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Background: Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a la...
Context in source publication
Context 1
... was designed around 4 scenarios, each presenting a clinical case involving a client with a given level of conviction (low or high) and confidence (low or high) regarding change in a health behavior (see Figure 2) [47]. Each motivation profile was associated with one of the following health behaviors: smoking cessation, medication adherence, physical activity, or diet. ...
Citations
... This makes the early diagnosis and treatment of pathological conditions difficult and negatively affects women's health (Özcan et al., 2020;Saleh et al., 2018;Skär et al., 2020;Taşkın, 2021). Online training and and counseling are important since it provides the opportunity to reach many people at the same time and allows individuals to receive training and counseling whenever they want (Fontaine et al., 2016;Telli & Altun, 2020). We found that most studies on gynecological examination in the literature had a descriptive design. ...
Gynecological examination has an very place among to maintain women's health. Negative attitudes and anxiety about gynecological examination may affect coming to the examination. In this study, we aimed to determine the effect of online training and counseling on women's attitudes and anxiety toward the gynecological examination. We randomized 100 women participating in the study into experimental and control groups. We concluded that online training and counseling had a positive effect on the attitudes of women in the experimental group toward gynecological examination. Also we determined that online training and counseling reduced wom-en's state anxiety toward gynecological examinations.
Since women's attitudes and anxiety toward gynecological examination may affect their willingness to attend subsequent examinations, health professionals need to develop a trusting relationship with women. Building a trusting relationship includes having enough time for communication , asking questions to healthcare professionals, and getting information about the examination. Situations such as the high number of women who come to the examination and the low number of health professionals may cause the examinations to take a short time and the women not being able to receive adequate training and counseling. We hypothesized that online training and counseling given to women would lead to gain/maintain positive attitudes toward gynecological examination and reduce anxiety about examination. It is important for women to be healthy for sustainable healthy societies. Gynecological diseases/cancers are diagnosed at an early stage with gyneco-logical examination, which is extremely important for the protection of reproductive and sexual health. Online training and counseling, which saves time and cost in health institutions, will add an important dimension to one of the most important roles of the nurse, training and counseling. In this study, we divided women into experimental and control groups by randomization. We gave the experimental group online training consisting of three sessions about gynecological examination within first 10 days after the gynecological examination. We also gave online counseling to the experimental group for 6 months. We did not provide any online training or consultancy to the control group. We analyzed data and thus believe the results of this study will guide the researchers who will work on the subject and will reveal the importance of online training and counseling in terms of showing the positive results of allocating time more to women who come to the gynecological examination.
... The findings of the randomized controlled trial demonstrated that participants improved their tested knowledge about the best practices and their self-efficacy for using the best practices after completing the e-learning course. These findings align with previous studies showing increased knowledge and self-efficacy among health, fitness and/ or lifestyle professionals after engaging in an (e-learning) training on healthy lifestyle and/or motivational interviewing [27,[39][40][41][42][43][44][45]. Within the field of educational psychology, self-efficacy has been identified as an important predictor of students' motivation to learning [46]. ...
Background
Health, fitness and lifestyle professionals can play important roles in promoting physical activity in groups at risk of developing an inactive lifestyle, such as people with spinal cord injury (SCI). Tailored counselling is a promising tool to promote and improve physical activity levels. To support professionals to effectively have a conversation about physical activity with clients with SCI, evidence-based training and resources are needed. This project aimed to (1) co-develop an e-learning course on best practices for SCI physical activity counselling and, (2) examine the effectiveness and usability of this course.
Methods
Guided by the technology-enhanced learning (TEL) evaluation framework, we used a systematic, multistep approach to co-develop and evaluate an e-learning course. The development process was informed by input and feedback from a diverse group of end-users and experts (n > 160) via online surveys and (think-aloud) interviews. A randomized controlled trial was used to compare learning outcomes (post-knowledge and self-efficacy) between participants who completed the course (intervention group) and the wait-listed control group. Usability, learning experiences, and satisfaction were assessed among all participants.
Results
Forty-one participants (21 intervention-group; 20 control-group) with various backgrounds (e.g., lifestyle counsellors, physiotherapists, occupational therapists, recreation therapists, fitness trainers) enrolled in the randomized controlled trial. After completing the course, participants in the intervention group showed significantly improved knowledge on the best practices for SCI physical activity counselling and higher self-efficacy for using these best practices in conversations with clients with SCI compared to the control group (p <.001). Participants reported above average usability scores, positive learning experiences, and high levels of satisfaction when completing the course.
Conclusion
We used a systematic, multi-step, theory-informed approach to co-develop and evaluate an evidence-based e-learning course on SCI physical activity counselling to support professionals to promote physical activity in their daily practices. The overall positive findings demonstrate that the e-learning course is feasible and ready for further implementation in various health and community settings. Implementation of the e-learning course can help professionals improve the physical activity support they provide to their clients, and subsequently increase physical activity participation in people with SCI.
... The ndings of the randomized controlled trial demonstrated that participants improved their tested knowledge about the best practices and their self-e cacy for using the best practices after completing the e-learning course. These ndings align with previous studies showing increased knowledge and selfe cacy among health, tness and/or lifestyle professionals after engaging in an (e-learning) training on healthy lifestyle and/or motivational interviewing [27,[39][40][41][42][43][44][45]. Within the eld of educational psychology, self-e cacy has been identi ed as an important predictor of students' motivation to learning [46]. ...
Background
Health, fitness and lifestyle professionals can play important roles in promoting physical activity in groups at risk of developing an inactive lifestyle, such as people with spinal cord injury (SCI). Tailored counselling is a promising tool to promote and improve physical activity levels. To support professionals to effectively have a conversation about physical activity with clients with SCI, evidence-based training and resources are needed. This project aimed to 1) co-develop an e-learning course on best practices for SCI physical activity counselling and, 2) examine the effectiveness and usability of this course.
Methods
Guided by the technology-enhanced learning (TEL) evaluation framework, we used a systematic, multistep approach to co-develop and evaluate an e-learning course. The development process was informed by input and feedback from a diverse group of end-users and experts (n > 160) via online surveys and (think-aloud) interviews. A randomized controlled trial was used to compare learning outcomes (post-knowledge and self-efficacy) between participants who completed the course (intervention group) and the wait-listed control group. Usability, learning experiences, and satisfaction were assessed among all participants.
Results
Forty-one participants (21 intervention-group; 20 control-group) with various backgrounds (e.g., lifestyle counsellors, physiotherapists, occupational therapists, recreation therapists, fitness trainers) enrolled in the randomized controlled trial. After completing the course, participants in the intervention group showed significantly improved knowledge on the best practices for SCI physical activity counselling and higher self-efficacy for using these best practices in conversations with clients with SCI compared to the control group (p < .001). Participants reported above average usability scores, positive learning experiences, and high levels of satisfaction when completing the course.
Conclusion
We used a systematic, multi-step, theory-informed approach to co-develop and evaluate an evidence-based e-learning course on SCI physical activity counselling to support professionals to promote physical activity in their daily practices. The overall positive findings demonstrate that the e-learning course is feasible and ready for further implementation in various health and community settings. Implementation of the e-learning course can help professionals improve the physical activity support they provide to their clients, and subsequently increase physical activity participation in people with SCI.
... Limitations identified with the standardised recoding of time for the online examination on the REDCap platform should also be considered in future studies evaluating consequences evidence for examinees. Suggestions from web-based eLearning evaluations may be applicable in future studies in defining thresholds for time on a page as long latency periods that may indicate absence from the platform and overestimate time spent on a question [76]. ...
Background
Physician decision-making skills training is a priority to improve adoption of the cerebral palsy (CP) clinical guideline and, through this, lower the age of CP diagnosis. Clinical guideline implementation aims to improve physician practice, but evaluating meaningful change is complex. Limitations in the validity evidence of evaluation instruments impact the evidence base. Validity frameworks, such as Kane’s, enable a targeted process to gather evidence for instrument scores, congruent to context and purpose. Yet, application of argument-based methodology to implementation validation is rare. Key-features examination methodology has established validity evidence supporting its use to measure decision-making skills, with potential to predict performance. We aimed to apply Kane’s framework to evaluate a pilot key-features examination on physician decision-making in early CP diagnosis.
Methods
Following Kane’s framework, we evaluated evidence across inferences of scoring, generalisation, extrapolation and implications in a study design describing the development and pilot of a CP diagnosis key-features examination for practising physicians. If found to be valid, we proposed to use the key-feature scores as an outcome measure of decision-making post education intervention to expedite CP diagnosis and to correlate with real-world performance data to predict physician practice.
Results
Supporting evidence for acceptance of scoring inferences was achieved through examination development with an expert group ( n = 10) and pilot results ( n = 10): (1) high internal consistency (0.82); (2) acceptable mean item-discrimination (0.34); and (3) acceptable reliability of examination scorers (95.2% congruence). Decreased physician acceptance of examination time (70%) was identified as a threat and prioritised in case reduction processes. Partial acceptance of generalisation, extrapolation and implications inferences were defensible with: (1) accumulated development evidence following established key-features methodology; (2) high pilot acceptance for authenticity (90%); and (3) plausibility of assumptions of score correlation with population register data.
Conclusions
Kane’s approach is beneficial for prioritising sources of validity evidence alongside the iterative development of a key-features examination in the CP field. The validity argument supports scoring assumptions and use of scores as an outcome measure of physician decision-making for CP guideline education implementation interventions. Scoring evidence provides the foundation to direct future studies exploring association of key-feature scores with real-world performance.
... Opportunities for continued learning have expanded considerably in recent years, with a 42% increase in clinicians (including GPs) opting for web-based offerings in 2018 (prepandemic) [2]. Web-based learning is regarded as effective as traditional modalities for improving professional competence and skill development [3,4]. Unfortunately, GPs and PNs experience many barriers to web-based learning [5][6][7][8][9][10][11]. ...
... Qualitative exploration found a reduction in perceived barriers to behavior change interventions, including time constraints, patient resistance, and improved clinician-patient relationships [21]. Furthermore, web-based learning containing motivational interviewing examples improved nurses' (n=31) perceived skill and self-reported skill use [4]. The Healthy Lifestyles contains communication examples and a simple model, which may help to facilitate professional knowledge and skill development for delivering behavior change interventions to patients. ...
Background:
Supporting patients to live well by optimizing behavior is a core tenet of primary health care. General practitioners and practice nurses experience barriers in providing behavior change interventions to patients for lifestyle behaviors, including low self-efficacy in their ability to enact change. Web-based learning technologies are readily available for general practitioners and practice nurses; however, opportunities to upskill in behavior change are still limited. Understanding what influences general practitioners’ and practice nurses’ adoption of web-based learning is crucial to enhancing the quality and impact of behavior change interventions in primary health care.
Objective:
This study aimed to explore general practitioners’ and practice nurses’ perceptions regarding web-based learning to support patients with behavior change.
Methods:
A qualitative, cross-sectional design was used involving web-based, semistructured interviews with general practitioners and practice nurses in Queensland, Australia. The interviews were recorded and transcribed using the built-in Microsoft Teams transcription software. Inductive coding was used to generate codes from the interview data for thematic analysis.
Results:
In total, there were 11 participants in this study, including general practitioners (n=4) and practice nurses (n=7). Three themes emerged from the data analysis: (1) reflecting on the provider of the Healthy Lifestyles suite; (2) valuing the web-based learning content and presentation; and (3) experiencing barriers and facilitators to using the Healthy Lifestyles suite.
Conclusions:
Provider reputation, awareness of availability, resources, content quality, usability, cost, and time influence adoption of web-based learning. Perceived quality is associated with culturally tailored information, resources, a balance of information and interactivity, plain language, user-friendly navigation, appealing visual presentation, communication examples, and simple models. Free web-based learning that features progress saving and module lengths of less than 2 hours alleviate perceived time and cost barriers. Learning providers may benefit by including these features in their future behavior change web-based learning for general practitioners and practice nurses.
... E-learning platforms for healthcare practitioners have been shown to be highly satisfactory (Hegerius et al., 2020), practical, and efficient for improving knowledge (Moattari et al., 2014;Rhodes et al., 2019;Sranacharoenpong & Hanning, 2012;Wilkinson et al., 2004). Within the context of MI, e-learning platforms have demonstrated increases in MI knowledge, confidence, and skills (Edwards et al., 2015;Lukaschek et al., 2019;Schechter et al., 2021), with positive user acceptability and satisfaction (Fontaine et al., 2016;Schechter et al., 2021). Health professional's self-efficacy to deliver care to patients has also demonstrated increases posttraining (Jones & McEwen, 2015;Karvinen et al., 2017;Nørgaard et al., 2012). ...
Small Steps for Big Changes (SSBC) is a community-based diabetes prevention program (DPP). SSBC utilizes a motivational interviewing (MI) informed counseling style to deliver a structured diet and exercise curriculum to empower healthy behavioral modifications and prevent type 2 diabetes (T2D). An electronic learning (e-learning) platform to train SSBC coaches was developed to improve flexibility, reach, and accessibility. While e-learning has shown to be an effective mode of teaching content to health professionals, less is known in the context of DPP coaches. This study aimed to assess the effectiveness of the SSBC e-learning course. Twenty coaches (eleven fitness staff personnel and nine university students) were recruited through existing fitness facilities to participate in the online SSBC coach training which included completing pre- and post-training questionnaires, seven online modules of content and a mock client session. Knowledge regarding MI (Mpre = 3.30 ± 1.95, Mpost = 5.90 ± 1.29; p < 0.01), SSBC content (Mpre = 5.15 ± 2.23, Mpost = 8.60 ± 0.94; p < 0.01), and T2D (Mpre = 6.95 ± 1.57, Mpost = 8.25 ± 0.72; p < 0.01), and self-efficacy to deliver the program (Mpre = 7.93 ± 1.51, Mpost = 9.01 ± 1.00; p < 0.01) all significantly increased from pre- to post e-learning training. Participants reported positively on the user satisfaction and feedback questionnaire with a mean score of 4.58/5 (SD = 0.36). These findings suggest e-learning platforms are a promising mode to improve DPP coaches’ knowledge, counseling skills, and to bolster confidence in program delivery with high levels of satisfaction. E-learning to train DPP coaches allows for effective and feasible expansion of DPP’s, ultimately permitting more reach to adults living with prediabetes.
... The duration of each e-learning session (module and virtual patient bank) and the number of links accessed in a session will be recorded. As long latency periods may also indicate absence from the platform, we define time on a page of greater than 15 min as a threshold that would be deducted from the total session time, as described by Fontaine et al. 93 The number of reminders sent to participants to complete the e-learning module or virtual patients is recorded in REDCap. ...
Introduction
Cerebral palsy (CP) is the most common childhood physical disability. Accurate diagnosis before 6 months is possible using predictive tools and decision-making skills. Yet diagnosis is typically made at 12–24 months of age, hindering access to early interventions that improve functional outcomes. Change in practice is required for physicians in key diagnostic behaviours. This study aims to close the identified research–practice gap and increase accurate CP diagnosis before 6 months of age through tailored web-based implementation interventions. This trial will determine whether adaptive e-learning using virtual patients, targeting CP diagnostic behaviours and clinical decision-making skills, effectively changes physician behaviour and practice compared with non-adaptive e-learning instructional design or control.
Methods and analysis
This study is a 3-arm parallel superiority randomised controlled trial of two tailored e-learning interventions developed to expedite physician CP diagnosis. The trial will compare adaptive (arm 1) and non-adaptive (arm 2) instructional designs with waitlist control (arm 3) to evaluate change in physician behaviour, skills and diagnostic practice. A sample size of 275 paediatric physicians enables detection of small magnitude effects (0.2) of primary outcomes between intervention comparators with 90% power (α=0.05), allowing for 30% attrition. Barrier analysis, Delphi survey, Behaviour Change Wheel and learning theory frameworks guided the intervention designs. Adaptive and non-adaptive video and navigation sequences utilising virtual patients and clinical practice guideline content were developed, integrating formative key features assessment targeting clinical decision-making skills relative to CP diagnosis.
Physician outcomes will be evaluated based on postintervention key feature examination scores plus preintervention/postintervention behavioural intentions and practice measures. Associations with CP population registers will evaluate real-world diagnostic patient outcomes. Intervention costs will be reported in a cost–consequence analysis from funders’ and societal perspectives.
Ethics and dissemination
Ethics approved from The University of Sydney (Project number 2021/386). Results will be disseminated through peer-reviewed journals and scientific conferences.
Trial registration number
Australian New Zealand Clinical Trials Registry: ACTRN 12622000184774.
... While cardiac patients' experiences with web-based interventions have been reported previously [12][13][14], knowledge of how cardiac nurses experience web-based care is sparse [15]. One study reported that an e-learning platform for motivational interviewing was acceptable to cardiac nurses [16]. The results were questionnaire-based, and the authors suggest further research to improve the understanding of health care professionals' engagement with web-based treatment. ...
Objective
The aim of this study was to explore cardiac nurses’ experiences with a comprehensive web-based intervention for patients with an implantable cardioverter defibrillator.
Methods
We conducted an explorative qualitative study based on individual semi-structured interviews with 9 cardiac nurses from 5 Danish university hospitals.
Results
We found one overall theme: “Between traditional nursing and modern eHealth”. This theme was derived from the following six categories: (1) comprehensive content in the intervention, (2) patient-related differences in engagement, (3) following the protocol is a balancing act, (4) online communication challenges patient contact, (5) professional collaboration varies, and (6) an intervention with potential. Cardiac nurses were positive towards the web-based intervention and believe it holds a large potential. However, they felt challenged by not having in-person and face-to-face contact with patients, which they found valuable for assessing patients’ wellbeing and psychological distress.
Conclusion
Specific training in eHealth communication seems necessary as web-based care entails a shift in the nursing role and requires a different way of communication.
Innovation
Focusing on the user experience in web-based care from the perspective of cardiac nurses is innovative, and by applying implementation science this leads to new knowledge to consider when developing and implementing web-based care.
... In the field of health information dissemination, some researchers have found that credibility and information participation are important variables affecting the trust process (5). Not only does the professionalism of opinion leaders have a significant impact on their work or interests, but the attractiveness of appearance and quality is also very important (6). ...
With the continuous expansion of COVID-19, many medical experts with the characteristics of “Internet Celebrities” are increasingly influencing people's vaccination behavior, which is crucial for overall social welfare. To explore the influence of Internet celebrity medical experts on people's vaccination against COVID-19, this study constructed a conceptual model of COVID-19 vaccination intention based on the professionalism, morality, interaction dimension, and information content of Internet celebrity medical experts, to generate perceived value by establishing a trusting relationship between them and the influenced people. The empirical analysis shows that interactivity and information content are important factors determining the influence of Internet celebrity medical experts. In the context of high demands for COVID-19 vaccines, it is more effective to influence vaccination intention through strong demand than through generating trust. The empirical analysis shows that Internet celebrity medical experts have a significant role in COVID-19 vaccination, and interactivity and information content are two important factors determining the influence. Through the connection of information-demand, Internet celebrity medical experts can greatly influence the perceived value, by coaction with trust to influence the final intention. Therefore, the COVID-19 vaccination persuasion information released by Internet celebrity medical experts should be elaborately organized and demonstrated, especially from the demand aspect, and government could put more resources to support the information to spread.
... There is a growing interest in developing and implementing online learning courses for MI (Albright et al. 2018;Carrington 2020;Fontaine et al. 2016;Goggin et al. 2020;Karvinen et al. 2017;Keifenheim et al. 2019;Lukaschek et al. 2019;Mullin et al. 2016;Tanana et al. 2019;Widder 2017). Given the need for standardised MI training that allows repetition and access at times that suit the learner, it is important to explore the feasibility of asynchronous MI online training (learning online without real time interaction) so learners can repeatedly interact with the content when needed. ...
Supporting behaviour change is important in health promotion and disease prevention. Motivational Interviewing (MI) is a core behaviour change counselling skill for health professionals to support people to make and maintain behaviour changes. MI is taught across many university courses and as continuing professional development. There is a need to provide repeatable MI training for health professionals and students that is accessible, affordable, and standardised and allows practise opportunities. This study tested the feasibility of asynchronous online MI training and using a virtual client interaction for practising MI skills. Postgraduate students (n = 22) from university health courses participated in the study. Participants completed questionnaires and interacted with a virtual client prior to and post-online training. Outcomes included MI skills (analysed using the Motivational Interviewing Treatment Integrity (MITI) code, version 4.2.1), attitudes towards behaviour change counselling, and acceptability of the online course. System usability of the virtual client interaction was evaluated using the System Usability Scale. There was a statistically significant improvement in both Relational and Technical MITI Scores, and in attitudes towards behaviour change counselling, from Pre-Course to Post-Course. Participants viewed the online course positively. System usability scored in the 90–95 percentile range. Results support the feasibility of providing MI training online and using virtual clients to facilitate the process. Further research is needed on the transferability of MI skills learned online to real world settings.
