Receiving any type of information affected reporting more in contemplators than in precontemplators. In actioners personalized feedback Adriamycin in vivo seemed to increase the number

of notifications more than standardized feedback. find more Strong points of this study are the randomized controlled design with relatively large intervention and control groups. This minimizes potential sources of bias such as selection bias or increases in reporting due to other reporting enhancing activities like education. Another strong point is the objective measurement of the performance of physicians before and after the intervention. Actual reporting behaviour is our primary outcome measure instead of self reported change in behaviour intention. Although

changing actual reporting behaviour is the ultimate goal of our intervention, this outcome measure might have been too insensitive to evaluate the present intervention. If the intervention caused forward stage transition, moving OPs from no intention to report to considering or even planning to report, we would not know until the OP actually starts reporting. Limitations must also be considered in interpreting the results of this study. Staurosporine One of the limitations is that we did not use a staging instrument to determine the stage of reporting behaviour of participating OPs at baseline. We assumed that OPs who did not notify any occupational disease in 2006 or 2007 could be identified as immotives or precontemplators and OPs who notified before June

1st 2007 but not afterwards, could be seen as contemplators or preparators. This might be a source of misclassification because precontemplators may already have the intention to report, contemplators may have lost this intention or be actually actioners that incidentally did not have anything to report. In this study, both stage-matched PIK-5 and stage-mismatched newsletters might in fact have been addressed to more mixed behavioural groups, weakening the influence of stage-matching. On the other hand, the results show that receiving any type of information affected reporting significantly more in contemplators than in precontemplators. This indicates that OPs may differ in regard to their reporting behaviour and that they might benefit from different interventions. Another limitation of this study is that we used a single intervention in precontemplators and contemplators: a personalized newsletter was only sent once to the participants, without information on receipt, perusal and assessment of the contents. A single information intervention is likely to be inferior to a repetitive or multifaceted intervention.