Greater Improvement In Knowledge Research Articles

Developing and Testing a Web-Based Survey to Assess Educational Needs of Multidisciplinary Palliative and End-of-Life Healthcare Professionals (318-B)

Likert scale, and satisfaction based on ranking of education quality from poor to excellent. The intervention group received 32 weekly e-mails. Results. The study group included 82 interns with a pretest response rate of 100% and posttest response rate of 70%. The intervention group showed greater improvement in knowledge (18% increase compared to 8% in the control group, p 1⁄4 0.005) than the control group. Preparedness in symptom management skills (ie, converting between opiates, differentiating types of pain, treating nausea, and vomiting) improved in the intervention group more than the control group (p 1⁄4 0.04, 0.01, and 0.02, respectively). Preparedness in discussing end-of-life decisions with patients increased for residents who participated in a palliative care elective versus those who did not (p 1⁄4 0.04). There were no differences in preparedness in communication skills or satisfaction between control and intervention. Conclusion. E-mailed FFAC are an educational technique that increases intern knowledge and self-reported preparedness in symptom management skills but not preparedness in communication skills or satisfaction with palliative care education. Implications for research, policy, or practice. Weekly e-mailed FFAC are a timeand cost-effective educational method that may be easily integrated into existing residency curricula.

Repetitive Pediatric Simulation Resuscitation Training

The objective of the study was to compare the effectiveness of repetitive pediatric simulation (RPS) training (scenario-debriefing-scenario) to standard pediatric simulation (STN) training (scenario-debriefing). Pediatric and emergency medicine residents prospectively participated in simulated pediatric resuscitation training sessions in an in situ simulation room. Residents anonymously reported their knowledge, skills, and confidence after each session. Four learners and 2 faculty preceptors (1 pediatric emergency medicine attending physician and 1 pediatric emergency medicine fellow) participated in each session. Scenarios were performed on a high-fidelity simulator (SimBaby; Laerdal Medical, Stavanger, Norway), and video debriefing was used for all training sessions. Standard pediatric simulation was used in the initial 6 months of the study, whereas RPS was used in the second 6 months of the study. One hundred fifteen subjects completed simulation sessions during the study period. The RPS group reported higher overall debriefing quality and were more likely to report that the simulation session was an excellent method of teaching. The RPS group reported greater improvement in knowledge and skills than did the STN group. Similar scores were reported for confidence, overall performance, stress levels, and realism of the simulator in both the STN and RPS groups. Feedback is a key feature of effective medical simulation. Repetitive pediatric simulation provides learners with a discrete opportunity to apply the knowledge and skills discussed during debriefing in an immediate second simulation session and thereby complete Kolb's experiential learning cycle. In this study, the RPS debriefing format was associated with higher self-reported knowledge and skills. The RPS group reported more positive attitudes toward simulation than the STN group.

Piloting the use of teen mentors to promote a healthy diet and physical activity among children in Appalachia

This study tested a mentoring model that paired trained teens with younger children in an after-school setting to deliver a curriculum aimed at promoting healthier patterns of dietary intake and physical activity. Using a pretest-posttest design, group comparisons were made. Descriptive, independent, and paired t-test analyses with Bonferroni corrections were conducted in a sample of 72 children. Group differences were noted with the intention to eat healthfully. Mentored children demonstrated greater improvement in knowledge, attitudes, efficacy, perceived support, and body mass index (BMI). Teen mentors can effectively impact children's intention to improve health behaviors, which is foundational to normalizing BMI.

Effects of a Rapid Peer-Based HIV/AIDS Educational Intervention on Knowledge and Attitudes of High School Students in a High-Income Arab Country

In response to low knowledge about HIV and intolerant attitudes toward persons living with HIV among Arab university students, a peer-based educational intervention was developed and impact evaluated on knowledge and attitudes of high school students in 2 of 4 main cities of United Arab Emirates. Four small teams of final year medical students, 3 female and 1 male, were trained. Multistage random sampling selected 14 female and 5 male Arab schools, then 56 female and 14 male grade 12 classes in Al Ain and Abu Dhabi. The 90-minute intervention included a factual presentation and 3 attitude workshops. Baseline and postintervention knowledge and attitudes were assessed. Significance was tested by McNemar, Wilcoxon signed rank, and multilevel regression tests. Response was 99.6%, 1398 females and 505 males. Misconceptions about modes of transmission and intolerant attitudes were evident. Mean knowledge score improved from 65% to 82% and attitude 51% to 64%, that is, relative increase 26% (P < 0.0005). Females had slightly lower baseline knowledge than males but showed greater improvement in knowledge and attitudes (P < 0.0005) Grade 12 students' knowledge about HIV/AIDS was inadequate and attitudes stigmatizing. Peer-based knowledge workshops were effective, especially among females. Concise integrated teaching and workshops designed to address key knowledge and attitudinal deficiencies can be highly effective.

Implementing the Illness Management and Recovery Program in Community Mental Health Settings: Facilitators and Barriers

Implementing the Illness Management and Recovery Program in Community Mental Health Settings: Facilitators and Barriers

Improvement of knowledge, attitude, and behavior about oral health in a population of alcohol addicted persons

To improve knowledge, attitude, and behavior about oral health and oral cancer prevention in a population of alcohol-addicted persons involved in a residential rehabilitation program in Italy. A questionnaire was administered to obtain socioeconomic and oral risk factors data, and a complete dental examination was performed. A lecture on oral health risk factors and healthy behaviors was delivered. A pre-post test questionnaire was used to assess the short-term effectiveness of the intervention. Long-term effectiveness was assessed by a follow-up interview at 1 year from the intervention. The independent effect of several covariates on oral health at baseline and on the outcome of the intervention was evaluated. Seventy-six individuals from the residential alcohol rehabilitation program participated in our study. About half had been addicted to alcohol for more than 10 years; 81.6% smoked at the time of survey; 31.0% declared that they never used toothbrushes or that they brushed less than once/day. We found an improvement of 25.0% in exact answers between the pre-post test questionnaire. At 1 year from the intervention, the 42 participants who reached follow up showed a great improvement in knowledge and attitude towards oral health. In particular, toothbrushing had become a daily routine after every meal for 67.1% of participants. Education of alcohol-dependent individuals in a rehabilitation setting may contribute to their attention to oral health and willingness to change habits.

What difference does training make? A randomized trial with waiting‐list control of general practitioners seeking advanced training in drug misuse

To measure changes in knowledge, attitudes and clinical practice of general practitioners (GPs) enrolled to receive training in the management of drug misusers. Two-group randomized trial with training (T) and waiting-list (WL) control comparison conditions. A total of 112 GPs working in primary care practices in England. A 6-month, part-time, mixed-methods training course provided by the Royal College of General Practitioners. GPs randomized to the WL control received no special training or guidance during the study period. Knowledge, therapeutic attitudes (commitment, role security, situational constraints and prescribing confidence) and clinical practice behaviour change (numbers of drug misusers seen, treated). Intention-to-treat/train (ITT) analysis, supplemented by treatment/training received (TR) analysis. Training applicants had positive attitudes towards and were already involved in the care of drug misusers. Improvements in attitudes and behaviour were greatest among the T group, although only 'role security' and 'situational constraint' reached statistical significance (ITT). A subgroup in the WL group circumvented their allocation and received training, prompting supplementary analysis by TR. Overall, GPs who received training showed markedly greater improvements in knowledge, attitudinal and prescribing confidence measures and remained more actively involved in treating drug misusers than GPs who remained in the WL control group (TR analysis). GPs seeking special training for the care of drug misusers are both positively disposed to this patient population and clinically active. Benefits unambiguously attributable to the course were modest. While a TR effect was observed, strict adherence to ITT analysis failed to identify significant benefits observed with the training provided. Randomisation and waiting-list controls design are insufficient as a research method for training evaluation studies if ITT analysis is used exclusively.

Promoting Heart Health in Women

The purpose of this study was to evaluate the effectiveness of a 5-week, 1 hour per week heart disease prevention program for sedentary female municipal workers with known heart disease risk factors. The program was designed to improve participants' knowledge and perceptions of their personal susceptibility to heart disease. In targeting an ethnically diverse, lower income working population, the researchers also sought to contribute to one of the goals of Healthy People 2010, the elimination of health disparities, specifically the reduction of health disparities in heart disease by 25% by the year 2010. A one-group, repeated measures, quasi-experimental design was employed. Forty-eight women 25 to 66 years old responded to the solicitation and participated in the program. Seventy-five percent were African American, 23% were White, and 2% were Latino. Participants completed a 33-item heart disease knowledge questionnaire, demographic questions, and a single visual analog scale statement to assess perceived susceptibility. Fifty-eight percent of the participants improved their knowledge of heart disease and 50% of the participants increased their perception of susceptibility to heart disease from pre- to post-intervention. The greatest improvement in knowledge and awareness of susceptibility occurred for those with limited knowledge and low perceptions of susceptibility. The gains from this workplace health education project for largely minority female municipal workers were modest, but notable. A workplace health education program for women targeted at increasing their knowledge of heart disease may also increase their perceptions of susceptibility to heart disease.

A randomized controlled trial of the use of self-help materials in addition to standard general practice treatment of depression compared to standard treatment alone

The purpose of the study was to examine whether the addition of a brief individual self-help package to standard primary-care treatment of depression with antidepressants is associated with any additional improvements in clinical outcome. Individuals with major depressive disorder who were prescribed an antidepressant were recruited through their general practitioner (GP) and allocated randomly to standard treatment alone or standard treatment plus self-help. Assessments of symptoms, social adjustment, global functioning, satisfaction with treatment and knowledge about the management of the disorder were completed at three time points over 26 weeks. One hundred and twelve individuals agreed to participate and 96 met criteria for inclusion in the randomized controlled trial. Subjects in both treatment conditions improved substantially over the study period; the mean Beck Depression Inventory (BDI) score fell from 27.3 to 13.9 in the intention-to-treat analysis. There were no between group differences in outcome on any of the primary outcome measures, nor did these approach even marginal significance. Patients and GPs were highly satisfied with the self-help programme, and the intervention as compared to the control group reported significantly greater improvements in knowledge about depression and satisfaction with information received about depression. An individualized self-help package improved perceived knowledge about depression but did not have identifiable effects on outcome when offered to patients treated in primary care. The study was sufficiently well powered to detect relatively small effects.

Is peer education the best approach for HIV prevention in schools? Findings from a randomized controlled trial

Purpose To evaluate the effectiveness of peer education when compared to teacher-led curricula in AIDS prevention programs conducted in schools in Rome, Italy. Methods Eighteen high schools were randomly assigned to one of two prevention programs: one led by teachers and the other by peer leaders. A sample of students attending the last 2 years (n = 1295) completed pre and post-intervention questionnaires. Changes in sexual behaviors, knowledge, prevention skills, risk perception and attitudes were first evaluated within each intervention group. Afterwards, changes in knowledge, prevention skills, risk perception, and attitudes total scale scores (post-test scores minus pre-test scores) were compared between the two groups, through linear regression models, in order to control for confounders, taking into account the within-school correlation in score changes. As for sexual behaviors, number of sexual partners and frequency of condom use in the 3 months before post-test were compared by intervention group through ordinal regression models, also taking into account behaviors reported before pre-test. Results For both groups, we observed significant improvements in skills, knowledge, attitudes and risk perception. The peer-led group showed a 6.7% (95% C.I. 1.9–11.5) scores greater improvement in knowledge, compared to the teacher-led group. In neither group were improvements observed in condom use or number of sexual partners. Conclusions The only apparent benefit of the peer-led intervention, compared to that led by teachers, was a greater improvement in knowledge of HIV. Neither of the interventions induced changes in sexual behavior. However, the role of possible biases and methodological problems must be considered when interpreting these results.

Effectiveness of community health workers for promoting use of safety eyewear by Latino farm workers

To evaluate The Community Health Worker "promotor de salud" (CHW) model is evaluated as a tool for reducing eye injuries in Latino farm workers. In 2001, 786 workers on 34 farms were divided into three intervention blocks: (A) CHWs provided protective eyewear and training to farm workers; (B) CHWs provided eyewear but no training to farm workers; (C) eyewear was distributed to farm workers with no CHW present and no training. Pre- and post-intervention questionnaires demonstrated greater self-reported use of eyewear in all blocks after the intervention (P < 0.0001), with Block A showing the greatest change compared to B (P < 0.0001) and C (P = 0.03); this was supported by field observations. Block A showed the greatest improvement in knowledge on questions related to training content. CHWs were an effective tool to train farm workers in eye health and safety, improving the use of personal protective equipment and knowledge.

Randomized Trial of a Specialist Genetic Assessment Service for Familial Breast Cancer

Because of the growing demand for genetic assessment, there is an urgent need for information about what services are appropriate for women with a family history of breast cancer. Our purpose was to compare the psychologic impact and costs of a multidisciplinary genetic and surgical assessment service with those of current service provisions. We carried out a prospective randomized trial of surgical consultation with (the trial group) and without (the control group) genetic assessment in 1000 women with a family history of breast cancer. All P: values are from two-sided tests. Although statistically significantly greater improvement in knowledge about breast cancer was found in the trial group (P: =.05), differences between groups in other psychologic outcomes were not statistically significant. Women in both groups experienced statistically significant reductions in anxiety and found attending the clinics to be highly satisfying. An initial specialist genetic assessment cost pound 14.27 (U.S. $22.55) more than a consultation with a breast surgeon. Counseling and genetic testing of affected relatives, plus subsequent testing of family members of affected relatives identified as mutation carriers, raised the total extra direct and indirect costs per woman in the trial group to pound 60.98 (U.S. $96.35) over costs for the control subjects. There may be little benefit in providing specialist genetics services to all women with a family history of breast cancer. Further investigation of factors that may mediate the impact of genetic assessment is in progress and may reveal subgroups of women who would benefit from specialist genetics services.

Human - computer interface design can reduce misperceptions of feedback

According to the misperceptions of feedback hypothesis, people make poor decisions because they do not heed the feedback dynamics in the environment, despite having perfect information about environmental structure. The thesis of this article is that dynamic decision-making performance can be improved by making the feedback structures of the environment more salient using human – computer interface design principles. An experiment was conducted in the context of Strategem-2, a management decision-making simulation used in previous research in this area. One group of participants used the original interface for Strategem-2, whereas another group used a new interface that was designed according to human – computer interface design principles. All participants were given a pre- and post-test to assess their knowledge of the simulation. The results reveal that the new interface leads to improved performance, and a greater improvement in knowledge of the microworld compared to the original interface. This finding is important because it suggests that misperceptions of feedback can be reduced through improved human – computer interface design. Copyright © 2000 John Wiley & Sons, Ltd.

Indicators of the educational effectiveness of subspecialty training programs in internal medicine.

To identify markers within the subspecialty educational process in internal medicine that are associated with greater improvements in knowledge and skill. Candidates for the 1991 cardiovascular disease examination of the American Board of Internal Medicine (ABIM) were matched to the fellowship programs they attended, and their performances on the internal medicine examination of the ABIM, demographic data, and performances on the cardiovascular disease examination were averaged within each program. Information on the programs themselves was also available. The variables were divided according to whether they controlled for input to the training programs, were indicators of educational process, or served as the outcome measure. Analyses were restricted to the 140 programs for which complete information was available and that had four or more candidates who took the cardiovascular examination (97 programs were excluded). The multiple correlation between all measures and scores on the cardiovascular disease examination was .80. Forty-five percent of the explained variance is attributable to previous performance on the internal medicine examination alone. The remaining 55% is shared by the educational indicators and the input measure or explained by the indicators alone. Among the indicators, location of medical school, length of fellowship training, ratings of overall clinical competence, fellow-to-faculty ratio, and number of subspecialties in the same institution made small contributions on their own. Program size, university affiliation, and period of approval by the residency review committee contributed little. The data are clear that indicators of educational process such as fellow-to-faculty ratio, longer periods of training, and performance during fellowship can generate greater gains in knowledge and judgment than would be expected if fellows merely built on their abilities at the time of entry to training. Such indicators may be useful if changes in health care delivery require reducing the numbers of specialty and subspecialty training positions.

The effectiveness of diabetes education programs for older patients and their spouses.

Improvements in diabetes knowledge, psychosocial functioning, and metabolic control were assessed following a six-week diabetes education program for older male patients (aged 65 to 82 years) and their spouses. Before and after the program, scored questionnaires were administered to patients and their wives regarding knowledge, quality of life, stress, family involvement in diabetes care, and patient involvement in social activities. The patients were again assessed six months later. Results were compared to those of younger adult male patients (aged 28 to 64 years). The older patients significantly increased their knowledge of diabetes (P less than .05), and to an extent equal to that of younger individuals. Reduction in stress correlated with their increase in knowledge (r = 0.9; P less than .05) and their improved diet-related quality of life (r = 0.7; P less than .02). A decrease in stress was still evident six months after the program P less than .01). Perceived quality of life for areas requiring greater life-style modification (diet and exercise) increased (P less than .01), and was maintained at six months. In contrast, younger patients reported decreases in perceived quality of life (P less than .05). Older patients with participating spouses, compared to those without, showed greater improvement in knowledge (P less than .02), increase in family involvement (P less than .05), less stress (P less than .02), and improvement in metabolic control of diabetes (P less than .001). The program increased spouses' knowledge and perceived involvement in the care of their diabetic partners (P less than .01). This study suggests that diabetes education is an effective intervention for elderly patients and their spouses.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of a social problem-solving skills program for third- and fourth-grade students.

The effects of a social problem-solving (SPS) training program for entire classrooms of third- and fourth-grade children were examined in two studies. In the first study, experimental children showed significantly greater improvement in knowledge and performance of SPS skills than control children. However, both positive and negative effects of the intervention (varying by classroom) were found on measures of behavioral adjustment, self-efficacy, and peer acceptance at a 6-month follow-up. The second study compared two different intervention strategies: (a) SPS training with teacher-student dialoguing, peer pairing, and self-monitoring, and (b) SPS training with dialoguing only. It was found that children in both the experimental and control groups improved significantly in performance of SPS skills but no differences between the groups were found for changes in behavioral adjustment, self-efficacy, and peer acceptance. The limitations of cognitively mediated interventions for young children were discussed.

Promoting awareness and prevention of child sexual victimization using the Red Flag/Green Flag program: An evaluation with follow-up

This study describes an evaluation of a school-based sexual abuse awareness and prevention program that featured the “Red Flag/Green Flag People” coloring book and included presentation of a film (“Better Safe than Sorry II”) and discussion of hypothetical and actual experiences involving inappropriate physical touching. Children, parents, and teachers from two experimental schools participated in the program and were compared to similar groups from a control school. Outcomes were evaluated using pre-post (2-month) assessment questionnaires. Among the findings obtained, experimental group children reported learning more about the differences between good and bad touching, and being more likely to both report instances of sexual victimization and utilize program-specific preventive skills, relative to controls. Parents exposed to program materials acknowledged greater improvements in knowledge about program goals and more positive communication at home about abuse. Although no significant differences were obtained for teachers, the ratings for one experimental group were consistently higher than those of the other groups. Staff volunteers evaluated the program as overwhelmingly positive and without adverse effects. Still, some children from all groups reported being touched inappropriately. Some of these improvements were also noted for the experimental group at 6-month follow-up assessment. The findings were discussed in the context of conceptual, clinical, training, and empirical considerations.