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gieneJournal of Hospital Infection (2005) 60, 218–225

www.elsevierhealth.com/journals/jhin

Hand hygiene posters: motivators or mixed messages?
E.A. Jennera,*, F. Jonesb, B.(C). Fletcherc, L. Millerd, G.M. Scotte a School of Nursing and Midwifery, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK School of Psychology, University of Leeds, Leeds LS2 9JT, UK c Department of Psychology, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB, UK d Institute for Employment Studies, University of Sussex, East Sussex BN1 9RF, UK e Department of Clinical Microbiology, University College London Hospitals, London WC1E 6DB, UK b Received 19 January 2004; accepted 15 December 2004 Available online 17 March 2005

KEYWORDS
Posters; Hand hygiene; Message framing; Fear appeals

Summary Poster campaigns regarding hand hygiene are commonly used by infection control teams to improve practice, yet little is known of the extent to which they are based on established theory or research. This study reports on the content analysis of hand hygiene posters (NZ69) and their messages (NZ75) using message-framing theory. The results showed that posters seldom drew on knowledge about effective ways to frame messages. Frequently, they simply conveyed information ‘telling’ rather than ‘selling’ and some of this was confusing. Most posters were not designed to motivate, and some conveyed mixed messages. Few used fear appeals. Hand hygiene posters could have a greater impact if principles of message framing were utilized in their design. Suggestions for gain-framed messages are offered, but these need to be tested empirically. Q 2005 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Introduction
Although poster campaigns on hand hygiene are commonly used by infection control teams to improve practice,1 the evidence

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