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Introduction Hand hygiene (HH) is regarded as the most cost-effective means of reducing health-care associate infections, including those involving antimicrobial resistant organisms (World Health Organisation, 2016). Yet, in both human and animal healthcare, studies have shown that adherence with HH guidelines is inadequate and remains suboptimal even after interventions intended to improve adherence (Erasmus, 2010; Shea and Shaw, 2012). Consequently, considerable efforts have been made to understand the factors underlying HH behaviour, especially as the World Health Organisation has called for more theory-informed research to help design more effective interventions (WHO, 2016). Following established methods in the behavioural sciences, several prominent studies have designed self-report Determinants of hand hygiene behaviour based on the Theory of Interpersonal Behaviour Tom R. Kupfer1,2 , Kayleigh J. Wyles1, Fraje Watson3, Roberto Marcello La Ragione4, Mark A. Chambers4 and Alastair S. Macdonald5 Abstract Background: Many investigations into the determinants of hand hygiene (HH) behaviour have explored only individual predictors or were designed according to arguably overly simplistic models of behaviour. Consequently, important influences on HH behaviour, including habit and emotion, are sometimes neglected. This study is the first to employ the Theory of Interpersonal Behaviour as a comprehensive model for understanding the determinants of HH behaviour. Method: A self-report questionnaire was conducted with staff from two large UK veterinary referral practices. Participants (n=75) reported their HH behaviour and responded to statements rating the importance of social norms, self-protection, patient protection, time pressures, access to equipment, habit and disgust, to their HH behaviour. Results: Regression analysis showed that, overall, determinants explained 46% of variance (P