding of the quality, impact and effectiveness of these videos.

As a starting point to investigating this, we conducted a social media content analysis of YouTube videos that focused on entertainment-education related to hand-hygiene promotion, to explore the extent to which these videos are produced, shared and interacted with.

Exploring the content — educational usefulness

Our paper, published in the American Journal of Infection Control, analysed YouTube videos that were directed at healthcare professionals and promoted or educated on hand hygiene principles in an entertaining manner. The search terms “hand hygiene” and “hand hygiene education” were used to query YouTube, resulting in over 900,000 hits.

Videos were systematically evaluated and grouped according to educational usefulness against our author-designed checklist. The videos were further evaluated against the categories of attractiveness, comprehension and persuasiveness; they were also informally evaluated from a qualitative perspective, resulting in descriptive analyses of observational features, such as cultural, ethnic and occupational diversity contained within the audiovisual content.

The videos used a range of entertaining means to promote hand hygiene messages, including music videos, skits and parodies. In several videos, appropriating or adapting lyrics to popular music was a strategy, and included the performance of original lyrics to the tune of recognised songs by popular artists (for example, The Beatles, Michael Jackson and Psy).

Just over half of the 70 YouTube videos analysed were categorised as educationally useful. Overall, they also scored higher than non-educationally useful videos across the categories of attractiveness, comprehension and persuasiveness.

These videos were more likely to have a higher median video duration, be produced in North America and demonstrate organisation-wide involvement or implied or explicit involvement of an executive leadership team member.

Lessons learnt

Want to create your own song and dance on hand hygiene?

Our study highlighted that educationally useful videos related to hand hygiene are clearly available. However, miscommunication of the “five moments of hand hygiene” concept was observed in several YouTube videos, and those which showed dance routines were more likely to have incomplete or incorrect demonstration of hand hygiene technique.

We also found that there is an opportunity for video content to be aligned with best practice principles, and for social media and health marketing strategies to exploit this medium to promote hand hygiene messages. This could include referring to the CDC Social Media Toolkit for guidance, ensuring that messaging remains clear and accurate, and including clear calls to action to maximise the effectiveness, reach and sustainability of this content.

*Kathryn Lim has a degree from the University of New South Wales in public health and international public health. She has a strong interest in public health policy and program initiatives, informed by her professional training as a pharmacist.

^Dr Holly Seale is a Senior Lecturer at the School of Public Health and Community Medicine, University of New South Wales. She leads a program of research that is focused on the social science aspects of infectious diseases and infection prevention, and has a special interest in how we educate, communicate and engage staff and patients around infection prevention, antimicrobial resistance and control.

Image credit: ©

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