Video engagement to improve handwashing duration: A longitudinal study assessing creative and messaging fatigue

Published:February 02, 2022DOI:


      • Video engagement improves handwashing duration by 7.5 seconds.
      • Creative and messaging fatigue starts at 3 months.
      • Effective handwashing (greater than or equal to 20 seconds) increases by 39% with video engagement.
      • Handwashing timing has some unique challenges.
      • Various aspects contribute to handwashing duration.



      Poor hand hygiene can contribute to increased rates of health care and community-acquired infections. Effective hand hygiene involves both a washer's technique and the duration of their wash.


      The purpose of this longitudinal study was 2-fold: to improve the ability of hand-washers to meet the recommended handwashing duration of ≥20 seconds and to assess the effect of washer fatigue with the intervention. An innovative system of smart connected soap and towel dispensers synchronized to engaging video content was implemented to meet this objective.


      The intervention increased mean handwashing duration by 7.5 seconds (95% CI: 6.6, 8.4) and improved handwashing duration ≥20 seconds by 39.3% (P < .001). Using a similar cohort of hand-washers over 26 months, the video content had peak effect in month 1, and declined to a new steady state at month 11.


      Handwashing for the recommended time can be difficult to achieve. Most hand hygiene studies examine the rate of completion without measuring duration.


      Video engagement can improve and sustain handwashing duration. To mitigate creative and messaging fatigue, video content refresh for this intervention should be considered at 3 months for optimal effect or at 11 months prior to full decline to new steady state.

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