Effect of Web-Based Module on Nursing Students' Knowledge, Practice and Attitude Regarding Polycystic Ovary Syndrome
Condition: PCOS
MeSH terms: Polycystic Ovary Syndrome
Study type: Interventional

Summary: 
      Background: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrinopathy among
      reproductive-aged women that has become a major international public health concern.
      Objective: Investigate the effect of web-based health education module on nursing students'
      knowledge, adaptive healthy measures and attitude regarding polycystic ovary syndrome.
      Research design: A two-armed, single-blind, parallel groups prospective randomized controlled
      trial (RCT), with a baseline pre-test and immediate post-test was used to carry out this
      study. Setting: The study was conducted at the Faculty of Nursing, Mansoura University, Egypt
      in December 2022 to May 2023. Subjects and sampling: Simple random sampling technique was
      employed to recruit the study subjects. Data collection: A questionnaire was developed to
      acquire data including six parts.
    

Detailed description: 
      Pre-intervention phase:

      Initial data was gathered about the participants' socio-demographic characteristics, their
      knowledge, adaptive healthy measures, and attitude toward PCOS before the implementation of
      the health education intervention. A brief introduction to the goals, processes, voluntary
      nature of participation, confidentiality and anonymity declarations, and questionnaire cover
      page were all included. Participants were made aware that they could withdraw from the study
      at any moment, there would be no negative repercussions, and they could choose to have any
      case data acquired for the study destroyed. The informed consent form must be signed by the
      participants and submitted back by ordinary mail to participate.

      The developed health education module was created based on the participants' preliminary
      assessment results and according to recommendations from [30]. It consisted of seven
      interactive modules (4 hours' sessions) in Arabic that covered the following topics:
      "overview of PCOS, etiology and risk factors, signs and symptoms, diagnosis, complications,
      preventive measures, and treatment of PCOS." It aimed at increasing health awareness
      regarding PCOS, encouraging and promoting adaptive healthy measures to prevent PCOS, and
      promoting a positive attitude regarding PCOS.

      The module development team gathered to discuss how each module would be prepared and
      formatted, as well as how the modules' sessions would be broken down. The program was
      designed with a defined purpose, precise goals, pertinent materials, and instructional
      techniques. In addition, it was developed to provide easy access to web-based education that
      incorporates sources to increase knowledge and support healthy measures and a positive
      attitude regarding PCOS. This is done using a set of technical and instructional standards
      developed by a web-based design team and an information technology expert. The researchers
      provided the web designer with word-processed documents representing each distinct learning
      session, videos, a storyboard of suggested graphics, and a description of interactions.

      The development team met once a week to go over any issues that might occur with the module,
      to offer ideas and comments where appropriate, and to address any queries that might have
      come up while each session was being developed. The web-based design team and researchers
      chose a learning platform that gave users access to data, tools, and resources to support the
      administration and delivery of education about PCOS and associated preventive actions online.
      To get rid of Wix's pop-up advertisements, the researchers bought a distinctive website
      domain URL.

      The site map and links to the tutorials, forums, and other resources are all accessible from
      the main screen. The web-based module also included a chat room where students and students
      conducting research could post questions and engage in conversation. To get user feedback on
      the learning experience and improve the interface, post-learning discussions and comments
      were created. Additionally, each student's frequency and amount of time spent were noted.

      To make it simple for the user to choose another menu, the primary menu is also continuously
      shown on the upper bar. No session could be skipped because the navigation was sequential
      from session 1 to session 7. The intervention group participants could move on to the
      following screen, replay the current screen, or go back to the previous screen at any time
      during a session. They were given as much time as they needed to consider the data displayed
      on each screen.

      The researchers developed the content of the web-based health education sessions. Besides,
      they drew lines between the elements to indicate how they were linked together. These lines
      helped dictate sessions' organization, navigation, and hyperlinks. Moreover, it was arranged
      into seven sessions. It was displayed by using text, pictures, and videos.

      The content was uploaded to the website by the researchers and professional programmers
      (https://healthconcerns.tech/). The link to the website was distributed to a panel of five
      external reviewers (experts in community health nursing, women's health and midwifery
      nursing, and professional programmers) to systematically test the content's validity,
      clarity, consistency, accuracy, applicability, and format before the application of the
      web-based education module. Any specific guidelines or suggestions from the experts'
      evaluation were recorded and considered while creating the web-based teaching sessions. The
      traditional training session that was given to the control group's students' material was the
      same.

      The face validity of the web-based modules was assessed concurrently with the review process
      using a sample group of students (n = 14) who had no prior knowledge of PCOS to assess the
      clarity, applicability, and reliability of the module and to determine the approximate time
      needed to implement these sessions. Each student in the intervention group completed a module
      each week and gave the content producer detailed comments afterward. In most cases, students'
      input noted areas that needed clarification and more examples, as well as those that were
      unclear and confusing. During the revision process, student feedback was considered. By
      clicking on the link, participants could view the questions and submit their responses.

      Intervention phase:

      The intervention condition: The research website was recommended to the students in the
      intervention group of the study who had completed the pre-self-administered questionnaires.
      There, they learned more about the study and what participating in it entailed. The members
      of the intervention group were forced to create accounts on the website using personal
      passwords after logging in. An informational session was conducted to teach the intervention
      group's members how to utilize the learning management system (LMS) before they started their
      virtual education. The participants were given instructions to complete the module on their
      own for the duration of the session after receiving a brief orientation to the navigational
      features in addition to the help screen in the module. The module can be used on mobile
      devices, laptops, and personal computers. The online education module was only given to the
      intervention group.

      The intervention group's participants were permitted to access the module as many times as
      necessary to finish all of the sessions (https://healthconcerns.tech/). The participants were
      instructed to finish at least one and no more than two modules per week. Each module took 30
      to 60 minutes to complete. The intervention was therefore planned to be finished in roughly 5
      to 7 weeks. They were also told to heed the health advice that was given. Through website
      chat, all of the participants' inquiries were addressed, and they received feedback.

      The control condition is: Regarding the traditional health education group, the students had
      full access to traditional face-to-face health education regarding PCOS for a similar
      duration and by the same researchers. They were divided into seven groups. Each group had
      nine to ten students. The nursing faculty's instructional hall served as the location for the
      sessions. Each group's session lasted 5 hours over 2 days per week (10 a.m.-12 p.m.).
      Lectures, discussions, brainstorming, blackboards, printed handouts, and audiovisual
      materials were employed as teaching and learning tools throughout the sessions.

      post-intervention phase Participants' knowledge, adaptive healthy measures, and attitude
      about PCOS were evaluated using the same pre-test questionnaire for the intervention group
      and the control group. Additionally, feedback about the website was assessed once after
      completion of the module for the intervention group. All participants from the intervention
      and control groups started and completed the PCOS educational module. The control group was
      invited and given access to receive the identical web-based instructional module once data
      collection, evaluation, and analysis were finished.
    

Intervention name(s): Web-Based Learning Module (WBL)
Intervention type(s): Other
Intervention description(s): To ensure a uniform starting point, the participants were recruited via faculty website and students' academic counseling services. At the baseline, after the initial assessment, the participants were randomized at a 1:1 allocation ratio into the following groups: 1) traditional health education group (control group) (n = 68) who received health education with traditional face-to-face method; 2) web-based health education group (intervention group) (n = 68) who received health education with Web-Based Learning Module (WBL).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A two-armed, single-blind, parallel groups prospective randomized controlled trial (RCT), with a baseline pre-test and immediate post-test was used to carry out this study
Masking: Double (Participant, Investigator)
Primary purpose: Other
Keywords: Web-Based Learning Model; Knowledge; Attitude