Can a handwashing intervention make a difference? Results from a randomized controlled trial in Jerusalem preschools

Laura Rosen*, Orly Manor, Dan Engelhard, David Brody, Bruce Rosen, Hannah Peleg, Marina Meir, David Zucker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background. Preschools are often focal points for the spread of illness among young children. The objective of this preschool intervention trial was to determine whether a hygiene program can promote handwashing and thereby reduce illness absenteeism. Methods. This cluster randomized trial included 40 Jerusalem preschools with 1029 children for 6 baseline days and 66 study days, yielding 73,779 child days. The main outcomes were rates of handwashing and illness absenteeism. The intervention included an educational program and environmental changes. A simultaneous subtrial was run to test a home component. Results. This multi-site intervention program produced sustained behavioral and environmental changes over a 6-month period. An approximately threefold increase in handwashing with soap was observed among preschool children exposed to the intervention. Neither the preschool nor the home intervention program reduced illness absenteeism or overall absenteeism. Conclusions. This trial illuminates the potential of the preschool as a promising venue for health promotion activities leading to sustained behavioral change, yet suggests the need for enhanced approaches for reducing illness absenteeism.

Original languageEnglish
Pages (from-to)27-32
Number of pages6
JournalPreventive Medicine
Issue number1
StatePublished - Jan 2006
Externally publishedYes


FundersFunder number
National Institute for Health Services Research
Ministerio de Sanidad, Consumo y Bienestar Social


    • Communicable disease prevention
    • Community intervention trial
    • Handwashing
    • Health education
    • Health promotion
    • Pediatric communicable disease
    • Preschool illness absenteeism
    • Randomized controlled trial


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