1
|
Cohen S, Halpern M, Stonbraker S. Mixed method evaluation of a clinic waiting room-based health education program in the Dominican Republic. HEALTH EDUCATION RESEARCH 2023; 38:177-191. [PMID: 36715740 DOI: 10.1093/her/cyad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 05/31/2023]
Abstract
Waiting rooms provide an ideal location to disseminate health information. In this mixed-methods study, we evaluated waiting room-based health education talks at two clinics in the Dominican Republic and explored recommendations for implementing this intervention in similar settings. The talks addressed noncommunicable diseases, sexually transmitted infections, family planning and gender-based violence. We conducted pre- and posttests to assess attendees' change in knowledge and conducted semi-structured interviews with a subset of them. We conducted a semi-structured focus group with educators. Analyses included Wilcox Signed Rank Tests and McNemar tests for pre- and posttests, conventional content analysis for individual interviews and transcript coding for the focus group. Patient participants were 69.3% female aged 39.6 years (SD = 13.5) on average at one clinic (n = 127) and 100% female aged 17.4 (SD = 1.3) on average at the second clinic (n = 24). Focus group participants (n = 5) had 4.8 years (SD = 3.3) of health educator experience on average. Pre- and posttests showed significant improvement (P < 0.05) across all talks. Qualitative interviews emphasized engaging, clear and brief content delivery with visual aids. The focus group highlighted the importance of patient-centered design with culturally concordant delivery and identified implementation challenges. Findings demonstrate that waiting room-based education talks improve knowledge and provide suggestions for similar interventions.
Collapse
Affiliation(s)
- S Cohen
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - M Halpern
- Clínica de Familia La Romana, C. Gaston Fernando Deligne 168, La Romana 22000, Dominican Republic
| | - S Stonbraker
- Clínica de Familia La Romana, C. Gaston Fernando Deligne 168, La Romana 22000, Dominican Republic
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO 80045, USA
| |
Collapse
|
2
|
Sivakumar M, Ali S, Rajagopal M, Yaskina M, Drury S, Wright B. The impact of humanoid robot presence in the paediatric emergency department waiting room: A prospective cohort study. Paediatr Child Health 2021; 26:470-477. [PMID: 34992700 DOI: 10.1093/pch/pxab027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 04/01/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The waiting room represents families' first point of contact with the emergency department (ED). We wished to study if a humanoid robot technology presence in the waiting room would improve satisfaction and decrease anxiety for caregivers in the paediatric ED. METHODS This observational cohort study was conducted from September to December 2018 at a Canadian paediatric ED. All caregivers and children >11 years in the ED waiting room were eligible. We compared a robotic intervention (RI) to standard of care (SOC) education in the waiting room. The RI was a 5-minute psychoeducational program describing the ED process and flow. Specific days were designated for RI or SOC. An anonymous survey was administered twice, at the same times, on both SOC and RI days. The primary outcomes were (a) caregiver satisfaction with waiting room experience using a 5-point Likert scale; and (b) caregiver-reported anxiety in the waiting room, as measured by the State Trait Anxiety Inventory - State Scale. RESULTS Six hundred and thirty-three caregivers participated, with a median age of 37 years (IQR 32 to 42); 80 children participated, with a median age of 15 years (IQR 13 to 16). Caregivers reported greater overall satisfaction in the RI cohort (174/200, 87.0%) compared to the SOC cohort (144/229, 62.9%; P<0.0001). Caregivers also reported lower anxiety in the RI cohort (39.38±11.38) compared to the SOC cohort (42.04±11.99; P=0.009). CONCLUSIONS A humanoid robot-based psycho educational intervention in the paediatric ED waiting room has a positive impact on caregiver satisfaction and anxiety.
Collapse
Affiliation(s)
- Mithra Sivakumar
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Samina Ali
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Women & Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, Alberta, Canada
| | - Manasi Rajagopal
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maryna Yaskina
- Women & Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, Alberta, Canada
| | - Sharon Drury
- Alberta Health Services, Edmonton, Alberta, Canada
| | - Bruce Wright
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Women & Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
3
|
McIntyre D, Thiagalingam A, Klimis H, Von Huben A, Marschner S, Chow CK. Education on cardiac risk and CPR in cardiology clinic waiting rooms: a randomised clinical trial. Heart 2021; 107:1637-1643. [PMID: 34290036 DOI: 10.1136/heartjnl-2021-319290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Waiting time is inevitable during cardiovascular (CV) care. This study examines whether waiting room-based CV education could complement CV care. METHODS A 2:1 randomised clinical trial of patients in waiting rooms of hospital cardiology clinics. Intervention participants received a series of tablet-delivered CV educational videos and were randomised 1:1 to receive another video on cardiopulmonary resuscitation (CPR) or no extra video. Control received usual care. The primary outcome was the proportion of participants reporting high motivation to improve CV risk-modifying behaviours (physical activity, diet and blood pressure monitoring) post-clinic. SECONDARY OUTCOMES clinic satisfaction, CV lifestyle risk factors (RFs) and confidence to perform CPR. Assessors were blinded to treatment allocation. RESULTS Among 514 screened, 330 were randomised (n=220 intervention, n=110 control) between December 2018 and March 2020, mean age 53.8 (SD 15.2), 55.2% male. Post-clinic, more intervention participants reported high motivation to improve CV risk-modifying behaviours: 29.6% (64/216) versus 18.7% (20/107), relative risk (RR) 1.63 (95% CI 1.04 to 2.55). Intervention participants reported higher clinic satisfaction RR: 2.19 (95% CI 1.45 to 3.33). Participants that received the CPR video (n=110) reported greater confidence to perform CPR, RR 1.61 (95% CI 1.20 to 2.16). Overall, the proportion of participants reporting optimal CV RFs increased between baseline and 30-day follow-up (16.1% vs 24.8%, OR=2.44 (95% CI 1.38 to 4.49)), but there was no significant between-group difference at 30 days. CONCLUSION CV education delivery in the waiting room is a scalable concept and may be beneficial to CV care. Larger studies could explore its impact on clinical outcomes. TRIAL REGISTRATION NUMBER ANZCTR12618001725257.
Collapse
Affiliation(s)
- Daniel McIntyre
- Westmead Applied Research Centre, The University of Sydney, Westmead, New South Wales, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, The University of Sydney, Westmead, New South Wales, Australia.,Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Harry Klimis
- Westmead Applied Research Centre, The University of Sydney, Westmead, New South Wales, Australia
| | - Amy Von Huben
- Westmead Applied Research Centre, The University of Sydney, Westmead, New South Wales, Australia
| | - Simone Marschner
- Westmead Applied Research Centre, The University of Sydney, Westmead, New South Wales, Australia
| | - Clara K Chow
- Westmead Applied Research Centre, The University of Sydney, Westmead, New South Wales, Australia.,Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
| |
Collapse
|
4
|
Mcintyre D, Thiagalingam A, Chow C. While you're waiting, a waiting room-based, cardiovascular disease-focused educational program: protocol for a randomised controlled trial. BMJ Open 2020; 10:e036780. [PMID: 33082181 PMCID: PMC7577035 DOI: 10.1136/bmjopen-2020-036780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Patients with cardiovascular disease (CVD) frequently attend outpatient clinics and spend a significant amount of time in waiting rooms. Currently, this time is poorly used. This study aims to investigate whether providing CVD and cardiopulmonary resuscitation (CPR) education to waiting patients in a cardiology clinic of a large referral hospital improves motivation to change health behaviours, CPR knowledge, behaviours and clinic satisfaction post clinic, and whether there is any impact on reported CVD lifestyle behaviours or relevant CPR outcomes at 30 days. METHODS AND ANALYSIS Randomised controlled trial with parallel design to be conducted among 330 patients in the waiting room of a chest pain clinic in a tertiary referral hospital. Intervention (n=220) participants will receive a tablet-delivered series of educational videos catered to self-reported topics of interest (physical activity, blood pressure, diet, medications, smoking and general health) and level of health knowledge. Control (n=110) participants will receive usual care. In a substudy, intervention participants will be randomised 1:1 to receive an extra video on CPR or no extra video. The primary outcome will be the proportion of intervention and control participants who report high motivation to improve physical activity, diet and blood pressure monitoring at end of clinic. The primary outcome of the CPR study will be confidence to perform CPR post clinic. Secondary analysis will examine impact on clinic satisfaction, lifestyle behaviours, CPR knowledge and willingness to perform CPR post clinic and at 30-day follow-up. ETHICS AND DISSEMINATION Ethics approval has been received from the Western Sydney Local Health District Human Research Ethics Committee. All patients will provide informed consent via a tablet-based eConsent framework. Study results will be disseminated via the usual channels including peer-reviewed publications and presentations at national and international conferences. TRIAL REGISTRATION NUMBER ANZCTR12618001725257.
Collapse
Affiliation(s)
- Daniel Mcintyre
- Westmead Applied Research Centre, University of Sydney, Westmead, New South Wales, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, University of Sydney, Westmead, New South Wales, Australia
- Cardiology Department, Westmead Hospital, Westmead, New South Wales, Australia
| | - Clara Chow
- Westmead Applied Research Centre, University of Sydney, Westmead, New South Wales, Australia
- Cardiology Department, Westmead Hospital, Westmead, New South Wales, Australia
| |
Collapse
|
5
|
Hendricks M, Varathan O, Cassim F, Kidd M, Moodley K. Impact of implementing an online interactive educational tool for future HIV "cure" research in an HIV clinic waiting room in Cape Town, South Africa. AIDS Care 2020; 32:965-969. [PMID: 32434383 PMCID: PMC7428067 DOI: 10.1080/09540121.2020.1766661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
Access to antiretroviral treatment (ART) in South Africa is suboptimal and erratic. For those on treatment, compliance remains a significant challenge. Interruptions to ART have negative implications for the individual and the epidemic. ART is therefore not a sustainable solution and there is an urgent need for a cure. As HIV cure research expands globally, the need to engage community members about cure is becoming a priority. It is vital that potential trial participants understand basic HIV cure research concepts. An online interactive educational tool was co-created with HIV stakeholders to engage and inform HIV research trial participants. The study was conducted with patients at the FAMCRU HIV clinic at Tygerberg Hospital in Cape Town, South Africa. The educational tool comprises two modules that provide information on HIV prevention, treatment and cure research. Participants completed a questionnaire before and after interacting with the programme. There was a significant increase in knowledge scores of participants demonstrated after using the tool. The interactive tool was successful in increasing participants' knowledge of HIV prevention, treatment and cure research.
Collapse
Affiliation(s)
- M Hendricks
- Centre for Medical Ethics and Law, Stellenbosch University, Cape Town, South Africa
| | - O Varathan
- Centre for Medical Ethics and Law, Stellenbosch University, Cape Town, South Africa
| | - F Cassim
- Centre for Medical Ethics and Law, Stellenbosch University, Cape Town, South Africa
| | - M Kidd
- Department of Statistics, Stellenbosch University, Cape Town, South Africa
| | - K Moodley
- Centre for Medical Ethics and Law, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
6
|
|
7
|
Habermehl N, Diekroger E, Lazebnik R, Kim G. Injury Prevention Education in the Waiting Room of an Underserved Pediatric Primary Care Clinic. Clin Pediatr (Phila) 2019; 58:73-78. [PMID: 30338699 DOI: 10.1177/0009922818806315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Unintentional injuries are the leading cause of childhood mortality in the United States. Study aims included educating families about injury prevention and improving satisfaction with the waiting room experience. Two hundred caregivers with young children in the waiting room of an underserved pediatric primary care clinic participated in brief individual education sessions and received a toolkit containing small safety items and content highlighting age-appropriate safety topics. Participants completed 2 follow-up surveys, and most caregivers (94%) reported learning new information about injury prevention and thought that the intervention resulted in a better waiting room experience (91%). Of those who completed the 2-week follow-up survey (84%), 93.5% made changes at home and 42.7% bought new safety equipment. Injury prevention education can be effectively provided in the waiting room of a pediatric primary care clinic by improving reported caregiver safety knowledge and behaviors as well as satisfaction with the waiting room experience.
Collapse
Affiliation(s)
- Nikita Habermehl
- 1 University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | - Elizabeth Diekroger
- 1 University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | - Rina Lazebnik
- 1 University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | - Grace Kim
- 1 University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| |
Collapse
|