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Tertiary Individual Prevention is an interprofessional inpatient rehabilitation programme offered to workers affected by work-related skin diseases. Health educational interventions aiming at changing skin protection behaviour are a pivotal component of the programme. This paper aims at characterizing the content of the educational interventions of the interprofessional inpatient rehabilitation programme and at reporting the mechanisms and functions for behaviour change. We retrospectively analysed existing health educational interventions with document analyses and field observations. The intervention was described using the Template of Intervention Description and Replication (TIDieR). For the intervention content, the Behaviour Change Technique (BCT) Taxonomy (v1) was applied. To characterize the intervention in detail, the BCTs were then mapped to the intervention functions, the COM-B model (Capability, Opportunity, Motivation) and the Theoretical Domains Framework (TDF) from the Behaviour Change Wheel (BCW). The health educational interventions consist of seven components. Five are delivered in a group and two as tailored face-to-face counselling. We identified 23 BCTs in 10 groups. The most common used BCTs are “instruction on how to perform skin protection behaviour,” “salience of consequences,” “information about skin health,” and “demonstration of skin protection behaviour.” To initiate the process of behaviour change in skin protection behaviour by the individuals, changes are required in all three behavioural sources (Capability, Opportunity, Motivation) and primarily in the theoretical constructs “behavioural regulation,” “skills,” and “beliefs about consequences.” For this purpose, the five intervention functions “enablement,” “training,” “education,” “modelling,” and “persuasion” are used. Health educational interventions to change skin protection behaviour consists of different BCTs, mechanisms of change and intervention functions. This work helps to better understand the mechanisms and means of behaviour change and enables replication in other settings. In the future, the intervention programme should be extended to include BCTs addressing domains for behaviour changes which have not yet been included to maintain the new behaviour in the long-term. Finally, we recommend to report more elements of the rehabilitation programme (e.g. psychological interventions) in a standardized manner by frameworks used in this paper.Well-established tools for transparently reporting behaviour change interventions have been applied in an intervention for patients with work-related skin diseases. The results show which strategies can be used to change skin protection behaviour. Our methodological approach in this paper is adaptable and can be used exemplarily for other fields of health empowerment interventions.In the treatment of work-related skin diseases (WRSD), skin protection behaviour has an important influence in the course of the disease. Health educational interventions as part of an inpatient rehabilitation programme support patients in the process of behaviour change. However, these educational interventions have not been reported in a standardized manner until now. Accurate reporting may contribute to disseminating evidence-based practices because practitioners can better identify strategies for behaviour change, compare the effectiveness in studies and implement an intervention in another contexts. Against this background, it is the aim of this paper to report this intervention using theory-based tools. The educational intervention consists of seven components which are delivered in a group or as tailored face-to-face counselling. The overall aims are to enable, train, and educate patients in changing and improving their skin protection behaviour. Health educators and occupational therapists inform patients about their skin disease, demonstrate, and practice new behaviours and prepare the implementation of new behaviours. Our findings help to better understand the mechanisms and means of behaviour change in the field of WRSD. We also conclude that patients may not receive sufficient educational support in health psychological determinants of behaviour change to implement the new behaviour in the long-term, e.g. to cope with relapses.Graphical Abstract

Patientenschulungen können Personen mit berufsbedingten Handekzemen dabei unterstützen, mit ihrer Hauterkrankung informiert und eigenverantwortlich umzugehen und das persönliche Hautschutzverhalten im beruflichen und privaten Alltag zu verbessern. Hauschutzschulungen in berufsdermatologischen Schwerpunktzentren sind im Rahmen des berufsgenossenschaftlichen Heilverfahrens in Deutschland zentraler Bestandteil der ambulanten und stationären Individualprävention für Personen mit Berufsdermatosen. Eine wichtige Voraussetzung für den Erfolg der Schulungen ist, dass diese patientenorientiert sind und das Lernen fördern, z. B. durch eine interaktive, aktivierende Gesprächsführung und Gestaltung, Alltagsbezüge sowie methodisch-didaktisch gut aufbereitete Medien und Materialien in klarer, verständlicher Sprache. In der Versorgungspraxis können sich jedoch herausfordernde Schulungssituationen ergeben z. B. durch subjektive Krankheitsvorstellungen, mangelnde Motivation der Teilnehmenden, Sprachbarrieren, funktionellen Analphabetismus oder die heterogene Zusammensetzung von Schulungsgruppen. In diesem Beitrag werden unterschiedliche Herausforderungen dargestellt sowie pädagogische und gesundheitspsychologische Perspektiven aufgezeigt, diesen Herausforderungen zu begegnen, um dem Versorgungsauftrag einer optimalen, patientenorientierten Individualprävention gerecht zu werden.

Occupational skin diseases (OSDs) are frequent in professions with exposure to skin hazards. Thus, a health educational intervention for apprentices of high-risk professions was conducted. It was the aim of this study to gain insight into possible effects of this intervention.

Since January 2015, squamous cell carcinoma or multiple actinic keratosis of the skin caused by natural ultraviolet irradiation (UVR) is recognized as occupational disease in Germany. Interventions which improve the sun protection behavior of outdoor workers are urgently needed. When developing preventive interventions, the attitudes of target groups need to be taken into consideration. Therefore, outdoor workers’ perceptions and attitudes were investigated. Seven guided, problem‐centered qualitative interviews with healthy male outdoor workers were conducted. A qualitative content analysis was used to analyze the data. We found an underestimation of the perceived skin cancer risk in the seven outdoor workers and heterogeneous attitudes toward the usage of sun‐protective measures. Participants stated that the feasibility of technical sun‐protective measures depends on the size of the working area. While using a headgear seemed common, none of the participants stated using additional neck protection. Wearing long‐sleeved shirts and long trousers were considered problematic. The interviews revealed important requirements for sun‐protective clothes, especially in terms of different materials. Although the usage of sunscreen was common, our interviewees seemed to apply it wrongly. Risk perceptions of outdoor workers and their attitudes toward sun protection measures may influence the factual UV protection behavior in the workplace. Structures to facilitate the implementation of technical and organizational sun‐protective measures seem to be necessary. Educational interventions and clear instructions which are tailored to the individual needs and attitudes of outdoor workers are required to improve the UV protection behavior and to avoid common mistakes.

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