Publications

Our project is producing a variety of academic journal papers. This page is updated as soon as a new paper becomes available.

Stark, J. F., & Stones, C. (2019). Constructing representations of germs in the twentieth century. Cultural and Social History, 1-28.

Abstract – Click here to view the paper
The development of germ theories of disease was reliant on the exchange of representations and descriptions of microorganisms. Visual properties were critical in establishing a shared understanding of agents of disease and their causal role. However, historians have yet to explore in detail the representation of microorganisms aimed at audiences beyond specialists. The public visual culture of germs offers a new window through which to understand health campaigns, their motivations, and intended audiences. We argue that still and moving images of germs made visible social anxieties surrounding health, race, class, and national security in ways not yet recognised.


Rutter, S., Stones, C., & Macduff, C. (2019). Communicating Handwashing to Children, as Told by Children. Health communication, 1-10.

Abstract – Click here to view the paper
Posters encouraging handwashing would seem to offer a low-cost solution addressing barriers to handwashing in schools. However, what barriers can be successfully addressed and, how effective posters targeted at children may be is not known. In this study, using a co-design methodology, seventy-nine children (aged 6 to 11) from three English schools evaluated and generated handwashing messages in two workshops.The results were then compared with an evaluation (by the authors) of handwashing posters targeted at children. Messages that children considered most effective addressed barriers relating to reminders and encouragement, and education and information (particularly germ transmission, consequence, location and avoidance).Messages that addressed time and social norms were not considered as effective.Posters targeted at children also used reminders and encouragement, and education and information messages. However, the focus of these education and information messages was on instruction (how and when to wash hands), not on germs. Unlike the posters targeted at children, the majority of children’s messages were persuasive in that they did more than simply instruct. This has implications for the design of posters and educational material in handwashing interventions.

Rutter, S. MacDuff C, Stones C, Gomez-Escalada, M. (2019). Evaluating children’s handwashing in schools: an integrative review of indicative measures and measurement tools. International Journal of Environmental Health Research.

Abstract – Click here to view the paper
Children are a key target of handwashing interventions as washing hands reduces the spread of disease and reliance on antibiotics. While there is guidance for evaluating handwashing with adults in other settings, this is lacking for children in schools. An integrative review of 65 studies where handwashing was measured in schools was conducted to establish which indicative measures (what is measured to evaluate the processes and/or impacts of, handwashing) and measurement tools (data collection instruments) have been applied to evaluate handwashing in schools, and under what circumstances. Further analysis highlighted different challenges when seeking to apply such measures and tools in schools, as opposed to other settings. It was concluded that indicative measures, and measurement tools need to be appropriate to the organizational setting, the study participants, and research objectives. A summative analysis of relevant considerations is presented.