Background
Hand hygiene education in elementary schools and ritual customs at shrines/temples
Reciprocity interrelated with school education and cultural experiences
Methods
Survey design
Outcome variables: handwashing and hygiene practices
Outcome Variables | In April (n = 6050) | In July/August (n = 4501) | ||
---|---|---|---|---|
Mean | Standard Deviation (S.D.) | Mean | S.D | |
Handwashing Practices with Water (0/1) | ||||
I wash my hands after coming home from outside | 0.953 | 0.213 | 0.957 | 0.203 |
I wash my hands before each meal | 0.854 | 0.353 | 0.873 | 0.333 |
I wash my hands at the workplace or in other public spaces after toilet use (urination) | 0.957 | 0.202 | 0.955 | 0.207 |
I wash my hands at the workplace or in other public spaces after toilet use (defecation) | 0.958 | 0.200 | 0.951 | 0.216 |
Average of the aforementioned four practices | 0.931 | 0.191 | 0.934 | 0.177 |
Handwashing Practices with Soap (0/1) | ||||
I wash my hands after coming home from outside | 0.833 | 0.373 | 0.810 | 0.393 |
I wash my hands before each meal | 0.585 | 0.493 | 0.566 | 0.496 |
I wash my hands at the workplace or in other public spaces after toilet use (urination) | 0.633 | 0.482 | 0.597 | 0.491 |
I wash my hands at the workplace or in other public spaces after toilet use (defecation) | 0.706 | 0.456 | 0.687 | 0.464 |
Average of the aforementioned four practices | 0.689 | 0.373 | 0.665 | 0.378 |
Hygiene Practices (0–7) | ||||
Wearing a mask | ||||
When coughing or sneezing, I place a mask or handkerchief over my mouth ("cough etiquette") | 5.249 | 2.460 | 5.380 | 2.378 |
I always wear a mask when talking to someone | 5.061 | 2.322 | 5.443 | 2.052 |
I always wear a mask when going out | 5.798 | 2.092 | 6.032 | 1.827 |
Preventing the spread of infection through hand contact | ||||
I practice gargling and frequently wash my hands, and disinfect my hands and fingers with alcohol | 5.968 | 1.783 | 5.978 | 1.700 |
I try to avoid shaking hands | 5.530 | 2.406 | 5.732 | 2.181 |
I use cashless payment methods (credit cards, electronic fund transfers, etc.) instead of cash | 4.500 | 2.559 | 4.654 | 2.419 |
Preventing occurrence of "clusters" | ||||
I talk with others via phone or video call whenever possible | 4.121 | 2.773 | 3.960 | 2.730 |
I designate one person to do the shopping or go out in a small group during times when stores are not crowded | 5.046 | 2.207 | 4.954 | 2.163 |
I use takeout or home delivery services instead of going to restaurants | 3.865 | 2.937 | 3.559 | 2.760 |
I use delivery or mail-order services for larger purchases | 3.721 | 2.848 | 3.682 | 2.749 |
Self-care during COVID-19 pandemic | ||||
I avoid going out when I feel unwell | 4.986 | 2.656 | 5.146 | 2.524 |
I try to stay home as much as possible even if I am not ill | 5.702 | 1.989 | 5.189 | 2.197 |
I try to avoid touching my face | 4.088 | 2.394 | 4.289 | 2.331 |
I try to get plenty of rest and sleep | 5.526 | 1.901 | 5.304 | 1.922 |
I try to eat nutritious foods | 4.755 | 2.052 | 4.673 | 2.058 |
Average of the aforementioned fifteen practices | 4.928 | 1.511 | 4.932 | 1.467 |
Empirical framework (1) regarding education and cultural factors
Empirical framework (2) regarding ritual customs and reciprocity
Compliance to hygiene public policy
Results
Descriptive statistics
Handwashing practices before the COVID-19 pandemic
Handwashing Practices (Before COVID-19) with Water | Handwashing Practices (Before COVID-19) with Soap | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Washing hands after coming home | Washing hands before eating | Washing hands after toilet use (urination) | Washing hands after toilet use (defecation) | Average of four items | Washing hands after coming home | Washing hands before eating | Washing hands after toilet use (urination) | Washing hands after toilet use (defecation) | Average of four items | |
(1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) | (10) | |
Panel A: Eq. (1) Adjustments for childhood education/residence as below, as well as demographic/ behavioral/labor/age and prefecture dummies | ||||||||||
Elementary School Education | ||||||||||
Everyone in my class was supervised by teachers to ensure that they washed their hands in turn | 0.0380*** | 0.0380*** | 0.0143* | 0.0160** | 0.0346*** | 0.0502*** | 0.1006*** | 0.0907*** | 0.0897*** | 0.0828*** |
(0.011) | (0.011) | (0.008) | (0.008) | (0.008) | (0.017) | (0.018) | (0.018) | (0.017) | (0.014) | |
There was a handmade soap making class | 0.0403*** | 0.0403*** | 0.0216** | 0.0113 | 0.0421*** | 0.0847*** | 0.1170*** | 0.1108*** | 0.0696*** | 0.0955*** |
(0.014) | (0.014) | (0.009) | (0.009) | (0.009) | (0.020) | (0.022) | (0.022) | (0.021) | (0.017) | |
Childhood Residential Area Near Shrines/Temples | ||||||||||
There were shrines near my house or along the school route | 0.0091 | 0.0091 | 0.0156** | 0.0123* | 0.0062 | -0.0096 | -0.0327* | -0.0236 | -0.0013 | -0.0168 |
(0.011) | (0.011) | (0.007) | (0.007) | (0.007) | (0.016) | (0.017) | (0.017) | (0.017) | (0.014) | |
There were temples near my house or along the school route | -0.0078 | -0.0078 | -0.0026 | -0.0021 | -0.0028 | 0.0005 | 0.0172 | 0.0089 | 0.0110 | 0.0094 |
(0.011) | (0.011) | (0.007) | (0.007) | (0.007) | (0.016) | (0.017) | (0.017) | (0.017) | (0.014) | |
Panel B: Eq. (2) Adjustments for handwashing experiences at shrines/temple and reciprocity as below in addition to those in Panel A | ||||||||||
Elementary School Education | ||||||||||
Everyone in my class was supervised by teachers to ensure that they washed their hands in turn | 0.0305*** | 0.0305*** | 0.0075 | 0.0087 | 0.0267*** | 0.0418** | 0.0890*** | 0.0776*** | 0.0788*** | 0.0718*** |
(0.011) | (0.011) | (0.008) | (0.007) | (0.008) | (0.017) | (0.018) | (0.018) | (0.017) | (0.014) | |
There was a handmade soap making class | 0.0359*** | 0.0359*** | 0.0192** | 0.0087 | 0.0378*** | 0.0783*** | 0.1071*** | 0.1007*** | 0.0635*** | 0.0874*** |
(0.014) | (0.014) | (0.009) | (0.009) | (0.009) | (0.020) | (0.021) | (0.021) | (0.021) | (0.017) | |
Childhood Residential Area Near Shrines/Temples | ||||||||||
There were shrines near my house or along the school route | 0.0112 | 0.0112 | 0.0115 | 0.0080 | 0.0057 | -0.0029 | -0.0244 | -0.0154 | 0.0056 | -0.0093 |
(0.011) | (0.011) | (0.007) | (0.007) | (0.007) | (0.016) | (0.017) | (0.017) | (0.017) | (0.014) | |
There were temples near my house or along the school route | -0.0089 | -0.0089 | -0.0039 | -0.0035 | -0.0044 | 0.0003 | 0.0151 | 0.0074 | 0.0104 | 0.0083 |
(0.011) | (0.011) | (0.007) | (0.007) | (0.007) | (0.016) | (0.017) | (0.017) | (0.017) | (0.014) | |
Childhood Handwashing Experiences at Shrines/Temples | ||||||||||
Never washed hands (Base) | ||||||||||
Washed hands only a few times | 0.0290** | 0.0290** | 0.0231** | 0.0227** | 0.0255** | 0.0009 | 0.0170 | 0.0123 | 0.0469** | 0.0193 |
(0.015) | (0.015) | (0.010) | (0.010) | (0.010) | (0.022) | (0.023) | (0.023) | (0.023) | (0.018) | |
Washed hands most of the time | 0.0644*** | 0.0644*** | 0.0281*** | 0.0284*** | 0.0490*** | 0.0651*** | 0.0976*** | 0.1016*** | 0.1033*** | 0.0919*** |
(0.014) | (0.014) | (0.009) | (0.009) | (0.009) | (0.021) | (0.022) | (0.022) | (0.021) | (0.017) | |
Always washed hands | 0.0778*** | 0.0778*** | 0.0304*** | 0.0312*** | 0.0672*** | 0.0986*** | 0.1617*** | 0.1607*** | 0.1228*** | 0.1360*** |
(0.015) | (0.015) | (0.010) | (0.010) | (0.010) | (0.022) | (0.024) | (0.024) | (0.023) | (0.019) | |
Reciprocity | ||||||||||
Reciprocity | 0.0082 | 0.0082 | 0.0292*** | 0.0299*** | 0.0140*** | 0.0090 | -0.0174** | 0.0016 | 0.0218*** | 0.0038 |
(0.005) | (0.005) | (0.003) | (0.003) | (0.004) | (0.008) | (0.008) | (0.008) | (0.008) | (0.007) | |
Observations | 6,050 | 6,050 | 6,050 | 6,050 | 6,050 | 6,050 | 6,050 | 6,050 | 6,050 | 6,050 |
Hand hygiene practices during and after the COVID-19-related state of emergency
Handwashing with water (Average of four items) | Handwashing with soap (Average of four items) | Hygiene practices (Average of fifteen items) | |||||||
---|---|---|---|---|---|---|---|---|---|
Time periods | April | July/August (J/A) | J/A(controlling for April) | April | July/August (J/A) | J/A(controlling for April) | April | July/August (J/A) | J/A(controlling for April) |
(1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) | |
Panel A: Eq. (1) Adjustments for childhood education/residence as below, as well as demographic/ behavioral/labor/age and prefecture dummies | |||||||||
Elementary School Education | |||||||||
Everyone in my class was supervised by teachers to ensure that they washed their hands in turn | 0.0256*** | 0.0191*** | 0.0124* | 0.0666*** | 0.0608*** | 0.0164 | 0.3159*** | 0.2871*** | 0.1084** |
(0.007) | (0.007) | (0.007) | (0.015) | (0.015) | (0.012) | (0.058) | (0.059) | (0.049) | |
There was a handmade soap making class | 0.0278*** | 0.0203** | 0.0122 | 0.0817*** | 0.0833*** | 0.0294** | 0.1864*** | 0.1452** | 0.0388 |
(0.009) | (0.009) | (0.009) | (0.019) | (0.019) | (0.014) | (0.071) | (0.072) | (0.060) | |
Childhood Residential Area Near Shrines/Temples | |||||||||
There were shrines near my house or along the school route | 0.0030 | 0.0008 | 0.0015 | -0.0074 | -0.0096 | -0.0047 | 0.0071 | 0.0510 | 0.0477 |
(0.007) | (0.007) | (0.007) | (0.014) | (0.015) | (0.011) | (0.055) | (0.056) | (0.046) | |
There were temples near my house or along the school route | 0.0035 | -0.0007 | -0.0011 | 0.0033 | 0.0070 | 0.0045 | 0.0982* | 0.0263 | -0.0284 |
(0.007) | (0.007) | (0.007) | (0.014) | (0.015) | (0.011) | (0.055) | (0.056) | (0.046) | |
Panel B: Eq. (2) Adjustments for handwashing experiences at shrines/temple and reciprocity as below in addition to those in Panel A | |||||||||
Elementary School Education | |||||||||
Everyone in my class was supervised by teachers to ensure that they washed their hands in turn | 0.0200*** | 0.0138* | 0.0084 | 0.0555*** | 0.0490*** | 0.0123 | 0.2617*** | 0.2435*** | 0.0968** |
(0.007) | (0.007) | (0.007) | (0.015) | (0.015) | (0.012) | (0.058) | (0.059) | (0.049) | |
There was a handmade soap making class | 0.0238*** | 0.0166* | 0.0095 | 0.0739*** | 0.0745*** | 0.0261* | 0.1500** | 0.1144 | 0.0294 |
(0.009) | (0.009) | (0.009) | (0.019) | (0.019) | (0.014) | (0.071) | (0.072) | (0.060) | |
Childhood Residential Area Near Shrines/Temples | |||||||||
There were shrines near my house or along the school route | 0.0027 | 0.0014 | 0.0016 | -0.0023 | -0.0040 | -0.0025 | 0.0138 | 0.0639 | 0.0567 |
(0.007) | (0.007) | (0.007) | (0.014) | (0.015) | (0.011) | (0.055) | (0.056) | (0.047) | |
There were temples near my house or along the school route | 0.0017 | -0.0019 | -0.0021 | 0.0013 | 0.0045 | 0.0033 | 0.0824 | 0.0174 | -0.0281 |
(0.007) | (0.007) | (0.007) | (0.014) | (0.015) | (0.011) | (0.055) | (0.055) | (0.046) | |
Childhood Handwashing Experiences at Shrines/Temples | |||||||||
Never washed hands (Base) | |||||||||
Washed hands only a few times | 0.0242*** | 0.0080 | 0.0058 | 0.0220 | 0.0032 | -0.0118 | 0.2240*** | 0.0704 | -0.0533 |
(0.009) | (0.009) | (0.009) | (0.019) | (0.020) | (0.015) | (0.074) | (0.075) | (0.063) | |
Washed hands most of the time | 0.0447*** | 0.0352*** | 0.0256*** | 0.0996*** | 0.0809*** | 0.0153 | 0.2981*** | 0.2319*** | 0.0664 |
(0.009) | (0.009) | (0.009) | (0.018) | (0.019) | (0.014) | (0.071) | (0.072) | (0.060) | |
Always washed hands | 0.0470*** | 0.0415*** | 0.0308*** | 0.1100*** | 0.1201*** | 0.0474*** | 0.4882*** | 0.3642*** | 0.0919 |
(0.010) | (0.010) | (0.010) | (0.020) | (0.020) | (0.016) | (0.076) | (0.077) | (0.065) | |
Reciprocity | |||||||||
Reciprocity | 0.0092** | 0.0138*** | 0.0119*** | 0.0199*** | 0.0210*** | 0.0078 | 0.1710*** | 0.1553*** | 0.0600** |
(0.004) | (0.004) | (0.004) | (0.008) | (0.008) | (0.006) | (0.029) | (0.029) | (0.025) | |
Handwashing/Hygiene Practices in April | |||||||||
Average of four/fifteen items | 0.0966*** | 0.6580*** | 0.5600*** | ||||||
(0.007) | (0.012) | (0.013) | |||||||
Observations | 4,501 | 4,501 | 4,501 | 4,501 | 4501 | 4501 | 4501 | 4501 | 4501 |