Hands4U: the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema-a randomised controlled trial among healthcare workers.
OBJECTIVE
To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema.


METHODS
The Hands4U study is a randomised controlled trial. A total of 48 departments (n=1649 workers) were randomly allocated to the multifaceted implementation strategy or the control group (minimal implementation strategy). Within the departments designated to the multifaceted implementation strategy, participatory working groups were set up to enhance the implementation of the recommendations for hand eczema. In addition, working group members were trained to become role models, and an education session was given within the department. Outcome measures were awareness, knowledge, receiving information, behaviour and behavioural determinants. Data were collected at baseline, with a 3- and 6-month follow-up.


RESULTS
Statistically significant effects were found after 6 months for awareness (OR 6.30; 95% CI 3.41 to 11.63), knowledge (B 0.74; 95% CI 0.54 to 0.95), receiving information (OR 9.81; 95% CI 5.60 to 17.18), washing hands (B -0.40; 95% -0.51 to -0.29), use of moisturiser (B 0.29; 95% CI 0.20 to 0.38), cotton under gloves (OR 3.94; 95% CI 2.04 to 7.60) and the overall compliance measure (B 0.14; 95% CI 0.02 to 0.26), as a result of the multifaceted implementation strategy. No effects were found for behavioural determinants.


CONCLUSIONS
The multifaceted implementation strategy can be used in healthcare settings to enhance the implementation of recommendations for the prevention of hand eczema.


BACKGROUND
NTR2812.
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Esther W C
EW
van der Meer
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands.
Cécile R L
CR
Boot
Department of Health Sciences Section Methodology and Applied Biostatistics, VU University, Amsterdam, The Netherlands.
Jos W R
JW
Twisk
Dermatology Department, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Pieter Jan
PJ
Coenraads
Department of Occupational Health, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Frank H W
FH
Jungbauer
Department of Primary and Community Care, Centre for Family Medicine, Geriatric care and Public Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Joost W J
JW
van der Gulden
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands Research Center for Insurance Medicine AMC-UMCG-UWV-VU University Medical Center, Amsterdam, The Netherlands.
Johannes R
JR
Anema
D000328:Adult; D001364:Awareness; D004485:Eczema / Q000517:prevention & control*; D005260:Female; D017575:Gloves, Protective; D003368:Gossypium; D006229:Hand Dermatoses / Q000517:prevention & control*; D006235:Hand Disinfection; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D063465:Skin Cream
implementation; randomized controlled trial