The Effect of Persuasive Messages on Hospital Visitors’ Hand Hygiene Behavior

Objective: Hospital visitors pose a risk for transmitting pathogens that can cause healthcare-associated infections. The present study aimed to test an evidence-based intervention to improve visitors’ hand hygiene behavior through persuasive messages. Methods: For the 14-week-long field experiment, seven signs were designed according to the principles of persuasion proposed by Cialdini: reciprocity, consistency, social-proof, unity, liking, authority, and scarcity. Each sign was displayed on a screen for one week directly above the hand-rub dispenser in a hospital lobby. Between each posting, the screen was blank for one week. Results: An electronic monitoring system counted 246,098 people entering and leaving the hospital’s lobby and 17,308 dispenser usages. The signs based on the authority and the social-proof principles significantly increased the hand-rub dispenser usage rate in comparison to the average baseline usage rate. Conclusions: These results indicate that simple and cost-efficient interventions can initiate expedient behavior change in hospitals. However, the findings also highlight the importance of careful planning and rigorous pre-testing of material for an intervention to be effective. Theoretical and practical implications of these findings are discussed.