To help teach and promote hand washing in primary schools the Health Protection Agency, in collaboration with schools, developed 'Hands Up for Max!' a hand washing resource pack, designed to teach children how to wash their hands and encourage them to do so.

In 2009, the Health Protection Agency, Healthy Schools, and the University of Bristol set out to evaluate the effectiveness of the Hands Up for Max! resource in reducing absenteeism in primary schools due to common infectious illnesses. 178 schools in the area of Bristol, BANES, North Somerset, South Gloucestershire, Swindon, and Wiltshire agreed to take part in the study. Of the 178 schools, 23 schools took part in collecting additional data about pupil and staff absences and completed questionnaires about hand washing.

The trial was funded by the National Institute for Health Research (NIHR), Research for Patient Benefit (RfPB) programme, and was a collaboration between the Health Protection Agency and the University of Bristol.

Publications:

Willmott M, Nicholson A, Busse H, Macarthur GJ, Brookes S, Campbell R. Effectiveness of hand hygiene interventions in reducing illness absence among children in educational settings: A systematic review and meta-analysis. Archives of Disease in Childhood. 2016 Jan 1;101(1):42-50. https://doi.org/10.1136/archdischild-2015-308875

Chittleborough CR, Nicholson AL, Young E, Bell S, Campbell R. Implementation of an educational intervention to improve hand washing in primary schools: process evaluation within a randomised controlled trial. BMC Public Health. 2013;13:757. https://doi.org/10.1186/1471-2458-13-757

Chittleborough CR, Campbell R, Nicholson AL, Gunn SL. A cluster-randomised controlled trial to test the effectiveness of a hand washing intervention in reducing infection-related absence in primary schools: insights from an embedded process evaluation. Journal of Epidemiology and Community Health. 2010 Sep;64 Supplement 1:A43. https://doi.org/10.1136/jech.2010.120477.24