156: An Interactive Web-Based Module Versus Website and Standard of Care for Parental Fever Education: A Randomized Controlled Trial

Abstract

Fever is currently the most common reason for an emergency department (ED) visit. Parental concerns regarding dehydration and seizures, lead to significant anxiety and ED visits. With rapid advances in software development and Internet access, web-based modules (WBMs) are a feasible way to educate parents. Studies using educational WBMs on antibiotics and autism have shown increased knowledge transfer and information retention. There are currently no such interventions to educate parents about fever. Our objectives were to assess caregivers' knowledge acquisition and satisfaction with an interactive WBM for fever education. We randomized caregivers of children presenting to the ED with a chief complaint of fever to receive education through an interactive WBM, read-only website (WEB), or standard of care handout (SOC). Primary outcome variable was the pre-post difference (gain score) on a novel questionnaire testing parental knowledge of the etiology, measurement, therapy, and complications of fever. Secondary outcome variable was parental satisfaction using a 13-item questionnaire. There were 70, 66, and 67 participants in the WEB, WBM, and SOC groups respectively. The mean (SD) caregiver age was 33 (6.7) years. Most (113/203, 55.7%) completed post-secondary education. 54/203 (26.6%) were employed in health care. Of a maximum score of 33, the mean (SD) gain scores on the knowledge questionnaire were 3.9 (4.0), 3.5 (4.2), and 0.2 (3.1) for the WBM, WEB, and SOC groups, respectively (P<0.001). Contrast analyses showed no significant differences in gain scores between WBM and WEB (P=0.55). Of a maximum score of 52, the mean (SD) parental satisfaction scores were 43 (5.2), 38.7 (8.1), and 29.9 (11.9), for the WBM, WEB, and SOC groups respectively (P<0.001). Contrast analysis showed that all groups were significantly different in terms of parental satisfaction in the following rank: WBM > WEB > SOC (P<0.01). The WBM and WEB educational tools lead to a significant improvement in caregivers' knowledge of fever, and caregiver satisfaction is significantly greater with WBM. Evidence for the effectiveness of WBMs on clinically important outcomes such as ED visits could lead to widespread adoption of this intervention.