Back in the late 1970s, the United States Dairy Board was facing a real problem. One of their staples of health – and funding – was in trouble. For decades, milk had been at the top of every American’s shopping list but sales were declining significantly.
But the Board knew this could be changed and sought the help of the advertising giant, McCann-Erickson Worldwide to come up with a slogan that was both accurate scientifically but more importantly, gave consumers the reason to keep milk atop their beverage choice. The result was one of the most remembered slogans in advertising history: “Milk: It does a body good.”
The campaign was a success. Over the coming years, milk production and consumption not only stabilized but increased steadily. It was a grand achievement and set the path for other health-related campaigns such as “Just Do It” (Nike) and “Eat Fresh” (Subway).
The same approach can be used in the context of hand hygiene. Granted, at first glance, this link between improving one’s quality of life and an act that is dictated to help save the lives of others may be elusive. But over the last decade, research into the benefits of hand hygiene apart from those microbial has led to a direction that could potentially bring more healthcare professionals and perhaps even the public at large to warm water and soap.
Back in 2006, Chen-Bo Zhong and Katie Liljenquist published a study that revealed how the simple act of handwashing could help to restore the “moral purity” of 30 individuals. The duo postulated that due to the fact soap and water is a tenet in many religions, there was an unaccounted emotional benefit that could calm the soul. They conducted a number of experiments to test their hypothesis and were quite impressed with the results. The act of physical cleaning was indeed enough to absolve individuals of stress and emotional discomfort.
To Zhong and Liljenquist, this opened the door to more research to address the use of handwashing to influence both social and ethical behaviour. However, there was little action taken to follow up on these findings. There seemed to be a clear understanding of the benefits of hand hygiene but apparently few were ready to act upon the information.
But at the University of Michigan, graduate student Spike W. S. Lee and his supervisor, Norbert Schwarz felt that there was more to the story. They believed the postulate of moral and ethical benefit and decided to see if handwashing could indeed resolve another human condition which we all tend to suffer: cognitive dissonance. In 2010 they published the findings of a study that tested their hypothesis. They took 40 students and subjected them to a test that challenged their decision-making abilities and the need to justify them. In between the actual decision and the justification steps, the students were offered the chance to wash their hands.
Though the opportunity appeared to be insignificant to the test, the results showed otherwise. Those students that chose to perform hand hygiene felt little need for justification; they felt comfortable with their decision. In contrast, those who did not wash their hands felt a need to justify their choices. In effect, hand hygiene cleaned the hands but more importantly, cleansed the soul.
Based on the successes of the milk campaign and the science of these two studies, a door has been opened to hand hygiene promoters. By merging these examples, new and more effective means to implement campaigns to increase interest and compliance can be found. The way forward would also help to move away from the negative imagery associated with healthcare associated infections, which to date continue to underperform. The focus would shift from pathogens and death to psychological benefit and happiness, making the message even more positive and optimistic. But perhaps most of all, it will bring into effect a truth that has been known for centuries but that has been set aside in a world more concerned with scientific rather than moral, ethical and spiritual values.
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