Author(s), Year, and Country | Source of Funding | Study Population | Definition Illness-related Absenteeism | Unit of analysis | Study Duration | Intervention Arm | Control Arm |
---|---|---|---|---|---|---|---|
Cluster Randomized Controlled Trials (RCTs) | |||||||
White 41 2001 United States | Industry (Woodward Laboratories, Inc.) | 1 private and 2 public elementary schools grades K-6; 72 initial classes (n = 1626 students) * Target group: • 16 classes, n = 388 students Control group: • 16 classes, n = 381 students | • GI or respiratory-related • Parents reported events | Grouped by classroom | 5 weeks | • Education: presentation and video describing germs and proper handwashing techniques (1 hr session) • Large involvement of both parents and school staff • Each child received 1-oz bottle of SAB (CleanHands®) (alcohol-free) instant hand sanitizer • Instructed to use spray under teacher supervision to supplement handwashing | • Education: presentation and video describing germs and proper handwashing techniques (1 hr session) • Large involvement of both parents and school staff • Each child received 1-oz bottle of placebo formulation • Instructed to use spray under teacher supervision to supplement handwashing |
Crossover | |||||||
Dyer 27 2000 United States | Industry (Woodward Laboratories, Inc.) | Private elementary school (K-6); 2 classrooms per grade level, n = 30 students per classroom Target group: • Children grades K-6 • 1 classroom per grade level • n = 210 students Control group: • Children grades K-6 • 1 classroom per grade level • n = 210 students | • GI (symptoms including vomiting, abdominal pain, and diarrhea) • Respiratory-related (symptoms included cough, sneezing, sinus trouble, bronchitis, fever alone, pink eye, headache, mononucleosis, and acute exacerbation of asthma) • Parents reported events | Grouped by classroom | 10 weeks (4 weeks first arm, 2 week washout period, 4 weeks second arm) | • Education: presentation and video describing germs and proper handwashing techniques (1 hr session) • Each child received 1-oz bottle of SAB (CleanHands®) (alcohol-free) instant hand sanitizer • Instructed to use spray under teacher supervision to supplement handwashing | • Education: presentation and video describing germs and proper handwashing techniques (1 hr session) • Instructed to wash hands as usual |
Morton 16 2004 United States | Maine Administrative School District #35 in Eliot, and South Berwick, Maine; Erie Scientific donated AlcoSCRUB® | 1 elementary school in northern New England, grades K-3; 17 classrooms and n = 285 students eligible PHASE 1: Target group: • 9 classrooms Control group: • 8 classrooms • PHASE 2: • reversed | • GI (symptoms including influenza, diarrhea, nausea, or vomiting (with or without fever)) • Respiratory-related (symptoms included nasal congestion, cough, or sore throat (with or without fever)) • Parents reported events | Grouped | 100 days (46 day first arm, 1 week washout period, 47 day second arm) | • Education: guardians provided with study information and a contact number for the school nurse; additionally, monthly updates were provided • Education: students received a carefully planned education program; 45 minute "Germ Unit", Glo Germ™ presentation • Reinforcement: 1st week: daily reminders given to students, after 1st week reinforcement given weekly and after holidays; each classroom visited twice by school nurse during two arms • AlcoSCRUB® dispensers were furnished in each classroom, located near the classroom entrance at a height that was accessible to all students • Gel use was monitored, and reinforcement was given to classes with low use | • Education: information was presented by school nurse about proper handwashing • Instructed to wash hands as usual |
Cluster Non-randomized Controlled Trials (NRCTs) | |||||||
Hammond 31 2000 United States | GOJO Industries, Inc. | 18 public elementary schools grades K-6 in 6 school districts * Target group: • 5 school districts: District 1 (Ohio; K-5; n = 1440 students), District 2 (Ohio; 2,3; n = 266 students), District 3 (Delaware; 3,4; n = 110 students), District 4 (Tennessee; K-6; n = 680 students), District 5 (California; K-5; n = 579 students) Control group: • 5 school districts: District 1 (K-5; n = 1136 students), District 2 (2,3; n = 552 students), District 3 (3,4; n = 113 students), District 4 (K-6; n = 592 students), District 5 (K-5; n = 612 students) | • Infectious process such as cold, flu, and gastroenteritis (common infectious illnesses such as pink eye, abscesses, and skin infections were not included) • No information regarding reporting of events | Grouped by school and grouped by classroom | 10 months | • Each test classroom was equipped with a dispenser of PURELL instant alcohol-based hand sanitizer; also placed in other locations around the school • Reinforcement by study co-ordinators every 3 months | • No intervention |
Guinan 10 2002 United States | GOJO Industries, Inc. | 5 elementary schools; 4 schools had 4 classrooms, 1 school had 2 classrooms (coed and single sex schools) Target group: • Children grades K-3 • 4 schools with 2 classrooms, 1 school with 1 classroom • n = 145 students Control group: • Children grades K-3 • 4 schools with 2 classrooms, 1 school with 1 classroom • n = 145 students | • Infectious process such as cold, flu, and gastroenteritis • Children and parents reported events • Had to be 5 days between episodes to count | Grouped by classroom | 3 months | • Education: presentation and video describing germs and proper handwashing techniques (1 hr session) • Each test classroom was equipped with a dispenser of an alcohol-based hand sanitizer | • No intervention |
Cluster Controlled Trials-randomization unclear | |||||||
Thompson 15 2004 United States (abstract only) | Not available | 5 grade two classrooms, and 1 one/two combination classroom, n = 138 children Target group: • 3 classrooms Control group: • 3 classrooms | • Illness = cold, flu, conjunctivitis, and gastrointestinal symptoms • Teachers recorded absences | n/a | n/a | • Age appropriate interactive learning session • Alcohol-based hand sanitizer installed in intervention classrooms | n/a |