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A Blended Gaming COVID-19 Training System (BGCTS) With WHO Guidelines for Staff in Residential Care Homes (BGCTS)

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ClinicalTrials.gov Identifier: NCT04783025
Recruitment Status : Not yet recruiting
First Posted : March 4, 2021
Last Update Posted : March 4, 2021
Sponsor:
Information provided by (Responsible Party):
Dr Angela Leung, The Hong Kong Polytechnic University

Brief Summary:

188 healthcare personnel from 20 residential care homes (RCHs) will be recruited to assess the effect of 2-week implementation of Blended Gaming COVID-19 Training System (BGCTS) on RCH staffs' infection control practices. These clusters (RCHs) will be randomly allocated to two study groups (the intervention group, IG; and the control group, CG) to assess 1. whether more staff in the IG perform infection control practices (by on-site observations) than the staff in the CG after receiving BGCTS and 2. whether more staff in the IG have infection control knowledge, positive attitudes towards infection control, and self-reported compliance rates than the staff in the CG. 5 Hypothesis have been set up for this study:

H1. After using BGCTS, a higher proportion of the staff in the IG will exhibit performance in complying with hand hygiene measures than those in the CG.

H2. After using BGCTS, a higher proportion of the staff in the IG will exhibit performance in complying with other infection control practices than those in the CG.

H3. After using BGCTS, a higher proportion of the staff in the IG will have high level of knowledge of infection control than those in the CG.

H4. After using BGCTS, a higher proportion of the staff in the IG will have positive attitudes towards infection control than those in the CG.

H5. After using BGCTS, a higher proportion of the staff in the IG will have a high self-reported compliance rate with infection control measures than those in the CG.

Infection control practices conducted by RCH staffs will be measured through unobtrusive on-site non-participatory observations. RCH staffs' knowledge, attitudes about infection control practice, and self-reported infection control practices will be assessed via an electronic quiz.


Condition or disease Intervention/treatment Phase
Infection Control COVID-19 Behavioral: Blended Gaming COVID-19 Training System (BGCTS) Behavioral: Usual care, infection control briefing Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 188 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: 20 clusters (Residentials care homes, RCHs) involved in the study will be randomly allocated to two study groups (the intervention group, IG; and the control group, CG). All of the healthcare personnel in one cluster will receive the assigned treatment in the study group accordingly. All units in one RCH will be grouped as IG or CG. Group designations will be decided by a computer-generated randomization list using a free online generator by a statistician in the research team (DYPL) and will have no potential contact with the participants of the study. An opaque, numbered envelope containing a code generated by computerized randomizations will be prepared by a project assistant unconnected to this study. The random coding will also be concealed from the participants and outcome assessors to be involved in the assessments. A standardized checklist will be used for outcome measurements to minimize bias.
Masking: Single (Outcomes Assessor)
Masking Description: Research team members who are responsible for data collection and involved in data analysis will be blinded to the group allocation.
Primary Purpose: Health Services Research
Official Title: A Blended Gaming COVID-19 Training System (BGCTS) With WHO Guidelines for Staff in Residential Care Homes: A Cluster Randomized Controlled Trial
Estimated Study Start Date : March 1, 2021
Estimated Primary Completion Date : December 31, 2021
Estimated Study Completion Date : March 1, 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Intervention Group (IG)
The participants in the IG will receive BGCTS, a blended training programme
Behavioral: Blended Gaming COVID-19 Training System (BGCTS)

BGCTS is a blended training programme integrated with games and short video clips for Residential Care Home staffs to learn the principles of infection control and reinforce actions needed to stop the spread of COVID-19 within the RCHs, and to care for those residents suspected of having COVID-19. The contents of the training will refer to the evidence-based contents from The COVID-19 Risk Communication Package For Healthcare Facilities.

Dosage of the intervention. Staffs are encouraged to learn each topic independently in 15 minutes. It will take a total of 120 minutes to complete all eight topics in 2 weeks. Staffs will attend two 30-minute face-to-face group sessions conducted by research nurse (and the Infection Control Officer of the RCH) to clarify concepts (one per week; after playing the games). Scores and progress bar will be shown to the staff so as a form of motivation to encourage continuous participation in the training.


Active Comparator: Control Group (CG)
Participants in the CG will receive usual care, the infection control briefing given by the Infection Control Officer (ICO) of the RCHs to all staff.
Behavioral: Usual care, infection control briefing
Participants in the CG will receive usual care, the infection control briefing given by the Infection Control Officer (ICO) of the RCHs to all staffs. Usually the briefing is irregular, non-standardized and determined by ICOs, depending on when the ICOs receive the information about infection control practice from Centre for Health Protection of the Hong Kong government. The format and duration of this briefing is determined by the ICO. Some ICOs deliver the infection control information in the form of posters or a written document, and circulate these materials to all staffs.




Primary Outcome Measures :
  1. Changes in unobtrusive observational-based compliance rate of infection control practices [ Time Frame: T0 (baseline) and T2 (after the intervention at Week 3) ]

    Observed infection control practices will be recorded through a software called eRub, developed by PolyU with a Finnish company. eRub comprises two sets of checklists: 1.hand hygiene (HH)2.infection control practice (ICP).

    Checklists are constructed based on the WHO's My 5 Moments list and COVID-19 risk communication package for healthcare facilities . The HH activities ( HH opportunities and its duration), will be rated as 'properly performed, performed, improperly performed, or missed performing'. Others infection control practices (eg. respiratory hygiene, disinfecting used surfaces/ equipment etc.), will also be rated. Staff with a rating of 'properly performed' and 'performed' will be classified as 'performed' while others will be regarded as 'not performed'.

    The content validity indices for the relevance and adequacy of the eRub items were greater than 0.83 (range, 0.83-1.00), indicating satisfactory content validity.



Secondary Outcome Measures :
  1. Knowledge and attitudes towards respiratory infection (KARI) [ Time Frame: T0 (baseline) and T2 (after the intervention at Week 3) ]

    a 24-item self-administered survey with 12 items about knowledge and 12 items on attitudes. It covers four areas: Clinical burden and the transmission of acute respiratory infection (7 items); Personal protective equipment and hand hygiene (6 items), Facility infection prevention and control policies for acute respiratory infection (6 items), and Influenza vaccination (5 items). The last five items will be omitted because these are not relevant to the COVID-19.

    For each knowledge item, respondents will be classified as (1) 'having knowledge' if 'strongly agree' or 'agree' are answered to the positive statements and 'strongly disagree' or 'disagree' to the negative statements, or (2) 'lack of knowledge' if otherwise. For each attitude item, respondents will be classified as (1) 'positive attitudes' if 'strongly agree' or 'agree' are answered to the positive statements and 'strongly disagree' or 'disagree' to the negative statements, or (2) 'negative attitudes' if otherwise.


  2. Self-reported Infection Control Practice (SICP) [ Time Frame: T0 (baseline) and T2 (after the intervention at Week 3) ]
    a 10-item self-administered survey asking healthcare personnel to indicate whether RCH staffs would always, usually, sometimes, rarely, or never perform the said actions as part of staffs' usual practice . For self-reported infection control practices, 'satisfactory' will be defined as (1) if respondents' answers are either 'always' or 'usually' to the positive statements and (2) 'sometimes', 'rarely', or 'never' to the negative statements, while 'unsatisfactory' will be defined as otherwise.

  3. Demographic data [ Time Frame: T0 (baseline) ]
    Age, employment mode (full time vs part time), professional discipline (doctor, nurse, physiotherapist, occupational therapist, health workers, personal care worker), types of working unit (nursing home, care and attention home, hostel for the elderly, respite services, infirmary care supplement), staff-to-client ratio.

  4. Data on experience [ Time Frame: T0 (baseline) ]
    Working experience in residential care homes in terms of years, working experience in other healthcare settings in terms of years, and experience in infection control training (whether the staff member has received any type of infection control training, the date of the last training session, the duration of the last training session, the contents of the last training session).


Other Outcome Measures:
  1. Number of log-ins on Blended Gaming COVID-19 Training System (BGCTS) [ Time Frame: T1 (During the intervention: at Week 2) ]
    The number of log-ins to the BGCTS

  2. Number of attempts on Blended Gaming COVID-19 Training System (BGCTS) [ Time Frame: T1 (During the intervention at Week 2) ]
    The number of attempts at each game

  3. Time spent on Blended Gaming COVID-19 Training System (BGCTS) [ Time Frame: T1 (During the intervention at Week 2) ]
    The time spent on each game

  4. Gaming result on Blended Gaming COVID-19 Training System (BGCTS) [ Time Frame: T1 (During the intervention at Week 2) ]
    The results of each game



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. Healthcare personnel who are working in the selected Residential care homes (RCHs)
  2. Able to read Chinese, and
  3. Possess an electronic device (smartphone or tablet) with which to download the BGCTS system.

Exclusion Criteria:

  1. Temporary staff who are about to cease employment, be on maternity leave, or go on a long vacation during the data collection period;
  2. Students or trainees (including nursing students, physiotherapy students, and health-related trainees), because training institutions are responsible for students' training, and such training may affect students' performance;
  3. Volunteer personnel who come to the RCHs at a specific period (for example, to organize activities for the residents during festivals);
  4. Clerical and administrative staff, kitchen staff, security staff, and engineering and facilities management staff;
  5. Ambulance officers who come to the RCHs to take residents to or from hospitals.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04783025


Contacts
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Contact: Angela Leung, PhD (852) 2766 5587 angela.ym.leung@polyu.edu.hk

Locations
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Hong Kong
The Hong Kong Polytechnic University
Hong Kong, Hong Kong
Contact: Angela Leung, PhD    2766 5587    angela.ym.leung@polyu.edu.hk   
Sponsors and Collaborators
The Hong Kong Polytechnic University
Investigators
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Principal Investigator: Angela Leung, PhD The Hong Kong Polytechnic University
  Study Documents (Full-Text)

Documents provided by Dr Angela Leung, The Hong Kong Polytechnic University:
Informed Consent Form  [PDF] February 11, 2021

Additional Information:
Publications:
World Health Organization (WHO) Western Pacific Region Office (WPRO). The COVID-19 Risk Communication Package for Healthcare Facilities. The COVID-19 risk communication package for healthcare facilities. March 2020. https://iris.wpro.who.int/handle/10665.1/14482 (accessed 6 Jun 2020).
Social Welfare Department. Resources of code of practice for residential care homes (Elderly Persons). Hong Kong: Social Welfare Department January 2020. https://www.swd.gov.hk/en/index/site_pubsvc/page_lr/sub_rche/id_copref/ (accessed 7 Jun 2020).
Center for Health Protection. Guidelines for residential care homes for the elderly or persons with disabilities for the prevention of Coronavirus disease (COVID-19). 2020. https://www.chp.gov.hk/files/pdf/advice_to_rche_rchd_on_prevention_of_nid_eng.pdf (accessed 7 Jun 2020).
World Health Organization (WHO). World Health Organization Guidelines on Hand Hygiene in Health Care. Geneva: WHO 2019. https://www.who.int/publications/i/item/who-guidelines-on-hand-hygiene-in-health-care (accessed 6 Jun 2020).
Vlachopoulos D, Makri A. The effect of games and simulations on higher education: a systematic literature review. Int J Edu Tech in Higher Edu 2017;14. doi:10.1186/s41239-017-0062-1
World Health Organization (WHO). 5 Moments for Hand Hygiene. May 2009. https://www.who.int/gpsc/5may/Your_5_Moments_For_Hand_Hygiene_Poster.pdf (accessed 8 Feb 2021).

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Responsible Party: Dr Angela Leung, Associate Professor; Deputy Director of WHO Collaborating Centre for Community Health Services; Director of Centre for Gerontological Nursing (CGN), The Hong Kong Polytechnic University
ClinicalTrials.gov Identifier: NCT04783025    
Other Study ID Numbers: HSEARS20200903007
First Posted: March 4, 2021    Key Record Dates
Last Update Posted: March 4, 2021
Last Verified: March 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Dr Angela Leung, The Hong Kong Polytechnic University:
COVID-19
Infection control
Training system
Gamification
Residential care homes
Healthcare personnel
Additional relevant MeSH terms:
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Infection