All analyses were done in R version 3.5.3. The path analyses were performed using the package lavaan version 0.6–3 [55]. The models were fitted using a robust maximum likelihood estimation (MLF), accounting for some non-normality in the data with full information maximum likelihood (FIML) for missing data.

We defaulted to using the most commonly reported indexes and relied on cut-off levels for a good model fit suggested in the literature [e.g., 56, 57]: χ2 /df ≤ 2 to 3, Root Mean Square Error of Approximation (RMSEA) < .06 to .08 with confidence intervals, Standardized Root Mean Square Residual (SRMR) .08, Comparative Fit Index (CFI) ≥ .95, and Tucker Lewis Index (TLI) ≥ .95. Also, we used the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) for model comparison, where the rule ‘the smaller, the better’ applies. If the majority of these fit indexes imply a good fit, we consider the model to fit the data well. To address the first research aim, we compared the model fit indices and the amount of variance in self-reported hand hygiene behavior explained by each theoretical model among both hospital patients and visitors. To attain the second research objective, we tested which variables of the three theoretical models correlate statistically significantly with self-reported hand hygiene behavior or intention among both target groups. The study’s pre-registration, data, and R-script will be made available online upon publication:

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