Zomer 2012 NED.

Methods	Cluster‐RCT Allocation sequence: unclear Allocation concealment: not described Blinding: open Inclusion of participants in the analysis: adequate Length of follow‐up: November 2011 to March 2012 Cluster‐adjustment method: adjusted
Participants	Number: 71 day‐care centres (DCC) (intervention 36; control 35) with 545 children (278 from 34 intervention DCC and 267 from 35 control DCC) Inclusion criteria: children attended the DCC at least two days a week, aged between 6 months and 3 to 5 years, intended to attend the DCC throughout the trial period, if their parents consented, were Dutch speaking and had access to e‐mail or regular post. Exclusion criteria: if the child had chronic illness, if the child was on medication that predisposed him/her to infection and if was sibling is taking part in the trial (one per child per family participant) Age: children between 6 months to 60 months
Interventions	Intervention (see Table 5 for detailed description): Hand hygiene products provided free of charge. Training on Dutch Hand Hygiene guidelines with booklet on its content distributed. Training sessions aimed at goal setting and formulating specific hand hygiene improvement activities. Provision of posters and stickers to children and caregivers as reminders and cue to action. Control: No intervention (They continued their usual hand hygiene practice).
Outcomes	Incidence of gastrointestinal infections (incidence of diarrhoea specifically). Caregivers hand hygiene compliance. Not used in this review: Incidence of respiratory infections
Notes	Location: Rotterdam‐Rijnmond, Gouda and Leiden regions of Netherlands Duration: September 2011 to April 2012 (7 months)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Stratified randomized allocation.
Allocation concealment (selection bias)	Unclear risk	Not described.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not described.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not stated.
Incomplete outcome data (attrition bias) All outcomes	Low risk	553 children included in the trial; 545 included in the analysis.
Selective reporting (reporting bias)	Unclear risk	Not observed.
Other bias	High risk	There were some differences in baseline characteristics between intervention and control group. "...the crude incidence of diarrhoeal episodes differed between intervention and control DCCs at baseline..."

^aSee Table 5; Table 6; and Table 7 for a detailed description of the interventions.