An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial
Summary Background Handwashing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic. However, the role of handwashing is debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess...
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| Veröffentlicht in: | The Lancet (British edition) 2015-10, Vol.386 (10004), p.1631-1639 |
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| creator | Little, Paul, Prof Stuart, Beth, PhD Hobbs, F D R, Prof Moore, Mike, Prof Barnett, Jane, BA Popoola, Deborah, MSc Middleton, Karen Kelly, Joanne, MSc Mullee, Mark, MSc Raftery, James, Prof Yao, Guiqing, PhD Carman, William, Prof Fleming, Douglas, PhD Stokes-Lampard, Helen, PhD Williamson, Ian, MRCGP Joseph, Judith, PhD Miller, Sascha, PhD Yardley, Lucy, Prof |
| description | Summary Background Handwashing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic. However, the role of handwashing is debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess whether an internet-delivered intervention to modify handwashing would reduce the number of RTIs among adults and their household members. Methods We recruited individuals sharing a household by mailed invitation through general practices in England. After consent, participants were randomised online by an automated computer-generated random number programme to receive either no access or access to a bespoke automated web-based intervention that maximised handwashing intention, monitored handwashing behaviour, provided tailored feedback, reinforced helpful attitudes and norms, and addressed negative beliefs. We enrolled participants into an additional cohort (randomised to receive intervention or no intervention) to assess whether the baseline questionnaire on handwashing would affect handwashing behaviour. Participants were not masked to intervention allocation, but statistical analysis commands were constructed masked to group. The primary outcome was number of episodes of RTIs in index participants in a modified intention-to-treat population of randomly assigned participants who completed follow-up at 16 weeks. This trial is registered with the ISRCTN registry, number ISRCTN75058295. Findings Across three winters between Jan 17, 2011, and March 31, 2013, we enrolled 20 066 participants and randomly assigned them to receive intervention (n=10 040) or no intervention (n=10 026). 16 908 (84%) participants were followed up with the 16 week questionnaire (8241 index participants in intervention group and 8667 in control group). After 16 weeks, 4242 individuals (51%) in the intervention group reported one or more episodes of RTI compared with 5135 (59%) in the control group (multivariate risk ratio 0·86, 95% CI 0·83–0·89; p |
| doi_str_mv | 10.1016/S0140-6736(15)60127-1 |
| format | Article |
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However, the role of handwashing is debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess whether an internet-delivered intervention to modify handwashing would reduce the number of RTIs among adults and their household members. Methods We recruited individuals sharing a household by mailed invitation through general practices in England. After consent, participants were randomised online by an automated computer-generated random number programme to receive either no access or access to a bespoke automated web-based intervention that maximised handwashing intention, monitored handwashing behaviour, provided tailored feedback, reinforced helpful attitudes and norms, and addressed negative beliefs. We enrolled participants into an additional cohort (randomised to receive intervention or no intervention) to assess whether the baseline questionnaire on handwashing would affect handwashing behaviour. Participants were not masked to intervention allocation, but statistical analysis commands were constructed masked to group. The primary outcome was number of episodes of RTIs in index participants in a modified intention-to-treat population of randomly assigned participants who completed follow-up at 16 weeks. This trial is registered with the ISRCTN registry, number ISRCTN75058295. Findings Across three winters between Jan 17, 2011, and March 31, 2013, we enrolled 20 066 participants and randomly assigned them to receive intervention (n=10 040) or no intervention (n=10 026). 16 908 (84%) participants were followed up with the 16 week questionnaire (8241 index participants in intervention group and 8667 in control group). After 16 weeks, 4242 individuals (51%) in the intervention group reported one or more episodes of RTI compared with 5135 (59%) in the control group (multivariate risk ratio 0·86, 95% CI 0·83–0·89; p<0·0001). The intervention reduced transmission of RTIs (reported within 1 week of another household member) both to and from the index person. We noted a slight increase in minor self-reported skin irritation (231 [4%] of 5429 in intervention group vs 79 [1%] of 6087 in control group) and no reported serious adverse events. Interpretation In non-pandemic years, an effective internet intervention designed to increase handwashing could have an important effect in reduction of infection transmission. In view of the heightened concern during a pandemic and the likely role of the internet in access to advice, the intervention also has potential for effective implementation during a pandemic. Funding Medical Research Council.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(15)60127-1</identifier><identifier>PMID: 26256072</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Disease transmission ; Hand Disinfection ; Hands ; Health behavior ; Households ; Humans ; Hygiene ; Illnesses ; Influenza, Human - prevention & control ; Influenza, Human - transmission ; Information Dissemination ; Internal Medicine ; Internet ; Intervention ; Medical research ; Pandemics ; Respiratory diseases ; Respiratory tract ; Respiratory Tract Infections - prevention & control ; Respiratory Tract Infections - transmission ; Statistical analysis ; Surveys and Questionnaires ; Websites</subject><ispartof>The Lancet (British edition), 2015-10, Vol.386 (10004), p.1631-1639</ispartof><rights>Elsevier Ltd</rights><rights>2015 Elsevier Ltd</rights><rights>Copyright © 2015 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Oct 24, 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5981-c8440ebcadb5fdbe7938cee784f7adb2409331bca316eac356a19f468bf5ff273</citedby><cites>FETCH-LOGICAL-c5981-c8440ebcadb5fdbe7938cee784f7adb2409331bca316eac356a19f468bf5ff273</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0140673615601271$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26256072$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Little, Paul, Prof</creatorcontrib><creatorcontrib>Stuart, Beth, PhD</creatorcontrib><creatorcontrib>Hobbs, F D R, Prof</creatorcontrib><creatorcontrib>Moore, Mike, Prof</creatorcontrib><creatorcontrib>Barnett, Jane, BA</creatorcontrib><creatorcontrib>Popoola, Deborah, MSc</creatorcontrib><creatorcontrib>Middleton, Karen</creatorcontrib><creatorcontrib>Kelly, Joanne, MSc</creatorcontrib><creatorcontrib>Mullee, Mark, MSc</creatorcontrib><creatorcontrib>Raftery, James, Prof</creatorcontrib><creatorcontrib>Yao, Guiqing, PhD</creatorcontrib><creatorcontrib>Carman, William, Prof</creatorcontrib><creatorcontrib>Fleming, Douglas, PhD</creatorcontrib><creatorcontrib>Stokes-Lampard, Helen, PhD</creatorcontrib><creatorcontrib>Williamson, Ian, MRCGP</creatorcontrib><creatorcontrib>Joseph, Judith, PhD</creatorcontrib><creatorcontrib>Miller, Sascha, PhD</creatorcontrib><creatorcontrib>Yardley, Lucy, Prof</creatorcontrib><title>An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Summary Background Handwashing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic. However, the role of handwashing is debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess whether an internet-delivered intervention to modify handwashing would reduce the number of RTIs among adults and their household members. Methods We recruited individuals sharing a household by mailed invitation through general practices in England. After consent, participants were randomised online by an automated computer-generated random number programme to receive either no access or access to a bespoke automated web-based intervention that maximised handwashing intention, monitored handwashing behaviour, provided tailored feedback, reinforced helpful attitudes and norms, and addressed negative beliefs. We enrolled participants into an additional cohort (randomised to receive intervention or no intervention) to assess whether the baseline questionnaire on handwashing would affect handwashing behaviour. Participants were not masked to intervention allocation, but statistical analysis commands were constructed masked to group. The primary outcome was number of episodes of RTIs in index participants in a modified intention-to-treat population of randomly assigned participants who completed follow-up at 16 weeks. This trial is registered with the ISRCTN registry, number ISRCTN75058295. Findings Across three winters between Jan 17, 2011, and March 31, 2013, we enrolled 20 066 participants and randomly assigned them to receive intervention (n=10 040) or no intervention (n=10 026). 16 908 (84%) participants were followed up with the 16 week questionnaire (8241 index participants in intervention group and 8667 in control group). After 16 weeks, 4242 individuals (51%) in the intervention group reported one or more episodes of RTI compared with 5135 (59%) in the control group (multivariate risk ratio 0·86, 95% CI 0·83–0·89; p<0·0001). The intervention reduced transmission of RTIs (reported within 1 week of another household member) both to and from the index person. We noted a slight increase in minor self-reported skin irritation (231 [4%] of 5429 in intervention group vs 79 [1%] of 6087 in control group) and no reported serious adverse events. Interpretation In non-pandemic years, an effective internet intervention designed to increase handwashing could have an important effect in reduction of infection transmission. In view of the heightened concern during a pandemic and the likely role of the internet in access to advice, the intervention also has potential for effective implementation during a pandemic. Funding Medical Research Council.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Disease transmission</subject><subject>Hand Disinfection</subject><subject>Hands</subject><subject>Health behavior</subject><subject>Households</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Illnesses</subject><subject>Influenza, Human - prevention & control</subject><subject>Influenza, Human - transmission</subject><subject>Information Dissemination</subject><subject>Internal Medicine</subject><subject>Internet</subject><subject>Intervention</subject><subject>Medical research</subject><subject>Pandemics</subject><subject>Respiratory diseases</subject><subject>Respiratory tract</subject><subject>Respiratory Tract Infections - prevention & control</subject><subject>Respiratory Tract Infections - transmission</subject><subject>Statistical analysis</subject><subject>Surveys and 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internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial</title><author>Little, Paul, Prof ; Stuart, Beth, PhD ; Hobbs, F D R, Prof ; Moore, Mike, Prof ; Barnett, Jane, BA ; Popoola, Deborah, MSc ; Middleton, Karen ; Kelly, Joanne, MSc ; Mullee, Mark, MSc ; Raftery, James, Prof ; Yao, Guiqing, PhD ; Carman, William, Prof ; Fleming, Douglas, PhD ; Stokes-Lampard, Helen, PhD ; Williamson, Ian, MRCGP ; Joseph, Judith, PhD ; Miller, Sascha, PhD ; Yardley, Lucy, Prof</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5981-c8440ebcadb5fdbe7938cee784f7adb2409331bca316eac356a19f468bf5ff273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Disease transmission</topic><topic>Hand Disinfection</topic><topic>Hands</topic><topic>Health behavior</topic><topic>Households</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Illnesses</topic><topic>Influenza, Human - prevention & control</topic><topic>Influenza, Human - transmission</topic><topic>Information Dissemination</topic><topic>Internal Medicine</topic><topic>Internet</topic><topic>Intervention</topic><topic>Medical research</topic><topic>Pandemics</topic><topic>Respiratory diseases</topic><topic>Respiratory tract</topic><topic>Respiratory Tract Infections - prevention & control</topic><topic>Respiratory Tract Infections - transmission</topic><topic>Statistical analysis</topic><topic>Surveys and Questionnaires</topic><topic>Websites</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Little, Paul, Prof</creatorcontrib><creatorcontrib>Stuart, Beth, PhD</creatorcontrib><creatorcontrib>Hobbs, F D R, Prof</creatorcontrib><creatorcontrib>Moore, Mike, Prof</creatorcontrib><creatorcontrib>Barnett, Jane, 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Little, Paul, Prof</au><au>Stuart, Beth, PhD</au><au>Hobbs, F D R, Prof</au><au>Moore, Mike, Prof</au><au>Barnett, Jane, BA</au><au>Popoola, Deborah, MSc</au><au>Middleton, Karen</au><au>Kelly, Joanne, MSc</au><au>Mullee, Mark, MSc</au><au>Raftery, James, Prof</au><au>Yao, Guiqing, PhD</au><au>Carman, William, Prof</au><au>Fleming, Douglas, PhD</au><au>Stokes-Lampard, Helen, PhD</au><au>Williamson, Ian, MRCGP</au><au>Joseph, Judith, PhD</au><au>Miller, Sascha, PhD</au><au>Yardley, Lucy, Prof</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>2015-10-24</date><risdate>2015</risdate><volume>386</volume><issue>10004</issue><spage>1631</spage><epage>1639</epage><pages>1631-1639</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Summary Background Handwashing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic. However, the role of handwashing is debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess whether an internet-delivered intervention to modify handwashing would reduce the number of RTIs among adults and their household members. Methods We recruited individuals sharing a household by mailed invitation through general practices in England. After consent, participants were randomised online by an automated computer-generated random number programme to receive either no access or access to a bespoke automated web-based intervention that maximised handwashing intention, monitored handwashing behaviour, provided tailored feedback, reinforced helpful attitudes and norms, and addressed negative beliefs. We enrolled participants into an additional cohort (randomised to receive intervention or no intervention) to assess whether the baseline questionnaire on handwashing would affect handwashing behaviour. Participants were not masked to intervention allocation, but statistical analysis commands were constructed masked to group. The primary outcome was number of episodes of RTIs in index participants in a modified intention-to-treat population of randomly assigned participants who completed follow-up at 16 weeks. This trial is registered with the ISRCTN registry, number ISRCTN75058295. Findings Across three winters between Jan 17, 2011, and March 31, 2013, we enrolled 20 066 participants and randomly assigned them to receive intervention (n=10 040) or no intervention (n=10 026). 16 908 (84%) participants were followed up with the 16 week questionnaire (8241 index participants in intervention group and 8667 in control group). After 16 weeks, 4242 individuals (51%) in the intervention group reported one or more episodes of RTI compared with 5135 (59%) in the control group (multivariate risk ratio 0·86, 95% CI 0·83–0·89; p<0·0001). The intervention reduced transmission of RTIs (reported within 1 week of another household member) both to and from the index person. We noted a slight increase in minor self-reported skin irritation (231 [4%] of 5429 in intervention group vs 79 [1%] of 6087 in control group) and no reported serious adverse events. Interpretation In non-pandemic years, an effective internet intervention designed to increase handwashing could have an important effect in reduction of infection transmission. In view of the heightened concern during a pandemic and the likely role of the internet in access to advice, the intervention also has potential for effective implementation during a pandemic. Funding Medical Research Council.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26256072</pmid><doi>10.1016/S0140-6736(15)60127-1</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 2015-10, Vol.386 (10004), p.1631-1639 |
| issn | 0140-6736 1474-547X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1755539097 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Disease transmission Hand Disinfection Hands Health behavior Households Humans Hygiene Illnesses Influenza, Human - prevention & control Influenza, Human - transmission Information Dissemination Internal Medicine Internet Intervention Medical research Pandemics Respiratory diseases Respiratory tract Respiratory Tract Infections - prevention & control Respiratory Tract Infections - transmission Statistical analysis Surveys and Questionnaires Websites |
| title | An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T23%3A51%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=An%20internet-delivered%20handwashing%20intervention%20to%20modify%20influenza-like%20illness%20and%20respiratory%20infection%20transmission%20(PRIMIT):%20a%20primary%20care%20randomised%20trial&rft.jtitle=The%20Lancet%20(British%20edition)&rft.au=Little,%20Paul,%20Prof&rft.date=2015-10-24&rft.volume=386&rft.issue=10004&rft.spage=1631&rft.epage=1639&rft.pages=1631-1639&rft.issn=0140-6736&rft.eissn=1474-547X&rft.coden=LANCAO&rft_id=info:doi/10.1016/S0140-6736(15)60127-1&rft_dat=%3Cproquest_cross%3E1755539097%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1725692798&rft_id=info:pmid/26256072&rft_els_id=S0140673615601271&rfr_iscdi=true |