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Sanitary Bathroom Habits: Men & Women

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Background: Single most effective behavior to reduce spread of infectious diseases In United States: infectious diseases = leading cause of death Sampled the hands of commuters using public transportation: ¼ of people had FECAL matter on hands Hand Washing with Soap: Recent Study:

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Background: Studies on Hand Washing Behavior: 65% WOMEN, 33% MEN 74% WOMEN, 61% MEN 75% WOMEN, 58% MEN 85% WOMEN, 69% MEN Wireless sensors measuring for 32 days: 1996 Observational study: 2000 Observational, 5 cities in U.S: 2004: Observation on college campus:

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Background: Of those that washed their hands, only used soap Only of hand washers washed hands for longer than 15 seconds of those who washed hands washed for 1-6 seconds 64% 10% 69% More about the 2004 College Study: 410 Students Observed

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97% Women 95% Men washed hands Background: 95% of respondents reported hand washing in public restrooms Hand washing = socially desirable (over-reported in surveys) Study conducted during SARS outbreak: Survey on Hand Washing:

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Data Collection: Observational Study: In Public Restrooms 132 MEN121 WOMEN Observed: Locations: Briarwood mall: Ann Arbor, MI RiverTown Crossings mall: Grandville, MI Hartsfield-Jackson Atlanta Int’l Airport: Atlanta, GA Quality 16 movie theater: Ann Arbor, MI Total time spent in bathroom Recorded: If hands were washed (with or without soap) Time spent washing hands

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Variables: 1. = whether or not subject washed hands (with or without soap) 2. = seconds spent washing hands (contact with soap or water) 3. = total time in minutes spent in the actual restroom Research Questions: 1.Do more females wash their hands in a public restroom than males? 2.Do females wash their hands for a longer period of time than males in public restrooms? 3.Do females spend more time in the public bathrooms than males? WASH HANDS TIME WASH TOTAL TIME

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Power Analysis: TEST 1:TEST 2:TEST 3: POWER: 80% SIGNIFICANCE: 0.05 HYPOTHESES: 1-Sided (compare proportions) Parameter: 15% diff. NEED: 134 each gender SAMPLE: 121 Females 132 Males (compare means) Parameter: 2 sec. diff NEED: 20 each gender SAMPLE: 29 Females 38 Males (compare means) Parameter: 0.5 min. diff NEED: 20 each gender SAMPLE: 27 Females 42 Males

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Relationship 1: Question: Is there a higher proportion of females who wash their hands after using a public restroom than males? Null Hypothesis: The same proportion of males and females wash their hands after using public restrooms Alternative Hypothesis: A higher proportion of females than males wash their hands after using public restrooms Variables Compared: Gender and Handwashing (both categorical)

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Cross Tabulation: Compare Proportions At Least Five of Each Response Variable: Yes

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Proportion Wash: Female Proportion Wash: Male 95.04%53.03% Sample Size Female: 121Sample Size Male: 132 In our sample, FEMALES washed hands more often than males. Traditional Test P-value: <0.0001 <.05

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Conclusion Relationship 1: 1. P-Value 0.003 is less than significance level of 0.05 REJECT NULL HYPOTHESIS ***it is unlikely that the difference in proportions observed occurred by chance!!! 2. Evidence supports the alternative hypothesis: ***in this sample, the proportion of females who wash their hands after using a public restroom is greater than the proportion of males 3.Within the population of Americans, adult females did indeed wash their hands more often than males after using a public restroom.

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Relationship 2: Question: Do females wash their hands after using public restrooms for a longer period of time than males? Null Hypothesis: Females and males wash their hands the same amount of time after using public restrooms Alternative Hypothesis: Females wash their hands for a longer amount of time than males after using public restrooms Gender and Time Spent Washing (one categorical and one quantitative) Variables Compared:

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BOX PLOT: COMPARE MEANS GENDER TIME SPENT HAND- WASHING (sec) SKEWNESS: NONE OUTLIERS: ONE

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Mean seconds MALES:Mean seconds FEMALES: 5.4 sec7.8 sec Sample Size Males: 29Sample Size Females: 38 Traditional Test P-value: 0.0034 < 0.05 In our sample, FEMALES washed hands in restroom for 2.4 seconds longer, on average

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Conclusion Relationship 2: 1.P-Value 0.003 is less than significance level of 0.05 REJECT NULL HYPOTHESIS ***it is unlikely that the difference in means observed occurred by chance!!! 2. Evidence supports the alternative hypothesis: ***in this sample, the difference in means found (females wash hands an average of 2.4 seconds longer) was significant 3.Within the population of Americans, adult females did indeed spend more seconds washing their hands after using a public restroom

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Relationship 3: Question: Do females spend more time in public restrooms than males? Null Hypothesis: Females and males spend the same amount of time in public restrooms Females spend more time than males in public restrooms Alternative Hypothesis: Gender and Time Spent in Restroom (one categorical and one quantitative) Variables Compared:

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OUTLIERS: ZERO SKEWNESS: Slight in males, nothing major BOX PLOT: COMPARE MEANS GENDER TIME SPENT IN BATHROOM (min)

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In our sample, FEMALES spent 1.7 more minutes in the bathroom, on average. Mean minutes MALES:Mean minutes FEMALES: 1.03 min2.73 min Sample Size Males: 42Sample Size Females: 27 Traditional Test P-value: <0.00001 < 0.05

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Conclusion Relationship 3: 1.P-Value <0.00001 is less than significance level of 0.05 REJECT NULL HYPOTHESIS ***it is unlikely that the difference in means observed occurred by chance!!! 2. Evidence supports the alternative hypothesis: ***in this sample, the difference in means found (females spend 1.7 more minutes in public restrooms than males) was significant 3.Within the population of Americans, adult females did indeed spend more minutes public restrooms

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Final Summary: Test 1: Proportion of males & females who wash hands in public restroom P-value < 0.001 REJECT NULL HYPOTHESIS Females proportion: 42% higher Test 2: Time spent washing hands P-value: 0.003 REJECT NULL HYPOTHESIS Females: 2.4 seconds longer, on average, in our sample Test 3: Time spent in public restrooms P-value < 0.001 REJECT NULL HYPOTHESIS Females spend 1.7 minutes longer, on average, in our sample

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Study Limitations: Lindsay & Christine created a SOCIAL PRESSURE during data collection (stood near the subjects as they washed hands) Difficult to MEASURE PRECICESLY how long subjects washed hands Couldn’t tell a difference between when subjects were ALONE and when they were being watched LOCATIONS : 3 public places in Michigan, and one place in Atlanta: NOT very representative of the whole country

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Resources for Background Information: Judah, G., Schmidt, W., Michie, S., Granger, S., & Curtis, V. Experimental Pretesting of Hand-Washing Interventions in a Natural Setting. 2009. American Journal of Public healh, 99(2), 405-411. Monk-Turner, E., Edwards, D., Broadstone, J., Hummel, R., Lewis, S., & Wilson, D. Another Look at Hand-Washing Behavior. 2005. Social Behavior and Personality, 33(7), 629-634.

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