HOWDY Partner: strategy for a Culture of Clean Hands

Hand hygiene is one of those universal public health practices – like fastening a seatbelt or getting an annual flu shot. I had the opportunity to support a hand hygiene campaign that blends strategic data, behavioral science, strategic communication, and just the right amount of playfulness: HOWDY.

A Friendly Reminder with Serious Intent

A cartoon cowboy character with a happy face, wearing a brown hat and a red bandana, surrounded by soap bubbles, promoting hand hygiene.

HOWDY stands for Hand sanitize Or Wash your hands, Decision is Yours. Its tone is friendly rather than authoritarian—rooted in encouragement, not enforcement. This was a strategic choice. Informed by the values of the New Public Service, we believed that public servants should not just enforce policy but also foster shared responsibility and meaningful engagement (Denhardt & Denhardt, 2015). HOWDY reflects this spirit of servant leadership, using humor and cultural cues to encourage hygiene without shame or compliance fatigue.

The campaign’s cowboy mascot—a soap figure reminding staff to sanitize—might seem whimsical, but it’s backed by intentional design. Employees are encouraged to say “Howdy!” to each other at sanitizer stations, turning hygiene into a shared social ritual. These soft nudges tap into the kind of informal peer accountability that is often more sustainable than top-down directives.

Strategic Framing: Applying Strategic Issues Management (SIM)

In the context of public administration, Strategic Issues Management (SIM) is essential for identifying emerging concerns that may evolve into significant challenges if left unaddressed. Infection control—especially after the COVID-19 pandemic—is not just a clinical matter, but a strategic one. By treating hand hygiene as a communication priority rather than a routine reminder, we elevated it to a strategic issue worthy of focused attention, cross-departmental alignment, and proactive planning (Bryson, 2011).

SIM guided our decision to launch the HOWDY campaign as a forward-facing, preventive measure rather than a reaction to noncompliance. We aimed to identify barriers to behavior (e.g., invisibility of paper towels, lack of social motivation) and design responses that were both systematic and culturally resonant. This proactive approach reflects best practices in strategic public management and issue anticipation.

Illustration depicting the 'HOWDY in Action!' campaign with five moments for hand hygiene, including steps before and after touching a patient, during clean procedures, and exposure to bodily fluids.

Building Buy-In Through Employee Engagement

An illustration for the HOWDY campaign featuring two cartoon soap characters; one wearing a cowboy hat and a bandana, encouraging employees to vote for their favorite mascot.

One of the most effective drivers of awareness and commitment came early in the campaign: a systemwide vote to select the official HOWDY mascot. Staff across RUHS were invited to review several proposed characters and vote for their favorite. This simple but meaningful step sparked conversation, boosted visibility, and gave employees a personal stake in the campaign’s direction.

Engaging employees in decision-making—even on seemingly lighthearted matters—can have significant organizational impacts. Participation fosters ownership, and in public administration, this aligns with democratic values of representation and inclusion (Denhardt & Denhardt, 2015). The mascot vote created positive buzz, made the campaign memorable, and contributed to its adoption as a shared initiative rather than a top-down directive.

Behavioral Design Meets Public Service

Behavioral studies significantly shaped our decisions. One study found that simply making paper towels visible—by partially dispensing them—led to higher compliance rates with hand hygiene (Judah et al., 2009). Why? Because people are more likely to act when the tools they need are clearly available. We’re now applying this insight by modifying towel dispensers at RUHS to encourage spontaneous use.

We also considered messaging tone. Research out of Australia found that signs using mild toilet humor—like “That’s pee, you know”—improved handwashing behavior more than traditional reminders, largely because people remembered and talked about them (Porzig-Drummond et al., 2009). This social sharing reinforced hygiene as a group norm, turning the message into what scholars of networked governance might recognize as a decentralized, peer-driven intervention (Frederickson et al., 2012).

Collaborating Through Networked Governance

HOWDY wasn’t rolled out by a single department. It involved collaboration across infection control, communications, environmental services, nursing, and executive leadership. This aligns with the networked governance model, where public outcomes are achieved through horizontal collaboration rather than strict hierarchies (Frederickson et al., 2012).

Instead of pushing a campaign down the org chart, we invited feedback from staff at multiple levels and adjusted accordingly. This participatory structure also reflects the principles of New Public Service, which emphasizes empowering public employees and stakeholders to co-create solutions rather than simply follow orders (Denhardt & Denhardt, 2015).

What’s Next

The next phase of HOWDY includes:

Adjusting towel dispensers to improve visibility, using cues from behavioral science.
Printing wipeable HOWDY stickers and placing them across all sanitizer stations

We’re also linking HOWDY to the CDC’s Project Frontline, a national effort to elevate infection control as foundational to patient safety. This positions our internal messaging within a broader national framework and reinforces that even simple actions—like washing hands—are strategic public health priorities.

Final Reflections

Working on HOWDY reminded me that public administration is not confined to policy memos or legislative processes—it lives in the details of how we serve. By blending SIM, behavioral research, and a networked approach to campaign design, we created a hand hygiene culture that’s welcoming, effective, and sustainable. Sometimes, all it takes is a cowboy with a bottle of soap to nudge behavior in the right direction.

References

Bryson, J. M. (2011). Strategic planning for public and nonprofit organizations: A guide to strengthening and sustaining organizational achievement (4th ed.). Jossey-Bass.

Denhardt, J. V., & Denhardt, R. B. (2015). The new public service: Serving, not steering (3rd ed.). Routledge.

Frederickson, H. G., Smith, K. B., Larimer, C. W., & Licari, M. J. (2012). The public administration theory primer (2nd ed.). Westview Press.

Judah, G., Aunger, R., Schmidt, W., Michie, S., Granger, S., & Curtis, V. (2009). Experimental pretesting of hand-washing interventions in a natural setting. American Journal of Public Health, 99(2), S405–S411. https://doi.org/10.2105/AJPH.2009.164160

Porzig-Drummond, R., Stevenson, R., Case, T., & Oaten, M. (2009). Can hand hygiene and illness-related messaging improve hand hygiene behavior? A field experiment. American Journal of Infection Control, 37(7), 507–510. https://doi.org/10.1016/j.ajic.2008.10.026