It’s not ‘news’ that handwashing prevents the spread of disease, from the common cold to the novel … [+]
dpa/picture alliance via Getty Images
The need for handwashing isn’t new in this time of the novel coronavirus pandemic, but it is more important now than ever that we keep our hands clean to prevent the continued spread of the virus. We all know we should wash our hands regularly in order to achieve this, but intention doesn’t necessarily translate into action. And given the shockingly low historic rate of handwashing in general (an average adherence of 38.7% among healthcare workers according to the World Health Organization), it seems fair to say that we don’t wash our hands as reliably as we know we should. With the coronavirus pandemic continuing to spread, behavioral scientists have risen to the occasion to offer suggestions that can help us act on our best intentions to wash our hands: not just regularly, but correctly.
The solutions in this compilation fall into seven categories: reminders, pleasure, disgust, commitment, bundling, visual cues, and virtue.
Set Timely and Salient Reminders
Ovul Sezer decorated her bathroom with streamers, balloons and birthday bags as a timely and salient … [+]
Set salient (and amusing) in-context reminders. By now you’ve heard about singing happy birthday twice to get to the recommended 20 seconds of handwashing, but how will you make sure you remember at the right time and place? Ovul Sezer decorated her bathroom with streamers, balloons and birthday bags as a timely and salient visual reminder.
Make out-of-context reminders salient by placing them in your visual field. Jonathan Corbin recommends writing “WASH YOUR HANDS!” on sticky notes and putting them in areas where you generally have to wash your hands after engaging in an activity in that area (such as the kitchen, dining room or front door of your house). Or, use technology to prompt you at regular intervals (similar to the Apple Watch’s “stand” feature), you could set up recurring reminders to prompt you to wash your hands.
Use evidence-based posters. The Behavioral Insights Team in the UK recently conducted a study testing the effectiveness of various posters intended to encourage handwashing, and found that those with bright, clear designs and minimal text with an emphasis on the step-by-step procedure worked best. If you want to hang something up in your bathroom, you might choose a poster like this:
An evidence-based handwashing poster from the UK government’s Behavioral Insights Team
Behavioral Insights Team
Tailor reminders for demographic. It turns out that different messaging styles are sometimes more or less effective for men and women. Researchers found that while messages around social norms and social status are equally effective irrespective of gender, men are particularly influenced by messages that invoke disgust (“Soap it off or eat it later” or “Don’t take the loo with you—wash with soap”) while women respond the most to knowledge-based information about how soap fights disease (“Washing hands with soap avoids 47% of disease”).
Make the act of handwashing pleasurable and fun
Reward handwashing with nice soap. To make hand washing desirable, Dan Berry recommends that you treat yourself to fancy soaps to really turn up the pleasure dial and make handwashing intrinsically more desirable. Make them yourself, or order them online and have them delivered for maximum safety!
Clear bars of soap with small toys inside, visibly tempting young handwashers to use the soap in … [+]
Save the Children
Use “surprise soap” with a toy in the middle as an incentive. In a Save the Children initiative, clear bars of soap were created with small toys inside, visibly tempting young handwashers to use the soap in order to get to their prize. The soap made these children four times more likely to wash their hands.
Make handwashing fun (and shareable). You are likely tired of hearing the birthday song by now, so you can join the movement to pair any song of your choice to the handwashing dance though washyourlyrics.com. As Dan Egan noted, this initiative effectively makes everyone think about washing their hands, gets people generating their own versions and sharing, and ultimately goes viral as a result of its inherent entertainment.
Taylor Swift’s Shake it Off populated into washyourlyrics.com
Leverage the feeling of disgust
Use the “cooties effect” for good. Most of us intuitively cringe at the sight of creepy crawlies, a fact that Roger Dooley has taken advantage of with his idea to place stickers of germs on door handles, eliciting an automatic disgust reaction that is likely to not only keep people from touching handles directly, but also motivate them to wash their hands soon after.
Placing stickers of germs on door handles can have the “cooties effect” and move people to cleanse … [+]
Put visibly gross and sensually sticky material on your hands. Like the plaque disclosing agents that dental hygienists put on your teeth (also known as the purple stain) to show you how much plaque you failed to remove during routine brushing, you can do the same for your hands! There are ‘wash & glow’ kits along these lines that illuminate germs with a UV light, revealing the invisible. A hand stamp that took 30 seconds to remove with soap and water reduced hand bacteria by 63% in one study. Make it a ritual to stick-ify and un-stickify your hands throughout the day, making the need to scrub more salient even in times that you wash without the sticky stuff.
Make a public commitment
#StandAgainstCorona Pledge. A group of behavioral scientists have banded together to create the #StandAgainstCorona Pledge, where you can make a commitment to keep your hands clean (to wash hands with soap often and for at least 20 seconds, or use hand sanitizer in a pinch), among other positive health behaviors to slow the spread of COVID-19. The act of committing can increase behavior change, a finding reinforced by my work with Pattern Health where patients commit to their “prescribed” digital health programs. This is compounded by the social aspect of sharing widely, where the influence of others can be highly influential on our own health behaviors.
The #StandAgainstCorona Pledge allows people to commit to healthy behaviors and share with others.
The #20secondchallenge asks people on social media to share who they wash their hands for.
Make public commitments fun and identity-relevant. In the vein of the incredibly successful #IceBucketChallenge to raise funds for ALS, social media challenges that tap into people’s desire to create and be seen can help spread a message. Neil Hopkins did just this for handwashing when he started the #20SecondChallenge inviting others to create videos like his original, washing hands and calling out the people you are washing your hands for.
Bundle handwashing with other behaviors
Pair handwashing with another important, desirable activity. It can be difficult to feel as though the time it takes to thoroughly wash your hands is time well spent. To counter this and make handwashing feel more productive, Jan Willem Lindemans suggests doing something useful with this time, bundling handwashing with other behaviors. For example, he recommends using the time to meditate: to focus on the water floating on your hands, the soap, the bubbles, and think of this time as an exercise of relaxation and mindfulness as a break from your busy day.
Use visual cues to prompt behavior
Researchers found that placing footprints from the bathroom to a handwashing station in Bangladesh … [+]
Robert Dreibelbis et al.
Put footprints on the floor leading to handwashing stations. To make handwashing stations more salient and gamify the road to get to them, Nina Bartmann and David Neal painted footprints on the floor in a study in Ethiopia based on similar research conducted in Bangladesh.
Put hand sanitizer in your way. Although washing your hands with soap and water is the ideal way to clean your hands, it helps to have a backup plan. And it’s a whole lot easier to place bottles of hand sanitizer around than it is to build new sinks. Lena Belogolova recommends establishing locations for hand sanitizer that are within your usual path (for example, if you typically take your dog on a walk through the front door, put a bottle right there). Keep travel-size bottles in convenient places: in your purse, your car, and so on.) Studies on choice architecture (such as this one from the CDC where fruit was strategically placed, at eye level and all around the cafeteria) show that making positive behaviors (such as eating fruit or using hand sanitizer) more convenient and in-your-face leads to an increase in those behaviors.
Make it virtuous
The SuperAmma intervention used narrative techniques to motivate mothers in India to promote … [+]
Adam Biran et al.
Create a role model narrative. A campaign in rural India was successful at increasing handwashing by creating a story around a “supermom,” or SuperAmma a role model mother raising children who wash their hands. Because most mothers believe themselves to be good, nurturing mothers, they strive to behave like the exemplar mother and teach their children to wash their hands (with the additional bonus that they model this behavior themselves).
My grandma Jan
Think of the people you’re protecting by not transmitting the virus to them. Finally, you can make it emotional with empathy. You may not be motivated enough by your desire to protect yourself, but perhaps you will find the motivation by thinking of others. Angela Duckworth recommends thinking of the people in your life who will benefit if you don’t get sick. Indeed, past research on hand hygiene shows this to be effective, and is confirmed by some recent research specifically looking at handwashing and related prosocial behaviors in the context of the COVID-19 pandemic.
This is my grandma Jan. If you don’t wash your hands for yourself, do it for her.
Translate your handwashing intentions into handwashing actions
When there is something (like handwashing) that we know we need to do (and want to do it), but for whatever reason we don’t actually execute, behavioral scientists call it an intention-action gap. Essentially, there’s a gap between your intention and your action. But by using these strategies that behavioral scientists recommend for remembering to wash your hands, you can begin to close this gap. Whether you set up timely reminders, make handwashing fun to do or disgusting to not do, make a commitment or bundle with other activities, or use visual cues or virtuous thinking, or even perhaps all of the above, these strategies should help you get from intention to action in no time.