HandHKU-VR-2026NCT07659340
Effectiveness of VR on the Sustainability of Hand Hygiene Compliance: School-based RCT With 10-month Follow-up
A study testing VR Handwashing Game (2 sessions) and VR Handwashing Game (1 session) + Video on hand hygiene (1 session) in people with Hand and Hygiene Practices and Knowledge, run by The University of Hong Kong at 1 site in Hong Kong.
Trial summary
This study aims to evaluate the effectiveness of a VR intervention on teaching handwashing skills which are promoted by the Centre for Health Protection, Department of Health, HKSAR. A 7-step handwashing approach will be taught through a customized VR game in secondary schools in Hong Kong. Read more about this study
- Who is it for?
- Ages 12 to 15 yearsHealthy volunteers can take part
- Conditions the study is for
- Hand, Hygiene Practices and Knowledge
- What is being tested?
- VR Handwashing Game (2 sessions) and VR Handwashing Game (1 session) + Video on hand hygiene (1 session)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 500 participants
- Where
- 1 siteHong Kong
- Study dates
- 1 Mar 2026to 30 Aug 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 12 to 15 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Hong Kong secondary school students studying junior forms
Who cannot join
- -
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Hong Kong1 site, 1 recruiting
- Recruiting
School of Future Media, The University of Hong Kong
Hong Kong
King-wa Fu, Professor, +852 3917 1643, kwfu@hku.hk
King-wa Fu, Professor
About this study
Official title: Effectiveness of Immersive and Embodied Enhancement Via "Virtual Reality" on the Sustainability of Hand Hygiene Compliance: School-based RCT With 10-month Follow-up
This study aims to evaluate the effectiveness of a VR intervention on teaching handwashing skills which are promoted by the Centre for Health Protection, Department of Health, HKSAR. A 7-step handwashing approach will be taught through a customized VR game in secondary schools in Hong Kong. Participant's handwashing skills and prolonged effects on handwashing habits and hygiene level will be assessed.
The main questions it aims to answer are:
Read more
- Does an intervention of our VR handwashing game enhance handwashing skills amongst junior secondary students?
- What are the factors hinder or enhance students' learning of handwashing skills in the intervention?
Participating students will be assigned into 3 groups. Each group will receive two sessions of educational training with different kinds of intervention throughout one school year (9 months). The first intervention group will participate in two VR-game sessions on handwashing skill; the second intervention group will participate in one VR-game session and one video session about handwashing; the baseline group will participate in two sessions of other VR activities unrelated to hand hygiene and view a handwashing skill poster. The research will compare the handwashing performance between the three groups.
Participants will:
- participate into a VR handwashing game intervention, or a video-based intervention, or placebo VR activities as stated hereinafter;
- perform handwashing in the VR game, and their hand-motion data will be captured;
- participate a UV lighting test after handwashing away fluorescent lotion; and,
- fill up questionnaires
Read the detailed description
Schools are often the site of infection outbreaks, including COVID-19, influenza and other infectious diseases. COVID-19 pandemic has accelerated the need to enhance hygiene levels at primary and secondary schools and, specifically, nurturing and enforcing students' regular handwashing practices is one of the key components of a preventive strategy to reduce the transmission of infectious illnesses. Meanwhile, Virtual Reality (VR) intervention has been shown to be an efficacious tool for behavioural change. It manipulates an array of behavioural and environmental variables to construct an immersive virtual environment for changing certain human behaviours. VR handwashing education system may be more helpful than conventional verbal explanation in encouraging school children to wash their hands thoroughly, especially overcoming difficult to wash areas including wrists. Nevertheless, a school-based VR intervention on handwashing education is lacked in Hong Kong.
Objective:
This study aims to evaluate the effectiveness of a VR intervention on teaching handwashing skills which are promoted by the Centre for Health Protection, Department of Health, HKSAR. A 7-step handwashing approach will be taught through a customized VR game in secondary schools in Hong Kong. Participant's handwashing skills and prolonged effects on handwashing habits and hygiene level will be assessed.
Methods:
A 3-arm randomized controlled trial will be adopted. About 500 students will be assigned into 3 groups which will be randomly assigned on class-basis. Each group will receive two sessions of educational training with different kinds of intervention throughout one school year (9 months). The first intervention group will participate in two VR-game sessions on handwashing skill; the second intervention group will participate in one VR-game session and one video session about handwashing; the baseline group will participate in two sessions of other VR activities unrelated to hand hygiene and view a handwashing skill poster. Comparison of pre- and post-intervention hand-images of participants will serve as primary measurement. Ultraviolet-sensitive fluorescent lotion will be applied to the participants' hands and digital photos will be taken under UV lighting environment. Image comparisons will adopt quantitative method of calculating the percentage of fluorescent pixels over total hand areas. Post-intervention hand-images will be collected 3 months after the second intervention in order to capture any prolonged effect on handwashing over the whole intervention period. The secondary measures will be deployed through pre-invention, immediate post-intervention and follow-up (3 months after intervention) surveys. The survey will comprise scales measuring self-efficacy, knowledge on hand hygiene, handwashing habits and intentions, attitudes, subjective norms, and perceived behavioral control, VR embodiment and VR experience.
Results:
The project has already commenced in March 2026. The data collection period of the randomized controlled trial will be started from Sep 2026 and will end in May 2027. Data will be analyzed during June and August 2027, and the results are expected to be released in September 2027.
Conclusion:
This study contributes to existing knowledge about infection prevention strategy through VR game as well as the hand hygiene of the student population in Hong Kong and elsewhere. The study fills a number of research gaps in the field by (1.) developing evidence-based and executable VR hand hygiene programmes in school settings; (2.) addressing the ill-solved sustainability issue of hand hygiene intervention effects; (3.) identifying factors underlying the pathway of behavioural changes on hand hygiene and issues related to barriers to change, and (4.) identifying handwashing patterns through hand motion data shaping the hand hygiene level. The experiences and results from this VR game project can be also transferable to develop other programme regarding public health by adopting VR devices.
- Conditions
- Hand, Hygiene Practices and Knowledge
- Being tested
- VR Handwashing Game (2 sessions), VR Handwashing Game (1 session) + Video on hand hygiene (1 session)
- Keywords
- Hand Hygiene, Virtual Reality, Hand Disinfection, Educational
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
VR Handwashing Game (2 sessions)Other
The intervention will be a VR game taught about the '7-Steps approach' of hand-washing promoted by Centre for Health Protection, HKSAR. The game is comprised of two parts: Training Mode and Challenge Mode. In Training Mode, students will be guided with text and voice feedback. A pair of 'ghost hands' will demonstrate what to do. Students follow the movements of the 'ghost hands' to complete the handwashing tasks. In the Challenge Mode, students are requested to perform all the steps at once by their own memory, hints will be given only when they encounter setback in an assigned duration.
Trained facilitators will teach participants how to use the VR devices and provide briefing sessions on how to play the game.
For the Intervention Group 1, they will play the game in two separate sessions (about 4 months between the two sessions).
VR Handwashing Game (1 session) + Video on hand hygiene (1 session)Other
For Intervention Group 2, participants will attain one VR game session and 1 video-instructed session.
| Study group | Role | What they receive |
|---|---|---|
| Intervention 1 | Experimental | Participants who attend two VR game sessions Receives: Other: VR Handwashing Game (2 sessions) |
| Intervention 2 | Experimental | Participants who attend one VR game session and one video-based education session Receives: Other: VR Handwashing Game (1 session) + Video on hand hygiene (1 session) |
| Baseline Group | No intervention | Participants who attend two non-hand hygiene related VR activity sessions |
What is being measured
The primary outcome is the main question the study is designed to answer.
Hand-imaging Data
Ultraviolet-sensitive fluorescent lotion (e.g., Glo Germ™) will be applied on participants' hands thoroughly to simulate full contamination (e.g., germs and pathogens) on hands. Then participants wash their hands. The areas where lotion has been washed out are considered as 'decontaminated'. The participants will put their washed hands in a black box with an Ultraviolet-A (365nm) lighting system. Both palms and dorsa of left and right hands will be photographed.
Measured: Hand-imaging data will only be collected before the 1st intervention and at the end of the data collection period (about 9 months after the 1st intervention).
Secondary outcomes (3)
Knowledge on Hand Hygiene and Handwashing
As this study is focused on handwashing skills and steps, questionnaires on this field are usually customized for the context of the research (i.e., steps and skills can be differed between studies). As our interventions mainly teach about the 7-handwashing steps suggested by the Centre for Health Protection, Department of Health, HKSAR, five questions will be developed to assess participants' knowledge of the handwashing procedures.
Measured: This measurement will be collected through questionnaire pre-intervention, immediately after 1st intervention, after 2nd intervention (5 months after 1st intervention) and in the follow-up survey (9 months after 1st intervention).
Handwashing Habit
Two components on handwashing habit will be measured frequency of handwashing. Five items on how often the participants cleaned their hands on five different scenarios (before meal, after using washroom, after taking public transportation, after arriving at the school and after going back home) will be asked to measure the frequency of handwashing (5-point scale from 'never' to 'always'.
Measured: This measurement will be collected through questionnaire pre-intervention, immediately after 1st intervention, after 2nd intervention (5 months after 1st intervention) and in the follow-up survey (9 months after 1st intervention).
Attitude and Intention
The attitude on automaticity of handwashing habit will be measured by the Self-Report Behaviour Automaticity Index (SRBAI), which has already been modified and validated into four items regarding handwashing in another study. The sample item is 'Hand washing is something I start doing before I realise I'm doing it'. The four items are measured on a 7-point Likert scale, ranging from 1 ("does not apply to me at all") to 7 ("completely applies to me"). Behavioural intention will be measured by a single item : "In my daily routine, I want to perform hand hygiene as correctly as possible" on a 7-point Likert scale.
Measured: This measurement will be collected through questionnaire pre-intervention, immediately after 1st intervention, after 2nd intervention (5 months after 1st intervention) and in the follow-up survey (9 months after 1st intervention).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Jun 2026
- Study start1 Mar 2026
- Primary completion30 Aug 2027 (estimated)
- Study completion30 Aug 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (19)Papers the sponsor has linked to this study.
- Other trials for HandStudies of the same condition, open and under way.
- More trials run by The University of Hong KongThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A 3-arm randomized controlled trial will be adopted. 369 students will be assigned into 3 groups which will be randomly assigned on class-basis. Each group will receive two sessions of educational training with different kinds of intervention throughout one school year (9 months). The first intervention group (full-intervention) will participate in two VR-game sessions on handwashing skill; the second intervention group (half-intervention) will participate in one VR-game session and one video session about handwashing; the baseline (control) group will participate in two sessions of other VR activities unrelated to hand hygiene and view handwashing promotion poster.
- Masking
- Double blind
- Who is masked
- Care provider, Outcomes assessor
- Enrolment
- 500 participants (estimated)
Sponsor and investigators
- Lead sponsor
- The University of Hong Kong
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, King-wa Fu, The University of Hong Kong
- Investigators
- King-wa Fu, Professor, Principal investigator, School of Future Media, The University of Hong Kong
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07659340
- Sponsor's protocol ID
- 23244181
- Acronym
- HKU-VR-2026
- Status last verified
- Jun 2026
- First submitted
- 15 Jun 2026
- Last updated
- 24 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Birrenbach T, Zbinden J, Papagiannakis G, Exadaktylos AK, Muller M, Hautz WE, Sauter TC. Effectiveness and Utility of Virtual Reality Simulation as an Educational Tool for Safe Performance of COVID-19 Diagnostics: Prospective, Randomized Pilot Trial. JMIR Serious Games. 2021 Oct 8;9(4):e29586. doi: 10.2196/29586.
PubMed 34623315Sin CS, Rochelle TL. Using the theory of planned behaviour to explain hand hygiene among nurses in Hong Kong during COVID-19. J Hosp Infect. 2022 May;123:119-125. doi: 10.1016/j.jhin.2022.01.018. Epub 2022 Feb 3.
PubMed 35124145O'Boyle CA, Henly SJ, Larson E. Understanding adherence to hand hygiene recommendations: the theory of planned behavior. Am J Infect Control. 2001 Dec;29(6):352-60. doi: 10.1067/mic.2001.18405.
PubMed 11743481Srigley JA, Corace K, Hargadon DP, Yu D, MacDonald T, Fabrigar L, Garber G. Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review. J Hosp Infect. 2015 Nov;91(3):202-10. doi: 10.1016/j.jhin.2015.06.019. Epub 2015 Aug 4.
PubMed 26321675Gasteiger N, van der Veer SN, Wilson P, Dowding D. Virtual reality and augmented reality smartphone applications for upskilling care home workers in hand hygiene: a realist multi-site feasibility, usability, acceptability, and efficacy study. J Am Med Inform Assoc. 2023 Dec 22;31(1):45-60. doi: 10.1093/jamia/ocad200.
PubMed 37846147Eichel VM, Brandt C, Brandt J, Jabs JM, Mutters NT. Is virtual reality suitable for hand hygiene training in health care workers? Evaluating an application for acceptability and effectiveness. Antimicrob Resist Infect Control. 2022 Jun 25;11(1):91. doi: 10.1186/s13756-022-01127-6.
PubMed 35752839Galvan Debarba H, Bovet S, Salomon R, Blanke O, Herbelin B, Boulic R. Characterizing first and third person viewpoints and their alternation for embodied interaction in virtual reality. PLoS One. 2017 Dec 27;12(12):e0190109. doi: 10.1371/journal.pone.0190109. eCollection 2017.
PubMed 29281736Asadzadeh A, Samad-Soltani T, Rezaei-Hachesu P. Applications of virtual and augmented reality in infectious disease epidemics with a focus on the COVID-19 outbreak. Inform Med Unlocked. 2021;24:100579. doi: 10.1016/j.imu.2021.100579. Epub 2021 Apr 27.
PubMed 33937503Mira J, Gonzalez M, Villalba C, Guerra L, Ramirez-Moya Y, Hernandez J, Moya O, Pineda L, Perez-Esteve C. Improving Hand Hygiene Skills Using Virtual Reality: Quasi-Experimental Study. J Med Internet Res. 2025 Oct 7;27:e78882. doi: 10.2196/78882.
PubMed 41057041The Centre for Health Protection, Department of Health, HKSAR. Proper Hand Hygiene. The Centre for Health Protection, Department of Health, HKSAR; 2026. https://www.chp.gov.hk/en/healthtopics/content/460/19728.html
Faruk Karabulut O, Celikcan U, Ellahi B, Dikmen D. Training of food handlers on handwashing using a virtual reality environment is more effective than traditional training approaches in a randomized trial. Int J Environ Health Res. 2025 Aug;35(8):2067-2078. doi: 10.1080/09603123.2024.2425781. Epub 2024 Nov 10.
PubMed 39522117Stuart JP, Gannon PR, Dotto VR, Regina R, Mumma JM. Visualizing the WHO "My Five Moments for Hand Hygiene," framework: A virtual reality training program for improving hand hygiene adherence among nurses. Am J Infect Control. 2025 May;53(5):576-581. doi: 10.1016/j.ajic.2025.01.007. Epub 2025 Jan 15.
PubMed 39824286Allegranzi B, Gayet-Ageron A, Damani N, Bengaly L, McLaws ML, Moro ML, Memish Z, Urroz O, Richet H, Storr J, Donaldson L, Pittet D. Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study. Lancet Infect Dis. 2013 Oct;13(10):843-51. doi: 10.1016/S1473-3099(13)70163-4. Epub 2013 Aug 23.
PubMed 23972825World Health Organization. WHO Guidelines on Hand Hygiene in Health Care. World Health Organization. https://www.who.int/publications/i/item/9789241597906.com
Hoyle E, Davies H, Bourhill J, Roberts N, Lee JJ, Albury C. Effectiveness of hand-hygiene interventions in reducing illness-related absence in educational settings in high income countries: systematic review and behavioural analysis. J Public Health. 2025;33(3):659-670. doi:10.1007/s10389-023-02044-7
Study at a glance
From the registry record, last updated by the sponsor on 24 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effectiveness of Immersive and Embodied Enhancement Via "Virtual Reality" on the Sustainability of Hand Hygiene Compliance: School-based RCT With 10-month Follow-up
- ClinicalTrials.gov ID
- NCT07659340
- Acronym / sponsor ID
- HKU-VR-2026 / 23244181
- Conditions
- Hand, Hygiene Practices and Knowledge
- Keywords
- Hand Hygiene, Virtual Reality, Hand Disinfection, Educational
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 500 participants (estimated)
- Lead sponsor
- The University of Hong KongUniversity, hospital or other
- Study start
- 1 Mar 2026 (actual)
- Primary completion
- 30 Aug 2027 (estimated)
- Study completion
- 30 Aug 2027 (estimated)
- First posted
- 22 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to evaluate the effectiveness of a VR intervention on teaching handwashing skills which are promoted by the Centre for Health Protection, Department of Health, HKSAR. A 7-step handwashing approach will be taught through a customized VR game in secondary schools in Hong Kong. Participant's handwashing skills and prolonged effects on handwashing habits and hygiene level will be assessed.
The main questions it aims to answer are:
- Does an intervention of our VR handwashing game enhance handwashing skills amongst junior secondary students?
- What are the factors hinder or enhance students' learning of handwashing skills in the intervention?
Participating students will be assigned into 3 groups. Each group will receive two sessions of educational training with different kinds of intervention throughout one school year (9 months). The first intervention group will participate in two VR-game sessions on handwashing skill; the second intervention group will participate in one VR-game session and one video session about handwashing; the baseline group will participate in two sessions of other VR activities unrelated to hand hygiene and view a handwashing skill poster. The research will compare the handwashing performance between the three groups.
Participants will:
- participate into a VR handwashing game intervention, or a video-based intervention, or placebo VR activities as stated hereinafter;
- perform handwashing in the VR game, and their hand-motion data will be captured;
- participate a UV lighting test after handwashing away fluorescent lotion; and,
- fill up questionnaires
Detailed description
Schools are often the site of infection outbreaks, including COVID-19, influenza and other infectious diseases. COVID-19 pandemic has accelerated the need to enhance hygiene levels at primary and secondary schools and, specifically, nurturing and enforcing students' regular handwashing practices is one of the key components of a preventive strategy to reduce the transmission of infectious illnesses. Meanwhile, Virtual Reality (VR) intervention has been shown to be an efficacious tool for behavioural change. It manipulates an array of behavioural and environmental variables to construct an immersive virtual environment for changing certain human behaviours. VR handwashing education system may be more helpful than conventional verbal explanation in encouraging school children to wash their hands thoroughly, especially overcoming difficult to wash areas including wrists. Nevertheless, a school-based VR intervention on handwashing education is lacked in Hong Kong.
Objective:
This study aims to evaluate the effectiveness of a VR intervention on teaching handwashing skills which are promoted by the Centre for Health Protection, Department of Health, HKSAR. A 7-step handwashing approach will be taught through a customized VR game in secondary schools in Hong Kong. Participant's handwashing skills and prolonged effects on handwashing habits and hygiene level will be assessed.
Methods:
A 3-arm randomized controlled trial will be adopted. About 500 students will be assigned into 3 groups which will be randomly assigned on class-basis. Each group will receive two sessions of educational training with different kinds of intervention throughout one school year (9 months). The first intervention group will participate in two VR-game sessions on handwashing skill; the second intervention group will participate in one VR-game session and one video session about handwashing; the baseline group will participate in two sessions of other VR activities unrelated to hand hygiene and view a handwashing skill poster. Comparison of pre- and post-intervention hand-images of participants will serve as primary measurement. Ultraviolet-sensitive fluorescent lotion will be applied to the participants' hands and digital photos will be taken under UV lighting environment. Image comparisons will adopt quantitative method of calculating the percentage of fluorescent pixels over total hand areas. Post-intervention hand-images will be collected 3 months after the second intervention in order to capture any prolonged effect on handwashing over the whole intervention period. The secondary measures will be deployed through pre-invention, immediate post-intervention and follow-up (3 months after intervention) surveys. The survey will comprise scales measuring self-efficacy, knowledge on hand hygiene, handwashing habits and intentions, attitudes, subjective norms, and perceived behavioral control, VR embodiment and VR experience.
Results:
The project has already commenced in March 2026. The data collection period of the randomized controlled trial will be started from Sep 2026 and will end in May 2027. Data will be analyzed during June and August 2027, and the results are expected to be released in September 2027.
Conclusion:
This study contributes to existing knowledge about infection prevention strategy through VR game as well as the hand hygiene of the student population in Hong Kong and elsewhere. The study fills a number of research gaps in the field by (1.) developing evidence-based and executable VR hand hygiene programmes in school settings; (2.) addressing the ill-solved sustainability issue of hand hygiene intervention effects; (3.) identifying factors underlying the pathway of behavioural changes on hand hygiene and issues related to barriers to change, and (4.) identifying handwashing patterns through hand motion data shaping the hand hygiene level. The experiences and results from this VR game project can be also transferable to develop other programme regarding public health by adopting VR devices.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (care provider, outcomes assessor)
- Number of arms
- 3
- Model description
- A 3-arm randomized controlled trial will be adopted. 369 students will be assigned into 3 groups which will be randomly assigned on class-basis. Each group will receive two sessions of educational training with different kinds of intervention throughout one school year (9 months). The first intervention group (full-intervention) will participate in two VR-game sessions on handwashing skill; the second intervention group (half-intervention) will participate in one VR-game session and one video session about handwashing; the baseline (control) group will participate in two sessions of other VR activities unrelated to hand hygiene and view handwashing promotion poster.
| Arm | Type | Receives |
|---|---|---|
| Intervention 1 | Experimental | Other: VR Handwashing Game (2 sessions)Participants who attend two VR game sessions |
| Intervention 2 | Experimental | Other: VR Handwashing Game (1 session) + Video on hand hygiene (1 session)Participants who attend one VR game session and one video-based education session |
| Baseline Group | No intervention | –Participants who attend two non-hand hygiene related VR activity sessions |
Who may qualify
- Ages
- 12 to 15 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (1 listed)
- Hong Kong secondary school students studying junior forms
Key exclusion criteria (1 listed)
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| VR Handwashing Game (2 sessions)The intervention will be a VR game taught about the '7-Steps approach' of hand-washing promoted by Centre for Health Protection, HKSAR. The game is comprised of two parts: Training Mode and Challenge Mode. In Training Mode, students will be guided with text and voice feedback. A pair of 'ghost hands' will demonstrate what to do. Students follow the movements of the 'ghost hands' to complete the handwashing tasks. In the Challenge Mode, students are requested to perform all the steps at once by their own memory, hints will be given only when they encounter setback in an assigned duration. Trained facilitators will teach participants how to use the VR devices and provide briefing sessions on how to play the game. For the Intervention Group 1, they will play the game in two separate sessions (about 4 months between the two sessions). | Other | Intervention 1 |
| VR Handwashing Game (1 session) + Video on hand hygiene (1 session)For Intervention Group 2, participants will attain one VR game session and 1 video-instructed session. | Other | Intervention 2 |
Primary outcome
Hand-imaging Data
Time frame: Hand-imaging data will only be collected before the 1st intervention and at the end of the data collection period (about 9 months after the 1st intervention).
Ultraviolet-sensitive fluorescent lotion (e.g., Glo Germ™) will be applied on participants' hands thoroughly to simulate full contamination (e.g., germs and pathogens) on hands. Then participants wash their hands. The areas where lotion has been washed out are considered as 'decontaminated'. The participants will put their washed hands in a black box with an Ultraviolet-A (365nm) lighting system. Both palms and dorsa of left and right hands will be photographed.
3 secondary outcomes
Knowledge on Hand Hygiene and Handwashing
Time frame: This measurement will be collected through questionnaire pre-intervention, immediately after 1st intervention, after 2nd intervention (5 months after 1st intervention) and in the follow-up survey (9 months after 1st intervention).
Handwashing Habit
Time frame: This measurement will be collected through questionnaire pre-intervention, immediately after 1st intervention, after 2nd intervention (5 months after 1st intervention) and in the follow-up survey (9 months after 1st intervention).
Attitude and Intention
Time frame: This measurement will be collected through questionnaire pre-intervention, immediately after 1st intervention, after 2nd intervention (5 months after 1st intervention) and in the follow-up survey (9 months after 1st intervention).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 24 Jun 2026.
- Background: PubMed 34623315Birrenbach T, Zbinden J, Papagiannakis G, Exadaktylos AK, Muller M, Hautz WE, Sauter TC. Effectiveness and Utility of Virtual Reality Simulation as an Educational Tool for Safe Performance of COVID-19 Diagnostics: Prospective, Randomized Pilot Trial. JMIR Serious Games. 2021 Oct 8;9(4):e29586. doi: 10.2196/29586.
- Background: PubMed 35124145Sin CS, Rochelle TL. Using the theory of planned behaviour to explain hand hygiene among nurses in Hong Kong during COVID-19. J Hosp Infect. 2022 May;123:119-125. doi: 10.1016/j.jhin.2022.01.018. Epub 2022 Feb 3.
- Background: PubMed 11743481O'Boyle CA, Henly SJ, Larson E. Understanding adherence to hand hygiene recommendations: the theory of planned behavior. Am J Infect Control. 2001 Dec;29(6):352-60. doi: 10.1067/mic.2001.18405.
- Background: PubMed 26321675Srigley JA, Corace K, Hargadon DP, Yu D, MacDonald T, Fabrigar L, Garber G. Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review. J Hosp Infect. 2015 Nov;91(3):202-10. doi: 10.1016/j.jhin.2015.06.019. Epub 2015 Aug 4.
- Background: PubMed 37846147Gasteiger N, van der Veer SN, Wilson P, Dowding D. Virtual reality and augmented reality smartphone applications for upskilling care home workers in hand hygiene: a realist multi-site feasibility, usability, acceptability, and efficacy study. J Am Med Inform Assoc. 2023 Dec 22;31(1):45-60. doi: 10.1093/jamia/ocad200.
- Background: PubMed 35752839Eichel VM, Brandt C, Brandt J, Jabs JM, Mutters NT. Is virtual reality suitable for hand hygiene training in health care workers? Evaluating an application for acceptability and effectiveness. Antimicrob Resist Infect Control. 2022 Jun 25;11(1):91. doi: 10.1186/s13756-022-01127-6.
- Background: PubMed 29281736Galvan Debarba H, Bovet S, Salomon R, Blanke O, Herbelin B, Boulic R. Characterizing first and third person viewpoints and their alternation for embodied interaction in virtual reality. PLoS One. 2017 Dec 27;12(12):e0190109. doi: 10.1371/journal.pone.0190109. eCollection 2017.
- Background: PubMed 33937503Asadzadeh A, Samad-Soltani T, Rezaei-Hachesu P. Applications of virtual and augmented reality in infectious disease epidemics with a focus on the COVID-19 outbreak. Inform Med Unlocked. 2021;24:100579. doi: 10.1016/j.imu.2021.100579. Epub 2021 Apr 27.
- Background: PubMed 41057041Mira J, Gonzalez M, Villalba C, Guerra L, Ramirez-Moya Y, Hernandez J, Moya O, Pineda L, Perez-Esteve C. Improving Hand Hygiene Skills Using Virtual Reality: Quasi-Experimental Study. J Med Internet Res. 2025 Oct 7;27:e78882. doi: 10.2196/78882.
- BackgroundThe Centre for Health Protection, Department of Health, HKSAR. Proper Hand Hygiene. The Centre for Health Protection, Department of Health, HKSAR; 2026. https://www.chp.gov.hk/en/healthtopics/content/460/19728.html
- Background: PubMed 39522117Faruk Karabulut O, Celikcan U, Ellahi B, Dikmen D. Training of food handlers on handwashing using a virtual reality environment is more effective than traditional training approaches in a randomized trial. Int J Environ Health Res. 2025 Aug;35(8):2067-2078. doi: 10.1080/09603123.2024.2425781. Epub 2024 Nov 10.
- Background: PubMed 39824286Stuart JP, Gannon PR, Dotto VR, Regina R, Mumma JM. Visualizing the WHO "My Five Moments for Hand Hygiene," framework: A virtual reality training program for improving hand hygiene adherence among nurses. Am J Infect Control. 2025 May;53(5):576-581. doi: 10.1016/j.ajic.2025.01.007. Epub 2025 Jan 15.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
King-wa Fu, Professor principal investigator
School of Future Media, The University of Hong Kong
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing VR Handwashing Game (2 sessions) and VR Handwashing Game (1 session) + Video on hand hygiene (1 session) in people with Hand and Hygiene Practices and Knowledge, run by The University of Hong Kong at 1 site in Hong Kong.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 24 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Siu-lun Chow, PhD (+852 3917 1155, chowcass@hku.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Hand-imaging Data (time frame: Hand-imaging data will only be collected before the 1st intervention and at the end of the data collection period (about 9 months after the 1st intervention).). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07659340, which also lists 19 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jun 2026.