Pre-post Evaluation Research Articles

P-1728. Let's Settle the "Score": Implementation of a Prioritization Tool into an Antimicrobial Stewardship Prospective Audit and Feedback Program

Abstract Background Prospective audit and feedback (PAF) remains the backbone of antimicrobial stewardship (AS) action. However, PAF is time consuming and does not always result in intervention. A prioritization scoring tool is a proposed solution to improve AS efficiency. We sought to assess the impact of a scoring tool (‘score’) on the efficiency of our AS program.Figure 1.Interrupted Time Series Analysis of Intervention Rate Pre-Post Score Implementation Methods A pre-post evaluation of AS PAF at an academic medical center was performed. The pre-score period (November 2022 – June 2023) consisted of standard PAF (largely 48-hour review). The post-score period (July 2023 – March 2024) included standard PAF in addition to the score. The scoring tool is embedded within the AS surveillance system in the electronic medical record and is used to readily identify patients with opportunities for antimicrobial optimization. It consists of pre-defined “points” for each programmed alert (e.g. bug-drug mismatch=10) which are reported in real-time as a prioritized list (higher score = higher priority). An interrupted time series was conducted to compare the intervention rate pre- and post-score implementation. A subgroup analysis was conducted on the post-score period comparing the reviews triggered by the score versus the 48-hour review. A univariate logistic regression was carried out to determine the association of the score with AS intervention.Table 1.Comparison of Score Interventions vs 48-hour Review during the Post-Period Results There were 5801 AS reviews in total, 2927 pre-score and 2874 post-score (92 missing outcome data). The mean intervention rate pre- and post-score was 46.2% and 52.3%, respectively (p< 0.001), with a +2.2% difference per month (p=0.036) as illustrated by Figure 1. The change was gradual without any significant, immediate level change. The score subgroup consisted of 312 reviews and were compared to 1180 48-hour reviews during the same period. Table 1 compares the two groups demonstrating overall high intervention rate in the score group (52.6% vs 40.9%, p < 0.0001); however, notable characteristics were different. An AS intervention was 1.6 times more likely when using the score approach (OR 1.6, 95% CI 1.3 – 2.0). Conclusion Implementation of an antimicrobial scoring tool may improve PAF efficiency by better predicting patients for antimicrobial optimization than standard 48-hour review. The scoring tool can be an impactful method when performing PAF. Disclosures Kimberly C. Claeys, PharmD, PhD, bioMérieux: Advisor/Consultant|bioMérieux: Honoraria

Cultivating cultural empathy among diabetes educators: A pre-post evaluation of a digital story intervention

Background: Indigenous Australians are disproportionately affected by diabetes, with a diagnosis rate nearly four times higher than people from a non-Indigenous background. This health disparity highlights the urgent need for healthcare providers to develop cultural empathy – a critical competency for delivering culturally safe and person-centered care. Cultural empathy is essential for building trust and effective communication in diabetes education and management within Indigenous people. However, there is a significant gap in targeted interventions to enhance this skill among healthcare providers. Aims: The aim of this study was to evaluate the effectiveness of a digital storytelling intervention for enhancing cultural empathy levels of postgraduate diabetes education students. Design: This study has a pre-post survey design to measure changes in participants’ cultural empathy levels after exposure to a digital story. Methods: Students enrolled in a postgraduate diabetes education course at an Australian university were eligible to participate. The intervention included a first-person digital story about an Indigenous man with type 2 diabetes, accompanied by group-based discussions and self-reflection. The Comprehensive State Empathy Scale was utilised to assess empathy levels. Results: A total of 98 students completed both pre- and post-intervention surveys. There was a statistically significant increase in mean Comprehensive State Empathy Scale scores post-intervention (p < 0.001), indicating higher empathy levels. Improvements were observed across all six Comprehensive State Empathy Scale subscales, suggesting a multidimensional impact of the intervention. Conclusions: The digital story intervention significantly enhanced the cultural empathy levels of postgraduate diabetes education students. This study contributes to the evidence base for narrative-based pedagogies in cultivating empathy among healthcare providers. The findings highlight the potential of digital storytelling as a tool for improving cultural competency in healthcare education and practice, ultimately contributing to more empathic care for Indigenous people with diabetes.

Outcomes and interventions used by mental health and wellbeing practitioners in older adult services

Background:The mental health and wellbeing practitioner (MHWP) role was introduced in 2022 as a key part of the plan for expanding psychological support in secondary mental healthcare. The low-intensity interventions they are trained in can facilitate change and improved wellbeing among service users -with equivalent low-intensity support working well with older people in NHS talking therapies. However, up to now, there has been a lack of evidence for the efficacy of MHWPs with older people in secondary care.Method:NHS Trusts have been encouraged to record the brief recovering quality of life questionnaire (ReQoL-10) at regular intervals. By accessing this data from Sussex Partnership Foundation Trust’s electronic patient record system, a pre-post evaluation indicated how scores change when older service users work with MHWPs. To complement this, MHWPs in both older adult and working age services were surveyed on which interventions were used.Results:When MHWPs worked with older service users, clinically significant improvement (of five points or more) was recorded in 48% of paired scores. The most commonly used interventions for older people were behavioural activation and self-soothing.Conclusion:This initial evaluation of MHWPs working with older people supports the use of low-intensity interventions in secondary care settings, but a larger follow-up evaluation is recommended.

Pre-post intervention evaluation of training in knowledge and practices in psychological first aid for teachers university tutors

This quasi-experimental pretest-posttest study evaluated the impact of a Psychological First Aid (PAPs) course-workshop on the knowledge and perceptions of 100 tutors from a Public University in Mexico. The participants, 60 women and 40 men from various academic areas, completed questionnaires before and after the intervention. The results indicated a significant increase in knowledge of PAPs, with a high effect size (d = 1.74) and high statistical power (1-β = .95). In addition, significant improvements were observed in the perception of the importance and training in PAPs, as well as in the perception of the integration of the gender perspective, although with a smaller effect size in this last aspect. The findings underline the need for continuous and specialized training for tutors, especially on mental health issues and gender perspective.

The Relationship Between Manual Dexterity and Toothbrushing Efficiency in Preschool Children: A Crossover Study.

The aim of this study was to evaluate the relationship between oral hygiene (OH) efficiency and manual dexterity skills in Spanish five-year-old children using two fine motor tests. A cross-sectional study with a pre-post evaluation was designed. The children's OH was measured according to the Silness and Löe plaque index (PI) before toothbrushing upon arrival at school (pre) and after supervised toothbrushing (post). Motor skills (children's dexterity) were determined with the Visual Motor Skills and Resistance to Fatigue test (VMSRF test) and the scale for the Behavioural Assessment of Preschool Skills (BAPS scale). Data were analysed with the SPSS® statistics software with a 95% confidence interval and bilateral significance. One hundred and twenty-nine children were evaluated. The mean PI was 2.5, indicating generally poor OH in the sample. No difference in OH was observed between genders or in the brushing frequency categories. No significant differences in OH or the PI were found between right- and left-handed children either (p > 0.05). Significant differences were found between the OH category pre and post toothbrushing in the total sample, as well as in the various sextants and surfaces evaluated. The results of the VMSRF and BAPS tests indicate moderate visuomotor skills and fatigue resistance and a poor average skill level. A statistically significant improvement in the PI was found in children with higher scores in the VMSRF and BAPS tests. A significantly higher OH efficacy was found in children with better motor skills, although five-year-old children showed moderate visuomotor skills and fatigue resistance and a poor average preschool skill level.

Nurse-led education for patients in plain language: Evaluation of a teaching concept for prospective nursing professionals

Nurse-led education for patients in plain language: Evaluation of a teaching concept for prospective nursing professionals Abstract: Background: Nurse-led education for patients is a core competency of nurses. A particular challenge is the education of the growing group of people with limited literacy skills. Aims: The aim of our project was to develop and evaluate a teaching concept that would gradually enable prospective nursing professionals to independently carry out nurse-led education for people with low literacy. Methods: First, a teaching concept for a nurse-led education for patients in plain language was developed, which was implemented with prospective nursing professionals of the Bachelor of Nursing programme at Charité - Universitätsmedizin Berlin and tested with a pre-post evaluation. Self-developed items were used to measure experience, confidence, competence and learning increase. Results: Before starting the teaching concept, 56% (n = 14) of the participants already had some experience with patient education. The relevance of the topic was rated as very high (Median = 9; IQR = 10-8; n = 25). After completing the teaching concept, participants felt more confident in conducting nurse-led education (T0: 36% vs. T1: 79%) and more competent in using plain language (T0: 4% vs. T1: 26%). Conclusion: A teaching concept that combines the development of nurse-led education for patients with the target group-specific approach of plain language increases the confidence of carers in their teaching skills and the self-management of people with low literacy.

Increasing the Use of Newborn Pain Treatment Following the Implementation of a Parent-Targeted Video: An Outcome Evaluation.

Despite strong evidence that breastfeeding, skin-to-skin care, and sucrose reduce pain in newborns during minor painful procedures, these interventions remain underutilized in practice. To address this knowledge-to-practice gap, we produced a five-minute parent-targeted video demonstrating the analgesic effects of these strategies and examined whether the use of newborn pain treatment increased in maternal-newborn care settings following the introduction of the video by nurses. The design was a pre-post outcome evaluation. The participants were infants born in eight maternal-newborn hospital units in Ontario, Canada. Data on newborn pain treatment were obtained from a provincial birth registry. Descriptive statistics and chi square tests were used to compare the before-and-after changes in the use of pain treatment. Data on 15,524 infants were included. Overall, there was an increase in the proportion of newborns receiving any pain treatment comparing before (49%) and after (54%) the video intervention (p < 0.0001) and a decrease in the proportion of newborns receiving no pain treatment pre- (17.6%) and post-intervention (11.5%) (p < 0.0001). Most of the change aligned with increased sucrose use (35% to 47%, p < 0.0001) in three of the larger units. Nevertheless, considerable increases in the use of breastfeeding and/or skin-to-skin care (24% to 38%, p < 0.0001) were also observed in three of the smaller units. The video intervention was effective at increasing the use of pain treatment for newborns. Though the overall increases were modest, there were some large increases for specific methods of pain treatment in certain maternal-newborn units, reflecting the diversity in practice and context across different sites.

Evaluation of occupational therapy in persons with COVID-19: a pre-post observational cohort study.

Persons with COVID-19 may experience limitations in daily functioning and can be referred to occupational therapy. To evaluate changes in daily functioning, cognitive complaints, fatigue and self-management of persons with COVID-19 who received occupational therapy in primary care.To get insights in the volume and duration of occupational therapy. A pre-post observational cohort study from October 2020 until April 2021. Fifty-eight occupational therapy practices in primary care throughout the Netherlands participated with 68 occupational therapists. 228 adults (≥18 years) with COVID-19, referred to occupational therapy, gave informed consent and participated in the pre-post evaluation. The mean age was 49 years (SD 13) and 79% of the patients was female. The most frequently reported complaints included fatigue and cognitive complaints. Occupational therapy using Dutch guidelines for occupational therapy in clients with COVID-19. Performance and satisfaction with performance using the Canadian Occupational Performance Measure (COPM); the impact of Cognitive Complaints on Participation (CoCo-P); and daily activities, self-management and perceived contribution of occupational therapy using the Patient Reported Outcome Measure for Occupational Therapy (PROM-OT). COPM-performance score improved with a mean difference of 2.9 points (95% CI 2.7 to 3.2), and COPM-satisfaction score improved with 3.2 points (95% CI 2.9 to 3.5). CoCo-P score improved with a mean difference of 20.9 points (95% CI from 14.4 to 27.4), and PROM-OT improved with 42.8 points (95% CI from 40.2 to 45.4). Participants received a median of seven sessions of occupational therapy (IQR 5-10) with a median duration of 18 weeks (IQR 12-25). They valued the contribution of occupational therapy to their improved functioning with a mean score of 8 (SD 1.4) and recommended this to others with a mean score of 9 (SD 1.2). Persons with COVID-19 who received occupational therapy in primary care improved significantly in daily functioning and highly valued occupational therapy.

One-to-one counselling and school attendance in the UK: a single group pre-post study

ObjectiveAbsence rates remain high in UK schools, with negative implications for attainment, life chances and inequality. Reasons for non-attendance are complex but include psychosocial factors. Few UK-based studies have evaluated...

Evaluation of a Faculty-Led Clinical Model to Meet Pediatric Preventive Care Competencies Through a Pediatric Mobile Clinic.

Limited pediatric primary care clinical placement sites and preceptors have made it difficult for family nurse practitioner (FNP) students to meet pediatric preventive clinical competencies. The purpose of this project was to evaluate a faculty-led clinical model to meet pediatric preventive care competencies through a pediatric mobile clinic. A pre-post evaluation design was used to evaluate student perceptions of their achievement of competencies. Students demonstrated improvement in all seven competencies. A faculty-led clinical model through a pediatric mobile clinic may be an effective way to improve pediatric clinical competencies for FNP students.

Ethical self-efficacy among healthcare professionals caring for people with dementia: a brief pre- and post-report on the CARE intervention

BackgroundInterventions targeting healthcare professionals’ confidence in managing ethical issues in dementia care are limited despite documented positive effects of educational programs on staff knowledge and self-efficacy. However, inconsistencies in the literature regarding the impact of educational programs underscore the need for targeted interventions. The CARE intervention, specifically designed to enhance confidence in ethical decision-making, aims to address this gap. This study evaluates the effectiveness of the CARE intervention in enhancing the ethical self-efficacy of healthcare professionals caring for people with dementia, particularly those with initially low levels of self-efficacy.MethodsUsing a non-experimental pre-post evaluation design, the CARE intervention was administered to healthcare professionals (n = 86), measuring ethical self-efficacy pre-and post-intervention. We hypothesized significant differences in ethical self-efficacy mean scores pre- and post-intervention for all participants, particularly those with low pre-measurement scores, whom we expected to benefit most from the intervention. Statistical analysis included paired t-tests and Wilcoxon tests for the low pre-measurement subgroup analysis.ResultsWhile no significant change was observed in the entire sample, participants with low initial self-efficacy showed a statistically significant improvement post-intervention.ConclusionsThe CARE intervention holds promise in improving ethical self-efficacy among healthcare professionals with initial low confidence levels. Targeted interventions are essential in addressing confidence gaps in managing ethical challenges in dementia care, with implications for professional well-being and quality of care. Further research should explore long-term effects and expand sample size to enhance generalizability and sustainability of findings.

Assessing the knowledge of low back pain among physiotherapists in Spain: A cohort study with pre- and post-educational course evaluation

BackgroundLow back pain (LBP) is the most prevalent musculoskeletal disorder worldwide and physiotherapists are among the primary healthcare professionals assessing and treating the condition. However, scientific knowledge regarding the management of LBP amongst physiotherapists is largely unknown. ObjectivesTo evaluate the level of evidence-based knowledge among Spanish physiotherapists in LBP management and assess knowledge enhancement following the completion of an e-learning course. DesignSingle-arm cohort study with pre-post evaluation. MethodsThis single-arm pre-post study involved 1350 physiotherapists practicing in Spain. Initially, participants underwent a 22-question test on evidence-based LBP knowledge, covering socio-economic impact, characteristics of LBP, rehabilitation goals, psychosocial factors, and high- and low-value interventions. After completing the course, participants took a final test with the same 22 questions in randomized order. ResultsOut of the 1350 physiotherapists enrolled, 857 completed the course. The initial responses demonstrated that almost half of the participants considered medical imaging essential before starting physiotherapy treatment, perceived glucocorticoids as recommended for chronic low back pain, and considered ergonomic adjustments crucial for managing the condition. Individuals who completed their education more than 10 years ago showed a minor improvement in evidence-based knowledge compared to those who recently finished their university degree. Following the course, participants displayed improved knowledge, narrowing prior disparities in error percentages across questions. ConclusionDue to existing gaps in physiotherapists’ evidence-based knowledge of LBP, particularly among those who have worked longer time as physiotherapists, e-learning initiatives may be a feasible approach to support continuous training of physiotherapists.

No Money No Time Culinary Nutrition Website eHealth Challenge: A Pre-Post Evaluation of Impact on Diet Quality, Food Expenditure, and Engagement.

No Money No Time (NMNT) is a culinary nutrition website designed to optimize diet quality. The primary aim was to evaluate the impact of an online targeted nutrition challenge email campaign that encouraged engagement with NMNT and goal setting to improve diet quality and weekly food expenditure. A secondary aim was to assess NMNT engagement. Australian adults ≥18 years were recruited to the eHealth nutrition challenge delivered via weekly emails. Diet quality was assessed using the Healthy Eating Quiz (HEQ) diet quality tool. Engagement was assessed using email open and click-through rates. Intention-to-treat (ITT) analysis was conducted using mixed effects linear regression. Of 481 adults (49.7 ± 13.9 years, 84% female) who enrolled 79 (16%) completed the challenge. ITT results indicated statistically significant 6-week increases in diet quality score (+3.8 points p ≤ 0.001, d = 0.58) with sub-scale improvements in vegetables (+0.9 points, p = 0.01, d = 0.32), fruit (+1.2 points, p ≤ 0.001, d = 0.55), and dairy (+0.9 points, p ≤ 0.001, d = 0.58). There were significant post-challenge reductions in household spending on takeaway/snacks/coffee of AUD 8.9 per week (p = 0.01, d = 0.29), body weight reduction (-0.6 kg, p = 0.03, d = 0.26), and BMI (-0.2 kg/m2p = 0.02, d = 0.28). The email open rate remained constant at around 67% (56% to 75%), with an average click-through rate of 18% (7.1% to 37.9%). The eHealth nutrition challenge significantly improved diet quality while reducing BMI and money spent on discretionary foods. Strategies to scale the challenge should be tested as an innovative population strategy for improving diet quality, health indicators, and managing household food budgets.

Implementation of a Childhood Lead Poisoning Prevention Program Data and Outcomes Management System Based on the Omaha System: A Pre-Post Evaluation.

Implementation of a Childhood Lead Poisoning Prevention Program Data and Outcomes Management System Based on the Omaha System: A Pre-Post Evaluation.

241 An All-Island Review of the Gaelic 4 Mothers &amp; Others (G4M&amp;O) Programme in Ireland

Abstract Purpose The Gaelic 4 Mothers &amp; Others (G4M&amp;O) initiative is a fun, non-competitive and recreational programme in Ireland for women to play Ladies Gaelic Football (LGF). The programme is aimed at women over 25 years of age who are not formally playing sport competitively. The initiative was introduced to community sports clubs in Ireland in 2008 by the Ladies’ Gaelic and Football Association (LGFA), and the programme now has over 500 sites across the island. The current study aims to assess the impact and benefits of the G4M&amp;O initiative on; (i) participants, (ii) clubs and (iii) communities across Ireland. The research should inform the development of the G4M&amp;O programme, providing critical insights for the LGFA and Sport Ireland. Project Description As part of this all-island study, a 12-week pre-post longitudinal research design evaluation will be undertaken in 2024, using established qualitative and quantitative research methodologies focusing on: 1) Participants involvement within the club; 2) Participants involvement within the community. A nationally representative sample of participants (N = 300 targeted) will be recruited through the LGFA, which is the main national governing body (NGB) for LGF participation in Ireland. A self-report validated online survey will be used to evaluate the impact of the programme on participants. Focus groups will also be conducted with a sample of participants (N = 40 targeted) across a variety of clubs exploring participants viewpoints and perspectives of the G4M&amp;O programme. Data will be analysed quantitively using Statistical Package for the Social Sciences (SPSS) version 29 and qualitatively using Thematic Analysis (TA). Conclusions This study will contribute to a qualitative and quantitative understanding of the benefits and impact of G4M&amp;O programme in clubs and communities and should inform how the G4M&amp;O initiative can be developed across Ireland over the next 10-years. The study will align to the Irish National Sports Policy 2018-2027, given that increasing physical activity and sports participation are the cornerstones of this new policy. The study may inform further research to develop a model for use in other sports.

On the Importance of Contextualizing an Educational Escape Room Activity

This paper describes the design and evaluation of "Enigma Bio", an educational escape room activity that aims to convey the abstract concept of biodiversity to children between 11 and 13 years of age, making them aware of the importance of climate change and its impact on biodiversity. The design of Enigma Bio is closely linked to the Biodiversity exhibition at the National Museum of Natural Sciences in Madrid, designed for a visit in groups of between 20 and 30 children, with an approximate duration of one hour, running on mobile devices and including augmented reality technology. The purpose of this research is to determine whether, in the case of educational escape room activities in museums with a limited time duration, it is more effective to have a pre-session introducing the topic. Our hypothesis is that without the context of the pre-explanation, the playful component of the game may be too powerful and may cause children not to pay enough attention to the message that the game intends to communicate, and even more so when dealing with a complex message such as the effect of climate change on biodiversity. To answer this research question, we follow an A/B testing experimental design involving two groups of children, one of which received an introductory talk on biodiversity and climate change before going to the museum and the other did not. The experimental design is completed with a pre-post evaluation of the children's environmental awareness by means of a previously validated questionnaire. The results of the experiment provide valuable insights into the effectiveness of the pre-session introduction in enhancing the learning outcomes of short educational escape room activities. Significant differences were observed between pre- and post-activity tests, indicating a moderate overall increase in awareness scores within both individual groups (A and B) as well as across the combined results. The findings suggest that the pre-session introduction indeed plays a role in enhancing students' awareness of the targeted message. These results represent a breakthrough in the e-learning practice that will be of value to other designers of educational escape rooms with a limited time duration.

Evaluation of the impact of an online video game as an educational intervention on sexual health and the prevention, diagnosis, and treatment of sexually transmitted infection: A randomized controlled trial protocol

BackgroundThe incidence of sexually transmitted infections (STIs) is increasing, especially among young people. Tools are needed to increase knowledge about sex education and STI prevention and treatment. Gamification can be a good training tool for both young people and health professionals. The primary objective of this study is to assess the impact of a training intervention on STI prevention, detection, and treatment in primary care professionals.Methods/designMulticentre cluster randomized controlled trial.Groups of primary care professionals will receive an intervention (online video game on sex education and STIs [SEXIT]) and will be compared with control groups that will not receive the intervention. Group assignments will be randomized by clusters.The study will consist of a pre-post evaluation of the intervention: a knowledge test will be administered before and after the intervention and 3 months after the intervention. This test will also be carried out on the same time sequence in the control groups. The impact of the training intervention will be assessed over a 6-month period, focusing on various variables associated with the clinical management of STIs. This evaluation entails the clinical records of diagnostic tests and antibiotic prescriptions related to the clinical approach to STIs.The required sample size is 262 (131 per group).DiscussionCompared with those in the control group, improvements in knowledge and clinical behavioural outcomes after the intervention are expected for participants in the intervention groups. We plan to develop an educational video game to increase the knowledge about sexuality, STIs and violence.Protocol registered at ISRCTN with reference number ISRCTN17783607.

Enhancing nursing students' cultural awareness through Community of Inquiry-guided online 'Internationalization at Home' strategies-An intervention study.

Internationalization at Home (IaH) strategies play an important role in nursing curricula to enhance nursing students' cultural awareness in the globalized world. The Community of Inquiry (CoI) is a theoretical framework for the optimal design of online learning environments to support critical inquiry and discourse among students and teachers. To optimise nursing students' online cultural awareness learning experiences, it was timely to develop online IaH strategies based on a sound theoretical model. This study aimed to examine the effectiveness of CoI-guided online IaH strategies on enhancing the cultural awareness of nursing undergraduates who enrolled in a community nursing course. This was an interventional pre-test post-test study. One hundred and six nursing undergraduates who enrolled in the course participated in the study. The online IaH strategies were developed focusing on the interactions of teaching presence, cognitive presence and social presence of CoI framework and they were integrated into the course. A previously validated Cultural Awareness Scale was adopted for pre-post evaluation. Higher scores indicate greater cultural awareness. The results showed that there was a significantly higher total score of cultural awareness of participating students at post-online IaH strategies. To be effective, aligning CoI-guided online IaH strategies with course content, pedagogy and assessment was shown to be significant. The inclusion of technological elements in related strategies was also critical to engage student learning. The positive change on the total score of cultural awareness suggested the effectiveness of the deployed strategies. In this ever-changing educational landscape, it may provide insights to educators regarding considering online IaH strategies with theoretical underpinning for curriculum planning and design.

A novel learner driver first aid eLearning program: a mixed-method pre-post pilot test and evaluation

BackgroundApproximately 1.35 million people worldwide are killed in road accidents every year. Mandatory first aid training for learner drivers has been introduced in some European countries but no such requirements are in effect in Australia. The current study aimed to pilot and evaluate a first aid eLearning program for Australian learner drivers undertaking their mandated supervised driving hours.MethodsA total of 103 participants (M age = 20.57; 52.4% female, 96% completion rate) responded to an online survey immediately before and two weeks after completing the Learner Driver First Aid program. Participants completed measures of first aid self-efficacy, first aid knowledge, and attitudes towards first aid, and provided qualitative feedback on the program. Paired samples t-tests and Mann-Whitney U tests assessed improvements in first aid self-efficacy, knowledge, and attitudes, and qualitative feedback were analysed thematically.ResultsParticipants showed significant pre-post program improvements in first aid self-efficacy (p < .001) and first aid knowledge (p < .001); however, there were no significant changes in attitudes towards first aid (p = .028). Self-efficacy and knowledge improvements were significantly greater for those without prior first aid training (p < .001). Participants rated the usability of the online program favourably and most (93.2%) were satisfied or extremely satisfied with the program. Qualitative feedback suggested participants found the program to be accessible and interactive but noted concerns about the transfer of skills to the real-world context.ConclusionsThe findings provide support for the efficacy of online first aid training for Australian learner drivers. However, further improvements to the eLearning program based on participant feedback should be considered. This study recommends the Learner Driver First Aid program be refined and rolled out to the Australian public.

Implementing a clinical decision support tool to increase early peanut introduction guidance

BackgroundGeneral pediatric providers are the frontline for early peanut introduction discussions, but many feel ill-equipped to handle such discussions as guidelines have quickly changed. ObjectiveWe hypothesized that a clinical decision support (CDS) tool could improve peanut introduction discussions. MethodsCDS tools were designed by stakeholders, improved through usability testing, and integrated into the current note templates. Based on queries of electronic health record (EHR), we did a pre-post performance evaluation of peanut introduction conversations, barriers for introduction, and percentage of 12-month WCC visits that had successfully introduced peanut. Providers completed surveys before and after intervention to assess awareness of early peanut introduction and comfort using CDS. ResultsProviders’ awareness of early peanut introduction guidelines increased from 17.8% to 66.7% after the CDS tool was implemented. 79.1% were comfortable using the tool. The CDS tool improved peanut introduction conversations at the 4-month well-child (WCC) care visit from 2.4% to 81.2%, at the 6-month WCC visit from 3.0% to 84.2%, and at the 12-month WCC visit from 2.7% to 82.9%. 56.6% of families had a plan to introduce peanut at the 4-month WCC visit. Of those who did not have a plan, the most common barrier was family's unawareness of the benefits of early peanut introduction. At the 12-month visit, 62.8% of families had introduced peanut without concerns. ConclusionA point-of-care CDS tool encouraged more discussions by general pediatric providers on early peanut introduction to all patients. CDS tools should be considered in quality improvement projects as an implementation method for the most up-to-date guidelines.