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Developing and Testing a Touch-Path Model for Hand Hygiene and Pathogen Risk

Researchers explored 48 fast-food restaurant and coffee shop restrooms for factors that influence hand hygiene and the spread of disease. Using a naturalistic-observation approach, a catalogue of restroom design features requiring a hand touch were tabulated. Restroom data provided the basis for a conceptual framework for modeling pathogen risk, as defined by the number of hand touches to operate a restroom facility. The touch-path model tested whether men’s and women’s “perceptions of risk” and “intent to hand wash” were influenced by restroom use of commodes, urinals, design innovations, and other design configurations. Results showed that men’s and women’s perceptions of risk and intent to hand wash decreased as a function of design innovations. Women, as compared with men, reported greater perceptions of risk and intent to hand wash. In addition to the social-norm and self-awareness theory, this research supported the approach of understanding design-behavior interactions with respect to hand hygiene.