JMIR Publications

ABSTRACT

Background:

After COVID-19 pandemic society has become more aware of the importance of some basic hygienic habits to avoid exposure to pathogens transmitted via hands. Given that a high frequency of touching the mucous membranes can lead to a high risk of infection, it is essential to establish strategies to reduce this behavior as a preventive measure for contagion. This risk can be extrapolated to a multitude of health scenarios and transmission of many infectious diseases. #RedPingüiNO has been designed as an intervention to prevent the transmission of SARS-CoV-2 and other pathogens, through the reduction of facial self-touches by thoughtfully engaging participants in a serious game.

Objective:

Facial self-touches should be understood as behaviors of limited control and awareness, used to regulate situations of cognitive and emotional demand, or as part of non-verbal communication. The objective of this study is to ensure participants to become aware of and reduce these behaviors through game.

Methods:

The intervention through the game was put into practice for two weeks with a control group (CG) and two experimental groups (EG-nR, no additional social reinforcement interventions; EG-R, with additional social reinforcement interventions) with the objective of improving the knowledge, perception and reduction of this risk behavior to prevent exposure to pathogens transmitted via hands not only in health multi-hazard scenarios like COVID-19 pandemic but also under ordinary circumstances. The ad hoc instrument used to analyze the experience is made up of 43 items and resulted valid and reliable for the purpose of study. Items are divided into five blocks extracted from the theoretical framework: sociological issues (1-5); hygiene habits (6-13); risk awareness (14-19); strategies for not touching the face (20-26); questions after the intervention (27-42), designed as a post-intervention tool about the game experience. Validation of content was achieved through the assessment of 12 expert referees. External validation was obtained by a test-retest procedure and reliability was verified using the Spearman correlation.

Results:

The results of the ad hoc questionnaire, analyzed using Wilcoxon signed-rank test and McNemar index to look for significant differences between test and retest, and the daily logs of the participants showed that facial self-touches were reduced, and awareness of this spontaneous behavior and its triggers was increased.

Conclusions:

The intervention exhibited a greater effect from sharing the game, with interactions between people, but, in both cases, it was effective in reducing this gesture. In short, this game can be suitable for reducing facial self-touches and, due to its free availability and design, can be adapted to various contexts.