Changes in Hand Hygiene Behaviors and Its Related Factors Among Northern Iranian Population During the First Peak and Subsidence of COVID-19 Pandemic Period: Results from PERSIAN Guilan Cohort Study (PGCS)

Background: Hand hygiene is a critical behavior for preventing COVID-19 transmission, emphasized throughout the pandemic. Objectives: This study investigated changes in hand-washing behaviors and related factors among the population of northern Iran. Methods: A sequential cross-sectional study was conducted in Guilan (northern Iran) during two periods: The first peak of the COVID-19 pandemic in Iran (March 23 - 30, 2020) and the first subsidence (May 3 - 10, 2020). A questionnaire was completed by 571 adult participants, collecting data on hand-washing frequency, procedure, circumstances, and obsessive-like behaviors. Multiple logistic regression was used to analyze potential correlates of reduced hand-washing frequency. Results: Compared to the first peak, hand-washing frequency, procedure, and obsessive-like behaviors were significantly reduced at the subsidence of the pandemic (all P < 0.05). Females with a negative family history of coronavirus disease had greater odds (adjusted odds ratio = 2.19, P = 0.03) of reduced daily hand-washing frequency. Younger males (under 50 years old) and males who reduced their hand-washing procedure had greater odds of reduced daily hand-washing frequency (AOR = 1.71, P = 0.02 and AOR = 2.16, P = 0.001, respectively). Conclusions: The population of northern Iran decreased their hand-washing frequency and quality, and obsessive-like behaviors, from the first peak to the first subsidence of the COVID-19 pandemic. Independent predictors of reduced hand-washing frequency were younger age and reduced hand-washing procedure in males, and a negative family history of coronavirus disease in females. Special attention should be paid to maintaining the general population’s perceived susceptibility to illness, especially in younger men, during pandemics.