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Feasibility of elementary school children’s use of hand gel and facemasks during influenza season
Authors:Mandy A Allison  Ginger Guest-Warnick  Douglas Nelson  Andrew T Pavia  Rajendu Srivastava  Per H Gesteland  Robert T Rolfs  Shannon Andersen  Lynne Calame  Paul Young  Carrie L Byington
Institution:1. Division of General Pediatrics, University of Utah, Salt Lake City, UT, USA.;2. Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, UT, USA.;3. Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City, UT, USA.;4. Division of Inpatient Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.;5. Utah Department of Health, Salt Lake City, UT, USA.;6. Salt Lake City Public School District, Salt Lake City, UT, USA.;7. Division of General Pediatrics, University of Utah, Salt Lake City, UT, USA.

Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City, UT, USA.

Abstract:Please cite this paper as: Allison et al. (2010) Feasibility of elementary school children’s use of hand gel and facemasks during influenza season. Influenza and Other Respiratory Viruses 4(4), 223–229. Background The feasibility of non-pharmacologic interventions to prevent influenza’s spread in schools is not well known. Objectives To determine the acceptability of, adherence with, and barriers to the use of hand gel and facemasks in elementary schools. Patients and Methods Intervention: We provided hand gel and facemasks to 20 teachers and their students over 4 weeks. Gel use was promoted for the first 2 weeks; mask use was promoted for the second 2 weeks. Outcomes: Acceptability, adherence, and barriers were measured by teachers’ responses on weekly surveys. Mask use was also measured by observation. Results The weekly survey response rate ranged from 70% to 100%. Averaged over 2 weeks, 89% of teachers thought gel use was not disruptive (week 1 – 17/20, week 2 – 16/17), 95% would use gel next winter (week 1 – 19/20, week 2 – 16/17), and 97% would use gel in a pandemic (week 1 – 20/20, week 2 – 16/17). Averaged over 2 weeks, 39% thought mask use was not disruptive (week 1 – 6/17, week 2 – 6/14), 35% would use masks next winter (week 1 – 5/17, week 2 – 6/14), and 97% would use masks in a pandemic (week 1 – 16/17, week 2 – 14/14). About 70% estimated that their students used hand gel ≥4×/day for both weeks (week 1 – 14/20, week 2 – 13/17). Students’ mask use declined over time with 59% of teachers (10/17) estimating regular mask use during week 1 and 29% (4/14) during week 2. By observation, 30% of students wore masks in week 1, while 15% wore masks in week 2. Few barriers to gel use were identified; barriers to mask use were difficulty reading facial expressions and physical discomfort. Conclusions Hand gel use is a feasible strategy in elementary schools. Acceptability and adherence with facemasks was low, but some students and teachers did use facemasks for 2 weeks, and most teachers would use masks in their classroom in a pandemic.
Keywords:Hygiene  influenza  masks  school health services
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