# Interactive Hand Hygiene Trainer for School-Age Children

> **NIH NIH R44** · INDELIBLE LEARNING, INC. · 2024 · $835,202

## Abstract

PROJECT SUMMARY
Proper hand washing is a cost-effective intervention that offers powerful protection against a host of gastrointestinal
and respiratory transmissible diseases, but only if done effectively, at the appropriate time, and consistently. Global
campaigns to increase handwashing have raised awareness, but significant barriers to improved handwashing
remain. Teachers and parents are not commonly taught proper technique. As a result, despite massive, and costly
installation of handwashing stations and signage, too often children do not use soap or sanitizer effectively—even
with adult supervision. Beyond technique, students struggle to remember when to wash when occasions require it.
Despite years of pandemic, heightened awareness, and sincere efforts by adults and children alike, durable
handwashing habits have not taken hold.
OBJECTIVE: We aim to create an interactive digital trainer that: 1) depicts hand anatomy correctly for more accurate
learning; 2) provides an immersive educational experience, with critical visual feedback of germs remaining, so that
students learn to use the appropriate scrub motion to address specific areas of that hand that were inadequately
cleaned; 3) engages students to play again, over several sessions, to foster habit formation, and durable gains in hand
hygiene.
RESEARCH DESIGN: In Phase I, we successfully created an innovative, engaging, and highly entertaining prototype:
the Bubble Beats handwashing trainer. We established that our technology works on Chromebooks, iOS devices, and
PCs. After a single session with the trainer, students demonstrated a significant increase in World Health Organization
(WHO) hand hygiene steps performed at the sink. In Phase II, we will develop a fully-featured solution, with
supporting material for teachers, and test this product in an independent evaluation across multiple classrooms, in
a randomized controlled trial.
METHODS:
AIM 1: PRODUCTION. Teacher co-developers, domain experts, and students will participate throughout the project
in rapid and frequent cycles of design, build, test, and refine. Early usability testing with small groups will test new
components of the trainer, for eventual integration into the completed product. We will evaluate the effectiveness
of these new components assembled together in authentic classroom settings. Handwashing proficiency will be
measured by photometric analysis of images of hands before and after washing, and video analysis of WHO scrub
steps performed while washing at the sink.
AIM 2: EVALUATION: Finally, a formal and independent evaluation across multiple classrooms will measure short-
and long-term impacts of the training, to determine healthy habit formation for handwashing.

## Key facts

- **NIH application ID:** 10823124
- **Project number:** 2R44GM144007-02A1
- **Recipient organization:** INDELIBLE LEARNING, INC.
- **Principal Investigator:** Jasminka Criley
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $835,202
- **Award type:** 2
- **Project period:** 2021-09-15 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10823124

## Citation

> US National Institutes of Health, RePORTER application 10823124, Interactive Hand Hygiene Trainer for School-Age Children (2R44GM144007-02A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10823124. Licensed CC0.

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