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

February 3, 2012 updated by: Helen Buchanan, University of Cape Town

Randomised Trial of the Effectiveness of Two Educational Interventions to Improve Evidence-based Practice Knowledge, Attitudes and Behaviour in Occupational Therapists

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

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

58

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • South Africa
    • Western Cape
      • Cape Town, Western Cape, South Africa, 7925
        • University of Cape Town

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

21 years to 65 years (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Shortened Fresno Test of Competence in Evidence-based Practice (SAFT)
Time Frame: 12 weeks
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.
12 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Audit checklist
Time Frame: 12 weeks
9-item checklist for auditing patient records to determine the extent to which occupational therapists monitor the effectiveness of their interventions.
12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Cape Town

Collaborators

National Research Foundation of 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

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2007

Primary Completion (ACTUAL)

January 1, 2009

Study Completion (ACTUAL)

March 1, 2011

Study Registration Dates

First Submitted

January 13, 2012

First Submitted That Met QC Criteria

January 13, 2012

First Posted (ESTIMATE)

January 19, 2012

Study Record Updates

Last Update Posted (ESTIMATE)

February 6, 2012

Last Update Submitted That Met QC Criteria

February 3, 2012

Last Verified

February 1, 2012

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • REC REF: 259/2006

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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