title: Social marketing analysis of 20 [corrected] years of hand hygiene promotion.
abstract: OBJECTIVE
  To assess published hand hygiene behavioral interventions that employed a social marketing framework and to recommend improvements to future interventions.
  
  
  METHODS
  We performed a systematic literature review by searching the PubMed database and the Cumulative Index to Nursing and Allied Health Literature for published articles about hand hygiene behavioral interventions in healthcare facilities, schools, and community settings. Our analysis included articles that describe multifaceted interventions and evaluated them with predefined social marketing benchmark criteria.
  
  
  RESULTS
  Of 53 interventions analyzed in this review, 16 (30.2%) employed primary formative audience research, 5 (9.4%) incorporated social or behavioral theories, 27 (50.9%) employed segmentation and targeting of the audience, 44 (83.0%) used components of the "marketing mix," 3 (5.7%) considered the influence of competing behaviors, 7 (13.2%) cultivated relationships with the target audience, and 15 (28.3%) provided simple behavioral messages. Thirty-five (66.0%) of the interventions demonstrated a significant improvement in performance, but only 21 (39.6%) were considered to have a strong evaluative design. The median duration of the interventions was 8.0 months.
  
  
  CONCLUSIONS
  From a social marketing perspective, the promotion of hand hygiene could be improved in several ways. The effectiveness of social marketing in hand hygiene promotion should be tested in future interventions.
authors.affiliation: Faculty of Medicine, O'Brien Centre for the Bachelor of Health Sciences Program, University of Calgary, Calgary, Alberta, Canada. manuel.mah@calgaryhealthregion.ca
authors.forename: Manuel W
authors.initials: MW
authors.lastname: Mah
authors.forename: Yat Cho
authors.initials: YC
authors.lastname: Tam
authors.forename: Sameer
authors.initials: S
authors.lastname: Deshpande
mesh_terms: D019985:Benchmarking; D006235:Hand Disinfection; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D006920:Hygiene / Q000193:education*; D015397:Program Evaluation; D040241:Social Marketing