The Impact of Multisensory Audio-Visual Education on Observed Handwashing Skills Among Second-Grade Elementary School Children

Siti Dewi Rahmayanti; Asep Tatan Solehudin; Nunung Nurjanah

doi:10.56741/IISTR.jphs.002058

Authors

Siti Dewi Rahmayanti
siti.dewi@kesmas.unjani.ac.id
Universitas Jenderal Achmad Yani https://orcid.org/0009-0008-4207-5103
Asep Tatan Solehudin Universitas Jenderal Achmad Yani https://orcid.org/0009-0006-6494-6411
Nunung Nurjanah Universitas Jenderal Achmad Yani https://orcid.org/0000-0003-2537-8635

Keywords:

Audio-Visual Education, Elementary School Children, Handwashing Skills, Hygiene Behavior, School Health Education

Abstract

Handwashing with soap is a critical preventive behaviour for reducing infectious disease transmission among school-aged children. Despite awareness of its importance, many children demonstrate inadequate handwashing techniques, reflecting limited procedural skill acquisition. Educational strategies that emphasize skill-based learning and engage multiple sensory modalities may be more effective, particularly for younger elementary school students. This study evaluated the effect of multisensory audio-visual education on observed handwashing skills among second-grade elementary school children. Methods: A cluster quasi-experimental pretest-posttest study with a control group was conducted among 200 second-grade elementary school students. Participants were allocated by classroom into intervention (n=100) and control (n=100) groups. Handwashing skills were assessed using a standardized observation checklist. Data were analyzed using generalized estimating equations (GEE) to examine the effects of group, time, and group-by-time interaction while accounting for repeated measurements. The findings indicate that baseline handwashing skills were comparable between groups. Following the intervention, the intervention group demonstrated substantial improvements in observed handwashing performance, whereas the control group showed only minimal changes. Generalized estimating equation analysis showed a significant group-by-time interaction (β = 27.60, SE = 2.90, p < 0.001), with a large intervention effect (Cohen's d = 1.45). Overall, multisensory audio-visual education effectively enhances handwashing skills among early elementary school children and supports its integration into school-based hygiene promotion programs.

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Author Biographies

Siti Dewi Rahmayanti, Universitas Jenderal Achmad Yani

is a permanent lecturer specializing in pediatric nursing at Universitas Jenderal Achmad Yani, Indonesia. She earned her nursing degree from Universitas Padjadjaran and her master’s degree from Universitas Indonesia. As a certified educator, she has published scientific articles and authored several books. She received national research grants in 2014 and 2026. Her professional memberships include the Indonesian National Nurses Association (PPNI) and Indonesian Pediatric Nurses Association (IPANI). (email: siti.dewi@kesmas.unjani.ac.id).

Asep Tatan Solehudin, Universitas Jenderal Achmad Yani

is affiliated with the Faculty of Health Sciences and Technology (FITKES), Universitas Jenderal Achmad Yani (UNJANI), Cimahi, West Java, Indonesia. Born in Garut in 2002, he completed his bachelor’s degree in nursing at FITKES UNJANI in 2025 and is currently undertaking the Ners professional program at the same institution. He was a member of the Undergraduate Nursing Student Association (HIMA Ilmu Keperawatan S1) from 2022 to 2023. (email: aseptatans15@gmail.com).

Nunung Nurjanah, Universitas Jenderal Achmad Yani

is a civil-service lecturer specializing in pediatric nursing at Universitas Jenderal Achmad Yani, Indonesia. She earned her undergraduate nursing degree from Universitas Padjadjaran and completed her master’s and pediatric nursing specialist education at Universitas Indonesia. She is an active member of the Indonesian Pediatric Nurses Association (IPANI). She has received two national research grants and several awards for outstanding poster and oral presentations at national and international conferences. (email: nunung.nurjanah@stikesayani.ac.id).

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