Behavioral interventions to improve infection control practices

Am J Infect Control. 1998 Jun;26(3):245-53. doi: 10.1016/s0196-6553(98)80008-4.


No single intervention has been successful in improving and sustaining such infection control practices as universal precautions and handwashing by health care professionals. This paper examines several behavioral theories (Health Belief Model, Theory of Reasoned Action and Theory of Planned Behavior, self-efficacy, and the Transtheoretic Model) and relates them to individual factors, also considering interpersonal and organizational factors. Further, this article includes recommendations of individual and organizational components to be addressed when planning a theoretically based intervention for improving infection control practices. A hypothetic framework to enhance handwashing practice is proposed.

PIP: This article reviews the Health Belief Model, the Theories of Reasoned Action and of Planned Behavior, self-efficacy, and the Transtheoretic Model to determine the application of these theories to attempts to improve infection control practices in the health professions. After a brief introduction, the article offers background information on compliance (the degree to which a person adheres to advice) as it pertains to hand-washing and the use of gloves. This review indicates that interventions to improve compliance must combine institutional and personal variables. Next, the article summarizes the four theoretical frameworks and studies that have sampled various components of the frameworks. The discussion notes that none of the theories consistently predicts behaviors but that constructs some of the theories hold in common (self-efficacy, beliefs, perceived health threat, cues, attitudes, subjective norms, perceived behavioral control, intention, and the stages and processes of change) can be integrated into an intervention to improve infection control practices. A further hypothetical intervention is suggested that addresses individual and organizational components.

Publication types

  • Review

MeSH terms

  • Communicable Disease Control*
  • Hand Disinfection
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Models, Theoretical