The University of Southampton
University of Southampton Institutional Repository

An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial

An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial
An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial
Background. Hand-washing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic, but the role of hand-washing is debated, and no good randomised evidence exists among adults in non-deprived settings. This study aimed to demonstrate whether an intervention to modify hand-washing reduces RTIs among adults.

Methods. Individuals sharing a household were recruited by mailed invitation through their general practice. Following consent, participants were randomised on-line by an automated computer-generated random number programme either to no access, or to access a bespoke automated web-based intervention which maximised hand-washing intention, monitored hand-washing behaviour, provided tailored feedback, reinforced helpful attitudes and norms and addressed negative beliefs. Participants could not be blinded, but the analysis syntax was constructed blind to group.

Results. 20,066/16,908 (84%) participants were followed up. An intention-to-treat analysis documented fewer RTIs reported after 16 weeks (intervention 51% (4242/8241); controls 59% (5135/8667); multivariate risk ratio 0.86; 95% confidence intervals 0.83 to 0.89). The intervention reduced transmission of RTIs (reported within one week of another household member) both to and from the index person. There was a modest increase in minor self-reported skin irritation (4.3% (231/5429) versus 1.3% (79/6087)) and no serious adverse events.

Interpretation. In non-pandemic years an effective internet intervention designed to increase hand-washing could have an important impact in reducing infection transmission. Given the heightened concern during a pandemic and the likelihood of accessing the internet for advice, the intervention also has potential for effective implementation during a pandemic.

Registration: ISRCTN75058295http://www.controlled-trials.com/ISRCTN75058295.
0140-6736
1631-1639
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Hobbs, F.D.R.
ed141f5b-6bb8-49d5-ba3f-833ff8176556
Moore, Mike
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Barnett, Jane
f10c0f99-e2f8-42e6-b52a-4987568453db
Popoola, Deborah
a701e73f-f1b2-414a-8c9c-9ca33379b251
Middleton, Karen
50b8579a-ca47-4efa-a4b0-65bc0e8c7348
Kelly, Joanne
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Raftery, James
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Yao, Guiqing
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Carman, William
91ceba0a-3d6c-4ab2-abca-5c584b509ff3
Stokes-Lampard, Helen
9a34f35a-5eef-4e5d-adb5-d5ea6c0fabaf
Williamson, Ian
12381296-edbf-4ac5-969b-dcb559c22f27
Joseph, Judith
d6b0dcec-cd05-4776-97e9-1d702d7f617b
Miller, Sascha
b1c434a6-041c-4771-8ed2-3d050eec6e5f
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Hobbs, F.D.R.
ed141f5b-6bb8-49d5-ba3f-833ff8176556
Moore, Mike
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Barnett, Jane
f10c0f99-e2f8-42e6-b52a-4987568453db
Popoola, Deborah
a701e73f-f1b2-414a-8c9c-9ca33379b251
Middleton, Karen
50b8579a-ca47-4efa-a4b0-65bc0e8c7348
Kelly, Joanne
b7094829-aeb1-4bc1-b64c-7b7c716f73b5
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Raftery, James
27c2661d-6c4f-448a-bf36-9a89ec72bd6b
Yao, Guiqing
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Carman, William
91ceba0a-3d6c-4ab2-abca-5c584b509ff3
Stokes-Lampard, Helen
9a34f35a-5eef-4e5d-adb5-d5ea6c0fabaf
Williamson, Ian
12381296-edbf-4ac5-969b-dcb559c22f27
Joseph, Judith
d6b0dcec-cd05-4776-97e9-1d702d7f617b
Miller, Sascha
b1c434a6-041c-4771-8ed2-3d050eec6e5f
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Little, Paul, Stuart, Beth, Hobbs, F.D.R., Moore, Mike, Barnett, Jane, Popoola, Deborah, Middleton, Karen, Kelly, Joanne, Mullee, Mark, Raftery, James, Yao, Guiqing, Carman, William, Stokes-Lampard, Helen, Williamson, Ian, Joseph, Judith, Miller, Sascha and Yardley, Lucy (2015) An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial. The Lancet, 386 (10004), 1631-1639. (doi:10.1016/S0140-6736(15)60127-1). (PMID:26256072)

Record type: Article

Abstract

Background. Hand-washing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic, but the role of hand-washing is debated, and no good randomised evidence exists among adults in non-deprived settings. This study aimed to demonstrate whether an intervention to modify hand-washing reduces RTIs among adults.

Methods. Individuals sharing a household were recruited by mailed invitation through their general practice. Following consent, participants were randomised on-line by an automated computer-generated random number programme either to no access, or to access a bespoke automated web-based intervention which maximised hand-washing intention, monitored hand-washing behaviour, provided tailored feedback, reinforced helpful attitudes and norms and addressed negative beliefs. Participants could not be blinded, but the analysis syntax was constructed blind to group.

Results. 20,066/16,908 (84%) participants were followed up. An intention-to-treat analysis documented fewer RTIs reported after 16 weeks (intervention 51% (4242/8241); controls 59% (5135/8667); multivariate risk ratio 0.86; 95% confidence intervals 0.83 to 0.89). The intervention reduced transmission of RTIs (reported within one week of another household member) both to and from the index person. There was a modest increase in minor self-reported skin irritation (4.3% (231/5429) versus 1.3% (79/6087)) and no serious adverse events.

Interpretation. In non-pandemic years an effective internet intervention designed to increase hand-washing could have an important impact in reducing infection transmission. Given the heightened concern during a pandemic and the likelihood of accessing the internet for advice, the intervention also has potential for effective implementation during a pandemic.

Registration: ISRCTN75058295http://www.controlled-trials.com/ISRCTN75058295.

Text
__soton.ac.uk_ude_personalfiles_users_ls_mydesktop_PRIMITLancetpaperrevisedfinalwithEME acknowledgement1.docx - Accepted Manuscript
Download (207kB)

More information

Accepted/In Press date: 21 January 2015
e-pub ahead of print date: 6 August 2015
Published date: 24 October 2015
Organisations: Faculty of Health Sciences, Primary Care & Population Sciences, Psychology

Identifiers

Local EPrints ID: 373929
URI: https://eprints.soton.ac.uk/id/eprint/373929
ISSN: 0140-6736
PURE UUID: 0f2e5bf3-e5a8-47ee-b9ae-bf8119203761
ORCID for Mike Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

Catalogue record

Date deposited: 30 Jan 2015 12:11
Last modified: 17 Sep 2019 01:03

Export record

Altmetrics

Contributors

Author: Paul Little
Author: Beth Stuart
Author: F.D.R. Hobbs
Author: Mike Moore ORCID iD
Author: Jane Barnett
Author: Deborah Popoola
Author: Karen Middleton
Author: Joanne Kelly
Author: Mark Mullee
Author: James Raftery
Author: Guiqing Yao
Author: William Carman
Author: Helen Stokes-Lampard
Author: Ian Williamson
Author: Judith Joseph
Author: Sascha Miller
Author: Lucy Yardley ORCID iD

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×