Structured PREreview of DEVELOPMENT AND CONTENT VALIDITY OF THE HANDWASHING INDEX (HWI)

Does the introduction explain the objective of the research presented in the preprint?

Partly

The introduction provides a strong justification for the study but lacks depth in terms of background on hand hygiene measurement tools?

Are the methods well-suited for this research?

Somewhat appropriate

There is need to provide a clearer rationale for why these specific health professionals were considered experts and how their experience qualifies them to validate the tool. More detail on the recruitment criteria and methods is necessary for reproducibility. Also, authors should p rovide additional justification for using PAQ-A and why it is suitable for the context of handwashing. Mention alternative instruments that were considered but rejected.

Are the conclusions supported by the data?

Somewhat supported

Author should strengthen the conclusion by providing a plan for further psychometric validation of the HWI in different populations and environments. Additionally, include a discussion of how the tool could be integrated into public health interventions.

Are the data presentations, including visualizations, well-suited to represent the data?

Highly appropriate and clear

How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research?

Somewhat clearly

Authors should include a more critical reflection on the limitations of the study, such as geographical and cultural constraints. Also, suggest areas for future research, such as testing the HWI in non-healthcare settings or among populations with limited water access. Similarly, author should discuss how social desirability bias was minimized or could be minimized in future studies using the HWI. Consider suggesting alternative validation methods, such as observational studies.

Is the preprint likely to advance academic knowledge?

Highly likely

The preprint manuscript is generally well-written to advance scientific knowledge but would benefit from improvements and simplification in certain areas.

Would it benefit from language editing?

Yes

Proofread for clarity, conciseness, and consistency in terminology. For example, terms like "regular hand washers" could be more clearly defined early in the manuscript.

Would you recommend this preprint to others?

Yes, but it needs to be improved

Focus on summarizing key contributions and avoid restating information already presented in the results and discussion sections.

Is it ready for attention from an editor, publisher or broader audience?

No, it needs a major revision

By addressing issues identified above, the manuscript can be made more robust and better positioned for peer review.

Competing interests

The author declares that they have no competing interests.