Hand hygiene in Kindergartens: Understanding the effect of live feedback on hand washing behavior

Research Highlights

- Improving hand hygiene can significantly reduce the spread of infectious diseases in kindergartens. The study is going to test an easy-to-implement digital feedback intervention to improve hand hygiene among young children. Together with nursing science researchers from the University of Turku, both the effects of live-feedback on compliance will be measured and the underlying mechanism of self-empowerment of children will be investigated.

- If the presented study confirms the predicted large effects of live-feedback in a kindergarten context, the experiment can be extended to additionally investigate self-efficacy and habit formation.



In kindergartens, where small children quickly absorb and spread infectious diseases, good hand hygiene practice has been shown to significantly reduce the number of sick days. Washing hands thus contributes to the well-being of the little ones and also reduces the burden on the health care system and the number of absences when parents of sick children cannot come to work. Consequently, considerable efforts should be made to improve hand hygiene in kindergartens, especially in times of pandemics. Nevertheless, viable, easy-to-implement options to improve children's hand hygiene that do not absorb too much time of the staff are missing.


- In a randomized controlled field trial, we test a digital feedback intervention provided during hand washing in kindergartens (“live feedback”).

- All participating kindergartens will be equipped with sensors measuring the duration of water extraction as well as soap and towel usage. Furthermore, a "how-to-handwash" session will be conducted in all kindergartens at the beginning of the study.

- In selected kindergartens, children will be presented a motivating animation during hand-washing on a display close to the sink. In the remaining kindergartens, children do not get any feedback intervention, serving as the control group.


We are going to determine effect sizes of the intervention and test if motivating feedback empowers kindergarten children to achieve better hand hygiene in the long term. Thus, the study is designed to provide empirical evidence for digital interventions as a viable and easy-to-implement instrument to sustainably increase hand-hygiene. 

Selected publications

Work in progress.




Joanna Graichen, Carlo Stingl, Sebastian Guenther and Thorsten Staake together with a research team from the University of Turku, Finnland.

Partners: Oras AG, Amphiro AG




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