An internet-delivered handwashing intervention to modify infl uenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial
An internet-delivered handwashing intervention to modify infl uenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial
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DOI：
10.1016/s0140-6736(15)60127-1
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发表时间：
2015-10-24
期刊：
影响因子：
168.9
通讯作者：
Yardley, Lucy
中科院分区：
文献类型：
--
作者：
Little, Paul;Stuart, Beth;Yardley, Lucy
背景预防呼吸道感染(RTI)传播的洗手一直被广泛提倡，特别是在H1N1大流行期间。然而，洗手的作用还存在争议，在非剥夺环境中的成年人中也没有很好的随机证据。我们的目的是评估通过互联网传递的改变洗手的干预措施是否会减少成年人及其家庭成员的生殖道感染数量。方法我们通过在英国的一般做法招募通过邮寄邀请分享家庭的个人。同意后，参与者通过自动计算机生成的随机数程序在网上随机进行，要么不接受，要么接受定制的基于网络的自动干预，该干预最大限度地提高洗手意图，监测洗手行为，提供量身定制的反馈，强化有益的态度和规范，并消除负面信念。我们将参与者纳入另一个队列(随机接受干预或不接受干预)，以评估关于洗手的基线问卷是否会影响洗手行为。参与者没有被屏蔽到干预分配中，但统计分析命令被构建成屏蔽到组中。主要结果是在修改后的意向治疗人群中，随机分配的参与者在16周后完成随访的指标参与者中发生RTI的次数。这项试验在ISRCTN注册中心注册，编号为ISRCTN75058295。在2011年1月17日至2013年3月31日的三个冬天里，我们招募了20066名参与者，并随机分配他们接受干预(n=10040)或不干预(n=10026)。16908人(84%)接受16周问卷调查(干预组8241人，对照组8667人)。16周后，干预组4242人(51%)报告一次或多次RTI，而对照组5135人(59%)报告一次或多次RTI(多变量风险比0.86，95%可信区间0.83-0.89；p
Background Handwashing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic. However, the role of handwashing is debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess whether an internet-delivered intervention to modify handwashing would reduce the number of RTIs among adults and their household members.Methods We recruited individuals sharing a household by mailed invitation through general practices in England. After consent, participants were randomised online by an automated computer-generated random number programme to receive either no access or access to a bespoke automated web-based intervention that maximised handwashing intention, monitored handwashing behaviour, provided tailored feedback, reinforced helpful attitudes and norms, and addressed negative beliefs. We enrolled participants into an additional cohort (randomised to receive intervention or no intervention) to assess whether the baseline questionnaire on handwashing would affect handwashing behaviour. Participants were not masked to intervention allocation, but statistical analysis commands were constructed masked to group. The primary outcome was number of episodes of RTIs in index participants in a modified intention-to-treat population of randomly assigned participants who completed follow-up at 16 weeks. This trial is registered with the ISRCTN registry, number ISRCTN75058295.Findings Across three winters between Jan 17, 2011, and March 31, 2013, we enrolled 20066 participants and randomly assigned them to receive intervention (n=10040) or no intervention (n=10026). 16 908 (84%) participants were followed up with the 16 week questionnaire (8241 index participants in intervention group and 8667 in control group). After 16 weeks, 4242 individuals (51%) in the intervention group reported one or more episodes of RTI compared with 5135 (59%) in the control group (multivariate risk ratio 0.86, 95% CI 0.83-0.89; p