Randomised Trial of Two Educational Intervention for Improving Evidence-based Practice Knowledge, Atttitudes and Practice (OTEBP)

This study has been completed.
Sponsor:
Collaborator:
National Research Foundation, South Africa
Information provided by (Responsible Party):
Helen Buchanan, University of Cape Town
ClinicalTrials.gov Identifier:
NCT01512823
First received: January 13, 2012
Last updated: February 3, 2012
Last verified: February 2012
  Purpose

This pragmatic randomised controlled trial (RCT) used a two-group parallel design with matched-pair stratification by type (clinician/manager) and knowledge score. The trial aimed to: 1) determine whether an IE was more effective than a DE for improving EBP knowledge, skills and use at 12 weeks, and 2) to investigate the feasibility of conducting a RCT with occupational therapists in a public health setting. Occupational therapists employed by the Western Cape Department of Health (DOH) form,ed the study population(N=98). Fifty-eight consented to participate and were randomly allocated to either an interactive (IE) or a didactic (DE) educational intervention using coin tossing. Data was collected at baseline and 12 weeks The primary outcome was increased EBP knowledge at 12 weeks shown by an improved total knowledge score. Secondary outcomes were improved attitudes and behaviour. Data were collected at the health facilities where participants were employed. Raters for the audit were blinded but participants and the provider could not be blinded.

Thirty participants were allocated to receive the IE and 28 the DE. Twenty-five participants in the IE and 21 in the DE completed the trial and were included in the 12 week analysis. Results revealed no significant difference between the groups in the primary knowledge outcome at 12 weeks. Examination of within-group changes revealed significant improvements in knowledge in both groups (IE: T=4.0, p<0.001; DE: T=12.0, p=0.002), but the IE also showed a significant increase in behaviour (T=64.5, p=0.044) and attitudes on one sub-scale (T=33.0, p=0.039). As the study was powered at 43%, it may have failed to detect significant differences at 12 weeks. Conducting a high-quality RCT was feasible and the risk of bias was assessed as low. The OTEBP trial adds strength to the existing evidence that both didactic and interactive educational interventions can improve knowledge, but it seems that interactive interventions may be more effective for changing behaviour. High-quality pragmatic trials can feasibly be conducted within the public health service


Condition Intervention
Health Knowledge, Attitudes, Practice
Behavioral: Education

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Official Title: Randomised Trial of the Effectiveness of Two Educational Interventions to Improve Evidence-based Practice Knowledge, Attitudes and Behaviour in Occupational Therapists

Further study details as provided by University of Cape Town:

Primary Outcome Measures:
  • Shortened Fresno Test of Competence in Evidence-based Practice (SAFT) [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
    Modified from the Adapted Fresno Test of Competence in EBP (AFT) (McCluskey and Bishop, 2009), the SAFT consists of three items testing knowledge of writing a PICO question based on a clinical scenario, ability to identify the most suitable study design to answer the question, and knowledge of possible sources of information. The total possible score is 30 points. The test is scored using a grading rubric. Two versions are availbale for measuring outcomes of educational interventions.


Secondary Outcome Measures:
  • Audit checklist [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
    9-item checklist for auditing patient records to determine the extent to which occupational therapists monitor the effectiveness of their interventions.


Enrollment: 58
Study Start Date: November 2007
Study Completion Date: March 2011
Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Interactive educational intervention
Two education sessions (four-hours and two-hours respectively), emailed notes and reminders
Behavioral: Education

Interactive educational intervention:

  • 4 hour education session (with notes and 'evidence packs'); presentations, small group discussion tasks and practice of particular skills - 2 hour session (1 week later)
  • Emailed notes from second session
  • Telephonic/email follow-up (reminders)

Didactic educational intervention:

- 4 hour education session (with notes and 'evidence packs'; questions answered but no discussion or application of skills

Experimental: Didactic educational intervention
Education alone
Behavioral: Education

Interactive educational intervention:

  • 4 hour education session (with notes and 'evidence packs'); presentations, small group discussion tasks and practice of particular skills - 2 hour session (1 week later)
  • Emailed notes from second session
  • Telephonic/email follow-up (reminders)

Didactic educational intervention:

- 4 hour education session (with notes and 'evidence packs'; questions answered but no discussion or application of skills


  Eligibility

Ages Eligible for Study:   21 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Occupational therapists employed by the Western Cape Department of Health (DOH)
  • Working at least 20 hours per week

Exclusion Criteria:

  • Working at a distance of more than 1½ hours from Cape Town
  • Therapists who would be leaving the DOH before December 2008 or taking leave during the time of the intervention
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01512823

Locations
South Africa
University of Cape Town
Cape Town, Western Cape, South Africa, 7925
Sponsors and Collaborators
University of Cape Town
National Research Foundation, South Africa
Investigators
Principal Investigator: Helen Buchanan, PhD University of Cape Town
Study Director: Nandi Siegfried, PhD South African Cochrane Centre & University of Cape Town
Study Director: Jennifer Jelsma, PhD University of Cape Town
  More Information

No publications provided

Responsible Party: Helen Buchanan, Principal investigator, University of Cape Town
ClinicalTrials.gov Identifier: NCT01512823     History of Changes
Other Study ID Numbers: REC REF: 259/2006
Study First Received: January 13, 2012
Last Updated: February 3, 2012
Health Authority: South Africa: University of Cape Town

Keywords provided by University of Cape Town:
randomised controlled trial
educational intervention
occupational therapy

ClinicalTrials.gov processed this record on April 16, 2014