Exploring the use of entertainment-education YouTube videos focused on infection prevention and control


      • YouTube is increasingly being used to disseminate messages about infection control.
      • Currently, we have no idea about whether the uploaded videos are educationally useful.
      • Miscommunication of the concept of My 5 Moments for Hand Hygiene was observed.
      • Opportunities exist to strengthen the utilization of social media platforms.


      As a communications strategy, education entertainment has been used to inform, influence, and shift societal and individual behaviors. Recently, there has been an increasing number of entertainment-education YouTube videos focused on hand hygiene. However, there is currently no understanding about the quality of these videos; therefore, this study aimed to explore the social media content and user engagement with these videos.


      The search terms “hand hygiene” and “hand hygiene education” were used to query YouTube. Video content had to be directed at a health care professional audience. Using author designed checklists, each video was systematically evaluated and grouped according to educational usefulness and was subsequently evaluated against the categories of attractiveness, comprehension, and persuasiveness.


      A total of 400 videos were screened, with 70 videos retained for analysis. Of these, 55.7% (n = 39) were categorized as educationally useful. Overall, educationally useful videos scored higher than noneducationally useful videos across the categories of attractiveness, comprehension, and persuasiveness. Miscommunication of the concept of My 5 Moments for Hand Hygiene was observed in several of the YouTube videos.


      The availability of educationally useful videos in relation to hand hygiene is evident; however, it is clear that there are opportunities for contributors using this medium to strengthen their alignment with social media best practice principles to maximize the effectiveness, reach, and sustainability of their content.

      Graphical abstract

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Hogue M.D.
        • Grabenstein J.D.
        • Foster S.L.
        • Rothholz M.C.
        Pharmacist involvement with immunizations: a decade of professional advancement.
        J Am Pharm Assoc (Wash DC). 2006; 46: 168-182
        • World Health Organisation, WHO Patient Safety
        WHO guidelines on hand hygiene in health care.
        World Health Organization, Geneva (Switzerland)2009: 6-7
        • Gould D.J.
        • Chudleigh J.H.
        • Moralejo D.
        • Drey N.
        Interventions to improve hand hygiene compliance in patient care.
        Cochrane Database Syst Rev. 2007; (CD005186)
        • Voss A.
        • Widmer A.F.
        No time for handwashing!? Handwashing versus alcoholic rub: can we afford 100% compliance?.
        Infect Control Hosp Epidemiol. 1997; 18: 205-208
        • Allegranzi B.
        • Bagheri Nejad S.
        • Combescure C.
        • Graafmans W.
        • Attar H.
        • Donaldson L.
        • et al.
        Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis.
        Lancet. 2011; 377: 228-241
        • World Health Organisation, WHO Patient Safety
        WHO guidelines on hand hygiene in health care.
        World Health Organization, Geneva (Switzerland)2009: 99-123
        • Jenner E.A.
        • Jones F.
        • Fletcher B.
        • Miller L.
        • Scott G.M.
        Hand hygiene posters: selling the message.
        J Hosp Infect. 2005; 59: 77-82
        • Jenner E.A.
        • Jones F.
        • Fletcher B.
        • Miller L.
        • Scott G.M.
        Hand hygiene posters: motivators or mixed messages?.
        J Hosp Infect. 2005; 60: 218-225
        • Pan S.-C.
        • Sheng W.-H.
        • Tien K.-L.
        • Chien K.-T.
        • Chen Y.-C.
        • Chang S.-C.
        Promoting a hand hygiene program using social media: an observational study.
        JMIR Public Health Surveill. 2016; 2: e5
        • Singhal A.
        • Cody M.J.
        • Rogers E.M.
        • Sabido M.
        Entertainment-education and social change: history, research and practice.
        (Mahwah (NJ)) Routledge, 2003
        • Singhal A.
        • Rogers E.M.
        A theoretical agenda for entertainment—education.
        Commun Theory. 2002; 12: 117-135
      1. YouTube playbook for creative advertising.
        (Available from:) (Accessed October 25, 2017)
      2. APIC 2016 Film Festival winner chronicles HCP hands through a dirty day.
        (Available from:) (Accessed April 2, 2017)
      3. ICPIC Clip Award.
        (Available from:) (Accessed October 25, 2017)
        • Murugiah K.
        • Vallakati A.
        • Rajput K.
        • Sood A.
        • Challa N.R.
        YouTube as a source of information on cardiopulmonary resuscitation.
        Resuscitation. 2011; 82: 332-334
        • Azer S.A.
        • AlGrain H.A.
        • AlKhelaif R.A.
        • AlEshaiwi S.M.
        Evaluation of the educational value of YouTube videos about physical examination of the cardiovascular and respiratory systems.
        J Med Internet Res. 2013; 15: e241
        • Azer S.A.
        • AlEshaiwi S.M.
        • AlGrain H.A.
        • AlKhelaif R.A.
        Nervous system examination on YouTube.
        BMC Med Educ. 2012; 12: 126
        • Shoemaker S.J.
        • Wolf M.S.
        • Brach C.
        Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information.
        Patient Educ Couns. 2014; 96: 395-403
        • Balakrishnan V.
        • Chandy Z.
        • Hseih A.
        • Bui T.-L.
        • Verma S.P.
        Readability and understandability of online vocal cord paralysis materials.
        Otolaryngol Head Neck Surg. 2016; 154: 460-464
        • Zellmer C.
        • Zimdars P.
        • Parker S.
        • Safdar N.
        Evaluating the usefulness of patient education materials on surgical site infection: a systematic assessment.
        Am J Infect Control. 2015; 43: 167-168
        • Agency for Healthcare Research and Quality
        PEMAT Tool for Audiovisual Materials (PEMAT-A/V).
        (Content last reviewed October 2013; Agency for Healthcare Research and Quality, Rockville, MD; Available from)
        • Ho M.
        • Stothers L.
        • Lazare D.
        • Tsang B.
        • Macnab A.
        Evaluation of educational content of YouTube videos relating to neurogenic bladder and intermittent catheterization.
        Can Urol Assoc J. 2015; 9: 320-354
        • Stellefson M.
        • Chaney B.
        • Ochipa K.
        • Chaney D.
        • Haider Z.
        • Hanik B.
        • et al.
        YouTube as a source of chronic obstructive pulmonary disease patient education.
        Chron Respir Dis. 2014; 11: 61-71
        • Pittet D.
        • Allegranzi B.
        • Boyce J.
        • World Health Organization World Alliance for Patient Safety First Global Patient Safety Challenge Core Group of Experts
        The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations.
        Infect Control Hosp Epidemiol. 2009; 30: 611-622
        • Centers for Disease Control and Prevention
        The health communicator's social media toolkit.
        Centers for Disease Control and Prevention, Atlanta (GA)2011: 15-17
        • Gould D.J.
        • Gallagher R.
        • Allen D.
        Leadership and management for infection prevention and control: what do we have and what do we need?.
        J Hosp Infect. 2016; 94: 165-168
        • World Health Organisation
        Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level.
        World Health Organisation, Geneva, Switzerland2016
        • Monsalve M.N.
        • Pemmaraju S.V.
        • Thomas G.W.
        • Herman T.
        • Segre A.M.
        • Polgreen P.M.
        Do peer effects improve hand hygiene adherence among healthcare workers?.
        Infect Control Hosp Epidemiol. 2014; 35: 1277-1285
        • Lankford M.G.
        • Zembower T.R.
        • Trick W.E.
        • Hacek D.M.
        • Noskin G.A.
        • Peterson L.R.
        Influence of role models and hospital design on hand hygiene of healthcare workers.
        Emerg Infect Dis. 2003; 9: 217-223