Thesis (M.A.)--Marshall University, 2002. / Title from document title page. Document formatted into pages; contains viii, 80 p. Includes vitae. Includes bibliographical references (p. 54-56).

Thesis (M. P. H.)--University of Hong Kong, 2005. / Also available in print.

Thesis (M.S.)--Missouri State University, 2008. / "November 2008." Includes bibliographical references (leaves 54-57). Also available online.

Thesis (M.P.H.)--University of Hong Kong, 2005.

Thesis (M. P. H.)--University of Hong Kong, 2010. / Includes bibliographical references (p. 58-62).

Source: Masters Abstracts International, Volume: 47-06, page: 3556. Adviser: T. Robert Harris. Includes bibliographical references.

Introduction: Hand hygiene, the most effective and economical way to prevent the transmission of many bacteria and viruses in healthcare settings, yet, its compliance rate remained unacceptably poor in many countries. Compliance with hand hygiene among healthcare workers increased substantially during outbreak of serious acute respiratory symptoms (SARS) in 2003 but decreased to the baseline after SARS, to improve compliance rate sustainable, many hand hygiene intervention programs have been established since 2003. However, the effectiveness of these programs were in big variations. The objectives of this review were to identify the effectiveness of these hand hygiene intervention programs. Methods: This review was conducted using the search engines – PubMed. The key words “hand hygiene”, “hand-washing”, “compliance”, “healthcare personnel”, and “program*” were used for searching literature published from 2003 to July 2012.. Forty-Seven articles were initially obtained. After screening and reviewing of these articles,9 articles met the requirements for inclusion and exclusion criteria were included in this review. The outcome measure was set as the differences and relative ratios in the observed hand hygiene compliance rate before and after intervention. Results: Results showed that 8 hand hygiene programs were effective while 1 programme was ineffective in improving hand hygiene compliance rates. Of the eight studies that reported improvement in compliance with hand hygiene, improvement in compliance rate after the interventions was ranged from (24% to 50%) while the relative ratio of compliance (after vs. before intervention) was ranged from 1.78 to 4. The study that reported no improvement in compliance with hand hygiene had a relative high naseline hand hygiene compliance rate of 61% Conclusion: Hand hygiene programs that improve compliance rate among healthcare workers were effective overall. The effectiveness of hand hygiene programs seemed to be positively associated with the numbers of intervention types involved. Research on non-compliance and intrapersonal behavior on hand hygiene was suggested for future investigation. / published_or_final_version / Public Health / Master / Master of Public Health

BACKGROUND Influenza is a potential threat to life, economies and security in our globalized world. However, it is still unclear how efficacious non-pharmaceutical interventions are in reducing the virus’ transmission and how the underlying mechanisms of its transmission modes work. Since 2008, numbers of randomized controlled trials (RCTs) regarding the efficacy of hand hygiene interventions in reducing influenza transmission have been published, yet no metaanalysis has ever been performed. Besides, a guinea pig model in 2009 showed that the efficiency of aerosol transmission is adjusted by the ambient temperature and humidity. Therefore, further evidence is needed to confirm the hypothesis. OBJECTIVES To evaluate the efficacy of hand hygiene interventions alone or combined with facemasks in reducing influenza transmission in the community and to investigate the possible roles of latitude, temperature and humidity in relation to the efficacy of the interventions in controlling the spread of influenza. SEARCH METHODS This meta-analysis followed the PRISMA statement. I searched the MEDLINE, PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Library databases. SELECTION CRITERIA I included all RCTs assessing the effect of hand hygiene interventions in preventing influenza spread in community settings with clear outcome definitions of laboratory confirmed influenza, clinically diagnosed influenza-like illness (ILI) and their related absenteeism. DATA COLLECTION AND ANALYSIS I ranked the methodological quality of each outcome with GRADEprofiler. I also assessed the heterogeneity across RCTs using I2 statistic and publication bias through visual inspection of Begg’s funnel plots and statistical assessment of regression and rank-correlation. I conducted the meta-analysis with random-effect models and further performed separate analyses for developed and developing countries data in case of a significant level of heterogeneity being noted across the studies. I also incorporated meta-regression to assess the association of latitude, temperature and humidity with the efficacy of hand hygiene interventions. RESULTS I identified 1,593 articles in the initial database search, excluded 1,535, included five from reference lists of review articles, retrieved full articles of 33 and included ten for analysis. The quality of evidence of both laboratory confirmed influenza and ILI were high while that of absenteeism was low. The combination of hand hygiene interventions and facemasks contributed to a significant 45% reduced risk of influenza-related absenteeism in the combined country data while it contributed a significant 23% to a reduced risk of both laboratory confirmed influenza and ILI in developed countries subgroup analysis. The metaregression revealed that the efficacy of the combination of hand hygiene interventions with facemasks increased in a less humid environment. CONCLUSIONS The combination of hand hygiene interventions with facemasks is an effective low-cost intervention to prevent influenza. Further studies to assess the association between humidity and mode of influenza transmission are critically important to support the international guideline on hand hygiene interventions and facemask use. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (M.S.)--Oregon State University, 2005. / Printout. Includes bibliographical references (leaves 74-82). Also available online.

Signs are commonly used in the foodservice industry to portray food safety messages. However, many of these signs do not consider employee preferences or current needs in the industry. Employee perceptions can provide crucial information about the design of effective food safety messages. Surveys were conducted with meat and poultry processing employers in the mid-Atlantic region to determine food safety needs in the industry. Follow-up focus groups in both English (5) and Spanish (5) were conducted based on language availability and size. The most important food safety topics were hand washing (60.9%), cleaning/sanitizing (78.3%), and cross contamination (69.9%). Employees believe that color, text, and multiple language options could increase employee recognition and retention of intended messages. New, employee-driven hand washing signs were developed from the information in the focus groups. Signs were evaluated by video observation through five hand washing practice behaviors (soap use, complete wash, time to wash, complete rinse, and towel use) at two different poultry processing facilities in the mid-Atlantic at three different time points (baseline, short term, and long term). Soap use significantly increased at both facilities when baseline data was compared to short term and long term time periods. Facility B showed a significant increase in washing, time, and rinsing when baseline data was compared to short term, which indicates that a new sign could increase hand washing compliance. Sign color had a significant effect on behavior for washing and time of washing, while time had a significant effect on behavior for four of five variables tested. New signs could be a useful way to encourage compliance to food safety message for multicultural employees; however, they may need to be frequently changed as workers tend to refer back to old habits. / Ph. D.