Development Of Educational Interventions Research Articles

A work-integrated educational intervention in health and social care – professionals’ experiences of joint education

ABSTRACT Worldwide, educational interventions (EI) are continuously carried out to support the development of individuals and organisations. Keeping pace with rapid changes in modern workplaces requires continuous learning on the part of professionals. The same requirement applies to professionals in the sector of health and social care. Although research has begun to identify the knowledge and competence requirements of professionals within the sector, we need more knowledge about the implementation of EIs as well as their impact on professionals’ learning in this context. Accordingly, this study aimed to explore professionals’ experience with a work-integrated learning – designed EI that combined web-based lectures and structured group reflections, with a focus on learning and the learning process. Qualitative content analysis of the interview data revealed that the work-integrated learning (WIL) design had a positive impact on individual, as well as intraprofessional and interprofessional, learning. This resulted in an understanding of the fundamentals of professionals’ learning and how it was supported or disrupted during the course of the intervention. Moreover, a sense of affirmation was shown to have an impact on professionals’ learning. These findings may constitute a meaningful contribution to the development of EIs for professionals both within this context and more generally.

Empathy in family medicine postgraduate education: A mixed studies systematic review

Purpose Empathy is an important construct in patient-physician relationships, particularly critical in family physicians’ daily practice. We aimed to understand how empathy has been conceived and integrated into family medicine postgraduate training. Materials and Methods Medline, PsyINFO, and Embase were searched in this systematic mixed studies systematic review. Two independent reviewers screened abstracts and full texts. Disagreements were solved through research team consensus-based discussion. Included studies were synthesized thematically. Results A total of 18 studies were included. Four themes were identified. (1) Empathy definition. Included studies stressed the cognitive component of empathy, paired either with a behavioural or an affective response. (2) Empathy modifiers. Starting residency right after medical school, having a role model, having high empathy levels before residency, having children, being married, and being exposed to patient involvement in education were found to have a positive impact on empathy. (3) Empathy-burnout relationship. Whereas greater burnout was related to lower empathy levels, excess empathy seems to favour burnout through ‘compassion fatigue.’ (4) Educational programs for empathy development. Five programs were identified: a communication workshop, a patient-led program, a mindfulness program, a family-oriented intervention, and an arts-based program. Conclusions Studies mostly measured the cognitive component of empathy. The moral component of empathy was underrepresented in the conceptualization of empathy and the development of educational interventions. Conflicting evidence exists regarding the decline of empathy levels during the family medicine residency. Longitudinal designs should be privileged when exploring the evolution of empathy levels across the continuum of medical education.

Concussion education for New Zealand high school rugby players: A mixed-method analysis of the impact on concussion knowledge, attitudes and reporting behaviours

Players who lack the knowledge to recognise the signs and symptoms of concussions may be less likely to disclose their injury. New Zealand Rugby's Community Concussion Initiative includes an interactive education session highlighting peer-recognition of concussions. This mixed-method study examined the effect of an education session on high school players’ concussion knowledge and attitudes as well as the impact of player demographics on these variables. Focus groups were used to explore player experiences. The RoCKAS-ST was used to measure concussion knowledge/attitudes before and after the education session. Multiple linear regression examined associations between demographic variables, including school decile (relative wealth of the geographic region the school serves), and pre-education concussion knowledge/attitudes scores. Wilcoxon signed-rank tests compared pre-concussion and post-concussion knowledge/attitudes scores. Qualitative data were analysed via thematic analysis. Overall, 532 players completed questionnaires; 75 players participated in focus groups. Pasifika players had lower concussion knowledge than NZ Europeans ( p < .001). Mid-decile schools had higher concussion attitudes scores than low decile schools ( p < .001). Pre-education and post-education session concussion attitudes and knowledge scores did not differ significantly, suggesting the one-off education session was not successful in improving these outcomes. Players identified: (i) the education session to be valuable, but some uncertainties remained; (ii) the importance of player comfort, interaction and comprehension; (iii) the need for role models, real stories and regular content refreshers. Requests for presenter diversity, support and easily understood information were more prominent in Māori/Pasifika and low-decile groups. Greater consideration of these factors is necessary in the development of education interventions.

Digitalization in entrepreneurship education and its effect on entrepreneurial capacity building

Entrepreneurship education, the process of knowledge, skill, competency, and attitude development, aims to maximize the effectiveness of the entrepreneurial capacity building. The pandemic boosted the digital transformation of higher education and brought the online incubation platform NETMIB to life. This paper introduces this unique platform solution and utilizes online opportunities for skill and attitude assessment. An online survey-based research method was applied, and an online Entrepreneurial Orientation (EO) Index was developed as a valid scale for measuring entrepreneurial attitudes in online incubation programs. Based on the findings, student idea owners in the online incubation process have a significantly higher propensity to engage in business activities and a stronger desire for independence and achievement. The findings of this paper can contribute to the targeting and development of educational interventions in the incubation programs, and the online EO Index can be a useful tool among the performance measures of various incubation programs.Summary: Entrepreneurship education, the process of knowledge, skill, competency, and attitude development, aims to maximize the effectiveness of the entrepreneurial capacity building. The pandemic boosted the digital transformation of higher education and brought the online incubation platform NETMIB (Network of multidisciplinary ideation and business model generation) to life. This paper introduces this unique platform solution of online incubation and utilizes online opportunities for skill and attitude assessment. Since education aims to influence entrepreneurial capacity, measured by attitudes, the paper develops a self-assessment tool for online entrepreneurship education. Hypothesizes that there are significant differences in the attitudes of the members according to their role in the online incubation process. An online survey-based research method was used, and an entrepreneurial attitude construct was created concerning the member’s desire for innovation, personal control, achievement, and self-esteem. Based on the findings, student idea owners in the online incubation process have a significantly higher propensity to engage in business activities and a stronger desire for independence and achievement. The findings of this paper contribute to the targeting and development of educational interventions in incubation programs, and the online Entrepreneurial Orientation Index can be a useful tool among the performance measures of various incubation programs.

Breastfeeding Practices and Associated Factors among Immigrant Muslim Arab Women Living in a Metropolitan Area of the Southwest of United States.

Muslim Arab immigrants are a fast-growing, under-studied, and underserved minority population in the United States. Little is known about breastfeeding practices in this population. The objective of this study was to describe infant feeding practices and factors associated with these practices among immigrant Muslim Arab women. A nonexperimental-one group, cross-sectional, descriptive, prospective design was used to identify infant feeding practices among immigrant Muslim Arab women. A convenience sample of one hundred sixteen immigrant Muslim Arab women with at least one child five years or younger was recruited from a large metropolitan area in the Southwestern region. Participants completed the social ecological model of health promotion self-reported questionnaire. Descriptive statistics were performed to identify infant feeding practices and logistic regression was used to identify factors associated with these practices. Immigrant Muslim Arab mothers demonstrate high breastfeeding initiation rates (99.2%) and lengthy breastfeeding duration (M = 11.86, SD = 8.04), but low rates of exclusive breastfeeding at six months (21.6%). The most frequent reasons for early termination of breastfeeding were perceived insufficient milk (44.4%), child was still hungry after breastfeeding (37.5%), and the belief that the child was old enough to stop breastfeeding (32.9%). Development of educational interventions are needed to improve breastfeeding exclusivity and raise women's awareness of the importance of exclusive breastfeeding. Healthcare providers should help women gain confidence in their ability to produce enough milk to successfully continue breastfeeding.

Community Knowledge about Attention Deficit Hyperactivity Disorder in Saudi Arabia: A Cross-Sectional Study.

Objectives: The majority of earlier studies on knowledge and attitudes around ADHD have been focused on parents of children with ADHD, the child themselves, primary care providers, teachers, and children's families, and they have found that they have negative perceptions of ADHD. This study aimed to explore community knowledge about ADHD in Saudi Arabia. Methods: A cross-sectional study using an online survey was conducted in Saudi Arabia in January 2022 to explore community knowledge about ADHD in Saudi Arabia. The convenience sampling technique was used to identify eligible participants and invite them to take part in the study. Logistic regression analysis was used to identify ADHD knowledge predictors. Results: A total of 718 participants were involved in this study. The participants in our study showed a weak level of knowledge about ADHD with a mean score of 6.4 (SD: 2.2) out of 17 (which is equal to 37.6% out of the maximum obtainable score). Males, those who work outside the healthcare sector, and those who are retired were less likely to be knowledgeable about ADHD compared to others (p ≤ 0.05). At the same time, participants who reported that they work inside the healthcare sector were more likely to be knowledgeable about ADHD compared to others (p ≤ 0.01). Conclusions: Our study showed that there is insufficient public knowledge about ADHD. The development of educational interventions is necessary to raise public awareness of ADHD. Social media platforms can be used to deliver education campaigns. All members of the community, including parents and those who want to get married, should be the target of these initiatives.

Abstract PO-083: Descriptive pilot study results of belief in research, religious coping, and willingness to participate in clinical trials among African Americans with hematologic malignancies

Abstract African Americans (AAs) are disproportionately affected by certain types of hematologic malignancies. AAs have a 45% higher probability of dying from acute lymphoblastic leukemia and a 12% higher risk of death from acute myeloid leukemia than Hispanics (6%) and non-Hispanic Whites. AAs also present with chronic lymphocytic leukemia at a younger age, have a more advanced stage disease, and lower survival rates in diffuse large B-cell lymphoma and Hodgkin lymphoma compared to non-Hispanic Whites. Despite the efforts of investigators, AAs with hematologic malignancies remain grossly underrepresented in cancer clinical trials. Underrepresentation of this subset of AAs leads to the non-generalizability of clinical trial findings, disparities in cancer treatment outcomes, and survival compared to other minority populations. Even so, few studies have evaluated the underrepresentation of this subgroup of patients in the context of their beliefs and willingness to participate in clinical trials. Yet, the willingness to participate in cancer clinical trials among AAs with solid tumors is well documented. There is also little evidence relating to the moderating effect of religious coping on the association of belief in research and willingness to participate in clinical trials among this subset of patients. Knowing, as well as believing, are essential elements to participating in any clinical trial. Thus, the aims of the descriptive pilot study were to determine if a relationship exists between belief in research and willingness to participate in clinical trials and determine if religious coping moderates the relationship between belief in research and willingness to participate in clinical trials. To address the aims, data on religious coping were captured at one time-point from 31 AAs with leukemia, lymphoma, and multiple myeloma using the validated Brief RCOPE scale and questions that addressed beliefs associated with research and willingness to participate in cancer clinical trials. The results show that there was no statistical difference between belief in research and willingness to participate in clinical trials, and religious coping did not moderate the effect of belief in research on willingness to participate in clinical trials. Statistically significant differences were found between education and belief in research. Participants with less than a high school education had lower belief in research scores than those with some college education, who showed higher belief in research scores. These findings provide preliminary results that suggest future studies are warranted in the study of AAs' beliefs in research. Such studies may contribute to the development of educational interventions to improve the recruitment of AAs with hematologic malignancies into the therapeutic clinical trials for these diseases, with a particular emphasis on educational interventions for those AAs with less than high school education. Citation Format: Marjorie Petty. Descriptive pilot study results of belief in research, religious coping, and willingness to participate in clinical trials among African Americans with hematologic malignancies [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-083.

Development of educational intervention on the responsible use of medicines in public

This study aimed to develop an educational program to improve the public’s knowledge and awareness about the use of medicines. Pre- and post-intervention studies were conducted to assess the impact of an educational intervention program on the use of medicines among the general public. Adult people over 18 years old who were using medicines at the time of the study or in the past month prior to the study were included. A convenience sampling method was used to invite the people to participate in a health education program in their household area in the State of Penang. This study showed that there was inadequate knowledge about some aspects of using medicines, with a mean score of 5.66 ± 2.39 out of 10 points. In addition, most of the participants have poor awareness about the role of pharmacists in drug management, with a mean score of 2.40 ± 1.73 out of 5 points. The mean score of knowledge and awareness was significantly increased after the educational intervention to 8.64 ± 1.65 and 4.12 ± 0.97, respectively. Educational intervention was useful, especially when it was followed by effective patient counselling to improve the knowledge and awareness about the use of medicines among medicine users.

INSPIRO project – Educational intervention against non-adherence to inhalation therapy for Romanian asthma and COPD patients

Abstract Background In the management of chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD), adherence to therapy represents a key to success. Objective The objective was to increase adherence to treatment through the development of educational intervention (EI) for asthma and COPD, addressed to patients and general practitioners (GPs). The educational programme includes group educational sessions and educational materials and was carried out in five Romanian hospitals. The results were assessed through Test of Adherence to Inhalers (TAI) questionnaire. Results Of note, 347 GPs and 435 patients were included. Seventy-six per cent of the GPs considered that the main causes of non-adherence are the disease misunderstanding, difficulty of using inhaled medication, fear of adverse effects, the patient’s conviction that no medicine is useful for his illness and financial nature (20%). Fifty-five per cent of surveyed GPs believed that their patients always or most of the time adhere to inhaled therapy but 57% of the same surveyed GPs checked the inhalation technique of their patients sometimes, rarely or never. Only 44% of the GPs discussed with the pulmonologist about their patient’s disease. Before the EI, only 32% of patients had a good adherence score to therapy; this percentage increases to 57% after EI. The most common reasons for non-adherence were: patient forgets to administer his inhalation medication daily (49%), fear of adverse effects (33%), belief that medication is useless (26%), and fear that inhalation medication affects everyday life of the patient (24%). Nearly half of the patients (47%) give up medication when they feel better. Forty per cent of patients drop off inhalation treatments due to financial reasons. The most influenced behaviours as a result of the EI were psychological component (85%), fear of the adverse events (82%) and social component (79%). Conclusions The non-adherence to therapy remains a real problem in asthma and COPD patients in our study group, but EI had positive effects. Extending medical education programmes for patients focused on main reasons of poor adherence, such as forgetting to take medication daily, use of inhalator devices, not understanding their disease, may significantly increase adherence to inhalation treatment.

Look, Ma, no hands! A preliminary study of educational interventions aimed at setting realistic expectations of semi-autonomous vehicle technology

Advanced driver-assist features are becoming fairly ubiquitous as more cars are equipped with features like autosteer and lane assist. While these features are primarily developed to promote driver safety, there are reports that drivers are not maintaining adequate supervisory control when the features are engaged. Vehicle technology branding, misinformation provided by dealership sales representatives, and even internet memes may be responsible for creating unrealistic expectations about the driver’s role when driving a semi-autonomous vehicle. In this experiment, we presented participants with a description of a fictitious semi-autonomous vehicle based off the Tesla Model 3 and one of two educational pieces based upon either the SAE levels of automation or an excerpt from an owner manual. We present the findings and discuss the implications for the development of educational interventions aimed at calibrating driver expectations about semi-autonomous vehicle technology and the role of the driver when using advanced driver-assist features.

Illuminating the complexities of conflict with evolution: validation of the scales of evolutionary conflict measure (SECM)

BackgroundAlthough personal, familial, and community conflict with evolution have been documented in the literature, these scales require conceptualization as a construct and operationalization as a measure. The Scales of Conflict with Evolution Measure (SECM) instrument was developed in response to these needs. Using a construct validity framework, the content, internal structure, convergent, and substantive validity of the SECM were evaluated using Rasch analysis, Structural Equation Modeling (SEM), and follow up questioning. The conceptual utility of the instrument was explored by examining whether it added explanatory insights into evolution acceptance above and beyond religiosity, evolution knowledge, and background variables.ResultsA literature review and expert consultation indicated that construct of evolutionary conflict perception should (i) encompass the hierarchical nature of human social structures (personal, family, community) and (ii) probe conflict as it relates to human values, cultures, and beliefs. A three-dimensional construct was operationalized as a nine-item rating scale measure. Using Rasch analyses of SECM responses from a diverse sample of > 1000 students studying evolution, the instrument met criteria of robust measurement, including: fit to model expectations; three-dimensional structure; high reliability; good rating scale function; measurement invariance with time; and convergence with a similar construct. SEM showed that: (i) family and community conflict had unique causal contributions to personal conflict, with family showing a stronger and modest impact, and (ii) personal conflict had a significant and modest causal impact on evolution acceptance above and beyond the contributions of religiosity, evolution knowledge, and background variables.ConclusionThe SECM is an easy-to-administer instrument to measure conflict with evolution and is supported by several forms of validity evidence. The SECM has potential for facilitating measurement of evolutionary conflict in educational settings, thereby raising instructor awareness of conflict levels in students, promoting rigorous evaluations of educational interventions designed to reduce conflict, and fostering conceptual advances in the field of evolution education. Future work is needed to gather additional forms of validity evidence and to test current validity claims in additional participant samples. SECM measures should also be incorporated into more complex SEM models that treat evolution knowledge and religiosity as part of the structural paths to evolution acceptance. Such models could provide insights into the most worthwhile targets for the development of educational interventions to mitigate conflict at multiple scales.

A qualitative evaluation of participants' experiences of using co-design to develop a collective leadership educational intervention for health-care teams.

IntroductionCo‐design involves stakeholders as design partners to ensure a better fit to user needs. Many benefits of involving stakeholders in design processes have been proposed; however, few studies have evaluated participants’ experience of co‐design in the development of educational interventions. As part of a larger study, health‐care professionals, researchers and patients co‐designed a collective leadership intervention for health‐care teams. This study evaluated their experiences of the co‐design process.MethodsSemi‐structured interviews were conducted with individuals (n = 10) who took part in the co‐design workshops. Interviews were audio‐recorded, transcribed verbatim and analysed thematically.ResultsFour key themes were identified from the data: (a) Managing expectations in an open‐ended process; (b) Establishing a positive team climate; (c) Focusing on frustrations—challenging but informative; and (d) Achieving a genuine co‐design partnership.ConclusionsThe development of a positive team climate is essential to the co‐design process. Organizers should focus on building strong working relationships from the beginning to enable open discussion. Organizers of co‐design should be conscious of establishing and maintaining a genuine partnership where participants are involved as equal partners and co‐creators. This can be done through the continuous use of feedback to allow participants to influence the workshop directions, and through limiting researcher domination. Lastly, co‐design can be daunting, but organizers can positively impact participants’ experience by acknowledging the emergent nature of the process in order to reduce participant apprehension, thereby limiting the barriers to participation.

Multiple Negative Emotions During Learning With Digital Learning Environments - Evidence on Their Detrimental Effect on Learning From Two Methodological Approaches.

Emotions are a core factor of learning. Studies have shown that multiple emotions are co-experienced during learning and have a significant impact on learning outcomes. The present study investigated the importance of multiple, co-occurring emotions during learning about human biology with MetaTutor, a hypermedia-based tutoring system. Person-centered as well as variable-centered approaches of cluster analyses were used to identify emotion clusters. The person-centered clustering analyses indicated three emotion profiles: a positive, negative and neutral profile. Students with a negative profile learned less than those with other profiles and also reported less usage of emotion regulation strategies. Emotion patterns identified through spectral co-clustering confirmed these results. Throughout the learning activity, emotions built a stable correlational structure of a positive, a negative, a neutral and a boredom emotion pattern. Positive emotion pattern scores before the learning activity and negative emotion pattern scores during the learning activity predicted learning, but not consistently. These results reveal the importance of negative emotions during learning with MetaTutor. Potential moderating factors and implications for the design and development of educational interventions that target emotions and emotion regulation with digital learning environments are discussed.

Development of an Internet-delivered educational video for acute whiplash injuries

ObjectiveTo describe the development of a preventive educational video for patients exposed to whiplash trauma following motor vehicle accidents.MethodsThe development followed a systematic approach and was theory-driven supplemented with available empirical knowledge. The specific content was developed by a multidisciplinary group involving health professionals and visual production specialists.ResultsA 14-min educational video was created. The video content focuses on stimulating adaptive recovery expectations and preventing maladaptive illness beliefs. The video presents a multifactorial model for pain incorporating physiological and cognitive-behavioural aspects, advice on pain relief, and exercises. Subjects interviewed for a qualitative evaluation found the video reassuring and that it aligned well with verbal information received in the hospital.ConclusionsThe development of the visual educational intervention benefitted from a systematic development approach entailing both theoretical and research-based knowledge. The sparse evidence on educational information for acute whiplash trauma posed a challenge for creating content. Further knowledge is required regarding what assists recovery in the early stages of whiplash injuries in order to improve the development of educational interventions.

The influence of an educational internet-based intervention in the beliefs and attitudes of primary care professionals on non-specific chronic low back pain: study protocol of a mixed methods approach

BackgroundPersonal convictions in referral to pain cause misbeliefs in health professionals, which can influence patients who suffer from non-specific chronic low back pain. Likewise, health professionals’ beliefs affect their advice and attitudes towards patients’ treatment, becoming a possible cause of greater disability. The development of educational interventions based on the best scientific evidence in neurophysiology of pain could be a way to provide information and advice to primary care health professionals to change their cognition towards chronic non-specific low back pain. The use of Information and Communication Technologies allows the development of web sites, which might be one of the effective resources to modify misbeliefs and attitudes, in relation to the origin and meaning of non-specific chronic low back pain, of primary care professionals and that may modify their attitudes in patients’ treatment.MethodsThe aim of this project is to identify misbeliefs and attitudes of primary care physicians and nurses about chronic non-specific low back pain to develop a web-based educational tool using different educational formats and gamification techniques. This study has a mixed-method sequential exploratory design. The participants are medical and nursing staff working in primary care centers in the city of Lleida, Spain. For the qualitative phase of this study, the authors will use personal semi-structured interviews. For the quantitative phase the authors will use an experimental study design. Subjects will be randomly allocated using a simple random sample technique. The intervention group will have access to the web site where they will find information related to non-specific chronic low back pain, based on the information obtained in the qualitative phase. The control group will have access to a video explaining the clinical practice guidelines on low back pain.DiscussionThis study has been designed to explore and modify the beliefs and attitudes about chronic low back pain of physicians and nurses working in primary care settings, using a web-based educational tool with different educational formats and gamification techniques. The aim of the educational intervention is to change their knowledge about the origin and meaning of pain, with the result of reducing their misbeliefs and attitudes of fear avoidance.Trial registrationClinicalTrials.gov Identifier: NCT02962817. Date of registration: 11/09/2016.

Appropriateness of pediatric outpatient transthoracic echocardiogram orders following cessation of an active educational intervention.

The educational intervention (EI) through the Pediatric Appropriate Use of Echocardiography (PAUSE) multicenter study resulted in improved appropriateness of transthoracic echocardiogram (TTE) orders at our center. The current study evaluated if this pattern persisted after cessation of EI and the potential physician characteristics influencing appropriateness. Outpatients (≤18years old) seen for initial evaluation during the EI (July to October, 2015) and 6-month post-EI (May to August, 2016) phases were included. Comparison was made between TTE rates and appropriateness ratings during EI and post-EI phase. Association between TTE rate and appropriateness with physician characteristics (age, experience, patient volume, and area of practice) was determined using odds ratio. The study included 7781 patients (EI: N=4016; post-EI: N=3765) seen by 31 physicians. Comparison of appropriateness ratings in a randomized sample (EI: N=1270; post-EI: N=1325 patients) showed no significant differences between the two phases (appropriate: 75.2% vs 74.9%, P = .960; rarely appropriate 4.1% vs 6.5%, P = .065). Though there was significant variability among physicians for TTE order appropriateness (P = .044) and ordering rate (P <.001), none of their characteristics were associated with appropriateness and only a higher patient volume was associated with decreased odds of TTE ordering (OR =0.7). The PAUSE study EI resulted in maintaining appropriate utilization of TTEs at our center for 6months following its cessation. Though not statistically significant, there was a trend toward increase in the proportion of studies for indications designated rarely appropriate (R). There was significant physician variability in TTE ordering and appropriateness during both phases. Development of EI to reduce physician variability and integration of EI with provider workflow may help sustain appropriate TTE utilization.

Know where to go: evidence from a controlled trial of a healthcare system information intervention among immigrants

BackgroundImmigrants may face problems with accessing the Danish healthcare system due to, for example, lack of knowledge of how to navigate it, which may cause inappropriate healthcare-seeking. Danish municipalities provide a mandatory introduction and language programme for newly arrived immigrants, but no information on the healthcare system is offered. This study investigated what effects information about the Danish healthcare system may have on the hypothetical healthcare-seeking behaviour of newly arrived immigrants and their actual healthcare use.MethodsA prospective intervention study of 1572 adult immigrants attending two language schools in Copenhagen was carried out. Two intervention groups received either a course or written information on the Danish healthcare system, respectively, while the control group received neither. Survey data included three case vignettes on healthcare-seeking behaviour (flu-like symptoms, chest pain and depression) and were linked to registry data on sociodemographic characteristics and healthcare use in the year to follow. Logistic regression and binomial regression analyses were performed.ResultsAppropriate hypothetical healthcare-seeking behaviour was reported by 61.8–78.8% depending on the vignette. Written information showed no effect on immigrants’ hypothetical healthcare-seeking behaviour, while the course showed a positive effect on hypothetical healthcare-seeking behaviour for flu-like symptoms (adjusted odds ratio [AOR] = 1.71, 95% confidence interval [CI] = 1.01–2.91, p-value = 0.0467), but not on chest pain or depression. The interventions did not affect immigrants’ actual healthcare use; all groups made lower use of health care services in the following year compared with the year where the study took place, except for the use of dental care which remained stable.ConclusionsInformation on the healthcare system embedded in the language school programme has the potential to facilitate immigrants’ access to healthcare. Yet, the results underscore the need for further refinement and development of educational interventions, as well as ensuring adequate utilisation of healthcare services by other means. Multi-dimensional and multi-sectional efforts are important for integration issues within healthcare in Europe.Trial registrationHealth-seeking behaviour among newly arrived immigrants in Denmark ISRCTN24905314, May 1, 2015 (Retrospectively registered).

Asthma medication use and parents perception of children’s health-related quality of life (HRQOL)

Obtaining consent for HIV research is complex, particularly in low- and middle-income countries. Low levels of education, complexity of science and research processes, confusion about basic elements of research, and socio-economic conditions that make access to medical care difficult have collectively led to concerns about the adequacy of the consent process. Given the exponential growth of HIV prevention and treatment research in South Africa, HIV researchers are increasingly facing challenges obtaining authentic informed consent from potential participants. It is anticipated that HIV cure research, despite being in its infancy in South Africa, will introduce a new discourse into a population that is often struggling to understand the differences between ‘cure’, ‘preventive and therapeutic vaccines’ and other elements of the research process. Coupled with this, South Africa has a complex history of ‘illegitimate’ or ‘false cures’ for HIV. It is therefore logical to anticipate that HIV cure research may face significant challenges during consent processes.HIV prevention research in South Africa has demonstrated the importance of early community engagement in educating potential research participants and promoting community acceptance of research. Consequently, in an attempt to extrapolate from this experience of engaging with communities early regarding cure research, a 15-minute educational video entitled ‘I have a dream: a world without HIV’ was developed to educate and ultimately empower potential research participants to make informed choices during consent processes in future HIV cure clinical trials. To aid others in the development of educational interventions, this paper discusses the challenges faced in developing this educational video.

Patient Academy- A platform for collaborative working to improve Paediatric Child Health &amp; to empower patients in the role of educators

Introduction: The expertise of parents and patients is often under-valued. Collaborative working with patients/parents has given new meaning to patient-centred care. Involving healthcare users from the outset and engaging them in healthcare decision making and in the wider context of healthcare, promotes understanding of healthcare use and has the potential to facilitate more effective design and development of educational interventions to improve higlighted problems. We were keen to develop a platform whereby patients, parents and healthcare professionals could come together, to identify barriers to healthcare and to use co-design and co-production models to develop educational initiatives which could improve self-management, access to healthcare and other health outcomes. Practice Change: The Patient Academy initiative was piloted in a busy central London teaching hospital. The first phase of the project was a scoping exercise to understand local services and pathways in our hospital setting. The next phase involved a large-scale collaborative event held at London Zoo. The aim was to bring together all those involved in looking after a child’s health, to understand parental influences around healthcare decision-making, to define characteristics of a positive health encounter and to co-design educational strategies to improve the management of children with mild-moderate acute health problems. Approximately 25 parents and 35 healthcare professionals from a wide range of disciplines across primary and secondary care attended. Theory of change: We hypothesised that the event would provide unique insights from various perspectives which it did. With this widened lens we were able to collaboratively create a guide for the most effective health encounter and to design sustainable interventions to empower patients/parents in the role of educators and to improve healthcare encounters. Five work-streams led by teams of parents and healthcare professionals have emerged, each focusing on a different educational intervention. Targeted population & Stakeholders: Aligned to the national agenda of ‘Early Years’ the project was focused on improving a number of components of healthcare in 0-5 year olds. Stakeholders were extensive and included parents, patients, hospital paediatricians, nurses, GPs, health visitors, midwives, school nurses, mental health teams, public health, schools, pharmacists and behavioural insights specialists. Timeline: A six-month time frame was dedicated to the scoping exercise, the launch collaborative event and initial formation of workstreams and collaborative design of educational interventions. Highlights/Sustainability/Transferability: The greatest outcome from the Patient Academy has been the connections and relationships formed between patients, parents and various healthcare professionals and organisations. Five exciting workstreams have emerged including; 1) development of multi-disciplinary learning events, 2) a community based educational programe designed entirely by parents for parents and healthcare professionals. The other work-streams involve the 3) creation of a consultation tool, 4) a wardround tool and the 5) inception of a children and young person’s advisory board. To ensure sustainability, interventions have been incorporated into existing networks of patients/parents and integrated into routine daily activities. The tools created could easily be adopted by other Paediatric departments but are equally transferrable to any adult medical discipline in the UK or abroad.

Development of an interface-focused educational complex intervention

Background: In many countries, the medical primary-secondary care interface is central to the delivery of quality patient care. There is prevailing interest in developing initiatives to improve interface working for the benefit of health care professionals and their patients. Aim: To describe the development of an educational intervention designed to improve working at the primary-secondary care interface in NHS Scotland (United Kingdom) within the context of the Medical Research Council framework for the development and evaluation of complex interventions. Methods: A primary-secondary care interface focused Practice-based Small Group Learning (PBSGL) module was developed building upon qualitative synthesis and original research. A ‘meeting of experts’ shaped the module, which was subsequently piloted with a group of interface clinicians. Reflections on the module were sought from clinicians across NHS Scotland to provide contextual information from other areas. Findings: The PBSGL approach can be usefully applied to the development of a primary-secondary care interface-focused medical educational intervention.