Lifting the Lid on Bacteria': Designing ambient communications to improve hygiene in primary school toilets

Context: AMR can be directly tackled by reducing the spread of infection in the first instance. The primary school toilet is a risk-laden space for the spread of bacterial infection given the behaviour of its users. Research reports that fewer than half of the children who use school toilets wash their hands afterwards. Neutral poster-based messages such as 'Now Wash Your Hands' or classroom material may aid understanding and reinforce hand hygiene messages but what is the potential of using more novel, engaging, friendly and site-specific communication in the toilet environment itself? Aims and objectives: The primary aim of this communication design-led research is to investigate the potential of using ambient, surface-based communications in the primary school toilet environment to improve hand hygiene practices (lowering the toilet lid, hand washing and hand drying). Ambient communication involves the clever and unexpected integration of graphics and media messages in specific environments. It is usually employed by commercial companies to improve engagement with a product or brand but it holds much potential for application in other areas. If bacteria and other appropriate message/images were clever represented in the environment, for instance, what impact would it have on behaviour in that space? This research involves three phases. Firstly a historical review of everyday representations of bacteria and hand hygiene aimed at children will be carried out. This will provide new knowledge of dominant ideas from the 20th Century about children, hygiene and bacteria and provide selected imaginative material to show to children in subsequent workshops. Secondly school children will be directly engaged with to gauge their understanding of the toilet space, what bacteria might look like there and where it is. Participatory design methods will be used to understand what children would design and why. Thirdly a set of ambient designs will be developed, informed by historical and contemporary design practice and children's imaginative ideas, for testing in school toilets and the toilets at Eureka! The National Children's Museum. The installation of the designs will facilitate the testing of the concept and provide opportunity for a pilot study of evaluation methods - what are the most effective and feasible ways to measure success of such an intervention? Applications and Benefits. This interdisciplinary, collaborative research project brings together academics and professionals from the areas of communication design, medical history, healthcare, education and microbiology. The project will involve a synthesis of approaches (historical analysis, participatory design methods, communication design practice, and science-led evaluation methods) and thus the application of the research is potentially wide. It can inform medical and public health historians about historical and contemporary ideologies underpinning bacteria representations aimed at children. It can also provide communication designers with an extensive set of designs and analysis to aid the designing of anti-bacterial products/interventions for children today. It will also bring microbiology research into a more public domain since we will use findings directly from microbiology research (related to toilet lid position) for one of the messages. The designs developed may also be applied not only within school toilets more widely but in children's hospitals or wards. One of the key benefits of the research, if the intervention is successful, is potentially reducing the spread of infection due to school toilet usage. There are number of benefits to this aspect of the work alone: reducing absenteeism, reducing the occurrence of infections within the wider family, and reducing the request for antibiotics. The research will promote discussion amongst teachers and child-focused museums about current and potential future communications in the toilet space.