The Influence of Media and Psychological Factors on Preventive Hand Cleaning Behavior in the Pandemic of COVID-19 Among Chinese Adults

Abstract

COVID-19 has been causing worldwide infections and mortality for the past 12 months.1,2 Hand cleaning is a World Health Organization–recommended and the most costeffective measure that prevents the spread of COVID-19. The emphasis on hand cleaning may be more significant than social distancing because hand cleaning can be adopted by people of all socioeconomic status and different occupations in all settings at a much lower cost.3 This study aimed to explore how demographic, psychological, and contextual factors affect hand cleaning behavior in the pandemic. A total of 2230 Chinese adults were recruited through an online survey that collected their demographic information, and social and health activities during the COVID-19 pandemic. The final sample size for analysis was 2130. A hierarchical binary logistic regression was used to evaluate whether demographic factors (eg, age, gender, education, marital status, income, general health condition, residential area, and living arrangement), psychological factors (depressive symptoms and psychological distress), and a contextual factor (time exposed to media) predict the odds of practicing hand cleaning. Logistic regression results are presented in Table 1. Hand cleaning is practiced less among unmarried people and people in rural areas. Daily time spent on media reading about COVID-19 significantly predicted the odds of washing hands (odds ratio [OR] = 1.42, P < .001). The findings indicated that married individuals were approximately 2.33 times more likely than unmarried individuals to practice hand cleaning in the COVID-19 pandemic. In previous studies, women were more likely than men to practice health-promoting behaviors.4 Perhaps hand cleaning is reinforced and reminded by spouses among Chinese couples; therefore, being married becomes a facilitating factor of engaging in preventive behaviors. Our results also lend new support to acknowledging health disparities in rural areas, whereby individuals reported significantly fewer hand cleaning behaviors. Like many other countries, China’s rural area is more likely than urban areas to suffer from poverty, lack of access to public health resources, and low awareness and personal hygiene culture. These factors were found associated with less engagement in hand cleaning practice in developing countries.5 Time spent on media to acquire information on COVID19 was a significant facilitator of practicing hand cleaning. The media was a powerful tool for individuals to obtain information and for the public health department to disseminate information on the pandemic. As a result, spending time on media to expose to the severe consequences of COVID19, high prevalence and mortality rates, and the recommended preventive behaviors will promote individuals’ hand cleaning practice. On the contrary, people who spent little time receiving information on COVID-19 from media may not be motivated or fail to perceive the need to practice the suggested COVID-19 preventive behaviors. It is reasonable to argue that media plays a positive role in promoting hand cleaning behavior among Chinese people. In conclusion, hand cleaning is the most cost-effective preventive measure for COVID-19. Individuals who are unmarried and reside in rural areas should be the target of the handwashing promotion interventions. Positive and prompt information from media may help health promotion for controlling this pandemic and managing future public health crises. 1014649 APHXXX10.1177/10105395211014649Asia Pacific Journal of Public HealthYang et al letter2021