Effect of Digital Method-Based Hand Hygiene Education on Handwashing Skills in Primary School Students

The Effect of Digital Method-Based Hand Hygiene Education on Correct Handwashing Skills in Primary School Students: A Randomized Controlled Trial

The aim of this study is to evaluate the effect of a digitally based hand hygiene education program developed for primary school students on their proper handwashing skills. School-age children are a vulnerable group with regard to infectious diseases, and hygiene behaviors acquired during this period have long-term significance for both individual and public health. Research has shown that primary school students often lack sufficient knowledge and skills regarding personal hygiene and handwashing, highlighting the need for the planning and implementation of hygiene education programs for children.

Although hand hygiene is one of the simplest and most effective methods for preventing the transmission of infections, children frequently do not perform it using the correct technique. The literature indicates that educational interventions significantly improve primary school students' knowledge and skills related to hand hygiene. However, studies examining the effectiveness of digitally designed educational interventions remain limited, which constitutes the primary motivation for this research. The visual, interactive, gamified, and repeatable features of digital content support students' active engagement in the learning process and enhance learning effectiveness.

This study designs a digital-method-based educational intervention aimed at improving students' proper handwashing skills. Initially, the hand hygiene skills of students in both groups will be assessed using the Semmelweis Hand Hygiene Scanner, an objective measurement device that analyzes hand-rubbing techniques during handwashing and provides visual and percentage-based feedback. Subsequently, students' knowledge levels will be assessed through an interactive game. While offering an enjoyable experience for children, the game will simultaneously enable the evaluation of their hand hygiene knowledge. At this stage, no educational intervention will be provided to the control group, whereas students in the intervention group will watch an animated film designed to teach proper handwashing techniques.

Following the implementation of the educational intervention exclusively in the intervention group, measurements will be repeated in both the intervention and control groups on Day 15, at Month 1, and at Month 3. The effects of the digital education program on hand hygiene knowledge and skill levels will then be compared between the groups over time.

The originality of this study lies in its examination of the effects of digital hand hygiene education for primary school students through the use of an objective assessment tool. The study will provide scientific evidence regarding the effectiveness of digital educational methods utilized by school health nurses. From a cultural perspective, it is expected to contribute to the development of proper handwashing habits and the adoption of healthy lifestyle behaviors among children. From an economic perspective, it may indirectly contribute to reducing infection-related hospitalizations and healthcare costs. Furthermore, the animated film and interactive game used during the educational process are expected to increase students' learning motivation, encourage active participation, and provide sustainable learning opportunities. In this way, the study aims to make an original and comprehensive contribution to both the academic literature and school health practice.

Inclusion Criteria:

• Children who have agreed to take part in the study and whose parents have signed a written consent form
• Children with intact skin
• Children without any physical, emotional or behavioural health issues that would prevent them from washing their hands

Exclusion Criteria:

• Children who have had an allergic reaction to the solution
• Children who were absent from school on the day the animation was shown and handwashing took place, and who did not take part in the screening tests