title: Individual prevention courses for occupational skin diseases: changes in and relationships between proximal and distal outcomes.
abstract: BACKGROUND
  To treat people with occupational contact dermatitis, the German Accident Prevention and Insurance Association in the Health and Welfare Services offers 2-day individual prevention (IP) seminars.
  
  
  OBJECTIVE
  We investigated whether there are short-term and medium-term changes in proximal (e.g. behaviour) and distal (e.g. symptoms) outcomes after an IP seminar, whether changes in proximal outcomes are associated with changes in distal outcomes, and whether subgroups can be identified that benefit in particular.
  
  
  METHODS
  In a prospective study, 502 participants of 85 IP courses completed the health education impact questionnaire (heiQ™) and skin symptom questionnaire (Skindex-29) at the start of the course, immediately thereafter, and after 6 months. Change was assessed according to standardized effect size. Regression techniques were used to analyse associations between proximal and distal outcomes.
  
  
  RESULTS
  After 6 months, participants showed improved self-management skills and preventive behaviour, and less fear of job loss, disease-related symptoms, and emotional distress. Significant associations between proximal and distal outcomes were found. Participants who felt more limited by their skin disease showed greater effects.
  
  
  CONCLUSIONS
  The results are consistent with the assumption that IP courses provide a range of benefits for people with occupational contact dermatitis. Changes in distal outcomes may be influenced by changes in proximal outcomes.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, D-97072, Würzburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schuler
authors.affiliation: Institute of Social Medicine and Epidemiology, University of Lübeck, D-23538, Lübeck, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Spanier
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, D-97072, Würzburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Lukasczik
authors.affiliation: Department of Rehabilitation Medicine, Medical School Hannover, D-30625, Hannover, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Schwarze
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, D-97072, Würzburg, Germany.
authors.forename: Gunda
authors.initials: G
authors.lastname: Musekamp
authors.affiliation: Population Health Strategic Research Centre, School of Health & Social Development, Deakin University, 3125, Melbourne, Australia.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Osborne
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, D-97072, Würzburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Faller
authors.affiliation: Accident Prevention and Insurance Association in the Health and Welfare Services (Berufsgenossenschaft für Gesundheit und Wohlfahrtspflege), D-10777, Berlin, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Pohrt
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003877:Dermatitis, Contact / Q000517:prevention & control*; D009783:Dermatitis, Occupational / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: Skindex-29; heiQ™; intervention; occupational skin disease; prevention; self-management