title: Hand washing among school children in Bogotá, Colombia.
abstract: OBJECTIVE
  We assessed hand-washing behaviors and intentions among school children in Bogotá, Colombia, to help identify and overcome barriers to proper hygiene practices.
  
  
  METHODS
  Data on hand-washing behavior and intentions and individual and contextual factors were collected from 2042 sixth- through eighth-grade students in 25 schools in Bogotá via anonymous questionnaires. A member of the school administration or teaching staff completed a questionnaire about the school environment. Site inspections of bathroom facilities were conducted.
  
  
  RESULTS
  Only 33.6% of the sample reported always or very often washing hands with soap and clean water before eating and after using the toilet. About 7% of students reported regular access to soap and clean water at school. A high level of perceived control was the strongest predictor of positive hand-washing intentions (adjusted odds ratio [AOR]=6.0; 95% confidence interval [CI]=4.8, 7.5). Students with proper hand-washing behavior were less likely to report previous-month gastrointestinal symptoms (OR=0.8; 95% CI=0.6, 0.9) or previous-year school absenteeism (OR=0.7; 95% CI=0.6, 0.9).
  
  
  CONCLUSIONS
  Scarcity of adequate facilities in most schools in Bogotá prevents children from adopting proper hygienic behavior and thwarts health promotion efforts. The current renovation program of public schools in Bogotá provides a unique opportunity to meet the challenges of providing a supportive environment for adoption of healthy behaviors.
authors.affiliation: Braun School of Public Health & Community Medicine, Hebrew University, Hadassah, PO Box 12272, Jerusalem, Israel.
authors.forename: Catalina
authors.initials: C
authors.lastname: Lopez-Quintero
authors.forename: Paul
authors.initials: P
authors.lastname: Freeman
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Neumark
mesh_terms: D000293:Adolescent; D002648:Child; D003105:Colombia; D003140:Communicable Disease Control; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006235:Hand Disinfection; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006293:Health Promotion; D006305:Health Status Indicators; D006801:Humans; D006920:Hygiene; D008297:Male; D016017:Odds Ratio; D010865:Pilot Projects; D011634:Public Health; D012574:Schools; D040241:Social Marketing; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires