{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T02:42:02Z","timestamp":1777430522818,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003803","name":"university of hong kong","doi-asserted-by":"publisher","award":["Seed Funding Program for Basic Research"],"award-info":[{"award-number":["Seed Funding Program for Basic Research"]}],"id":[{"id":"10.13039\/501100003803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Asia Pac J Public Health"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>\n                    Toilet hygiene is an important preventive measure for infectious diseases, including severe acute respiratory syndrome (SARS) and COVID-19. This study explored public\u2019s opinions on improving toilet environment and hygiene practices in Hong Kong. A mixed-method approach was applied. We conducted 4 focus groups plus 3 individual interviews among the Hong Kong Chinese, followed by a questionnaire survey with 300 respondents recruited from various districts. Difference in response distributions between groups with different demographics was tested by Pearson \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    test. Instead of advocating for advanced toilet facilities, respondents were mostly concerned about basic hygiene issues. Malfunctioning facilities resulting from poor toilet management, such as clogged toilets, stained facilities, and problematic flushing systems, were most cited as barriers to toilet hygiene practices. Three quarters of the survey respondents expressed concerns over worn and poorly maintained toilets, shortage of janitors, and cleansing supplies. However, respondents who were older ( P &lt; .001), less educated ( P &lt; .001), and had lower income ( P = .001) were significantly more likely to find hygiene conditions in public toilets satisfactory. The findings reflected the substandard of the current provisions as a developed city in Asia. Enhanced efforts by the government to maintain basic toilet supplies and facilities is the key to improving public compliance to toilet hygiene practices.\n                  <\/jats:p>","DOI":"10.1177\/1010539521993685","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T02:54:05Z","timestamp":1613530445000},"page":"378-387","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Improving Public Toilet Environment and Hygiene Practices in an Asian City: Voices From Hong Kong Residents"],"prefix":"10.1177","volume":"33","author":[{"given":"Kai Sing","family":"Sun","sequence":"first","affiliation":[{"name":"The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1740-2172","authenticated-orcid":false,"given":"Tai Pong","family":"Lam","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai Sin","family":"Tang","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoi Yan","family":"Chan","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwok Fai","family":"Lam","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, Hong Kong, China"},{"name":"Duke-NUS Medical School, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enoch Ching Yeung","family":"Chow","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Wu","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, Hong Kong, China"},{"name":"London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu Dong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Zhejiang University, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia Yao","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang University, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pak Leung","family":"Ho","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,2,16]]},"reference":[{"key":"bibr1-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30154-9"},{"key":"bibr2-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30260-9"},{"key":"bibr3-1010539521993685","first-page":"26","volume":"68","author":"McKinney KR","year":"2006","journal-title":"J Environ Health"},{"key":"bibr4-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1080\/09603120701254276"},{"key":"bibr5-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001191"},{"key":"bibr6-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.061741"},{"key":"bibr7-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028132"},{"key":"bibr8-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2672.2012.05234.x"},{"key":"bibr9-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2012.04.330"},{"key":"bibr10-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.11"},{"key":"bibr11-1010539521993685","first-page":"585","volume":"63","author":"Altun I","year":"2013","journal-title":"J Pak Med Assoc"},{"key":"bibr12-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2014.03.026"},{"key":"bibr13-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-8014-4"},{"key":"bibr14-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1177\/0013916510395729"},{"key":"bibr15-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1177\/0013916514527590"},{"key":"bibr16-1010539521993685","unstructured":"Food and Environmental Hygiene Department of the Hong Kong SAR Government. Legislative Council Panel on Food Safety and Environmental Hygiene Refurbishment of Public Toilets Managed by the Food and Environmental Hygiene Department. Published April 16, 2019. Accessed January 25, 2021. https:\/\/www.legco.gov.hk\/yr18-19\/english\/panels\/fseh\/papers\/fseh20190416cb2-1182-3-e.pdf"},{"key":"bibr17-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"bibr18-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2010.07.002"},{"key":"bibr19-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/5928924"},{"key":"bibr20-1010539521993685","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0071438"},{"key":"bibr21-1010539521993685","doi-asserted-by":"crossref","unstructured":"Duflo E, Greenstone M, Guiteras R, Clasen T. Toilets can work: short and medium run health impacts of addressing complementarities and externalities in water and sanitation. NBER Working Paper No. 21521. Published August 2015. Accessed January 25, 2021. https:\/\/bfi.uchicago.edu\/wp-content\/uploads\/SSRN-id2654864.pdf","DOI":"10.3386\/w21521"},{"key":"bibr22-1010539521993685","doi-asserted-by":"crossref","unstructured":"Gertler P, Shah M, Alzua ML, Cameron L, Martinez S, Patil S. How does health promotion work? Evidence from the dirty business of eliminating open defecation. NBER Working Paper No. 20997. Published March 2015. 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