title: Hands4U: the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial.
abstract: BACKGROUND
  Healthcare workers have an increased risk of developing hand eczema. A multifaceted implementation strategy was developed to implement a guideline to prevent hand eczema among healthcare workers.
  
  
  OBJECTIVE
  To investigate the effects of the implementation strategy on self-reported hand eczema and preventive behaviour.
  
  
  METHODS
  A randomized controlled trial was performed. A total of 48 departments (n = 1649) were randomly allocated to the multifaceted implementation strategy or the control group. The strategy consisted of education, participatory working groups, and role models. Outcome measures were self-reported hand eczema and preventive behaviour. Data were collected at baseline, and 3, 6, 9 and 12 months of follow-up.
  
  
  RESULTS
  Participants in the intervention group were significantly more likely to report hand eczema [odds ratio (OR) 1.45; 95% confidence interval (CI) 1.03-2.04], and they reported significantly less hand washing (B, - 0.38; 95%CI: - 0.48 to - 0.27), reported significantly more frequent use of a moisturizer (B, 0.30; 95%CI: 0.22-0.39) and were more likely to report wearing cotton undergloves (OR 6.33; 95%CI: 3.23-12.41) than participants in the control group 12 months after baseline.
  
  
  CONCLUSIONS
  The strategy implemented can be used in practice, as it showed positive effects on preventive behaviour. More research is needed to investigate the unexpected effects on hand eczema.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, 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: Joost W J
authors.initials: JW
authors.lastname: van der Gulden
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: Frank H W
authors.initials: FH
authors.lastname: Jungbauer
authors.forename: Pieter Jan
authors.initials: PJ
authors.lastname: Coenraads
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
mesh_terms: D000328:Adult; D009783:Dermatitis, Occupational / Q000517:prevention & control*; D004485:Eczema / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D017575:Gloves, Protective / Q000706:statistics & numerical data; D006229:Hand Dermatoses / Q000517:prevention & control*; D006235:Hand Disinfection; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D016272:Occupational Health; D015397:Program Evaluation; D057566:Self Report; D063465:Skin Cream / Q000627:therapeutic use
keywords: hand eczema; healthcare workers; implementation; randomized controlled trial; workplace