This study examined the effects of picture and text prompts on hand sanitizer use in university students. Researchers observed hand sanitizer dispenser usage in a university library lobby over multiple baseline and intervention sessions. During intervention, signs with pictures of sick animals and text saying "It's cold and flu season, just use hand sanitizer" were placed above the dispensers. Results showed dispenser one usage decreased slightly with prompts while dispenser two usage increased slightly. Overall usage remained similar, providing little evidence that prompts significantly increased hand sanitizer use. The researchers concluded future studies should address limitations like observation timing and sign visibility.

1. Effects of Picture and Textual Prompts on Hand Sanitizer Use in University
Students
Alison Beveridge, Callie Kreutzberger, Joshua Hazel
Western Michigan University
Background
Purpose
Method
Method
Results
Results
Discussion
Background
The influenza season lasts roughly from October until May and
the virus is easily spreadable through direct and indirect contact
(www.cdc.gov).
• The CDC recommends to wash hands regularly or use an
alcohol-based hand sanitizer when soap and water is not
available
• Kampf and Kramer (2004) suggest that using a hand sanitizer
with an alcohol concentration between 60-95% is far more
effective at killing bacteria than non-alcohol based hand
sanitizer
• An easy way to help combat the spread of the influenza virus is
to use and alcohol based hand sanitizer, such as; Purell®
(MacDonald, Weir & Langley, 2007).
• Hartley, Kieley, and Slabach (1990) found that “prompts
provide an instruction about what aspect of the target is to be
responded to” (p. 523). The study found that seeing visual
prompts, regardless of age, push an individual to react in
certain ways.
Purpose
Determine the effects of picture and textural prompts on the use
of hand sanitizer in university students.
• Conducted at Western Michigan University’s main library. Data
collection and independent variable implementation occurred
in the library’s main entrance
• Population included university students, staff, or otherwise any
patron of the library.
• Implementation of independent variable followed baseline
data collection. Picture and textural prompts were placed
above two designated hand sanitizer dispensers to examine
whether or not target behavior would increase.
• Dependent variable was measured as any individual utilizing
either one of the two hand sanitizer dispensers.
Participants and Setting
• Study was conducted at Waldo Library at Western Michigan
University.
• Two hand sanitizer dispensers in the circular lobby.
• The dispensers were about three feet from the ground.
• Any student or faculty member of Western Michigan
University in the library during the sessions was an eligible
participant.
• Across both baseline and intervention a total of 29 participants
used one of the hand sanitizers available.
Materials
• Two Purell hand sanitizer dispensers.
• Data charts (see Table 1).
• 8X10 inch textual prompts designed on Microsoft Word.
• Both stated “It’s cold and flu season, just use
hand sanitizer.”
• Included cartoon pictures of a sick dog and bear.
• Blue tape was used to hang the signs above the dispensers.
Experimental Design
• An ABA reversal design was used.
• This design was used to see if the textual prompts made a
difference once the intervention was removed.
Procedure
• Both baseline measurements and intervention was conducted
on Monday and Wednesdays from 1:00 to 1:30 pm.
• Observers monitored how many people used hand sanitizer
dispensers, machine one and machine two.
• Data was tallied on an event recording form (see Table 1).
• The 8X10 inch signs were hung on each dispenser during
intervention.
• The independent variables were the textual prompts.
• The dependent variable was the total hand sanitizer usage
during the 30 minute sessions.
• A non example of the dependent variable would be times
people walked by without using hand sanitizer.
Interobserver Agreement
• At least two observers were present for each session.
• They were positioned on different sides of the lobby.
• The minimal acceptability was 80% for Interobserver
agreement.
• The total Interobserver agreement for 100%.
Social Validity
• Social validity was not addressed during this study.
• Practicing hand sanitation use is important, especially during
flu season.
• The library is a busy place, and it is easy to spread germs on
the computers and door handles.
• The baseline data for both machines were variable.
• There was not a steady trend in the data.
• Four sessions of intervention were recorded.
• The baseline usage average for machine one is 2.5 times.
• After intervention, the average usage decreased to 1.25 times
per session.
• The baseline average usage after for machine two is 1.25
times.
• The average increased to 2.25 times after intervention.
• The total average use during baseline is 3.75 times.
• The total average after intervention was 3.5 times on average.
• Two sessions of second baseline was conducted.
• Zero participants used the hand sanitizer in either
session.
Authors Conclusion
• The four sessions of intervention show that the usage
decreased slightly with the introduction of the prompts.
• Textual prompts and cues had a slight effect on the use of
hand sanitizer when looking at the second baseline.
• There was a slight difference between the first baseline and
the intervention, but there was no usage during the second
baseline.
• Future studies should not only record participants appropriate
behavior of machine use, but also the participants
inappropriate behavior, in order to gather more accurate data.
Confounding variables could have obstructed the results.
• Relocating observation site. The library was not very busy
between 1:00 and 1:30 PM. Selecting a different location at a
different time might provide more substantial results than
currently gathered.
• Signs to use for Textual Prompts. The signs for this study
blended in with the machines and is thought that they were
not receiving enough notice to be effective in order to increase
behavior. Signs with arrows or bright colors (e.g. red or orange)
might be an appropriate alternative.
• The location of the two dispensers was directed more toward
the people leaving the library. To increase the probability of
participants using the machines they should be relocated to a
more prominent location of the library.
Poster Presented at:
Western Michigan University, Behavioral
Psychology Department
December 2, 2014
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NumberofUses
Sessions
Total Amount of Hand Sanitizer Use
Baseline Intervention Baseline
Table 1
Event Recording Form for Hand Sanitizer Use
Class: Students and faculty at Western Michigan University
Observer: Calli Kreutzberger, Joshua Hazel, Alison Beveridge
Time/ Length of Observation: 30 minutes.
Behavior: Use of the hand sanitizer dispenser.
Instructions: Make a mark each time the behavior occurs. Add of
the total occurrences for each machine.
Additional Comments: Intervention started on November 3rd, as
suggested by the bolded dates.
Figure 3: The total number of times the hand sanitizer was used
from machine one and machine two across the ABA reversal
design.