["Journal of School Health, Volume 96, Issue 7, July 2026. ", "\nABSTRACT\n\nBackgroundReliable and valid assessment tools are critical for evaluating and improving primary school students' hand hygiene behaviors, yet corresponding adaptable assessment methods are currently limited. We aimed to develop and validate a Hand Hygiene Behavior Questionnaire for Primary School Students (HHBQ‐PSS).\n\nMethodsCluster sampling recruited 376 Grade 4–5 students from two central primary schools. The 15‐item HHBQ‐PSS encompasses three dimensions (capability, opportunity, motivation) of hand hygiene, using a 5‐point Likert scale. HHBQ‐PSS was evaluated through internal consistency reliability, split‐half reliability, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).\n\nResultsThe Cronbach's α coefficient of HHBQ‐PSS was 0.844, and all Cronbach's α coefficients remained above 0.750 after corresponding dimensions were deleted. The Spearman–Brown coefficient was 0.784. EFA extracted four common factors (cumulative variance contribution rate = 58.67%). CFA confirmed adequate model fit (χ2/df = 2.832, CFI = 0.905, GFI = 0.927, AGFI = 0.893, and RMSEA = 0.070).\n\nImplications for School Health Policy, Practice, and EquityThe reliable and valid HHBQ‐PSS may inform the implementation of targeted health interventions and the improvement of hand hygiene levels among primary school students.\n\nConclusionHHBQ‐PSS demonstrates good reliability and validity to assess hand hygiene behaviors in Chinese primary school students.\n"]