Oregon's Handwashing Legends Project

Project Timeline and Highlights

2002 - 2007 - History of the Handwashing Legends Project (HLP)

After finding handwashing to be the #1 out of compliance item statewide during the Oregon Baseline Risk Factor Study in 2002, the OHA Foodborne Illness Prevention Program decided to make improving handwashing statewide an active part of our existing program goals.  Then, with help from Oregon's EHS-Net program, we focused on collecting data that would help us develop an intervention that would be effective.  Some items were addressed in rule change, like restoring missing soap and paper towels at a designated handsink as a critical violation.  Other items, such as creating a meaningful approach to target food service workers, took more time for the research and focus group testing. 

First, a study conducted in 2004 by Dr. Donna Beegle (pdf) identified potential differences in the way that some food service workers best receive and retain information and the differences between inspectors and food workers communication styles.  She calls these styles oral vs. print culture.  

Next, was a study led by an Oregon State University student, that used focus groups to shed light on the issues food service workers and managers perceived to be barriers to handwashing in their facilities.  This was published in the June 2007 Journal of Environmental Health.

Using funding from the CDC EHS-Net program grant, professional social marketers and graphic artists were hired to create an intervention targeting food service workers to impact their behavior regarding handwashing.  This endeavor, called the Handwashing Legends Project (HLP), involves spreading a meaningful story about the consequences of poor handwashing to each licensed restaurant in Oregon.  The success of this intervention depends on inspectors providing an illustration telling a true story of a handwashing-related outbreak to each operator during their routine inspection, along with some discussion about the importance of handwashing to prevent foodborne illness.

The illustrations were posted in each restaurant's main kitchen handwashing sink in two phases corresponding with their semi-annual inspections.  When all the facilities have had the two consecutive illustrations posted in their business for a year, we will draw a random sampling of restaurants to use for our follow-up statewide Risk Factor Study.  Upon completion of our second study, we will be able to see if there is a measurable increase in proper handwashing statewide.  

Original HLP materials:

• Phase 1 Illustration in English, Spanish, Chinese Simplified*, and Chinese Traditional*.
• Phase 1 Original Story and References

• Phase 2 Illustration in English and Spanish
• Phase 2 Original Story and References

*Thank you to Tak (Sam) Ho and his son, David Ho of OM Seafood Co & Restaurant in Portland, OR for providing these Chinese translations free-of-charge and to Multnomah County Environmental Health for facilitating the translation to help spread the message.

Thank you to BehaviorWorks and HappyLucky of Portland for their help in creating and designing our illustrations

Funding: EHSNET, EHSB, NCEH, CDC