Children attending child day care centres are at increased risk of acquiring gastrointestinal and respiratory infections compared to children cared for at home. Hand hygiene is known to be an effective measure to prevent infections. However, compliance with hand hygiene guidelines is generally low. In order to develop successful interventions to improve hand hygiene compliance and reduce gastrointestinal and respiratory infections among children attending day care, it is necessary to assess the key determinants that underlie hand hygiene behaviour. Interventions targeting these determinants can then be developed and evaluated. This thesis focuses on infection control in child day care centres by improving caregivers’ compliance with hand hygiene guidelines. It includes studies on caregivers’ compliance with hand hygiene guidelines, determinants of caregivers’ hand hygiene behaviour, the translation of these determinants into a hand hygiene intervention, and the evaluation of this intervention in a randomised controlled trial.

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J.H. Richardus (Jan Hendrik)
Erasmus University Rotterdam
The research project was funded by the Netherlands Organisation for Health Research and Development (ZonMw). Financial support for the publication of this thesis was kindly given by the Erasmus University Rotterdam, the Erasmus University Medical Centre Rotterdam, Department of Public Health, and the Municipal Public Health Service Rotterdam-Rijnmond.
Erasmus MC: University Medical Center Rotterdam