• Mandy A Allison, Ginger Guest-Warnick, Douglas Nelson, Andrew T Pavia, Rajendu Srivastava, Per H Gesteland, Robert T Rolfs, Shannon Andersen, Lynne Calame, Paul Young, and Carrie L Byington.
• Division of General Pediatrics, University of Utah, Salt Lake City, UT 84158, USA. mandy.allison@hsc.utah.edu
• Influenza Other Respi Viruses. 2010 Jul 1; 4 (4): 223-9.

BackgroundThe feasibility of non-pharmacologic interventions to prevent influenza's spread in schools is not well known.ObjectivesTo determine the acceptability of, adherence with, and barriers to the use of hand gel and facemasks in elementary schools.Patients And MethodsInterventionWe provided hand gel and facemasks to 20 teachers and their students over 4 weeks. Gel use was promoted for the first 2 weeks; mask use was promoted for the second 2 weeks.OutcomesAcceptability, adherence, and barriers were measured by teachers' responses on weekly surveys. Mask use was also measured by observation.ResultsThe weekly survey response rate ranged from 70% to 100%. Averaged over 2 weeks, 89% of teachers thought gel use was not disruptive (week 1--17/20, week 2--16/17), 95% would use gel next winter (week 1--19/20, week 2--16/17), and 97% would use gel in a pandemic (week 1--20/20, week 2--16/17). Averaged over 2 weeks, 39% thought mask use was not disruptive (week 1--6/17, week 2--6/14), 35% would use masks next winter (week 1--5/17, week 2--6/14), and 97% would use masks in a pandemic (week 1--16/17, week 2--14/14). About 70% estimated that their students used hand gel ≥ 4 x/day for both weeks (week 1--14/20, week 2--13/17). Students' mask use declined over time with 59% of teachers (10/17) estimating regular mask use during week 1 and 29% (4/14) during week 2. By observation, 30% of students wore masks in week 1, while 15% wore masks in week 2. Few barriers to gel use were identified; barriers to mask use were difficulty reading facial expressions and physical discomfort.ConclusionsHand gel use is a feasible strategy in elementary schools. Acceptability and adherence with facemasks was low, but some students and teachers did use facemasks for 2 weeks, and most teachers would use masks in their classroom in a pandemic.

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