Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Study Participants
2.2. Ethical Considerations
2.3. Recruitment and Data Collection
2.4. Survey Instrument
2.5. Statistical Analyses
2.6. Sample Size Justification
3. Results
3.1. Sample Characteristics
3.2. Characteristics of Study Variables and Inferential Statistics
4. Discussion
4.1. Implications for Practice
4.2. Strengths and Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Characteristics | Mean ± S.D. | n (%) |
---|---|---|---|
Age | - | 24.61 ± 8.60 | - |
Gender | Female | - | 501 (70.3) |
Male | - | 176 (24.7) | |
Others | - | 14 (2.0) | |
Not reported | - | 22 (3.1) | |
Race/ethnicity | White/Caucasian | - | 530 (74.3) |
Black or African | - | 33 (4.6) | |
Hispanic or Latino | - | 56 (7.9) | |
Asian American | - | 39 (5.4) | |
Others | - | 31 (4.4) | |
Not reported | - | 24 (3.4) | |
Current year in school | First-year undergraduate | - | 164 (23.0) |
Second-year undergraduate | - | 95 (13.3) | |
Third-year undergraduate | - | 90 (12.6) | |
Fourth-year undergraduate | - | 104 (14.6) | |
Fifth-year undergraduate | - | 30 (4.2) | |
Graduate | - | 195 (27.3) | |
Professional degree | - | 11 (1.5) | |
Not reported | - | 24 (3.4) | |
Employment | Yes | - | 373 (52.3) |
No | - | 318 (44.6) | |
Not reported | - | 22 (3.1) | |
Number of hours worked weekly * | - | 23.0 ± 12.3 | |
Hand washing at least six times in the past day | Yes | - | 489 (68.6) |
No | - | 224 (31.4) |
Groups | Those Who Followed Handwashing Recommendations (n = 489) | Those Who Did Not Follow Handwashing Recommendations (n = 224) | |||||||
---|---|---|---|---|---|---|---|---|---|
Constructs | Possible score range | Observed score range | Mean ± S.D. | Cronbach’s alpha | Possible score range | Observed score range | Mean ± S.D. | Cronbach’s alpha | p-value |
Initiation | 0–4 | 0–4 | 3.40 ± 0.88 | - | 0–4 | 0–4 | 2.3 ± 1.14 | - | <0.0001 |
Participatory dialogue: advantages | 0–20 | 0–20 | 16.40 ± 4.85 | 0.96 | 0–20 | 0–20 | 15.24 ± 5.35 | 0.96 | 0.004 |
Participatory dialogue: disadvantages | 0–20 | 0–20 | 4.35±3.73 | 0.81 | 0–20 | 0–17 | 7.21 ± 4.13 | 0.74 | <0.0001 |
Participatory dialogue: advantages—disadvantages score | −20–20 | −20–20 | 12.75 ± 6.25 | - | −20–+20 | −13–+20 | 9.13 ± 6.14 | - | <0.0001 |
Behavioral confidence | 0–24 | 4–24 | 20.12 ± 4.41 | 0.90 | 0–24 | 0–24 | 15.9 ± 5.3 | 0.87 | <0.0001 |
Changes in the physical environment | 0–12 | 0–12 | 10.52 ± 2.1 | 0.83 | 0–12 | 2–12 | 9.7 ± 2.52 | 0.78 | <0.0001 |
Entire initiation scale | - | - | - | 0.72 | - | - | - | 0.69 | - |
Sustenance | 0–4 | 0–4 | 3.35 ± 0.90 | - | 0–4 | 0–4 | 2.16 ± 1.13 | - | <0.0001 |
Emotional transformation | 0–12 | 1–12 | 9.85 ± 2.5 | 0.88 | 0–12 | 0–12 | 7.34 ± 3.04 | 0.87 | <0.0001 |
Practice for change | 0–12 | 0–12 | 7.96 ± 2.75 | 0.70 | 0–12 | 0–12 | 5.4 ± 2.73 | 0.76 | <0.0001 |
Changes in the social environment | 0–12 | 0–12 | 7.35 ± 3.74 | 0.87 | 0–12 | 0–12 | 4.43 ± 3.82 | 0.85 | <0.0001 |
Entire sustenance scale | - | - | - | 0.88 | - | - | - | 0.87 | - |
Entire scale | - | - | - | 0.86 | - | - | - | 0.85 | - |
Construct(s) | |||||
---|---|---|---|---|---|
Those who followed handwashing recommendations (n = 489) | 1 | 2 | 3 | 4 | |
1 | Likelihood for Initiation | - | 0.358 ** | 0.671 ** | 0.515 ** |
2 | Participatory dialogue: advantages—disadvantages score | - | 0.464 ** | 0.365 ** | |
3 | Behavioral confidence | - | - | - | 0.631 ** |
4 | Changes in the physical environment | - | - | - | - |
1 | Likelihood for Sustenance | - | 0.625 ** | 0.550 ** | 0.378 ** |
2 | Emotional Transformation | - | - | 0.651 ** | 0.418 ** |
3 | Practice for Change | - | - | - | 0.565 ** |
4 | Changes in the Social Environment | - | - | - | - |
Those who did not follow handwashing recommendations (n = 224) | 1 | 2 | 3 | 4 | |
1 | Likelihood for Initiation | - | 0.361 ** | 0.520 ** | 0.284 ** |
2 | Participatory dialogue: advantages—disadvantages score | - | 0.469 ** | 0.483 ** | |
3 | Behavioral confidence | - | - | - | 0.537 ** |
4 | Changes in the physical environment | - | - | - | - |
1 | Likelihood for Sustenance | - | 0.602 ** | 0.604 ** | 0.476 ** |
2 | Emotional Transformation | - | - | 0.643 ** | 0.423 ** |
3 | Practice for Change | - | - | - | 0.516 ** |
4 | Changes in the Social Environment | - | - | - | - |
Variables | Model 1 | Model 2 | Model 3 | Model 4 | ||||
---|---|---|---|---|---|---|---|---|
B | β | B | β | B | β | B | β | |
The likelihood for initiation as a dependent variable | ||||||||
Constant | 3.334 ** | 2.386 ** | 0.874 ** | 0.629 ** | ||||
Age | 0.001 | 0.008 | 0.001 | 0.008 | −0.006 | −0.057 | −0.005 | −0.050 |
Gender | −0.141 | −0.080 | −0.004 | −0.002 | 0.027 | 0.015 | 0.027 | 0.015 |
Race/Ethnicity | 0.106 | 0.054 | 0.132 | 0.066 | 0.056 | 0.028 | 0.045 | 0.023 |
Participatory dialogue | 0.070 ** | 0.496 | 0.022 ** | 0.159 | 0.019 * | 0.137 | ||
Behavioral confidence | 0.116 ** | 0.585 | 0.104 ** | 0.524 | ||||
Changes in the physical environment | 0.049* | 0.116 | ||||||
R2 | 0.009 | 0.249 | 0.471 | 0.479 | ||||
F | 1.256 | 33.819 ** | 72.520 ** | 62.157 ** | ||||
ΔR2 | 0.009 | 0.240 | 0.222 | 0.008 | ||||
ΔF2 | 1.256 | 130.318 ** | 170.971 ** | 5.940 * | ||||
The likelihood for sustenance as a dependent variable | ||||||||
Constant | 3.231 ** | 1.282 ** | 1.256 ** | 1.254 ** | ||||
Age | 0.007 | 0.071 | −0.003 | −0.026 | −0.006 | −0.058 | −0.007 | −0.062 |
Gender | −0.240 * | −0.133 | −0.061 | −0.034 | −0.036 | −0.020 | −0.034 | −0.019 |
Race/ethnicity | −0.003 | −0.002 | −0.044 | −0.022 | −0.052 | −0.026 | −0.051 | −0.026 |
Emotional transformation | 0.222 ** | 0.624 | 0.164 ** | 0.461 | 0.162 ** | 0.456 | ||
Practice for change | 0.085 ** | 0.259 | 0.073 ** | 0.224 | ||||
Changes in the social environment | 0.017 | 0.070 | ||||||
R2 | 0.020 | 0.393 | 0.430 | 0.434 | ||||
F | 2.901 * | 67.430 ** | 62.843 ** | 52.953 ** | ||||
ΔR2 | 0.020 | 0.372 | 0.038 | 0.003 | ||||
ΔF2 | 2.901 * | 255.71 ** | 27.41 ** | 2. |
Variables | Model 1 | Model 2 | Model 3 | Model 4 | ||||
---|---|---|---|---|---|---|---|---|
B | β | B | β | B | β | B | β | |
The likelihood for initiation as a dependent variable | ||||||||
Constant | 2.563 ** | 1.852 ** | 0.684 * | 0.771* | ||||
Age | −0.005 | −0.042 | −0.003 | −0.022 | 0.000 | −0.003 | −0.001 | −0.004 |
Gender | −0.234 | −0.028 | −0.057 | −0.026 | −0.015 | −0.007 | −0.014 | −0.007 |
Race/ethnicity | −0.075 | −0.028 | −0.069 | −0.026 | −0.206 | −0.078 | −0.197 | −0.074 |
Participatory dialogue | 0.065 ** | 0.352 | 0.026 ** | 0.142 | 0.028 * | 0.152 | ||
Behavioral confidence | 0.099 ** | 0.461 | 0.102 ** | 0.474 | ||||
Changes in the physical environment | −0.016 | −0.035 | ||||||
R2 | 0.015 | 0.132 | 0.294 | 0.295 | ||||
F | 0.931 | 6.959 ** | 15.164 ** | 12.615 ** | ||||
ΔR2 | 0.015 | 0.117 | 0.162 | 0.001 | ||||
ΔF2 | 0.931 | 24.682 ** | 41.784 ** | 0.202 | ||||
The likelihood for sustenance as a dependent variable | ||||||||
Constant | 2.533 ** | 0.700 * | 0.525 | 0.481 | ||||
Age | −0.007 | −0.060 | −0.003 | −0.027 | −0.003 | −0.021 | −0.001 | −0.011 |
Gender | −0.246 | −0.113 | −0.033 | −0.015 | −0.047 | −0.022 | −0.059 | −0.027 |
Race/ethnicity | −0.128 | −0.049 | −0.086 | −0.033 | −0.098 | −0.037 | −0.064 | −0.024 |
Emotional transformation | 0.222 ** | 0.597 | 0.133 ** | 0.358 | 0.122 ** | 0.330 | ||
Practice for change | 0.154 ** | 0.370 | 0.123 ** | 0.296 | ||||
Changes in the social environment | 0.053 * | 0.180 | ||||||
R2 | 0.020 | 0.365 | 0.445 | 0.468 | ||||
F | 1.293 | 26.685 ** | 29.660 ** | 26.972 ** | ||||
ΔR2 | 0.020 | 0.344 | 0.080 | 0.023 | ||||
ΔF2 | 1.293 | 100.790 ** | 26.772 ** | 7.957 * |
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Sharma, M.; Batra, K.; Davis, R.E.; Wilkerson, A.H. Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey. Healthcare 2021, 9, 55. https://doi.org/10.3390/healthcare9010055
Sharma M, Batra K, Davis RE, Wilkerson AH. Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey. Healthcare. 2021; 9(1):55. https://doi.org/10.3390/healthcare9010055
Chicago/Turabian StyleSharma, Manoj, Kavita Batra, Robert E. Davis, and Amanda H. Wilkerson. 2021. "Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey" Healthcare 9, no. 1: 55. https://doi.org/10.3390/healthcare9010055