title: Hands4U: a multifaceted strategy to implement guideline-based recommendations to prevent hand eczema in health care workers: design of a randomised controlled trial and (cost) effectiveness evaluation.
abstract: BACKGROUND
  Workers in wet work occupations have a risk for developing hand eczema. Prevention strategies exist, but compliance to the proposed recommendations is poor. Therefore, a multifaceted implementation strategy (MIS) is developed to implement these recommendations to reduce hand eczema among health care workers performing wet work.
  
  
  METHODS
  This study is a randomised controlled trial in three university hospitals in the Netherlands. Randomisation to the control or intervention group is performed at department level. The control group receives a leaflet containing the recommendations only. The intervention group receives the MIS which consists of five parts: 1) within a department, a participatory working group is formed to identify problems with the implementation of the recommendations, to find solutions for it and implement these solutions; 2) role models will help their colleagues in performing the desired behaviour; 3) education to all workers will enhance knowledge about (the prevention of) hand eczema; 4) reminders will be placed at the department reminding workers to use the recommendations; 5) workers receive the same leaflet as the control group containing the recommendations. Data are collected by questionnaires at baseline and after 3, 6, 9 and 12 months. The primary outcome measure is self-reported hand eczema. The most important secondary outcome measures are symptoms of hand eczema; actual use of the recommendations; sick leave; work productivity; and health care costs.Analyses will be performed according to the intention to treat principle. Cost-effectiveness of the MIS will be evaluated from both the societal and the employer's perspective.
  
  
  CONCLUSIONS
  The prevention of hand eczema is important for the hospital environment. If the MIS has proven to be effective, a major improvement in the health of health care workers can be obtained. Results are expected in 2014.
  
  
  BACKGROUND
  NTR2812.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
authors.forename: Esther W C
authors.initials: EW
authors.lastname: van der Meer
authors.forename: Cécile R L
authors.initials: CR
authors.lastname: Boot
authors.forename: Frank H W
authors.initials: FH
authors.lastname: Jungbauer
authors.forename: Jac J L
authors.initials: JJ
authors.lastname: van der Klink
authors.forename: Thomas
authors.initials: T
authors.lastname: Rustemeyer
authors.forename: Pieter Jan
authors.initials: PJ
authors.lastname: Coenraads
authors.forename: Joost W
authors.initials: JW
authors.lastname: van der Gulden
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
mesh_terms: D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D004485:Eczema / Q000191:economics / Q000517:prevention & control*; D004526:Efficiency; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006229:Hand Dermatoses / Q000191:economics / Q000517:prevention & control*; D017048:Health Care Costs; D006801:Humans; D008505:Medical Staff, Hospital; D008875:Middle Aged; D009426:Netherlands; D009784:Occupational Diseases / Q000191:economics / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018582:Sick Leave; D055815:Young Adult