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Table 3 Selection* of the most relevant techniques and their determinant with this overview

From: A systematic review of hand hygiene improvement strategies: a behavioural approach

Determinant Behaviour change technique Description of the activity in studies
Knowledge Provide general information Educational sessions or educational materials
Increase memory or understanding of information Group discussion, answering questions, clarification
Awareness Risk communication Information about risks of non adherence or inadequate hand hygiene (infection rates, costs)
Delayed feedback of behaviour Overview of recorded hand hygiene behaviour
Direct feedback of behaviour Using a system to make professionals aware of their hand hygiene behaviour soon after planned execution
Feedback of clinical outcomes Overview of nosocomial infections
Social influence Provide information about peer behaviour Information about peers’ opinions of correct hand hygiene
Provide opportunities for social comparison Group sessions with peers in which discussion and social comparison of hand hygiene practices can occur
Mobilise social norm: Exposing the professional to the social norm of important others (not peers) such as opinion leaders
Attitude Persuasive communication Positive consequences of proper hand hygiene
Reinforcement of behavioural progress Praise, encouragement, or material rewards
Self-efficacy Modeling Use of a role model. Demonstration of proper hand hygiene behaviour in group, class, or team
Verbal persuasion Messages designed to strengthen control beliefs about the way of performing correct hand hygiene
Guided practice Teaching skills and providing feedback. Specific instruction for correct hand hygiene behaviour
Plan coping responses Identification and coping with potential barriers
Set graded tasks, goal setting: Desired hand hygiene behaviour is achieved with a stepwise model
Intention General intention information Explanation of the goals and targets concerning hand hygiene
Agree to behavioural contract Contract or commitment with formulated goals of hand hygiene behaviour
Action control Use of cues Reminders
Maintenance Following behavioural change Not addressed
Facilitation of behaviour Provide materials to facilitate behaviour Supportive materials are provided for the healthcare workers
  Continuous professional support Involves service provided by infection control team or working group, and/or an additional nurse who attends the implementation
  1. * Only terms and definitions for techniques identified in the studies on promoting hand hygiene in healthcare workers are presented.