Hand Hygiene Promotion in Primary Schools Using a KAP-Emotional Design Framework: A Cluster-Randomized Controlled Feasibility Study

This study provided critical insights into the feasibility and potential effectiveness of the "Fun Hand Hygiene Workshop" for primary school students, developed with guidance of a novel framework of KAP-ED. The mixed findings in hand hygiene knowledge and skills highlight the inherent complexity of changing health behaviors among young children. Hand-washing timing questionnaire score: To assess the knowledge of handwashing timing among students, this study employed a validated cartoon-based questionnaire. Baseline scores revealed a high level of hand hygiene knowledge in both groups, with no significant changes observed post-intervention . This suggests limited scope for further improvement in hand hygiene knowledge alone. Hand-wahsing skill score: Consistent with our hypothesis, the KAP-ED guided workshop made the learning process enjoyable and emotionally engaging, leading to a measurable improvement in handwashing skills among the participants. Results showed that handwashing skill in the intervention group was improved by by the one-week workshop.