Video modelling to educate patients

Virtual Reality in Cancer Care: Enhancing Knowledge and Reducing Anxiety about Chemotherapy among Patients and Caregivers

Virtual reality (VR) technology has evolved from entertainment to significant applications in healthcare and education. Despite its potential, there is limited research on the role of VR in cancer care. This study investigates VR's ability to simulate the chemotherapy process, aiming to enhance patients' knowledge and mitigate anxiety associated with chemotherapy. Utilizing a two-arm, mixed-methods pre/post-survey design, the study measured changes in patients' anxiety and knowledge before and after exposure to a VR simulation. Participants (n = 267) engaged with VR simulations or interactive 360-degree videos depicting the chemotherapy process. Data analyses revealed a significant median increase in chemotherapy knowledge post-exposure to the VR content (z = 12.511, p < 0.001). Demographic factSors significantly influenced perceptions of VR realism and usefulness (p < 0.05). Additionally, VR exposure was correlated with reduced anxiety levels and improved treatment expectations (p < 0.05). Participants with higher post-understanding chemotherapy scores considered VR a useful tool for managing anxiety about chemotherapy and recommended VR for other medical procedures (p < 0.001). These findings underscore VR technology's potential as a valuable tool in cancer treatment, suggesting it can enhance patient education and reduce anxiety, thereby improving patient outcomes during cancer therapy.

The effect of educational animation compared to leaflets on patients' knowledge regarding root canal treatment: a randomized controlled trial

BACKGROUND

Incorporating video as a tool for education offers a multitude of advantages. However, it is unknown what is the best educational tool to use for increasing public awareness, consequently reducing fear about root canal treatment. For this reason, this study aimed to compare the effectiveness of educational animation and leaflets as delivery methods for providing information on root canal treatment to patients and to assess their ability to retain the information.

METHODS

One hundred fifty adult volunteers were recruited via social media and Umm Al-Qura University Dental Hospital to participate in this randomized control trial study. The volunteers were divided into the study group (SG) and the control group (CG). The SG was provided with information through animations created by the research team, while the CG received the same information through a leaflet. Pre-intervention (T1), immediate post-intervention (T2), and one-month post-intervention (T3) validated questionnaires were completed by the participants to assess the changes in their knowledge. To evaluate the impact of the information delivery method, the knowledge scores of T2 and T3 were compared to T1 within each group using Paired T-tests. Additionally, the study compared the knowledge scores of the two groups using unpaired T-tests. The significance level was set at a P-value of less than 0.05.

RESULTS

A significant improvement in endodontic therapy knowledge among the participants in both groups (T1 compared to T2 in the same group) was noted (P < 0.050). However, when comparing T2 between groups, no significant difference was found in delivering the information and improving the knowledge (P = 0.080). Still, the mean differences between T1 and T2, as well as T1 and T3, were greater (P < 0.050) in the SG than in the CG. Furthermore, the total knowledge score in the SG at T3 was significantly higher than the CG.

CONCLUSION

Both educational animation and leaflets are practical tools to increase patients' awareness about root canal treatment. However, educational videos are more effective than leaflets in delivering and retaining information about root canal treatment.

TRIAL REGISTRATION

This study was retrospectively registered as a randomized control trial at the ISRCTN registry with the document number ISRCTN18413241, 15/05/2023.

Effectiveness of technology-aided education on self-efficacy among individuals post pulmonary surgery: A randomized controlled trial

BACKGROUND

Patient education is an effective tool in enhancing compliance and comprehension to therapy. Preoperative video-based education (VBE) on knowledge and understanding of surgical procedures and physical therapy provides an insight into the essential need for treatment adherence and early post-operative recovery. Self-efficacy (SE) is an individual self-belief about one's ability to cope and is denoted as a sign of healthy behavior and empowerment. Although little is known about VBE and self-efficacy (SE) in rehabilitation of pulmonary surgery patients. The objective was to assess the influence of VBE in pulmonary rehabilitation on SE post pulmonary surgery patients using the Manipal Self Efficacy Questionnaire (MSEQ).

METHODS

Study design: Mixed methods pilot study. The MSEQ and educational video were designed and developed for this study. Piloting was conducted with the MSEQ (CVI = 0.95) and educational video (CVI = 1). After approval from the ethics committee, written informed consent was obtained from twenty preoperative pulmonary surgery patients were randomized to two groups. The control group (n = 30) received routine post-operative exercises and experimental group (n = 30) received preoperative VBE along with exercises.

RESULTS

Validation of MSEQ and educational video was derived as per content validation index. Mann- Whitney U test and Wilcoxon signed rank test were used to compare the groups. SE scores in the experimental group was higher than the control (p = 0.004).

DISCUSSION AND CONCLUSION

VBE on PR improved SE of the patients after pulmonary surgery. The study's main limitation was the difficulty in attaining the desired sample size because it was a time-bound study.

Impacts of a COVID-19 Educational Video: Evaluation of the Influence of Race, Gender, Political Affiliation, Study Major, and Age on Vaccine Acceptance among University Students

BACKGROUND

The World Health Organization (WHO) warns that vaccine hesitancy is an ongoing major global health threat. While vaccination against severe acute respiratory syndrome coronavirus (SARS-CoV-2) proves to be an effective strategy in protecting against the disease, vaccine hesitancy represents a major barrier to stopping the spread of the virus. Willingness for vaccination can be influenced by several factors, including education level and health literacy. Although several studies demonstrate the value of video educational programs in improving coronavirus disease 2019 (COVID-19) vaccine knowledge and acceptance, no studies to date have evaluated if race, gender, and other demographic factors impact the influence of an educational video on COVID-19 vaccine knowledge and hesitancy among university students in the United States (U.S.).

AIMS

This study was conducted to determine the impact of an educational video on U.S. university undergraduate students' COVID-19 vaccine perception and acceptance. It also aims to evaluate whether demographic factors affect the influence of the video.

METHODS

An online survey was used to measure perceived understanding and acceptance of COVID-19 vaccines before and after viewing a video regarding the effectiveness and safety of COVID-19 vaccinations. The impact of demographic factors on the Video Influence Score was analyzed.

KEY RESULTS

After viewing the video, respondents' (n = 285) perceived awareness and acceptance of COVID-19 vaccines significantly increased (p < 0.05). In addition, gender, political party affiliation, age, study major, and influenza vaccination history did not significantly impact the Video Influence Score (p > 0.05). However, African American/Black respondents (3.81 ± 4.24) were significantly more influenced by the video compared to respondents of other races (p < 0.05), such as White/Caucasian (1.91 ± 3.75), Hispanic/Latino (0.17 ± 3.67), Asian (0.29 ± 1.53), and Indigenous American (0.64 ± 2.52).

CONCLUSIONS

This study suggests the potential impact of an educational video on COVID-19 vaccine perception and acceptance among university students. Despite limitations such as a modest survey response rate, this study provides valuable insight concerning the influential factors affecting vaccine acceptance in diverse student populations. Future studies are warranted to explore how student response to vaccine educational videos may vary depending on students' racial and cultural backgrounds.

IMPLICATIONS

A targeted educational video to promote vaccine acceptance is a valuable tool for public health campaigns to combat vaccine hesitancy. The study also highlights the importance of tailoring interventions to specific demographic groups such as considering racial factors to maximize the impact of educational interventions on vaccine attitudes.

[Improved Patients' Satisfaction Level of Radiation Therapy: The Effect of "Explainer Videos about Radiation Therapy", "Treatment of Breast Cancer Patients by Female Radiation Therapists" and "Treating Male Patients While Wearing Underwear in Pelvic Radiation Therapy"]

PURPOSE

The questionnaire survey investigated whether "Explainer videos about radiation therapy (RT-Video)", "Treatment of breast cancer patients by female radiation therapists (F-RTT)" and "Treating male patients while wearing underwear in pelvic radiation therapy (M-RTT)" can improve patient's satisfaction.

METHODS

The RT-Video survey included questions regarding the impression of radiation therapy, improving its understanding, and anxiety reduction (102 patients received radiation therapy). Fifty-one breast cancer patients were asked whether they preferred an F-RTT treatment. Subsequently, the patients treated with F-RTT (41 patients) and M-RTT (50 patients) were surveyed about their treatment satisfaction on a five-point scale.

RESULTS

RT-Video improved the understanding of radiation therapy for 86 out of 102 patients (84%). In all, 68 out of 102 patients (68%) had a negative impression of radiotherapy; among them, watching the RT-Video reduced anxiety in 63% of patients. A total of 14 out of 51 breast cancer patients (28%) preferred the F-RTT treatment. The percentage of patients who received treatment satisfaction by F-RTT and M-RTT was 95% and 84%, respectively.

CONCLUSION

RT-Video, F-RTT and M-RTT treatments improved patients' satisfaction.

Effects of Music and Preoperative Education on Coronary Artery Bypass Graft Surgery Patients' Anxiety

PURPOSE

The aim of this study was to evaluate the effectiveness of music and preoperative education on anxiety, physiological responses, length of hospital stay, and quality of life in Coronary Artery Bypass Graft Surgery (CABG) patients.

DESIGN

This was a non-randomized quasi-experimental study.

METHODS

For this study, 214 patients were separated into an experimental and control group. A dual intervention using preoperative education and a CD with classical Turkish music was applied to the experimental group. The control group was provided with an uninterrupted rest period at the same time. The primary outcome was the difference in anxiety of the patients. Other outcomes included differences in the physiological responses, length of hospital stay, and quality of life.

FINDINGS

Anxiety decreased in the preoperative and postoperative periods in both groups (P = .000), and patients' anxiety level in the experimental group was lower than the control group (P = .000). The experimental group patients had a decrease in systolic blood pressure, diastolic blood pressure, and heart rate in the preoperative period (P = .000), and all physiological responses in the postoperative period were lower than the control group (P = .000). Furthermore, the experimental group's length of hospital stay was shorter (5.8 ± 1 days), and their quality of life was better (P = .000).

CONCLUSIONS

The dual integrative nursing intervention (music and preoperative education) was effective in reducing anxiety in CABG patients. The results of the study will contribute to nonpharmacological approaches in the management of anxiety in CABG patients.

A randomized trial of comparing video telecare education vs. in-person education on dietary regimen compliance in patients with type 2 diabetes mellitus: a support for clinical telehealth Providers

BACKGROUND

Compliance to dietary recommendations by patients is the most difficult part of diabetes management. The nature of any educational method is to increase patients' awareness. But the question is, what is the effect of each method and for this purpose a comparative method should be considered. Therefore, this study was conducted to compare the effects of in-person education versus video tele-education on dietary regimen compliance in patients with T2DM.

METHODS

In this trial, 378 patients with type 2 diabetes mellitus (T2DM) were random allocated into video tele-education, in-person education and control groups. The patients' weight and biochemical parameters were measured before educational programs and three-month later.

RESULTS

The mean changes of patients' weight, glycemic parameters, and Lipid profiles decreased more in the two educational groups than the control group in a three-month period. There were no significant differences in the all study variables between the in-person and video education groups in post interventions except Total Cholesterol (TC). The pre- and post-intervention changes in the weight, TC, hemoglobin A1c, Triglyceride, and Very Low-density Lipoprotein Cholesterol were significant in both in-person group and video group. None of the educational programs had a significant impact on the Fasting blood sugar, Low-Density Lipoprotein Cholesterol, and High-Density Lipoprotein Cholesterol.

DISCUSSION

Video tele-education was just as effective as in-person educational method on dietary regimen compliance among patients with T2DM in a three-month period. Therefore, it is recommended to use video tele-education in combination with or as an alternative to the in-person education method. This study provides support for diabetes educator.

TRIAL REGISTRATION

This investigation was registered in the Iranian Registry of Clinical Trials Center ( IRCT20150302021307N4 ).

To Watch Before or Listen While Doing? A Randomized Pilot of Video-Modelling versus Telementored Tube Thoracostomy

BACKGROUND

New care paradigms are required to enable remote life-saving interventions (RLSIs) in extreme environments such as disaster settings. Informatics may assist through just-in-time expert remote-telementoring (RTM) or video-modelling (VM). Currently, RTM relies on real-time communication that may not be reliable in some locations, especially if communications fail. Neither technique has been extensively developed however, and both may be required to be performed by inexperienced providers to save lives. A pilot comparison was thus conducted.

METHODS

Procedure-naïve Search-and-Rescue Technicians (SAR-Techs) performed a tube-thoracostomy (TT) on a surgical simulator, randomly allocated to RTM or VM. The VM group watched a pre-prepared video illustrating TT immediately prior, while the RTM group were remotely guided by an expert in real-time. Standard outcomes included success, safety, and tube-security for the TT procedure.

RESULTS

There were no differences in experience between the groups. Of the 13 SAR-Techs randomized to VM, 12/13 (92%) placed the TT successfully, safely, and secured it properly, while 100% (11/11) of the TT placed by the RTM group were successful, safe, and secure. Statistically, there was no difference (P = 1.000) between RTM or VM in safety, success, or tube security. However, with VM, one subject cut himself, one did not puncture the pleura, and one had barely adequate placement. There were no such issues in the mentored group. Total time was significantly faster using RTM (P = .02). However, if time-to-watch was discounted, VM was quicker (P = .000).

CONCLUSIONS

Random evaluation revealed both paradigms have attributes. If VM can be utilized during "travel-time," it is quicker but without facilitating "trouble shooting." On the other hand, RTM had no errors in TT placement and facilitated guidance and remediation by the mentor, presumably avoiding failure, increasing safety, and potentially providing psychological support. Ultimately, both techniques appear to have merit and may be complementary, justifying continued research into the human-factors of performing RLSIs in extreme environments that are likely needed in natural and man-made disasters.

The Effect of Video Education on Skin-to-Skin Contact at the Time of Delivery: A Randomized Controlled Trial

Objective  The objective of this study was to measure the impact of video education at the time of admission for delivery on intent and participation in skin-to-skin contact (SSC) immediately after birth. Methods  This study was a randomized controlled trial of educational intervention in women ( N  = 240) of 18 years or older admitted in anticipation of normal spontaneous term delivery. Alternate patients were randomized into video ( N  = 120) and no video ( N  = 120) groups. Both groups received a survey about SSC. The video group watched an educational DVD and completed a postsurvey about SSC. Results  During the preintervention survey, 89.2% of those in the video group compared with 83.3% of those in the no video group indicated that they planned to use SSC ( p  = 0.396). After the video, 98.3% planned to do SSC after delivery ( p  < 0.001). However, only 59.8% started SSC within 5 minutes of delivery in the video group and only 49.4% started SSC within 5 minutes of delivery in the no video group ( p  = 0.17). Conclusion  Video education alters the intention and trends toward participation in SSC within 5 minutes of delivery. Despite the plans for SSC, however, there was no significant difference in rates between the two groups. These findings support that obstacles, other than prenatal education, may affect early SSC. Key Points Significant obstacles impact skin-to-skin rate.Video education alters skin-to-skin intent.Video education can improve skin-to-skin rate.Education can happen at the time of delivery.Video education can impact mothers and infants.

Watch and learn? A systematic review comparing oral health educational videos with written patient information aimed at parents/carers or children

Introduction Childhood caries remains a major UK health issue. The COVID-19 pandemic has necessitated rapid introduction of innovative practice to minimise footfall into dental clinics. Video-based oral health education could help promote oral health advice remotely and has been included in national guidance. This systematic review evaluates the impact of video education versus written patient leaflets on knowledge and oral health behaviours in parents/carers or children.Method PubMed and Medline were searched. In total, 47 articles were identified and relevance assessed by examining titles and abstracts. Seven full-text articles were assessed and reference lists manually screened for additional publications. Three studies met the inclusion criteria.Results Only one study assessed participant knowledge gain and found no statistical significance between scores at baseline and after video, leaflet or hygienist-led education. For oral health behaviour change, one study demonstrated no significant difference in plaque score improvements between video and leaflet groups. The other showed significant improvements in plaque and bleeding scores for both leaflet and video groups compared to the control.Conclusion This review identified too few studies with heterogeneity to make conclusions on the impact of written versusvideo oral health education. A standardised outcome measurement tool is needed to evaluate the impact of current educational videos on oral health behaviour and knowledge. There is potential for video to educate the masses as we navigate through this pandemic.

Randomized Controlled Trial of Patient Education Tools for Patients With Rheumatoid Arthritis

OBJECTIVE

The present study was undertaken to evaluate the efficacy of 2 educational tools for patients with rheumatoid arthritis (RA) by comparing a newly developed video tool, including storylines and testimonials, combined with a written booklet to the same written booklet alone.

METHODS

We conducted a randomized controlled trial. Our primary outcome was disease knowledge. Secondary outcomes were decisional conflict, self-efficacy, effective health care management, and satisfaction. Outcomes were measured before and after reviewing the materials, and 3 and 6 months later. Linear mixed-effects models were performed to evaluate changes over time.

RESULTS

In total, 221 participants received an educational video and booklet (n = 111) or a booklet alone (n = 110). The mean age was 50.8 years, mean disease duration was 4.8 years, 85% were female, and 24% had limited health literacy levels. Within groups, most outcomes improved between baseline and follow-up, but there were no statistically significant differences across groups. Patients receiving the video and booklet were more likely than those receiving the booklet alone to rate the presentation as excellent for providing information about the impact of RA, medication options, evidence about medications, benefits of medication, and self-care options. Factors significantly associated with greater improvements in knowledge and decisional conflict from baseline to 6 months included limited health literacy, lower educational level, and shorter disease duration.

CONCLUSION

Regardless of the delivery method, outcomes were improved up to 6 months after educational materials were delivered. Our findings support the implementation of self-administered educational materials in clinical settings, as they can result in sustained improvements in disease knowledge and decisional conflict.

Developing a video intervention to improve youth question-asking and provider education during paediatric diabetes clinic encounters: The Promoting Adolescents Communication and Engagement study

BACKGROUND

Research on long-term health conditions indicates that adolescents are not actively involved during their medical visits. Active involvement is essential because this can help adolescents learn how to self-manage their treatment plan.

OBJECTIVE

To co-design a video intervention to improve youth question-asking and provider education during paediatric diabetes visits.

PATIENT INVOLVEMENT

A participatory-led approach was used to co-design the video, through a combination of interviews/ focus groups and the establishment of a Youth Advisory Group.

METHODS

First, focus groups and one-to-one interviews were held with adolescents, parents and healthcare providers. Second, two workshops were held with the Youth Advisory Group, Parent Advisory Group and stakeholders on script design. Finally, an iterative development of the video took place between the research team, videographer, both advisory groups and the steering committee. There were three rounds of feedback before the video was finalised.

RESULTS

Adolescents' content preferences included: 1) message of empowerment; 2) managing your diabetes so you can get on with the fun stuff in life; 3) Promoting independence; 4) Reasons for not speaking at clinic visits and reassurance; 5) Becoming comfortable to speak and ask questions at clinic visits; 6) Practical advice on how to ask questions. Formatting preferences included that the video should be short, divided into segments, with adolescents with diabetes acting in it, and speaking directly to the camera.

DISCUSSION

Identifying and reflecting adolescents' needs and preferences for engagement with healthcare providers was critical in the development process. Adolescents' participation in the co-design process was pivotal to the acceptability of the intervention for adolescents with diabetes.

PRACTICAL VALUE

The intervention may increase adolescents' participation in communication and interactions with healthcare providers, which may help them to be more active in the self-management of their condition.

Delivery of a smoking cessation induction intervention via virtual reality headset during a dental cleaning

Smokers who are not motivated to quit are less likely to seek help or utilize medication for cessation, so it is critical to proactively reach them to motivate cessation. This study aims to determine feasibility and satisfaction of a smoking cessation induction intervention via a virtual reality (VR) headset worn during dental cleaning. Participants (n = 23) were adult dental patients who were current smokers. During their teeth cleaning, participants wore a VR headset to watch two 5-min smoking cessation videos, one targeted to smokers who are not ready to quit and one for those who are ready to quit. Questionnaires were administered pre- and postappointment, and 1 month later. Interviews were conducted immediately after the appointment. Implementation did not interfere with care delivery, including instrument manipulation and patient-provider communication. On a 1-7 scale, participants indicated satisfaction with the experience (M = 5.4, SD = 1.3), and a positive impact on their willingness to quit (15 of 22 rated ≥ 6) and their knowledge of the effects of smoking on their health (22 of 23 rated as ≥ 6). Participants were highly satisfied with the video content (M = 4.3; 1-5 scale). When prompted, 82.6% were able to recall three things from the video. One month later, four to five participants reported that they quit smoking (varied by measure) and 14 of 23 intentionally quit smoking ≥ 24 hr. Among nonquitters, motivation to quit increased from baseline to follow up. This study may help guide the integration of virtual reality headset use in the dental setting to promote smoking cessation regardless of motivation to quit.

Association Between Patient Education Videos and Knowledge of Radiation Treatment

PURPOSE

Patient knowledge of radiation therapy (RT) before consult is typically limited, with many having misconceptions or fears. There exists a need to improve patient education in RT. Our purpose was to study the impact of patient education videos on patient-reported knowledge of RT, anxiety/fear, and satisfaction.

METHODS AND MATERIALS

At our institution, we created 2 RT educational videos: a general RT video and a breast cancer-specific video. Patients presenting for breast RT who agreed to participate (n = 107) were randomly assigned to receive a link to the videos (video group; n = 58) or not (no-video group; n = 49) before consultation. Pre- and postconsult surveys were administered assessing patient-reported measures on a 5-point Likert-type scale.

RESULTS

Patients in the video group reported significantly higher levels of confidence in their knowledge of radiation side effects, with 45.6.% at least somewhat confident versus 21.3% in the no-video group (P = .009; median on a 5-point Likert-type scale, 2 [interquartile range {IQR}, 2-3] versus 2 [IQR, 1-2], respectively [P = .012]). There was a trend toward higher knowledge of the radiation treatment process in the video group (median, 3 [IQR, 2-3] versus 2 [IQR, 2-3] for no-video group; P = .064). There were no significant differences in preconsult anxiety or fear between the groups, but of those who were assigned videos, 46.8% reported decreased anxiety afterward, and 66.0% felt more comfortable coming to a consult. While those in the no-video group hypothesized that a video would be helpful (median, 3; IQR, 3-4), those in the video group found them to be very helpful in real life (median, 4; IQR, 45; P = .0009). After the consult, all patients in both groups were satisfied.

CONCLUSIONS

Patient education videos increase patient-reported knowledge of RT and are found to be very helpful.

Can the Use of Video-Based Interventions Increase Public Knowledge About Endocrine Surgeons?

BACKGROUND

Endocrine surgery (ES) is a relatively young subspecialty of general surgery, and prior research has shown low public awareness of these specialists' roles. We hypothesized that a video-based intervention could increase public knowledge of the specialty in an effective and efficient manner.

METHODS

Participants were recruited at three public locations (a farmer's market, a public park, and a university hospital) and were given a three-question survey to assess baseline knowledge of ES. They then watched one of two video-based educational interventions and completed an identical postintervention survey. Two surveyors recruited 80 individuals per site, with 40 participants in each intervention group. Participants' sex and age and whether or not they were on clinical staff at the University of Alabama at Birmingham were recorded.

RESULTS

A total of 240 participants were recruited; 61.3% female with median age 40 y. Preintervention, only 42.1% of participants could correctly define ES. ES were confused with endocrinologists by 44.6%, which was not different between sites (P = 0.09). Significantly, more participants at all sites could correctly define ES postintervention (67.9% versus 42.1%; P < 0.001). Clinical staff did not perform better than the lay public at any location (P = 0.32). The long video had a significantly greater increase in correct responses compared with the short video overall (32.5% versus 19.1%; P < 0.001) and at each location.

CONCLUSIONS

This study confirms the public's general lack of knowledge about ES and their scope of practice. A video-based intervention was successful in improving knowledge of the practice of ES, with a longer, explanatory video being most effective.

Effectiveness of a short web-based film targeting parental oral health knowledge in a well-child care setting

Young children rely on their parents with respect to oral health routines. However, parental knowledge on this topic is often insufficient. Well‐child care may be an excellent route to reach parents because almost all of them attend. To evaluate the effectiveness of an 8.5 min web‐based film about oral health, provided by well‐child care, a non‐blinded quasi‐experimental study was performed. Parents attending well‐child care clinics in the Netherlands were assigned to an intervention (n = 88) or control group (n = 41). The control group received care as usual. We measured parental knowledge of oral health with a questionnaire (range of scores 1–12) before and directly after the intervention, and 6 months later, and assessed differences between the intervention and the control group. Parental oral health knowledge improved after watching the film: the intervention group’s mean score of 11.1 (SD 1.3) was greater than the mean score of 7.1 (SD 2.0) of the control group (Cohen's d = 2.64). Scores remained higher in the intervention group 6 months after watching the film (mean 9.1, SD 1.3) than before (Cohen's d = 1.25). A web‐based educational film delivered in a well‐child care setting can be an effective way to address oral health and to improve parental knowledge.

Comparison of multimedia and printed patient education tools for patients with osteoporosis: a 6-month randomized controlled trial

We conducted a randomized controlled trial to compare the efficacy of adding a video tool to a printed booklet on osteoporosis. Both strategies were effective in increasing knowledge and decreasing decisional conflict. There was no difference in the measured outcomes between the intervention and control groups. Patient preferences and learning styles are key factors in deciding a presentation format when educating patients with osteoporosis.

INTRODUCTION

Innovative approaches to patient education about self-management in osteoporosis may improve outcomes.

METHODS

We conducted a randomized controlled trial to compare the efficacy of adding a multimedia patient education tool involving video modeling to a printed educational booklet on osteoporosis. Participants were post-menopausal women with osteoporosis. We assessed osteoporosis knowledge, decisional conflict, self-efficacy, and effectiveness in disease management at baseline, immediately post-intervention, and at 3 and 6 months. Linear regression models were used to explore changes in outcomes at 6 months with respect to baseline characteristics.

RESULTS

Two hundred and twenty-five women were randomized, 111 to receive the multimedia tool in addition to the booklet and 114 to receive the booklet alone. Knowledge and decisional conflict scores significantly improved in both groups at all post-intervention assessment points, but with no significant differences in score changes between the groups. Self-efficacy and disease management effectiveness showed no significant changes from baseline. In the entire cohort, younger age was associated with better effectiveness in disease management and Hispanic women had greater gains in knowledge at 6 months compared to White women. Women with limited health literacy who had received the multimedia tool in addition to the printed materials had higher decisional conflict than those who received printed materials alone.

CONCLUSION

Both multimedia and printed tools increased knowledge and decreased decisional conflict to the same extent, neither of the educational materials proved to be better than the other. For women with limited health literacy, receiving the booklet alone was more effective in reducing decisional conflict after 6 months, than adding the multimedia tool.

Video-Based Interventions for Cancer Control: A Systematic Review

Background. The use of videos for patient and public health education has been widely adopted and well documented in the literature. Aims. To conduct a systematic review of empirical studies that used video-based interventions for cancer prevention and control to document study designs, settings, approaches, targeted cancer sites and behaviors, and outcomes and to identify gaps in research and practice. Method. PubMed, PsychINFO, CINAHL, SCOPUS, and Web of Science were searched for studies published in the 30-year period from 1984 to 2014. Of 1,521 articles identified, duplicates were removed, and titles and abstracts of 779 were examined for eligibility. In all, 315 articles met the inclusion criteria and were coded by three independent coders. Interrater reliability was assessed. Descriptive frequencies and proportions were calculated. Results. Studies evaluating video interventions for cancer prevention and control have increased over time. The majority used randomized controlled trial designs (54%), followed by single-group pre-posttest designs (18%). Most were delivered in health care settings (39%). Detection (30%) and treatment (16%) were the cancer control continuum stages most frequently addressed, with breast cancer (29%) being the most frequently targeted cancer site. The behavior most commonly targeted was screening/early detection (39%). Topics such as caregiving, coping, palliative care, and end of life were rarely addressed. The majority (69%) reported being successful at achieving their stated objectives, though outcomes varied across studies. Conclusions. Video interventions have been widely utilized for cancer prevention and control, with demonstrated successes. Future research should test innovative designs and new delivery platforms and should include underrepresented topics and cancer sites.

A multicentre audit to assess the effectiveness of the British Orthodontic Society ‘Hold that Smile’ retainer videos

Introduction:

Retention is a crucial part of orthodontic treatment; however, patients often do not wear their retainers as advised. The British Orthodontic Society developed the ‘Hold that Smile’ campaign in 2017, to improve patient knowledge about retention. Information is provided in two formats: a cartoon and a conventional film.

Objective:

To assess whether patients find the ‘Hold that Smile’ videos useful and whether they improved patients’ intended retainer wear. The gold standard was that 90% of patients should intend to wear their retainers in the long term after watching the videos.

Design:

National multicentre audit.

Setting:

Nine units in the UK.

Methods:

Patients aged ⩾ 10 years, in fixed appliances or retention, watched the retainer videos and then completed a questionnaire that was designed specifically for this audit. Each unit collected data for approximately 30 patients.

Results:

Data were collected for 278 patients in total. The average age was 17.9 years; 64.4% of patients were female and 35.6% were male. Most patients (86.3%) watched both videos and, of these, 44.1% preferred the film, 31.3% preferred the cartoon and 24.6% had no preference. The majority of patients (81.3%) felt that the film provided them with new information, compared with a lower percentage (48.5%) for the cartoon. More patients said they would recommend the film (76.3%) compared with the cartoon (63.3%). Before watching the videos, 77.0% of patients felt they knew about long-term retainer wear and 74.3% of those intended to wear their retainers in the long term. After watching the videos, 96.4% of all patients thought they would now wear their retainers long term.

Conclusion:

After watching the videos, there was a notable increase in the number of patients planning to wear their retainers long term and the gold standard was met. Therefore, these videos may be beneficial in improving understanding and compliance with retention.

Deploying Clinical Process Improvement Strategies to Reduce Motion Artifacts and Expiratory Phase Scanning in Chest CT

We hypothesized that clinical process improvement strategies can reduce frequency of motion artifacts and expiratory phase scanning in chest CT. We reviewed 826 chest CT to establish the baseline frequency. Per clinical process improvement guidelines, we brainstormed corrective measures and priority-pay-off matrix. The first intervention involved education of CT technologists, following which 795 chest CT were reviewed. For the second intervention, instructional videos on optimal breath-hold were shown to 245 adult patients just before their chest CT. Presence of motion artifacts and expiratory phase scanning was assessed. We also reviewed 311 chest CT scans belonging to a control group of patients who did not see the instructional videos. Pareto and percentage run charts were created for baseline and post-intervention data. Baseline incidence of motion artifacts and expiratory phase scanning in chest CT was 35% (292/826). There was no change in the corresponding incidence following the first intervention (36%; 283/795). Respiratory motion and expiratory phase chest CT with the second intervention decreased (8%, 20/245 patients). Instructional videos for patients (and not education and training of CT technologists) reduce the frequency of motion artifacts and expiratory phase scanning in chest CT.

Understanding the psychosocial impact of joint hypermobility syndrome and Ehlers-Danlos syndrome hypermobility type: a qualitative interview study

PURPOSE

Little attention has been paid to psychosocial factors in Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome (hypermobility type). This study sought to identify the psychosocial impact by examining participants' lived experiences; and identify characteristics of effective coping.

MATERIALS AND METHODS

Adults with Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome (Hypermobility Type) were invited to discuss their own lived experiences and the impact of the condition. All met recognized criteria for clinically significant joint hypermobility, and had a self-confirmed diagnosis. The transcripts were coded and analyzed using inductive thematic analysis.

RESULTS

Seventeen participants (14 women, 3 men) purposively selected to broadly represent different genders, ages and ethnicities. Analysis identified five key themes: healthcare limitations, a lack of awareness of Joint Hypermobility, and Ehlers-Danlos Syndrome (Hypermobility Type) among healthcare professionals; a restricted life; social stigma; fear of the unknown; and ways of coping.

CONCLUSIONS

The results highlight the significant psychosocial impact on participants' lives. Coping approaches identified included acceptance, building social networks, learning about joint hypermobility, and adapting activities. Physiotherapists supported regular exercise. Further research should consider potential interventions to improve information provision, address psychological support, and increase awareness of hypermobility among healthcare professionals.Implications for rehabilitationParticipants who had help from family members to complete activities described guilt and shame, highlighting the need for a greater rehabilitation focus on maintaining independence.Difficulties with sexual relationships due to prolapse or erectile dysfunction, and associated anxieties have indicated a need for greater awareness of these issues within primary care.The provision of reliable information and materials is vital, both for healthcare professionals and patients, to reduce misinformation and fear.Physiotherapists with knowledge of Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome hypermobility type were cited as sources of support and hope, which helped people to cope with and manage their condition.

Prescription Opioid Misuse After a Recent Sexual Assault: A Randomized Clinical Trial of a Video Intervention

BACKGROUND AND OBJECTIVES

Prescription opioid (PO) misuse is increasing and is associated with overdose. Individuals who experienced a recent sexual assault are at risk for increased substance use, yet limited interventions target PO misuse after sexual assault. The current study examined the efficacy of video interventions on PO misuse after sexual assault.

METHODS

Adolescent girls and women (n = 154) were recruited in the context of a sexual assault medical forensic exam in the emergency department. Effects of a prevention of post-rape stress (PPRS) video and a pleasant imagery and relaxation instruction (PIRI) video were compared with treatment as usual (TAU) during a sexual assault medical forensic exam on PO misuse. Participants reported if they had used POs for non-medical purposes since the sexual assault at 1.5 month follow-up.

RESULTS

Results from a logistic regression analysis indicated that participants with a prior sexual assault were less likely to misuse prescription opioids 1.5 months after the assault in the PIRI condition compared with TAU. There were no main effects for video condition and no interactions for the PPRS condition on PO misuse.

DISCUSSION AND CONCLUSIONS

Providing the PIRI video, or teaching other types of mindfulness or relaxation exercises, may be warranted as a secondary prevention for individuals during the sexual assault medical forensic exam for those with a prior sexual assault history.

SCIENTIFIC SIGNIFICANCE

This research provides an initial examination of the impact of mindfulness skills recently after traumatic event exposure on PO misuse. (Am J Addict 2019;28:376-381).

Development of an Internet-delivered educational video for acute whiplash injuries

Objective

To describe the development of a preventive educational video for patients exposed to whiplash trauma following motor vehicle accidents.

Methods

The development followed a systematic approach and was theory-driven supplemented with available empirical knowledge. The specific content was developed by a multidisciplinary group involving health professionals and visual production specialists.

Results

A 14-min educational video was created. The video content focuses on stimulating adaptive recovery expectations and preventing maladaptive illness beliefs. The video presents a multifactorial model for pain incorporating physiological and cognitive-behavioural aspects, advice on pain relief, and exercises. Subjects interviewed for a qualitative evaluation found the video reassuring and that it aligned well with verbal information received in the hospital.

Conclusions

The development of the visual educational intervention benefitted from a systematic development approach entailing both theoretical and research-based knowledge. The sparse evidence on educational information for acute whiplash trauma posed a challenge for creating content. Further knowledge is required regarding what assists recovery in the early stages of whiplash injuries in order to improve the development of educational interventions.

Developing a Living with Hope Program for Caregivers of Family Members with Advanced Cancer

A theory-based intervention, the Living with Hope Program (LWHP), was designed to foster hope in caregivers of family members with advanced cancer. The LWHP was developed from qualitative data and using Harding and Higginson's recommendations for family caregiver interventions as a guide. The LHWP is: a) focused specifically on the caregivers themselves, b) theory based, c) feasible, d) acceptable, and e) pilot tested. The program consists of a hope video and a hope activity titled Stories of the Present. A mixed-method, concurrent triangulation, pre- and post-test design was used to pilot test the LWHP. The results of the pilot test suggest the LWHP is easy to use, flexible, and feasible, and shows promise in increasing hope and quality of life scores in family caregivers.

Evaluation and Implementation of ListeningTime: A Web-Based Preparatory Communication Tool for Elderly Patients With Cancer and Their Health Care Providers

Background

Effective patient-provider communication is an important condition to deliver optimal care and it supports patients in coping with their disease. The complex and emotionally loaded setting of oncology care challenges both health care providers (HCPs) and patients in reaching effective communication. ListeningTime is developed for elderly patients with cancer and their oncological HCPs to help them (better) prepare the clinical encounter and overcome communication barriers. ListeningTime is a Web-based preparatory communication tool including modeling videos and has an audio-facility to listen back to recorded encounters.

Objective

This study aims to evaluate the usability, perceived usefulness, and actual use of ListeningTime, through the eyes of elderly patients with cancer and their oncological HCPs. If highly rated, the ultimate goal is to make ListeningTime publicly available.

Methods

First, members of a panel of elderly cancer survivors and patients (age ≥65 years) were approached to evaluate ListeningTime through a Web-based questionnaire. The usability and perceived usefulness were assessed. Second, ListeningTime was evaluated in real-life practice through a pilot study in 3 Dutch hospitals. In these hospitals, elderly patients with cancer and their oncological HCPs were approached to evaluate ListeningTime through a similar Web-based questionnaire, measuring the perceived usefulness. In addition, we examined log files and user statistics to get insight into how the program was used.

Results

A total of 30 cancer survivors or patients from the patient panel, and 17 patients and 8 HCPs from the hospitals, evaluated ListeningTime. Overall, both panel members and hospital patients were positive about the ListeningTime website, audio-facility, and video fragments. Some patients suggested improvements with respect to the actors’ performances in the video fragments and believed that ListeningTime is mainly suitable for non experienced patients. HCPs were also positive about ListeningTime; they valued the video fragments for patients and the audio-facility for patients and themselves. However, providers did not relisten their own recorded encounters. Patients did use the audio-facility to relisten their encounters.

Conclusions

ListeningTime was highly rated, both by patients and their oncological HCPs. As a result, the video fragments of ListeningTime are now made publicly available for elderly patients with cancer through the Dutch website “kanker.nl.”

Visualized nutrition education and dietary behavioral change: A systematic review and meta-analysis

Effectiveness of using visual approaches in health education and its influential factors were still in debate. This study aimed to asess the effects of visualized nutrition education on dietary knowledge and behavioral changes, and factors influencing them. A comprehensive search of PubMed, EMBASE, Scopus, and Cochrane Library was conducted. Eligible studies were trials assessed effects of visualized nutrition education on dietary knowledge or behavior changes, compared with non-visualized or no education group. Fourteen studies (n = 7,259) were qualitatively analyzed and 7 of them were included in the meta-analysis. We found a higher fiber intake in both short term (1.59 g/1000 kcals, 95% CI 0.90-2.27) and long term (1.36 g/1000 kcals, 95% CI 0.64-2.09). A marginal advantage was shown in short-term fruits and vegetables consumption (F&V consumption) (standardized mean difference [SMD] = 0.08, 95% CI -0.00 to 0.16). The education effects were more pronounced when education was delivered in series (SMD_{F&V consumption} = 0.09, 95% CI 0.00-0.17), avoiding loss-framing (SMD_{Fat intake} = 0.31, 95% CI 0.10-0.51) and video modeling (SMD_{F&V consumption} = 0.23, 95% CI 0.03-0.43), with short length plus cultural adaptation. Visualized nutrition education was overall promising in improving dietary behaviors. Delivering in series, short in length, with cultural adaptation were features tended to enlarge the benefits of visualized education while loss-framing and video modeling might be avoided.

Effectiveness of health education materials in general practice waiting rooms: a cross-sectional study

BACKGROUND

Health education materials (HEMs) are widely used in general practice. However, there is little information on the variety of HEMs currently available to patients in the UK, or their preferences for accessing educational materials.

AIM

To assess patients' perceptions of HEMs, and the variety and accessibility of these materials.

DESIGN AND SETTING

Cross-sectional study conducted in general practices in Brighton and Hove.

METHOD

An anonymous questionnaire was distributed to patients in the waiting room (WR). Additionally, an audit was conducted to measure the variety of the HEMs. Results were analysed using binary multiple logistic regression.

RESULTS

In all, 556 participants (response rate 83.1%) from 19 practices took part. The mean age of participants was 49.3 years (SD ±18.9) and 63% were female. Perceived usefulness of HEMs was associated with reading in the WR using written HEMs, and not having a university degree; noticeability was associated with reading in the WR, and being female; attractiveness was associated with not having a university degree and shorter waiting time. On average, WRs contained 72 posters covering 23 topics, and 53 leaflets covering 24 topics, with many outdated and poorly presented materials of limited accessibility.

CONCLUSION

This study found substantial variation in the amount, topicality, and quality of material available in WRs. As most patients notice HEMs and find them useful, available technology could be better utilised to widen access to HEMs. The introduction of wireless free internet (Wi-Fi) to waiting rooms should provide an opportunity to update this area.

Comparison of the Efficacy of Three Different Methods of Explaining the Surgical Procedure of Hemithyroidectomy

BACKGROUND

For patients indicated for surgical treatment, adequate information about the procedure and its complications is a prerequisite for consent, reassures the patient, and allows them to make a well-informed decision. This prospective randomized study aimed to compare the outcomes of three different methods of explaining the procedure of hemithyroidectomy to patients' satisfaction.

MATERIAL AND METHODS

The three different methods for explaining the surgical procedure included a conventional diagram, three-dimensional (3D) thyroid model, and 2-minute animated video. A modified Patient Satisfaction Questionnaire was used to evaluate the efficacy of the methods and assess overall patient experience; 20 patients were randomized to each group. An endocrine surgeon performed the operative procedure using a sutureless technique. The procedure was explained to the patient a week before surgery in the outpatient department.

RESULTS

Majority of the patients were female. The most common indication for surgery was a solitary thyroid nodule. Patients who watched the animated video demonstrated significantly higher satisfaction levels and significantly lower anxiety levels than those in the other groups (P < 0.01). Patients who watched the video or who received instructions using the 3D model also reported that their information needs were met. Overall experience with the procedure and hospital stay was not significantly different between the groups.

CONCLUSION

Overall patient satisfaction for the surgical procedure was similar across the three groups. However, the animated video appeared to be a better model to explain the procedure to the patient, resulting in enhanced knowledge acquisition, reduced anxiety, and improved patient satisfaction.

Cultural factors that influence the treatment of osteosarcoma in Zulu patients: Healthcare professionals' perspectives and strategies

PURPOSE

International and national research regarding the discussion of cancer treatment across cultural boundaries is sparse. This study was conducted in the province of KwaZulu-Natal, South Africa, where healthcare encounters are largely culturally discordant; and this study focused on adult Zulu patients diagnosed with osteosarcoma. The purpose of this research study was to identify the cultural factors associated with discussing the different treatment options - and to explore healthcare professionals' responses to these cultural factors - from the healthcare professionals' perspective.

METHODS

A qualitative, exploratory, descriptive and contextual research design was used. We conducted focus group interviews with professional nurses, allied health professionals and orthopaedic physicians. These three focus groups comprised a total of 23 participants, and interviews were conducted with each of these groups. We thematically analysed the interview transcripts, using Guba's model of trustworthiness to ensure rigour.

RESULTS

We found that the factors, influencing treatment discussions in this cross-cultural clinical setting, included the meaning and the disclosure of cultural health beliefs.We identified strategies for responding to the cultural factors associated with amputation, namely timing treatment discussions, using support services, patient models and DVDs or videos. Strategies for responding to cultural and health beliefs that affect the treatment included initiating the cultural discussion, demonstrating an understanding of patients' cultural beliefs and liaising with family and cultural decision-makers wherever possible.

CONCLUSION

Our findings emphasised healthcare professionals' reports of how patients can experience the discussion of culturally discordant treatment options as bad news. We recommend that the treatment discussion form an integral part of the guidelines for culturally competent communication with such cancer patients.

Video-based education versus nurse-led education for partner notification in Thai women with sexually transmitted infections: a randomized controlled trial

Health education on sexually transmitted infections (STIs), condom use, and partner notification (PN) is required to increase partner evaluation/treatment (PET) rate. To examine this issue, a randomized controlled trial comparing video-based and nurse-led education in women diagnosed with their first STI at the Siriraj Female STI clinic was conducted from March 2015 to March 2017. PN was assessed at two weeks and PET was done at four weeks. Of 330 patients, 225 were included in the analysis (N = 113 and N = 112 for video-based and nurse-led groups, respectively). Each participant reported one partner who needed to be notified. The participants' median age was approximately 30 years old and they had been diagnosed with PID (N = 85), hepatitis B (N = 49), trichomoniasis (N = 45), syphilis (N = 30), and gonorrhea (N = 16). Characteristics were comparable between groups. There was no statistical difference in the PN rates (95.6% vs. 90.2%, p = 0.116), while the PET rate was significantly higher in the nurse-led group (49.6% vs. 67.9%; OR 0.47, 95% CI: 0.27-0.81; p = 0.005). Having endured symptoms for <7 days, being pregnant and detection of STIs during antenatal/pre-operative blood tests were positive predictors of PET (OR: 3.34, 95% CI: 1.81-6.14; 18.70, 95% CI: 5.61-62.31; and 22.07, 95% CI: 6.46-75.41, respectively). In conclusion, video-based education is as effective as nurse-led education in terms of PN rate but results in lower PET.

Using a Film Intervention in Early Addiction Treatment: a Qualitative Analysis of Process

PURPOSE

There is a need for knowledge about how self-help materials can be made useful in treatment for Substance Abuse Disorders (SUD), as a supplement to ongoing treatment, or as independent tools for change.

OBJECTIVE

In this study, we explored the use of self-help films in early addiction treatment, taking into account both patient and therapist perspectives, as well as dyadic functions. We explored how active mechanisms might be related to intervention format and implementation context. A secondary aim was to examine the potential mechanisms related to the specific content of the intervention: mindfulness and acceptance psychoeducation.

METHODS

A qualitative exploratory research design, including a general inductive analytic approach, constructivist grounded theory, and source triangulation features, was used to code and analyze interview material. Emerging themes were developed into concepts, and finally an operational model. Participants included 12 patients and 22 therapists, in in-/outpatient addiction clinics, all in urban areas of Norway. The purpose of the design was empirical grounding of developed concepts, to promote different potential user perspectives (patients' and therapists') and obtain process data.

RESULTS

The core concept constructed, "Alliance as experiential process," gives a description of the data where patients and therapists accept or reject the film as a result of an experience process conceptualized as alliance formation. The alliance process model reflects the observation that patients constructed alliances autonomously, while therapists built alliances indirectly through their patients' experiences.

CONCLUSIONS

Use of a self-help film may be a helpful adjunct to face-to-face therapy for patients who create a personally meaningful attachment to the film. Mindfulness/acceptance may offer one basic framework for such connection to take place.

Development and Pilot Testing of Multimedia Patient Education Tools for Patients With Knee Osteoarthritis, Osteoporosis, and Rheumatoid Arthritis

OBJECTIVE

We developed and tested multimedia patient education tools (video tools) for patients with knee osteoarthritis (OA), osteoporosis (OP), and rheumatoid arthritis (RA).

METHODS

We followed an "edutainment" model, incorporating educational patient story lines. The goals were designed to make the programs both didactic and entertaining, with navigation and graphic user interfaces as simple as possible. We created both English and Spanish language versions. Once the video tool was finalized, 60 patients, 20 per disease, were shown the tool and interviewed. Disease knowledge was our primary outcome, and decision conflict, disease management, and acceptability were secondary outcomes.

RESULTS

We observed statistically significant differences in pre- to postintervention knowledge questionnaire scores (before and after viewing the video tool) (OA: P = 0.03, OP: P = 0.01, and RA: P < 0.0001). Most participants felt they gained "clarity" on disease duration, symptoms, and the time medication takes to start acting; were "encouraged to see their doctor regularly"; and were more aware about taking their medications. In terms of acceptability, most patients in all disease groups found the length and amount of information presented in the video tools to be "just right," and the presentation to be "balanced." In terms of comprehension, all participants provided a favorable evaluation of the video tool; all found the video easy to use, the vocabulary easy to understand, and the materials to be well organized.

CONCLUSION

Multimedia tools that incorporate videos may help patients better understand and manage their disease. Patient involvement in the development process is essential to ensure relevant content and usability.

The Use of Spanish Language Educational Materials by American Cleft Palate–Craniofacial Association Teams

Objective

The goals of this study were to assess U.S.-based American Cleft Palate–Craniofacial Association (ACPA) teams’ use and perceived need for Spanish-language educational materials and to evaluate trends in number of Spanish-speaking patients treated.

Methods

A facsimile survey was sent to U.S.-based teams listed in the ACPA 1999 to 2000 and 2001 to 2002 Team Directories. Questions addressed demographics for Spanish-speaking patients/families and use of Spanish-language educational materials. Teams with a recent increase in Spanish speakers, 25% or more Spanish speakers, or both received a more in-depth follow-up survey.

Results

Response rate to the initial survey was 71%. Almost 16% of teams reported having greater than 25% primarily Spanish speakers. Forty-four percent of responders saw an increase in Spanish speakers over the past 5 years, and 41% of responders used Spanish-language materials of some type. Fifty-seven teams were sent a follow-up survey and 29 (51%) teams responded. Teams reported a need for more Spanish-language educational materials on specific craniofacial conditions, and many expressed frustration in communication and interaction with Spanish speakers.

Conclusions

Many U.S.-based ACPA teams reported an increase in primarily Spanish speakers and expressed a need for more Spanish-language educational materials in different formats. Consideration of the diverse dialectic, cultural, and literacy needs of U.S. Spanish speakers can contribute to more effective educational efforts and improved care of the increasing number of Latinos treated by ACPA teams.

ListeningTime; participatory development of a web-based preparatory communication tool for elderly cancer patients and their healthcare providers

OBJECTIVE

This paper outlines the participatory development process of a web-based preparatory communication tool for elderly cancer patients and their oncological healthcare providers (HCPs). This tool aims to support them to (better) prepare their encounters. An overarching aim of the project is to develop the tool in a participatory way to increase uptake and use.

METHODS

Scrum, a participatory framework originated from software development, was applied to develop the tool. Using constant feedback loops, elderly (former) cancer patients, oncological HCPs and their representatives were, as end-users, involved.

RESULTS

During six 'sprints', the communication tool 'ListeningTime' was developed with input from end-users. The use of scrum in developing an innovative tool was challenging in this context, because of time constraints of seriously-ill patients and busy HCPs and the co-creation involving non-profit scientific researchers and a for-profit development company.

CONCLUSIONS

The collaboration with end-users facilitated the development process of ListeningTime. Early involvement of end-users and flexibility in terms of planning and setup appear to be preconditions for creating a bottom-up inspired development procedure. Several challenges emerged from using scrum as participatory framework. Nevertheless, the 'pressure cooking situation', using scrum, resulted in a quick development process and a product ready for implementation.

Video Material as an Effective Educational Tool to Address Informational and Educational Needs of Cancer Patients Undergoing Radiation Therapy

With increasing rates of cancer patients undergoing radiation therapy, the treatment itself can cause patients significant amounts of anxiety and distress. This can be attributed to the diagnosis of the disease, lack of knowledge of what radiation therapy is, expectations and management of side effects, and the lack of knowledge of supportive care for patients and their families. Providing patients with effective educational tools to meet the informational needs of cancer patients undergoing radiation therapy can empower patients and allow them to participate in treatment decision-making and their own healthcare. This discussion paper will evaluate several studies on the psychological impact of cancer patients undergoing radiation therapy and how video material can effectively meet the informational and educational needs of this patient population group.

PatientVOICE: Development of a Preparatory, Pre-Chemotherapy Online Communication Tool for Older Patients With Cancer

Background

Good communication around cancer treatment is essential in helping patients cope with their disease and related care, especially when this information is tailored to one’s needs. Despite its importance, communication is often complex, in particular in older patients (aged 65 years or older). In addition to the age-related deterioration in information and memory processing older patients experience, communication is also complicated by their required yet often unmet role of being an active, participatory patient. Older patients rarely express their informational needs and their contributions to consultations are often limited. Therefore, older patients with cancer need to be prepared to participate more actively in their care and treatment.

Objective

The objective of this paper was to report the development of PatientVOICE, an online, preparatory tool with audio facility aimed to enhance the participation of older patients during educational nursing encounters preceding chemotherapy and to improve their information recall.

Methods

PatientVOICE was developed by applying the following 6 steps of the intervention mapping framework that involved both patients and nurses: (1) needs assessment, (2) specifying determinants and change objectives, (3) reviewing and selecting theoretical methods and practical strategies, (4) developing intervention components, (5) designing adoption and implementation, and (6) making an evaluation plan.

Results

A careful execution of these consecutive steps resulted in the ready-to-use preparatory website. PatientVOICE provides pre-visit information about chemotherapy (ie, medical information, side effects, and recommendations of dealing with side effects), information about the educational nursing visit preceding chemotherapy (ie, aim, structure, and recommendations for preparation), techniques to improve patients’ communication skills using a question prompt sheet (QPS) and video-modeling examples showing “best practices”, and the opportunity to upload and listen back to an audio recording of a patient’s own nursing visit.

Conclusions

The development process resulted in PatientVOICE, a multi-component online intervention targeted to older patients with cancer. PatientVOICE contains information about the treatment as well as information about the role of the patient during treatment. Using different methods (QPS and audio facility), we hope to support these patients during their treatment. In the future, the utility and usability of this complex intervention will be evaluated in a group of older patients who receive or have received chemotherapy.

Exploring the Experiences of Left-Sided Breast Cancer Patients Receiving Radiation Therapy Using the Active Breathing Coordinator

BACKGROUND

The Active Breathing Coordinator (ABC) to induce breath hold during radiation therapy is used with the intent to reduce the risk of long-term, radiation-induced cardiovascular morbidity. Many studies have explored the dosimetric and toxicity benefits of using the device, but limited research has been done on the patient's perspective. The aim of this study was to explore the patient's experience using the ABC device and to evaluate the teaching provided.

METHODS AND MATERIALS

Following Research Ethics Board approval and written informed consent, paper questionnaires were used, and cross-sectional data were collected from 30 English-speaking women receiving radiation therapy for left-sided breast cancer using the ABC device. Questions were both quantitative (a 10-point Likert scale) and qualitative in nature and evaluated patient-reported anxiety levels, confidence levels, and suggestions for process improvement. Descriptive and inferential statistics were used to analyze the results, with thematic analysis of qualitative comments.

RESULTS

Fifty-three percent of patients reported higher than 5 on the Likert scale for anxiety related to using the ABC device. Half the sample indicated that they were equally anxious about using the ABC as they were about receiving radiation therapy, a third reported being more anxious about using ABC than they were about receiving radiation therapy. Participants under 50 years were significantly more likely to feel "highly" anxious about using ABC than those older than 50 years (37% vs. 5%; P = 0.001). Half the participants indicated that their confidence level increased as treatment progressed, and suggested that the inclusion of a training video, practice sessions and constant communication via the treatment unit intercom would be helpful in reducing their anxiety.

CONCLUSIONS

This hypothesis generating study suggests that moderate-to-high levels of anxiety were common for left-sided breast cancer patients using the ABC device, particularly for patients younger than 50 years. As treatment progressed, patients seemed to become less anxious and more confident using the device. These preliminary findings support the need for further research in this area, using formal validated anxiety scoring tools.

The development of an educational video to motivate teens with asthma to be more involved during medical visits and to improve medication adherence

OBJECTIVES

Our objective was to develop a series of short educational videos for teens and parents to watch before pediatric visits to motivate teens to be more actively involved during their visits.

METHODS

The development of the short educational videos was theoretically guided by Social Cognitive Theory. First we conducted four focus groups with teens (ages 11 to 17) with asthma, four focus groups with the teens' parents, and seven focus groups with pediatric providers from four clinics. The research team, which included two teens with asthma and their parents, analyzed the focus group transcripts for themes and then developed the initial video script. Next, a visual storyboard was reviewed by focus groups with parents and four with teens to identify areas of the script for improvement. The English videos were then produced. Focus groups with Hispanic parents and teens were then conducted for advice on how to modify the videos to make a more culturally appropriate Spanish version.

RESULTS

Based on focus group results, teen newscasters narrate six one- to two-minute videos with different themes: (a) how to get mom off your back, (b) asthma triggers, (c) staying active with asthma, (d) tracking asthma symptoms, (e) how to talk to your doctor and (f) having confidence with asthma. Each video clip has three key messages and emphasizes how teens should discuss these messages with their providers.

CONCLUSIONS

Teens, parents, and providers gave us excellent insight into developing videos to increase teen involvement during medical visits.

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar

BACKGROUND

Visualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing.

RESULTS

Our final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions.

CONCLUSIONS

We have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However, attention needs to be paid to the potential ambiguity associated with images and thus the concept of visual literacy among patients. Our revised model may be helpful as a guide to aid development, acceptability, and ultimately effectiveness.

Testing Videotape Education for Heart Failure

This pilot study tested a videotape intervention designed to improve patient selfmanagement of heart failure (HF). Content of the video series (produced professionally under a federal grant) is based on national, scientifically validated guidelines for HF home management. Outcomes tested were HF knowledge, symptom reporting, and functional status. Participants were 10 newly diagnosed HF patients (mean age 67). After viewing the tapes, data indicated participants had a clinically relevant improvement in HF knowledge, and improved or maintained HF health status. None were rehospitalized during the 60-day follow-up period. One patient contacted his/her physician to report weight gain, as prompted by the videotapes. The cost data indicated that patients paid $177 out of pocket monthly for medications and all were low income. These results indicate the need for further testing of the videotape as a potentially cost-effective method of teaching aboutHFself-management and daily home self-monitoring.

Television-based health promotion in general practice waiting rooms in London: a cross-sectional study evaluating patients' knowledge and intentions to access dental services

BACKGROUND

This study aimed to evaluate whether television-based dental health promotion initiatives in General Practice waiting rooms would increase patients' knowledge of and intentions to seek dental services.

METHODS

This cross-sectional survey of 2,345 patients attending 49 General Practices in Brent, northwest London, evaluated the 'Life Channel' - a series of six brief health promotion advertisements, including one dental health promotion advertisement, displayed over ten minutes on television in General Practice waiting rooms. Primary outcome measures were a self-reported gain in the knowledge to contact a National Health Service (NHS) and emergency dentist, and an intention to seek dental services, attributed to viewing the Life Channel.

RESULTS

Among the 1,088 patients who did not know how to contact an NHS dentist prior to the survey, and the 1,247 patients who did not know how to contact an emergency dentist prior to the survey, 48.0 % (95 % CI 45.0-51.0 %) and 35.1 % (95 % CI 32.4-37.8 %) attributed the Life Channel to educating them how to do so, respectively. Among the 1,605 patients who did not have any intention to contact a dentist prior to the survey, 15.2 % (95 % CI 13.4-17.0 %) attributed the Life Channel to creating such an intention. We report adjusted odds ratios on sociodemographic disparities in this evaluation.

CONCLUSIONS

Television-based dental health promotion may significantly increase knowledge of and intention to seek dental services in this sample in London. Television-based dental health promotion may appeal more to certain population groups. More research is needed to identify longer term outcomes of television-based health promotion.

The impact of watching educational video clips on analogue patients' physiological arousal and information recall

OBJECTIVE

Investigating the influence of watching three educational patient-provider interactions on analogue patients' emotional arousal and information recall.

METHODS

In 75 analogue patients the emotional arousal was measured with physiological responses (electrodermal activity and heart rate) and self-reported arousal.

RESULTS

A moderate increased level of physiological arousal was measured but not too much to inflict emotional distress. Recall of information was within the pursued range.

CONCLUSION

Hence, physiological arousal is not expected to hinder the goals we pursue with our online intervention.

PRACTICE IMPLICATIONS

Still, developers and researchers should remain attentive to the self-reported (conscious) and hidden (subconscious) emotions evoked by the content of educational video clips presented in self-help interventions. A moderate increased level of arousal is preferred to increase the learning capacity. However, too much arousal may decrease the learning capacity and may cause distress, which should obviously be avoided for ethical reasons.

Integrating a Parenting Intervention With Routine Primary Health Care: A Cluster Randomized Trial

OBJECTIVE

More than 200 million children globally do not attain their developmental potential. We hypothesized that a parent training program could be integrated into primary health center visits and benefit child development.

METHODS

We conducted a cluster randomized trial in the Caribbean (Jamaica, Antigua, and St Lucia). Fifteen centers were randomly assigned to the control (n = 250 mother-child pairs) and 14 to the intervention (n = 251 mother-child pairs) groups. Participants were recruited at the 6- to 8-week child health visit. The intervention used group delivery at 5 routine visits from age 3 to 18 months and comprised short films of child development messages, which were shown in the waiting area; discussion and demonstration led by community health workers; and mothers' practice of activities. Nurses distributed message cards and a few play materials. Primary outcomes were child cognition, language, and hand-eye coordination and secondary outcomes were caregiver knowledge, practices, maternal depression, and child growth, measured after the 18-month visit.

RESULTS

Eight-five percent of enrolled children were tested (control = 210, intervention = 216). Loss did not differ by group. Multilevel analyses showed significant benefits for cognitive development (3.09 points; 95% confidence interval: 1.31 to 4.87 points; effect size: 0.3 SDs). There were no other child benefits. There was a significant benefit to parenting knowledge (treatment effect: 1.59; 95% confidence interval: 1.01 to 2.17; effect size: 0.4).

CONCLUSIONS

An innovative parenting intervention, requiring no additional clinic staff or mothers' time, was integrated into health services, with benefits to child cognitive development and parent knowledge. This is a promising strategy that merits further evaluation at scale.

Communicating Breast Cancer Screening With Young Women: An Experimental Test of Didactic and Narrative Messages Using Video and Infographics

Cancer is one of the leading causes of death around the world. Mortality from breast cancer can be reduced if the cancer is detected early enough. It is important to find effective communication that encourages early detection of breast cancer. This study aimed to measure differences between narrative and didactic communication on breast cancer awareness, knowledge of appropriate diagnostic exams, attitude toward breast self-exam, and intention to screen for breast cancer through a breast self-exam. It further aimed to test whether any differences in outcomes were associated with the format used to deliver the communication: video or infographic. The effects of the communication strategies were tested using an experimental design with a control group and four experimental groups: narrative video, didactic video, narrative infographic, or didactic infographic. A total of 194 Italian-speaking women ages 18-30 years completed questionnaires before and after exposure. Positive increases were found for all outcome variables after exposure to any communication strategy tested. The didactic message delivered in video format had the most positive effect on awareness and knowledge, whereas the narrative video message had the most positive effect on attitude and intention. For both message types, videos had a more positive influence than infographics when communicating breast cancer information for this audience. This was the first study of message effects of breast cancer communication with Italian-speaking young women. Further research is warranted to understand how to maximize communication strategies so that they are the most effective in influencing behaviors and if these results are consistent with other linguistic populations.