Table 2. Joint display of mixed methods results for the three central hand hygiene reminders.
| Construct of acceptability23 (n) | Overall (n-342) | HIC* (n=76)† | LMIC‡ (n=187)† | Difference between proportions of good and excellent scores in HIC* and LMIC‡ (t-test p value) | Illustrative quotation from interviews/focus group | |||
| Median Likert (IQR)¶ | Good or Excellent scores§ n (%) | Median Likert (IQR)¶ | Good or Excellent scores§ n (%) | Median Likert (IQR)¶ | Good or excellent scores§ n (%) | |||
| Intervention coherence** (684) | 5 (4–5) | 623 (91) | 5(4–5) | 133 (88) | 5(4–5) | 349 (93) | 0.0290 | ‘I think that everyone would know what to do when they see the posters. Like I said the message is clear, so reading through that and with the pictures attached everyone would know when to wash hands and how to do it.’ P2 Interviewee (LMIC) |
| Perceived effectiveness†† (991) | 4 (3–5) | 714 (72) | 4 (3–5) | 137 (60) | 4 (4–5) | 430 (77) | <0.0001 | ‘The messaging here is very clear as to how to do it, not why you need to do it. But I think why you need to do it also needs to be communicated.’ P12 Interviewee (HIC) |
| Burden‡‡ (307) | 4 (3–5) | 182 (59) | 4 (3–5) | 46 (61) | 4 (3–5) | 115 (62) | 0.8835 | ‘In an emergency setting or in a pressured environment where you have to attend multiple places, probably I will still end up washing my hands or doing a hand rub, but am I actually going to do all the steps on this? Unlikely.’ P10 Interviewee (HIC) |
| Self-efficacy‡‡ (307) | 5 (4–5) | 246 (80) | 5 (4–5) | 62 (82) | 5 (4–5) | 154 (82) | 0.8819 | ‘Everybody has got a hand to do, a role to play in the preventing sepsis and infection, worldwide that is, everybody has got a role to play. If someone doesn’t do it, we have a problem there.’ P3 Interviewee (LMIC) |
| Opportunity cost‡‡ (307) | 5 (3–5) | 230 (75) | 4 (3.5–5) | 57 (75) | 5 (4–5) | 144 (77) | 0.7284 | ‘By doing hand hygiene you tend to lower the cases of maternal infection and maternal sepsis thereby lessening your job.’ P3 Interviewee (LMIC) |
| Ethicality‡‡ (307) | 5 (4–5) | 258 (84) | 5 (4–5) | 62 (82) | 5 (4–5) | 160 (86) | 0.4196 | ‘It’s already part of the work because we have to do the right things and the infection prevention is one of the right things which we are supposed to do.’ P7 Interviewee (LMIC) |
| Affective attitude (342) | 4 (3–5) | 214 (63) | 4 (3–5) | 50 (66) | 4 (3–5) | 111 (59) | 0.3319 | ‘I am thinking that for the picture it would be good to have a pregnant woman, her picture, because that would relate directly to the department that you are referring to, and for our setting we really like to have pictures that have a meaning for what exactly we are trying to achieve.’ P2 Interviewee (LMIC) |
*
High- income countries.
†
For analysis by country income status, data is excluded if country unknown.
‡
Low or middle- income countries.
§
Good or excellent scores represent a score of 4 (Ggood) or 5 (Eexcellent) on the lLikert scale.
¶
Interquartile rangeIQR.
**
Two -component questions reflected to define this construct.
††
Three -component questions reflected to define this construct, 3% missing data.
‡‡
10% missing data.
HIChigh-income countryLMIClow- and middle-income country