Interactive Educational Intervention Research Articles

A pilot randomized controlled trial of an online intervention for Hodgkin lymphoma survivors to increase knowledge about late effects and recommended screening.

Hodgkin lymphoma (HL) survivors who received chest radiotherapy are at risk for breast cancer and cardiovascular disease, but screening adherence is low. We assessed the acceptability/feasibility of a web-based educational intervention and its impact on knowledge of health risks and screening. HL survivors were randomized to either an interactive online educational intervention or handouts only. Surveys were completed at baseline and 3months post-intervention. We described the acceptability/feasibility of the intervention and compared knowledge between groups. Fifty-two HL survivors participated; 27 in the intervention group and 25 in the control group. Eighteen (66%) intervention participants completed the intervention and reported high acceptability (89-100%). At baseline, adherence to breast cancer screening was low across all participants. Post-intervention, those in the intervention group more often than controls correctly identified breast cancer and echocardiogram screening guidelines (35% vs. 28%, P = 0.02 and 82% vs. 52%, P = 0.04) and reported knowing how to address potential complications from cancer treatments (87% vs. 64%, P = 0.03). We detected no increase in screening behavior post-intervention. Online education modules for high-risk HL survivors are an acceptable method to improve knowledge of health risks and screening guidelines. Future interventions should focus on improving screening uptake in this population. Web-based learning can be useful in increasing cancer survivor knowledge of their unique risks and screening recommendations but does not necessarily change patient behavior. Involvement in a cancer survivorship program can help assess individual barriers and monitor uptake of screening.

Counseling intervention on iron-folic acid adherence and clinical outcomes among pregnant women and women planning to be pregnant: a scoping review

Anemia during pregnancy is a major health problem that affects 25-50% of the world's population and around 50% of pregnant women. One of the causes of stunting is Low Birth Weight, which most often occurs in mothers who suffer from anemia. Making sure pregnant women have access to iron-folic acid supplement programs is challenging. People's inability to comply often occurred as the result of a lack of understanding of the benefits or harms of the supplement. Providing counseling to pregnant women to improve adherence to taking blood-added supplements has resulted in significant benefits and impacts on changes discussed in several studies that have been conducted in several countries. Through a review of the literature, this study seeks to ascertain the contribution that counseling interventions have to improving iron-folic acid prescription adherence. This study used a literature study research method by examining 8 journals published on the SCOPUS, PubMed, and Garuda Websites. After that, descriptive analysis was used to examine the data from the selected journals. The 8 journals supported the idea that counseling can improve adherence to iron and folic-acid supplementation. There are numerous ways to provide counseling, including the traditional face-to-face approach, the 5A brief approach, leaflet/brochure-based approaches, and counseling through illustrated books. This study concludes that counseling interventions are more effective due to the careful planning of tailored interventions with more regular follow-ups, various forms of interactive educational media, patient characteristics, and direct health professional intervention related to counseling.

The Delirium Objective structured clinical examination Education (DOE) Pilot Study: implementation of the delirium OSCE education package within hospital education for registered healthcare professionals.

Objectives To evaluate an interactive delirium educational intervention on confidence and competence in delirium assessment tools and delirium knowledge; delirium knowledge scores; clinical practice; planned practice change and perceived usefulness of the education. Methods We conducted a quasi-experimental pilot study, with qualitative follow-up, at two metropolitan hospital sites in Australia. Participants were active registered healthcare practitioners. Survey data were collected pre (T0) and six weeks after the educational intervention (T1). Scores were derived from the seven-item OSCE marking rubric (maximum 15). At T1, observations of delirium care in practice were undertaken using a 10-item (maximum 12) tool. Results There was a significant increase in perceptions of confidence and competence in using delirium assessment tools and knowledge (p<0.001). Delirium knowledge scores improved significantly from 13.6 (SD 1.7) at baseline to 14.6 (SD 1.1) at T1(p<0.001). The high level of competency in delirium care demonstrated and gained during the OSCE (88.7%, SD 0.1) was translated and maintained into clinical practice (81.5%, SD 0.1) (p=0.07). Open-ended survey responses generated three themes: (1) Assess for Delirium, (2) The usefulness of The Delirium OSCE Package and, (3) A need for ongoing education on delirium care. Conclusion This study generated evidence on integrating The Delirium OSCE Education Package in other clinical settings and private hospital sites. Following this pilot study, a RCT was designed using the tools and methods developed to evaluate the effectiveness of The Delirium OSCE Education Package against conventional professional development education.

Ob/Gyn Residents’ Confidence Completing Genetic Carrier Screening-Related Tasks Before and After an Interactive Educational Intervention

Ob/Gyn Residents’ Confidence Completing Genetic Carrier Screening-Related Tasks Before and After an Interactive Educational Intervention

Virtual Design of the Brain Health Support Program and CAN‐THUMBS UP

AbstractBackgroundModifiable lifestyle factors account for ∼40% of the population attributable risk of dementia. This provides a strong rationale to develop remotely administered, personally tailored, home‐based interventions to reduce these risk factors. CAN‐THUMBS UP (CTU) is a fully remote program that has enrolled a cohort of individuals at risk of dementia, developed an interactive online educational intervention to address personalized risk factors and their modification, and supports an open platform trial to test and compare the efficacy of multidomain interventions. CTU is reaching a broader geography with potential for inclusion of more representative research populations and with an easier and less demanding participant experience.MethodCTU’s two research intervention programs include: a) The Brain Health Support Program (BHSP) with individuals at increased risk of dementia participating in the Brain Health PRO, a 12‐month online educational program which focuses on lifestyle and dementia risk factors; b) Synchronizing, Exercises and Remedies to Gain Cognition (SYNERGIC), a clinical trial intervention platform whose RCTs are investigating personalized multidomain interventions including those administered fully remotely. In SYNERGIC‐2, the BHPro educational intervention is used as an active control to a more personalized and tailored interventional approach. CTU programs are informed by initial pilot studies, have extensive community input, and incorporate innovative features including an interactive E‐consent platform, remote cognitive testing, wearable technology for sleep and activity monitoring, and home saliva collection for genomics.ResultTarget enrollment of 350 participants in BHSP has been rapidly achieved within 8 months utilizing geotargeted mailing and a coordinated national media campaign. Participants are recruited from all regions of Canada. Pilot studies demonstrated the feasibility of conducting a 100% remote study with high rates of participant satisfaction and completion rates across various virtual outcomes. Results of each of these components of the remote program will be detailed in this FRS.ConclusionCTU demonstrates the feasibility and high rate of participant acceptance in fully remote, comprehensive, online programs that include an educational intervention as well as fully remote, multi‐domain lifestyle intervention trials. The adoption of the various technologies has exceeded expectations and supports further clinical trial development with this approach.

Effect of Interactive Web-based Educational Intervention on Preventive Practices of Covid-19 among Internship Students

Effect of Interactive Web-based Educational Intervention on Preventive Practices of Covid-19 among Internship Students

CAN‐THUMBS UP: Recruitment in the Virtual Era

AbstractBackgroundThe Brain Health Support Program (BHSP) of the CAN‐Thumbs Up Study is an online, interactive educational intervention designed to increase dementia literacy, self‐efficacy and address modifiable lifestyle risk factors. Recruiting for a virtual study presented both opportunities and challenges. This included the need to attract participants through means beyond referrals from medical clinics, as well as opportunities to reach geographically diverse Canadian population less feasible with in‐person evaluations.MethodsA comprehensive recruitment strategy for a virtual environment was implemented. A central website provided any interested candidate with study information, and a link to register and provide basic demographic information via a secure form. Potential participants were directed to the website via traditional recruitment through CCNA specialty clinics or existing cohorts, through geotargeting mailing to specific target populations throughout Canada, social medial advertising, partner organizations, and a coordinated National press release.ResultsThe study had an 8‐month open recruitment window. During this time 964 participants agreed to be contacted through our online portal. Of these, 18‐81 were consented to enroll in the study per month. A total of 7,569 geotargeted postcards were sent, with 153 individuals agreeing to be contacted for the study (2%). Social media advertising generated 974 clicks, with 6.8% subsequently agreeing to be contacted for more information. The majority of participants enrolled in the study came from existing clinical cohorts, CCNA clinical sites, and partner organizations. The recruitment cohort was from a diverse geographical location, 45% urban, 35% suburban, and 20% rural. Overall, the target cohort of 350 subjects was successfully enrolled by the end of the recruitment period.ConclusionRecruitment for the BHSP intervention demonstrates the value of relatively underutilized clinical trials recruitment strategies, such as geotargeted mailing, and social media advertising. We also show the value of a centralized web site for initial screening of interested participants. While traditional recruitment methods still directed the majority of participants to the recruitment website, geotargeted mailing, social advertising, partner organizations, and earned media can all be scaled up, and will likely play a major role in future recruitments efforts in the broader CAN‐Thumbs Up Study.

Intervention to improve acute care nurses confidence and knowledge in hospital dementia care

ProblemAcute care nurses are the front line of hospital care for persons with dementia (PwD), yet many have inadequate dementia education and lack the confidence to appropriately manage PwD in the hospital setting. ImplementationTwo acute care units with high rates of PwD in a large tertiary-care hospital were provided an education intervention involving interactive case-based discussion of the challenges of inpatient dementia care. ResultsOut of 190 nurses, 171 completed a one-hour virtual educational session, 142 completed pre/post-session confidence surveys, and 123 completed pre/post-session knowledge tests. There was a statistically significant improvement in knowledge scores from 75.8% pre-session to 88.4% post-session (p < 0.001), and pre/post-session dementia care confidence increased from 3.49 to 4.44 ( + 27.22%; p < 0.001) ConclusionAn interactive virtual education intervention improves acute care nurses’ confidence and knowledge in managing PwD in the acute care setting and may improve hospital outcomes for this population.

An Interactive Educational Tool to Improve Human Papillomavirus Vaccine Knowledge and Recommendation Among Nurses.

In United States, only 57% of women and 53% of men in the recommended age groups have received all recommended doses of the human papillomavirus (HPV) vaccine. Healthcare provider education has been associated with strong vaccine recommendation and vaccination uptake. Our objective was to create a 7-min interactive online educational tool to improve knowledge and willingness to recommend the HPV vaccine among nurses. This is a prospective pre-test/post-test study to evaluate the effectiveness of the educational tool consisting of 10 flashcards in a question-answer format. Oncology nurses at our cancer center were invited to participate by email, which led them to the educational tool (i.e., intervention) along with pre- and post-test questions on HPV-associated cancers, vaccine-eligible age groups, dosing schedules, adverse events, and willingness to recommend. Of the 110 participants (mean age of 41.2 ± 11.4, 98% female, 64% >10 years of practice), there was improvement in knowledge after intervention in HPV-associated cancers (81% to 97%; p = 0.02), percentage of cervical caused by HPV (33% to 64%; p < 0.05), and dosing schedule (47% to 93%; p < 0.05). All participants correctly stated that continued screening is needed after vaccination both pre- and post-intervention. Eighty-five percent strongly agreed that the intervention improved their HPV knowledge, and 77% stated they were more likely to recommend the HPV vaccine after the intervention. While nurses are willing to recommend the vaccine, there remains persistent knowledge gaps. A brief 7-min self-administered online interactive flashcard educational intervention is effective in improving the HPV vaccine knowledge among nurses.

Increasing urban health awareness in adolescents using an interactive approach: evidence from a school-based pre-post pilot study in Rome, Italy

BackgroundCities contribute to and are affected by the climate crisis, determining significant health issues in urban settings. Educational institutions have a privileged position to contribute to achieving the transformations needed for a healthier future, so Urban Health education is fundamental to empowering the health of the youth living in cities. This study aims to measure and raise the awareness of Urban Health among students attending a high school in Rome (Italy).MethodsAn interactive educational intervention, consisting of four sessions, was conducted in a Roman high school during spring 2022. Overall, 319 students aged between 13 and 18 attended the sessions and were asked to complete a 11-items questionnaire before and another after the interventions. Data was gathered anonymously and analyzed using descriptive and inferential statistics.ResultsFifty-eight percent of respondents improved their post-intervention questionnaire score, while 15% did not improve and 27% got worse. The mean score significantly improved after the intervention (p < 0.001; Cohen’s d = 0.39).ConclusionsThe results suggest that school-based interventions using interactive approaches on Urban Health could be effective in increasing students’ awareness and promoting health especially in urban settings.

Evaluating the effectiveness of the safety experience room, an affordable interactive education intervention to prevent unintentional injury among rural preschoolers in China: protocol for a cluster randomized controlled trial

BackgroundInteractive and experiential learning programs have proven effective to teach children safety and prevent child unintentional injury. However, previously-published programs were designed primarily to address safety concerns of children living in urban, well-resourced areas, and therefore might be less effective or economically infeasible to distribute to children in resource-limited areas, such as those living in rural areas or underdeveloped regions. This proposed study will evaluate the effectiveness of teaching children safety lessons to rural preschoolers in China through the preschool-based Safety Experience Room intervention that was developed based on relevant theories, the lessons of previous intervention research, the characteristics of child injuries in underdeveloped rural areas, and the needs and circumstances of rural families and preschools in China. The study will also evaluate the cost-effectiveness of delivering the program.Methods and analysisA single-blinded, 12-month follow-up, parallel-group cluster randomized controlled trial with a 1:1 allocation ratio will be implemented in two selected counties. In total, at least 2378 rural preschoolers aged 3–6 years old will be recruited from 12 preschools, 6 in Yang County and 6 in Shicheng County. Clusters will be randomized at the preschool level and allocated to the control group (routine school-based education) or the intervention group (routine school-based education plus the Safety Experience Room education). External support strategies will be implemented by local partners to minimize attrition. Data collection will be conducted at baseline and then every 3 months during a 12-month follow-up time period. Intention-to-treat (ITT) data analysis will be used. Generalized estimation equations (GEE) will evaluate the effectiveness of the program and generalized cost-effectiveness analysis (GCEA) will evaluate the cost-effectiveness of it. A per-protocol (PP) sensitivity analysis will assess the robustness of ITT results. Subgroup analyses will be performed to evaluate the impact of socio-demographic factors on the intervention effect, following the same strategies as the primary analyses.DiscussionThe newly-designed Safety Experience Room program is expected to be feasible, effective, and financially beneficial. If these hypotheses prove true, we will take steps to disseminate the program to rural preschools across China.Trial registrationChinese Clinical Trial Registry (http://www.chictr.org.cn), CHiCTR2000038025, registered on 8 September 2020.

Investigating the effectiveness of three school based interventions for preventing psychotic experiences over a year period – a secondary data analysis study of a randomized control trial

IntroductionPsychotic experiences (PEs) are associated with increased risk of later mental disorders and so could be valuable in prevention studies. However, to date few intervention studies have examined PEs. Given this lack of evidence, in the current study a secondary data analysis was conducted on a clustered-randomized control trial (RCT) of 3 school based interventions to reduce suicidal behaviour, to investigate if these may reduce rates of PEs, and prevent PE, at 3-month and 1-year follow-up.MethodsThe Irish site of the Saving and Empowering Young Lives in Europe study, trial registration (DRKS00000214), a cluster-RCT designed to examine the effect of school-based interventions on suicidal thoughts and behaviour. Seventeen schools (n = 1096) were randomly assigned to one of three intervention arms or a control arm. The interventions included a teacher training (gate-keeper) intervention, an interactive educational (universal-education) intervention, and a screening and integrated referral (selective-indicative) intervention. The primary outcome of this secondary data-analysis was reduction in point-prevalence of PEs at 12 months. A second analysis excluding those with PEs at baseline was conducted to examine prevention of PEs. Additional analysis was conducted of change in depression and anxiety scores (comparing those with/without PEs) in each arm of the intervention. Statistical analyses were conducted using mixed-effects modelling.ResultsAt 12-months, the screening and referral intervention was associated with a significant reduction in PEs (OR:0.12,95%CI[0.02–0.62]) compared to the control arm. The teacher training and education intervention did not show this effect. Prevention was also observed only in the screening and referral arm (OR:0.30,95%CI[0.09–0.97]). Participants with PEs showed higher levels of depression and anxiety symptoms, compared to those without, and different responses to the screening and referral intervention & universal-education intervention.ConclusionsThis study provides the first evidence for a school based intervention that reduce & prevent PEs in adolescence. This intervention is a combination of a school-based screening for psychopathology and subsequent referral intervention significantly reduced PEs in adolescents. Although further research is needed, our findings point to the effectiveness of school-based programmes for prevention of future mental health problems.

P016 Evaluating the effectiveness of an interactive educational intervention on sleep health for second-year pharmacy students

Abstract Background Pharmacists are usually the most frequently consulted professionals in primary care for health concerns, such as sleep disturbances. However, conventionally, curricular space devoted to sleep health has been insufficient and this eventuates in suboptimal care provision. For example, pharmacists often provide over the counter/complementary medicines rather than the recommended behavioural counselling for insomnia management. Clearly, pedagogically informed learning experiences about sleep health/insomnia management are important to improve practice. Objectives To develop, implement and evaluate an interactive sleep health educational intervention for 2nd year pharmacy students. Methods An educational intervention utilising a flipped classroom approach, with interactive lectures, self-reflection around personal sleep habits, and role-playing behavioural treatment provision was designed and implemented. A questionnaire assessing pre- and post-intervention changes in knowledge about and attitudes towards sleep as well as post-intervention learning satisfaction, was administered to students. Results Mean total knowledge scores for participating students (n=125, 70.4% females) improved significantly post-intervention from a baseline of 11.1 ± 3.8 to 17.1 ± 3.5 post-intervention, p &amp;lt;0.05 (Score range= 0-25). The mean total attitudes scores also improved from 28.8 ± 3.2 at baseline to 29.4 ± 3.8 (Score range= 10-50), p=0.07; however, this change was insignificant. Conclusion Carefully crafted educational interventions for pharmacy students can help improve sleep health knowledge. Whilst a trend to improved sleep health attitudes was evident, it was not significant, possibly because of positive sleep health attitudes even at baseline. Such programs should be incorporated into pharmacy pre-registration curricula to potentially enhance future pharmacists’ skills in sleep health provision.

Perceptions Of An Interactive Concussion Education Platform Among Reserve Officer Training Corps (ROTC) Cadets

Effective concussion educational intervention concerning the clinical presentation and the benefits of concussion care-seeking is essential to allow for timely identification and treatment of concussions among reserve officers’ training corps (ROTC) cadets. PURPOSE: Explore perceptions of a novel, interactive concussion education platform in ROTC cadets. METHODS: As a part of a larger study, participants viewed a theory-driven, decision-based, interactive concussion education intervention. The current study used a consensual qualitative research tradition grounded in phenomenology. 20 ROTC Cadets (7 males, 13 females; mean age 19.95 ± 1.96) were interviewed. Cadets were recruited via convenience sampling until data saturation was met. Semi-structured in-person interviews were transcribed verbatim. The interviews addressed platform perception. A four-person research team of novice and expert qualitative researchers coded data into themes and categories before meeting to attain consensus on coding accuracy and comprehensiveness. An internal auditor reviewed results. RESULTS: Interviews highlighted two key themes concerning the educational platform: 1) platform impressions and 2) education considerations. The platform impression theme included categories for visual content, verbal content, decision point, general impressions, perceived benefits, and enhancements. Cadets discussed the relatable and straightforward visual content portraying training scenarios. The platform was described as a catalyst to reinforce previously attained concussion knowledge and influence concussion knowledge in those newly exposed. Educational considerations included categories considering implementation, source, channel, and message. Cadets discussed the need and desire for concussion education to be captivating and military specific. The interactive component and military context of the platform allowed them to relate to the material in a way conducive to learning. CONCLUSION: Findings suggest that interactive education platforms that consider the ROTC specific audience are favored by cadets. This highlights that concussion education should be engaging and inclusive to foster buy-in from the targeted audience.

Human albumin solution utilization patterns prior and during COVID-19 pandemic in United Arab Emirates: Time to develop and implement national guidelines on prescription and utilization.

The human albumin solution (HAS) has limited but important indications in clinical practices. However, the inappropriate use of HAS can be costly. Thus, it is imperative to establish a practical protocol to use albumin products and rationalize its usage. The aim of this study was to identify HAS utilization patterns in a multi-specialty private hospital in Dubai, United Arab Emirates (UAE), before and during the COVID-19 pandemic. In addition, the objective was to demonstrate the importance of reconsidering the prescribing strategies for HAS administration. All data on 20% HAS administration in Mediclinic Welcare Hospital (MWEL) were retrieved between January 2019 and May 2021, including the total quantities administered and data on primary diagnosis. A total of 579 patient admissions with various diagnoses were included in this study. Our data suggested that the percentage of clinically indicated 20% HAS administrations decreased from 13.0% in the pre-COVID-19 phase to 1.5% in the COVID-19 phase (p<0.001). An increase in the administration of 20% HAS not backed by agreed clinical evidence followed the increase in new number of COVID-19 cases in the UAE. Our study suggests a large proportion of administered HAS, that drastically increased during COVID-19 with lack of evidence of its benefit. This study can be helpful to refine the institutional guidelines of HAS use, and frequent audits and interactive educational interventions are recommended to tackle this issue. In turn, the refinement of HAS administration guidelines could help to reduce the unjustified cost of inappropriate HAS use.

EFFECTS OF EDUCATIONAL INTERVENTION ON SEXUAL HEALTH KNOWLEDGE, ATTITUDE AND BEHAVIORAL PRACTICES: A SCHOOL-BASED STUDY IN CALABAR, NIGERIA

Background: High risk sexual behavior (HRSB) contributes significantly to sexually transmitted diseases (STIs) and unwanted pregnancy. This study was aimed at assessing effects of interactive educational intervention, on knowledge, attitude and practice of safe sexual behavior, among sexually active in-school adolescent girls in Calabar, Nigeria. Methods: Quasi-experimental study design was used, with recruitment of one hundred and twenty (120) respondents in two senior secondary schools, comprising sixty (60) each, in groups 1 (control) and 2 (intervention). Group 2 received 2-hour daily, 3-day face-to-face educational teachings on sexual health. Outcome measures assessed at baseline, immediate post-intervention and 12-weeks follow-up, were level of knowledge, attitude and sexual health behavioral practices, with maximum scores of 62, 55 and 35, respectively. Independent t-test was used as inferential statistic, with p-value set at 0.05. Result: Mean age was 17.2 ± 1.1 years (14-19 years). At baseline, comparing groups 1 and 2, there was no significant difference in level of knowledge (24.7 vs. 26.1), attitude (33.7 vs. 32.2) and practice (23.8 vs. 24.7) of sexual health. Compared with group 1 (control), respondents in group 2 (intervention) had significantly higher level of knowledge of sexual health at immediate post-intervention (25.5 vs. 56.4, p&lt;0.05) and 12-weeks follow-up (24.0 vs. 50.8, p&lt;0.05). There was no significant difference in practice scores between the groups comparing these periods (p&gt;0.05). Conclusion: Interactive educational intervention, is effective in improving knowledge of sexual health among sexually active adolescent girls. Concerted effort at establishing and sustaining school-based sexual health education should be encouraged.

Playing With Your Emotions

As a result of the COVID-19 pandemic, online misinformation has proliferated, requiring innovative interventions to improve information literacy for the public. In this paper we report on an evaluation of an interactive narrative education intervention developed as part of a design-based research project into microlearning and COVID-19 misinformation. The intervention aimed to enable learners to (1) name the role that fear and anger play in the spread of misinformation, and (2) identify a strategy for interrupting the spread of misinformation driven by fear or anger. Using a pre- and post-test design, we surveyed 195 Canadian women to evaluate whether the intervention was effective at achieving its learning outcomes. Results indicate that the intervention was effective in improving understanding about emotionally-driven misinformation, the role of emotions in the circulation of misinformation, and self-efficacy with respect to this type of misinformation. Based on these results, we suggest that short interactive narratives may be useful in education efforts aimed to address online misinformation and that this technique may have wide appeal to educators seeking accessible web tools for teaching this type of content.

Academic detailing interventions for opioid-related outcomes: a scoping review.

BackgroundAcademic detailing (AD) is a tailored, interactive educational outreach intervention that may improve patient outcomes. Insight into the design of AD interventions and the extent to which they are effective can help inform future AD-based programmes. The objective of this scoping review was to characterize opioid-focused AD interventions and describe their findings.MethodsA scoping review focused on AD interventions for opioids was conducted in PubMed, EMBASE and CINAHL databases through July 1, 2021. Studies were eligible for inclusion if written in English, included interactive opioid-focused educational interventions, and were conducted either in person, virtually or via telephone. Four independent reviewers reviewed titles and abstracts. Data extraction from full-text publications was completed using a standardized form.ResultsOf 6086 articles initially identified, 22 articles met the inclusion criteria and 20 unique interventions were identified. The AD intervention was either delivered one-on-one (n=16) or in a small, interactive group setting (n=4). AD interventions varied in design. Effectiveness was evaluated in terms of opioid and naloxone prescribing rates, provider knowledge gaps, provider adherence to guidelines, and intervention feasibility. Sixteen (80%) interventions resulted in statistically significant improvement in one or more outcomes.ConclusionGenerally, opioid-related AD was effective and programmes were primarily conducted one-on-one between pharmacists and primary care providers for 16–30 minutes. A variety of metrics and outcomes were used to assess the success/effectiveness of AD interventions, which is an important consideration in future studies as no single metric captures the effectiveness of an educational outreach-based intervention for pain management.

Burden of upper respiratory tract infections in primary care facilities and excessive antimicrobial over-prescription: A community-oriented primary care project in rural Kenya.

During their community oriented primary care (COPC) rotation in rural coastal Kenya, residents of the Family Medicine programme at the Aga Khan University–Nairobi, identified a high burden of upper respiratory tract infections (URTI) in the dispensaries with high prescription of antimicrobials (AMs) in over 80% of the patients presenting with URTI. An interactive participatory education intervention, designed based on principles of community participation and capacity building, reduced AM prescription in the under 5-year age group with 44% in the 2 weeks after the intervention, and with 18% at week 8 and 9. In the over 5-year age group, this was reduced with 18% and 8%, respectively. Key challenges for upholding AM stewardship after the intervention included the high patient workload in the clinics, difficulties in addressing patient’s concerns regarding the prognosis, inaccessibility to ingredients for home therapies, and easy availability of AMs without prescription at local chemists. Interventions addressing improper prescription at the facility level should include provision of continuous training, including communication training, for health facility staff, as well as audits on prescription practices. Collaboration with Community Health Volunteers (CHVs) can help in increasing community awareness on antimicrobial resistance (AMR). This study demonstrates the value of family physicians in clinical governance and improving the quality of care through implementation of guidelines and training. Joint action with the Kilifi county Ministry of Health and the private sector is needed to address mal-regulated access to AMs beyond health facility control.

Enhancing primary care capacity in chronic kidney disease management: a quality improvement educational initiative

BackgroundGaps in identification, medical management and appropriate referral for patients with chronic kidney disease (CKD) are evident.ObjectiveWe designed and implemented an interactive educational intervention (accredited workshop) to improve primary care...