Hand hygiene practice among health care workers is considered to be the single most effective method of preventing nosocomial infection in hospital settings. Infection control practices in psychiatric facilities are particularly challenging as hand hygiene protocols are specific to acute care facilities, areas where hands are visibly soiled, and when procedures are completed that may involve body fluid exposure. The inability to motivate and change the hand washing practices of health care workers suggests that hand washing behaviour is complex, involving individual beliefs and attitudes and institutional commitment and rigor.

The current study examined important predictors of substance use during early adolescence. The authors hypothesized that adolescents' relationships with key adults (i.e., teachers and parents) influence their choices to use substances indirectly through links with their decisions regarding peer groups. A total of 461 middle school students from an affluent suburban community completed self-report measures of authoritative parenting, perceived social support from teachers, affiliation with rule-breaking and substance-using peers, and frequency of alcohol, cigarette, and drug use. Results of structural equation modeling supported the hypothesized model. Authoritative parenting and teacher support accounted for 31% of the variance in affiliation with deviant peers which, in turn, accounted for 27% of the variance in adolescent substance use; direct paths from parenting and teacher support to substance use were not indicated. Implications for school psychologists' involvement in substance use prevention and intervention are discussed.