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Improving Patient Knowledge of Aneuploidy Testing Using an Educational Video: A Randomized Controlled Trial.

ABSTRACT: OBJECTIVE:To evaluate the effectiveness of an educational video explaining aneuploidy testing. METHODS:This was a randomized controlled trial of women with singleton pregnancies having aneuploidy testing at less than 14 weeks of gestation from September 2016 to March 2017 at our prenatal ultrasound center. We developed an educational video on aneuploidy testing. Participants, stratified by age younger than or 35 years or older at estimated delivery date, were randomized to either view or not view the video before their ultrasonogram. Participants 35 years or older also met with a genetic counselor at the ultrasound appointment. All participants completed a survey assessing knowledge of genetic testing (score of 0-15) at baseline and after the appointment. The primary outcome was change in knowledge score after the intervention. A sample size of 23 per group (n=92) was planned for a total of 46 women younger than 35 years of age and 46 women aged 35 years or older. Data are presented as median (interquartile range). RESULTS:Of 104 eligible women who were approached, 92 were randomized. Forty women aged younger than 35 years and 41 women aged 35 years or older completed the study. Baseline characteristics were similar across groups. In women younger than 35 years, the video group had a significant improvement in knowledge score (+2.0 [1.0-5.0]) compared with the control group (0 [-1.0 to 1.0]; P=.01) and reported better understanding of the information compared with the control group (P<.001) with no change in patient satisfaction (P=.25). In women 35 years or older, change in knowledge score was similar for the video and control groups (P=.98) with no difference in self-reported understanding (P=.49) or patient satisfaction (P=.30). CONCLUSION:A patient-centered educational video explaining aneuploidy testing options improved knowledge and self-reported understanding of the information in women younger than 35 years with no change in patient satisfaction. No difference was seen for women 35 years or older, likely as a result of genetic counseling provided to these women.

SUBMITTER: Mulla BM

PROVIDER: S-EPMC6059992 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Improving Patient Knowledge of Aneuploidy Testing Using an Educational Video: A Randomized Controlled Trial.

Mulla Bethany M BM Chang Olivia H OH Modest Anna M AM Hacker Michele R MR Marchand Karen F KF O'Brien Karen E KE

Obstetrics and gynecology 20180801 2

<h4>Objective</h4>To evaluate the effectiveness of an educational video explaining aneuploidy testing.<h4>Methods</h4>This was a randomized controlled trial of women with singleton pregnancies having aneuploidy testing at less than 14 weeks of gestation from September 2016 to March 2017 at our prenatal ultrasound center. We developed an educational video on aneuploidy testing. Participants, stratified by age younger than or 35 years or older at estimated delivery date, were randomized to either ...[more]

PMID: 29995739

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Project description:ObjectiveTo determine whether a behavioral intervention delivered through a video game can improve the appropriateness of trauma triage decisions in the emergency department of non-trauma centers.DesignRandomized clinical trial.SettingOnline intervention in national sample of emergency medicine physicians who make triage decisions at US hospitals.Participants368 emergency medicine physicians primarily working at non-trauma centers. A random sample (n=200) of those with primary outcome data was reassessed at six months.InterventionsPhysicians were randomized in a 1:1 ratio to one hour of exposure to an adventure video game (Night Shift) or apps based on traditional didactic education (myATLS and Trauma Life Support MCQ Review), both on iPads. Night Shift was developed to recalibrate the process of using pattern recognition to recognize moderate-severe injuries (representativeness heuristics) through the use of stories to promote behavior change (narrative engagement). Physicians were randomized with a 2×2 factorial design to intervention (game v traditional education apps) and then to the experimental condition under which they completed the outcome assessment tool (low v high cognitive load). Blinding could not be maintained after allocation but group assignment was masked during the analysis phase.Main outcome measuresOutcomes of a virtual simulation that included 10 cases; in four of these the patients had severe injuries. Participants completed the simulation within four weeks of their intervention. Decisions to admit, discharge, or transfer were measured. The proportion of patients under-triaged (patients with severe injuries not transferred to a trauma center) was calculated then (primary outcome) and again six months later, with a different set of cases (primary outcome of follow-up study). The secondary outcome was effect of cognitive load on under-triage.Results149 (81%) physicians in the game arm and 148 (80%) in the traditional education arm completed the trial. Of these, 64/100 (64%) and 58/100 (58%), respectively, completed reassessment at six months. The mean age was 40 (SD 8.9), 283 (96%) were trained in emergency medicine, and 207 (70%) were ATLS (advanced trauma life support) certified. Physicians exposed to the game under-triaged fewer severely injured patients than those exposed to didactic education (316/596 (0.53) v 377/592 (0.64), estimated difference 0.11, 95% confidence interval 0.05 to 0.16; P<0.001). Cognitive load did not influence under-triage (161/308 (0.53) v 155/288 (0.54) in the game arm; 197/300 (0.66) v 180/292 (0.62) in the traditional educational apps arm; P=0.66). At six months, physicians exposed to the game remained less likely to under-triage patients (146/256 (0.57) v 172/232 (0.74), estimated difference 0.17, 0.09 to 0.25; P<0.001). No physician reported side effects. The sample might not reflect all emergency medicine physicians, and a small set of cases was used to assess performance.ConclusionsCompared with apps based on traditional didactic education, exposure of physicians to a theoretically grounded video game improved triage decision making in a validated virtual simulation. Though the observed effect was large, the wide confidence intervals include the possibility of a small benefit, and the real world efficacy of this intervention remains uncertain.Trial registrationclinicaltrials.gov; NCT02857348 (initial study)/NCT03138304 (follow-up).

Project description:IntroductionPatient education plays an important role in the management of chronic diseases such as juvenile idiopathic arthritis (JIA). This study compared the effectiveness of a brochure and a video regarding JIA-related knowledge immediately after the intervention, and at 4 weeks post-intervention.MethodsA prospective randomized controlled trial was conducted. Patients with JIA or parents were randomized to receive education from either a brochure (n = 50) or a video (n = 50) at the clinic. Participants answered questionnaires about disease-specific knowledge before the intervention (T0), immediately after the intervention (T1), and at follow-up 4 weeks later (T2). The questionnaire comprised 15 multiple-choice questions. Final scores ranged from 0 to 15, and were scaled from 0% to 100% to calculate the percentage of knowledge scores. Ninety participants completed the questionnaire at T2 (42 in the brochure and 48 in the video group).ResultsThe mean percentage of knowledge scores at T0 was not significantly different between the brochure group and the video group. At T1, the mean percentage of knowledge scores was significantly higher in the video group compared with the brochure group (86.7 ± 12.9% vs. 76.0 ± 21.4%, p = 0.003). Among parents with an educational level below secondary school, the mean percentage of knowledge scores at T1 was significantly higher in the video group compared with the brochure group (83.5 ± 14.4% vs. 69.1 ± 23.2%, p = 0.006). Participants in both groups had significantly higher mean percentage of knowledge scores at T2 compared with T0 (72.7 ± 20.3% vs. 51.1 ± 24.7%, p < 0.001 in the brochure group and 78.3 ± 15.7% vs. 56.1 ± 21.9%, p < 0.001 in the video group). There was no significant difference in the mean percentage of total score change between T2 and T1 between the brochure and video groups (-4.7 ± 13.3% vs. -8.5 ± 11.0%, p = 0.152).ConclusionThe video was more effective for improving disease-related knowledge immediately post-intervention, particularly in participants with limited education. Although both educational tools had lasting effects on knowledge, the retention rate declined at 4 weeks after both interventions.Trial registrationThai Clinical Trials Registry (TCTR)20200310004, retrospectively registered since 06/03/2020.

Project description:Objective: Audio-visual interventions have been used to provide relevant patient information to reduce pre-operative anxiety in children. The aim of the study was to investigate whether self-reported state anxiety in children could be reduced by presenting a child-friendly educational video on the day of surgery. Methods: A prospective, single-blinded, two-armed, randomized controlled study was designed with three measurement time points including 90 children (6-17 years) and their parents. In the intervention group (IG), the children and their parents were shown a child-friendly video explaining the perioperative procedures that would be applied during the hospital stay, in addition to receiving standard information. In the control group (CG), children and parents received standard information provided by the nursing staff. The primary outcome was any change in the children's pre-operative state anxiety levels, as measured by the State-Trait Operation Anxiety Inventory (STOA). A secondary outcome was patient satisfaction regarding the received information. Results: Anxiety was significantly reduced in both groups after receiving either the intervention plus standard information or the standard information only. No significant difference in anxiety reduction was observed between the IG and the CG. However, the children and parents in the IG reported fewer worries than those in the CG. Conclusion: A child-friendly, educational video can be an additional tool for providing patient information and reducing pre-operative anxiety in children and their parents. Further studies should focus on the timing of the intervention and on age- and developmentally appropriate information formats and contents to address children's pre-operative anxiety. Clinical Trial Registration: Patient Anxiety Reduction in Children by Using Simple Explanation Videos, ID: NCT0441377; www.clinicaltrials.gov, Data Sharing Statement: Deidentified individual participant data will not be made available.

Project description:BackgroundIn Norway, a disproportionately high number of children receiving Child Welfare Services (CWS) struggle academically and drop out of school. Academic attainment is one of the strongest protective factors against societal marginalization. The present study is part of a knowledge translation project in collaboration with local CWS with the aim to develop, implement, and evaluate Enhanced Academic Support (EAS) for primary school children in CWS.Methods/designThe study is a mixed-methods hybrid type 2 randomized, controlled pragmatic trial. The participants are approximately 120 children whose families receive support measures from three child welfare agencies in and around Oslo, Norway, and practitioners from these agencies. Families are randomly assigned to either the EAS condition or "business as usual" support. Primary outcomes are math and reading skills, parental involvement in school, and intervention fidelity. Questionnaires and academic tests are administered at baseline, post-intervention (after 6 months), and at follow-up (after 12 months). Implementation drivers are assessed before and after the trial period, and intervention fidelity is monitored during the trial through checklists and structured telephone interviews. Semi-structured interviews and focus groups are conducted after the trial.DiscussionThis hybrid study has two implications. (1) The effects of providing EAS to children in child welfare will be investigated. The study also explores how each core component of the intervention and the use of specific adaptations, implementation drivers, and other important child-level covariates moderate the overall effects. The results can provide valuable knowledge about how to deliver precise and effective academic support to increase academic skills and prevent dropout. In turn, this can promote academic completion and well-being, outcomes that are beneficial for both children and society at large. (2) The study also evaluates the feasibility of applying an Integrated Knowledge Translation model designed to develop, implement, and evaluate research-supported practice in health, care, and welfare services in less time than is usually the case. If deemed successful, this model will provide an efficient collaborative approach to translate the best available evidence into effective evidence-based practice, applicable in effectiveness research and quality improvement efforts.Trial registrationISRCTN, ISRCTN38968073 . Registered on 18 September 2017. https://doi.org/10.1186/ISRCTN38968073 .

Project description:Introduction: Innovative methods to increase awareness about clinical trials and address barriers associated with low participation among racial/ethnic minorities are desperately needed. African Americans comprise 5% of all clinical trial participants, and Hispanics make up 1%. Use of multimedia educational material has shown promise as an effective strategy to increase minority clinical trial enrollment. However, this approach has not been broadly implemented. We tested the effect of a video educational program on clinical trial knowledge and enrollment in a sample of oncology outpatients. Methods: A randomized controlled trial was conducted with 63 oncology patients without previous history of clinical trial participation. Participants were randomly assigned to the intervention, to watch a clinical trial educational video in the office, or to the control group which did not receive in-office education. The Clinical Trial Knowledge survey was administered before the intervention and 1 week after the intervention. Participation in clinical trials was assessed 1-year post study participation. Results for white participants and ethnic minorities were compared. Ethnicity was self-reported through the electronic health record and confirmed by self-reporting on questionnaire. Results: Sixty-three participants were recruited in this study. At 1-year follow-up, 3 participants enrolled in clinical trials in the study group which had received office-based video intervention and 2 participants enrolled in the control group (Z = 0.39, p = 0.69). These results were not statistically significant. Impact of the intervention by ethnicity could not be assessed due to low total clinical trial enrollment. The video intervention did not change knowledge, attitudes, or barriers as measured by the Clinical Trial Knowledge Survey. Minority participants did report significantly more negative beliefs and barriers to participation than white participants. Conclusions: Increasing awareness and knowledge about clinical trials in underrepresented communities is an important step to providing opportunities for participation. Future studies should focus on how to address the negative expectations of clinical trials and the greater information needs in minority populations. Tailored or personalized messaging may address negative perceptions of clinical trial participation.

Project description:ObjectiveTo compare the Centers for Disease Control and Prevention's (CDC) contraceptive effectiveness poster with a more patient-centered poster on factors affecting the likelihood of using effective contraceptives.MethodsThe posters were tested in a randomized controlled trial. Women were eligible if they were aged 18-44 years, could speak and read English, were not pregnant or trying to conceive, and had engaged in vaginal intercourse in the past 3 months. An online survey administered through Amazon Mechanical Turk was used to collect baseline and immediate follow-up data on three primary outcomes: contraceptive knowledge (measured using the Contraceptive Knowledge Assessment), perceived pregnancy risk, and the effectiveness of the contraceptive the woman intended to use in the next year. Subgroup analyses were conducted in women with prior pregnancy scares, low numeracy, and no current contraceptive. Within- and between-group differences were compared for the two randomized groups.ResultsFrom January 26 to February 13, 2018, 2,930 people were screened and 990 randomized. For the primary outcomes, the only significant result was that the patient-centered poster produced a greater improvement in contraceptive knowledge than the CDC poster (P<.001). Relative to baseline, both posters significantly improved contraceptive knowledge (CDC +3.6, patient-centered +6.4 percentage points, P<.001) and a constructed score measuring the effectiveness of the contraceptive that women intended to use in the next year (CDC and patient-centered +3 percentage points, P<.01). This is equivalent to 1-17 of every 100 women who viewed a poster changing their intentions in favor of a more effective contraceptive.ConclusionThis study suggests that both posters educate women about contraception and may reduce unplanned pregnancy risk by improving contraceptive intentions. Of the three primary outcomes, the patient-centered poster performs significantly better than the CDC poster at increasing contraceptive knowledge.Clinical trial registrationClinicalTrials.gov, NCT03372369.

Dataset Information

Improving Patient Knowledge of Aneuploidy Testing Using an Educational Video: A Randomized Controlled Trial.

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Improving Patient Knowledge of Aneuploidy Testing Using an Educational Video: A Randomized Controlled Trial.

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