Effectiveness of Digital Handwashing Intervention as a Breakthrough to Control COVID-19 and Transmissible Disease Outbreaks: A Meta-Analysis of Clinical Trials

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Nathaniel Gilbert Dyson
Valerie Josephine Dirjayanto
Aldithya Fakhri
Stephanie Amabella Prayogo


Introduction: The unprepared global health community is severely impacted by COVID-19 pandemic, which increases the urgency of reducing disease transmission. Handwashing is a protective behaviour, but its practice is insufficient with current methods. Digital intervention is potentially efficient in promoting better handwashing not only in COVID-19 but also in other diseases.

Objective: This review is aimed to explore the effectiveness of digital handwashing interventions for transmissible diseases.

Method: Following PRISMA, we searched PubMed, Scopus, MEDLINE, Cochrane, EBSCOHost, Scopus, and Google Scholar, for clinical trials assessing handwashing behaviour change utilizing digital intervention from inception up to November 2021. Critical appraisal was performed using Cochrane Risk of Bias Tool 2.0 and converted to AHRQ standards. We utilised inverse variance, random effects model for quantitative synthesis.

Results: Four studies were included in this study. A significant handwashing frequency pooled mean difference (MD) of 0.71 [95%CI: 0.41-1.01, P<0.00001] towards the intervention group was obtained from this meta-analysis. The subgroup analysis done reported highest influence of digital intervention in frequency of handwashing before eating snacks (MD 1.04 [95%CI: 1.01-1.07]), after sneezing or coughing (MD 0.97 [95%CI: 0.85-1.08]), and after being close to ill person (MD 0.90 [95%CI: 0.97-0.93]). All of the results were found significant (P<0.0001) and homogenous (I2 <40%), except for handwashing after coming into the house subgroup. Another parameter, theory of planned behaviour (TPB), which may influence behavioural changes also gave a significant mean difference of 0.90 [95%CI: 0.54-1.27, P<0.0001]. In addition, notable MDs were obtained in attitude changes of participants (MD 2.01 [95%CI: 0.86-3.15, P=0.0006] and subjective norms (MD 0.57 [95%CI: 0.35-0.79, P<0.00001]) components.

Conclusion: Digital intervention significantly improves handwashing in terms of both frequency and planned behaviour, which leads to better transmission control. We recommend the possible widespread application of this intervention in facing the current pandemic and future outbreaks.

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How to Cite
Dyson, N. G., Dirjayanto, V. J., Fakhri, A. and Prayogo, S. A. (2022) “Effectiveness of Digital Handwashing Intervention as a Breakthrough to Control COVID-19 and Transmissible Disease Outbreaks: A Meta-Analysis of Clinical Trials”, Journal of Asian Medical Students’ Association. Kuala Lumpur, Malaysia. Available at: https://jamsa.amsa-international.org/index.php/main/article/view/385 (Accessed: 1October2023).
Scientific Posters (EAMSC 2024 Singapore)


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