Azor‐Martinez 2016.

Study characteristics
Methods	Randomised, controlled, and open study with an 8‐month follow‐up. The experimental group washed their hands with soap and water, together with using hand sanitiser, and the control group followed their usual handwashing procedures. Absenteeism rates due to URIs were compared between the 2 groups through a multivariate Poisson regression analysis. The per cent of days missed in both groups were compared with a z test.
Participants	A sample of 1341 (intervention group = 621, control group = 720) Inclusion criteria: children 4 to 12 years old, attending 5 state schools in Almerıa (Spain) whose parents/guardians had signed an informed consent document Exclusion criteria: children who had any of the following chronic illnesses that predisposed them to infection: neoplasia, primary and secondary immunodeficiencies, cystic fibrosis, chronic treatment with high doses of steroids or immunosuppressants
Interventions	Hand‐washing workshops of 2‐hour duration. The experimental group washed their hands with soap and water together with using hand sanitiser, whilst the control group followed usual hand‐washing procedures. See Table 4 for details.
Outcomes	Absenteeism rates due to URIs Per cent of days missed Respiratory illness was defined by 2 of the following symptoms during 1 day, or 1 of the symptoms for 2 consecutive days: (1) runny nose; (2) stuffy or blocked nose or noisy breathing; (3) cough; (4) feeling hot or feverish or having chills; (5) sore throat; or (6) sneezing. A school absenteeism case (episode) was defined as when a child failed to attend school due to an URI. Common infectious illnesses, such as conjunctivitis, and skin infections were not included. Other causes for absenteeism, such as doctors’ appointments, family vacations, and accident injuries, were also excluded. No safety outcomes reported.
Notes	Government funded
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	A random number table was used.
Allocation concealment (selection bias)	Low risk	Schools/classes allocated prior to children recruited.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Unblinded study
Blinding of outcome assessment (detection bias) All outcomes	High risk	Unblinded study
Incomplete outcome data (attrition bias) All outcomes	High risk	Attrition levels high and different in the 2 groups
Selective reporting (reporting bias)	Unclear risk	No protocol available