Establishing and Evaluating the Effectiveness of an Augmented Reality Technology in Gender Empowerment System

Study Overview
=================
Brief Summary
-----------------
Background: In the interventional study of gender mainstreaming, few studies have been conducted on gender empowerment in long-term care. And there are still some limitations in the gender curriculum of current in-service education. This research will cooperate with the digital learning promotion plan to stimulate learners' senses to strengthen their feelings about gender equality issues and events to have a more flexible and diverse learning experience and enhance geriatric care competencies. Purpose: This study is a two-year plan, and the purpose of each year are as follows: 1). To conduct learning needs assessment of long-term care workers, and to develop and construct an educational training module for gender empowerment system of AR interactive experience. 2). To verify the effectiveness of the gender equality knowledge, attitude, awareness, and self-confidence of the research subjects after the Apply of augmented reality technology was introduced into the gender curriculum.

Detailed Description
-----------------
Background: In the interventional study of gender mainstreaming, few studies have been conducted on gender empowerment in long-term care. And there are still some limitations in the gender curriculum of current in-service education. This research will cooperate with the digital learning promotion plan to stimulate learners' senses to strengthen their feelings about gender equality issues and events to have a more flexible and diverse learning experience and enhance geriatric care competencies. Purpose: This study is a two-year plan, and the purpose of each year are as follows: 1). To conduct learning needs assessment of long-term care workers, and to develop and construct an educational training module for gender empowerment system of AR interactive experience. 2). To verify the effectiveness of the gender equality knowledge, attitude, awareness, and self-confidence of the research subjects after the Apply of augmented reality technology was introduced into the gender curriculum. Methods: This study will adopt a mixed research approach. We'll conduct focus group interviews in the first year. The interviewers want to invite specialists in the fields of long-term care/geriatric nursing education, scholars from the gender talent pool of the Ministry of Education, and specialists in the engineering of digital smart systems. Additionally, it is intended to include senior front-line long-term care providers in the planning and creation of lesson plans for this platform system. A randomized clinical trial (RCT) will be adopted which uses a 2-armed, controlled experiment, parallel-group design, and multi-center in the second year. The setting and participants will be recruited from four long-term care institution in Taipei and New Taipei city. Through the cluster random sampling method, two institutions will be randomly selected from the computer based on the  institution  from each long-term care institution, and then the allocation concealment mechanism will be based on the inclusion criteria to recruit research participants, then according to their willingness to participate in this project. The intervention will be divided into two groups, namely treatment group (AR intervention group) and control group (waiting list control group). The experimental group's intervention consists of a course that embraces AR's platform for gender empowerment. The intervention course will require 50-60 minutes for preliminary planning, and participants in the experimental group can design at least three course modules to suit their learning needs. The control group will adopt the classroom narration method. The following are the primary outcome indicators: gender equality knowledge scale, gender equality attitude and awareness scale, self-confidence visual analog scale, learning effectiveness and System Usability Scale (SUS). The researcher uses structured questionnaires to collect data before intervention (To) and after intervention (T1), 1 month (T2) after the intervention. Data will be analyzed using the Generalized Estimating Equation to analyze the repeated measurements and intention-to-treat analysis for reducing attrition bias.

Official Title
-----------------
Establishing and Evaluating the Effectiveness of an Augmented Reality Technology in Gender Empowerment System for Long-term Care Workers: A Randomized Controlled Trial

Conditions
-----------------
Gender, Empowerment, Long Term Care

Intervention / Treatment
-----------------
* Other: AR's platform for gender empowerment


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Acceptance conditions for research subjects have worked in the home care institution for at least one year have normal vision and hearing, and can operate digital mobile phones or tablets are willing to participate in this research. Exclusion Criteria: The exclusion conditions are under the age of 20 the staff member is currently an administrative post and does not belong to the front-line long-term care staff.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: AR's platform for gender empowerment<br>The experimental group's intervention consists of a course that embraces AR's platform for gender empowerment. The intervention course will require 50-60 minutes for preliminary planning, and participants in the experimental group can design at least three course modules to suit their learning needs. | Other: AR's platform for gender empowerment<br>* The intervention of the experimental group is to accept the courses of the gender empowerment platform introduced by AR. The preliminary plan is 50-60 minutes each time. The content of the teaching plan course will adopt the course module design. Group content, and among the three module courses, there must be a core module course unit that is the workplace sexual harassment prevention unit<br>|
| No Intervention: control group<br>The control group will adopt the classroom narration method. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attitudes and Consciousness Awareness Scale for Gender Equality | This scale will refer to the Sustainable Development Goals development attitude and awareness (Álvarez-Nieto et al., 2022), and initially formulate the attitude of gender equality (8 items) and the self-awareness scale of practical awareness (4 items), with a total of 12 items ( One of the questions is a reverse question), and its answer options range from 1 (strongly disagree) to 7 (strongly agree) on a Likert scale, with a maximum score of 84 points. The higher the score, the attitude towards Sustainable Development Goals 5 (gender equality) and The self-awareness of practical awareness is better; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of this research object will be carried out | pre-intervention | 
| Knowledge Scale for Gender Equality | According to the literature, aiming at friendly sex discrimination (Clow, Ricciardelli, & Bartfay, 2014 ), gender concept and workplace sexual harassment prevention law (Xie, Huang, 2018), which are easy to be ignored, a 10-item cognitive topic is initially formulated. Higher means that the knowledge of personal gender equality is better; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of this research object will be carried out. | pre-intervention | 
| Self-Attitude toward Gender Roles | This scale was developed by the Industrial Bureau of the Ministry of Economic Affairs of the Chinese government (2012) with reference to World Health Organization (2011) and foreign research, with a total of 6 items (Council of Europe, 2004; Su, , Richardson & Wang, 2010), and after four sessions After the expert meeting, it was confirmed that it conforms to the measurement concept of gender mainstreaming construction (Industrial Bureau, Ministry of Economic Affairs, 2012). In addition, it was found to have good internal consistency in the study of gender equality, and the Cronbach's α value was .82 (Hsieh et al., 2022), the higher the score of this scale, the better the individual's gender awareness; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of the research objects will be carried out. | pre-intervention | 
| Gender Awareness toward Health Care | This scale is mainly developed after referring to the literature of Attitudes towards Women Scale, with a total of 5 items (Spence, Helmreich & Stapp, 1978). It is better to verify the reliability and validity of domestic scholars surnamed Lu (1988). And this study also cites this scale in the field of health care. The higher the score of this scale, the more serious the gender awareness bias in health care. The scale itself has good expert content validity, and Cronbach's α value is .90 (Hsieh et al., 2022) | pre-intervention | 
| Clinical Executive Confidence Scale (Visual Analog Scale) | Based on the effectiveness evaluation of past literature courses, the research subjects are evaluated based on their own handling of clinical cases or the actual situation of event items, and self-assessment of the degree of confidence in mastering the situation, measured by Visual Analogue Scale (VAS) 0-100mm 0 means the lowest level of confidence in mastering the care, and 100 means the highest level of confidence in mastering the care (Xu, Wang, Liu, Zheng, Yang, 2018). | pre-intervention | 
| Attitudes and Consciousness Awareness Scale for Gender Equality | This scale will refer to the Sustainable Development Goals development attitude and awareness (Álvarez-Nieto et al., 2022), and initially formulate the attitude of gender equality (8 items) and the self-awareness scale of practical awareness (4 items), with a total of 12 items ( One of the questions is a reverse question), and its answer options range from 1 (strongly disagree) to 7 (strongly agree) on a Likert scale, with a maximum score of 84 points. The higher the score, the attitude towards Sustainable Development Goals 5 (gender equality) and The self-awareness of practical awareness is better; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of this research object will be carried out | one week after intervention | 
| Knowledge Scale for Gender Equality | According to the literature, aiming at friendly sex discrimination (Clow, Ricciardelli, & Bartfay, 2014 ), gender concept and workplace sexual harassment prevention law (Xie, Huang, 2018), which are easy to be ignored, a 10-item cognitive topic is initially formulated. Higher means that the knowledge of personal gender equality is better; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of this research object will be carried out. | one week after intervention | 
| Self-Attitude toward Gender Roles | This scale was developed by the Industrial Bureau of the Ministry of Economic Affairs of the Chinese government (2012) with reference to World Health Organization (2011) and foreign research, with a total of 6 items (Council of Europe, 2004; Su, , Richardson & Wang, 2010), and after four sessions After the expert meeting, it was confirmed that it conforms to the measurement concept of gender mainstreaming construction (Industrial Bureau, Ministry of Economic Affairs, 2012). In addition, it was found to have good internal consistency in the study of gender equality, and the Cronbach's α value was .82 (Hsieh et al., 2022), the higher the score of this scale, the better the individual's gender awareness; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of the research objects will be carried out. | one week after intervention | 
| Gender Awareness toward Health Care | This scale is mainly developed after referring to the literature of Attitudes towards Women Scale, with a total of 5 items (Spence, Helmreich & Stapp, 1978). It is better to verify the reliability and validity of domestic scholars surnamed Lu (1988). And this study also cites this scale in the field of health care. The higher the score of this scale, the more serious the gender awareness bias in health care. The scale itself has good expert content validity, and Cronbach's α value is .90 (Hsieh et al., 2022) | one week after intervention | 
| Clinical Executive Confidence Scale (Visual Analog Scale) | Based on the effectiveness evaluation of past literature courses, the research subjects are evaluated based on their own handling of clinical cases or the actual situation of event items, and self-assessment of the degree of confidence in mastering the situation, measured by Visual Analogue Scale (VAS) 0-100mm 0 means the lowest level of confidence in mastering the care, and 100 means the highest level of confidence in mastering the care (Xu, Wang, Liu, Zheng, Yang, 2018). | one week after intervention | 
| Learning Effectiveness and Usability Assessment scale | This assessment refers to questions (8 items) by which the reference literature was used to understand the usefulness and ease of use of the lessons and scenarios taught. The validity of the content of this assessment was determined through discussions among nursing practice educators and experts (Álvarez-Nieto et al .,2022), used to examine the perceived reality and relevance of teaching methods and content, this scale responds to a seven-point Likert-style scale, where 1 (strongly disagree) to 7 (strongly agree), the score The higher the value, the better the effectiveness of the teaching and learning and the ease of operation of the equipment; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of the research object will be carried out | one week after intervention | 
| Attitudes and Consciousness Awareness Scale for Gender Equality | This scale will refer to the Sustainable Development Goals development attitude and awareness (Álvarez-Nieto et al., 2022), and initially formulate the attitude of gender equality (8 items) and the self-awareness scale of practical awareness (4 items), with a total of 12 items ( One of the questions is a reverse question), and its answer options range from 1 (strongly disagree) to 7 (strongly agree) on a Likert scale, with a maximum score of 84 points. The higher the score, the attitude towards Sustainable Development Goals 5 (gender equality) and The self-awareness of practical awareness is better; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of this research object will be carried out | from enrollment to end of treatment at one month | 
| Knowledge Scale for Gender Equality | According to the literature, aiming at friendly sex discrimination (Clow, Ricciardelli, & Bartfay, 2014 ), gender concept and workplace sexual harassment prevention law (Xie, Huang, 2018), which are easy to be ignored, a 10-item cognitive topic is initially formulated. Higher means that the knowledge of personal gender equality is better; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of this research object will be carried out. | from enrollment to end of treatment at one month | 
| Self-Attitude toward Gender Roles | This scale was developed by the Industrial Bureau of the Ministry of Economic Affairs of the Chinese government (2012) with reference to World Health Organization (2011) and foreign research, with a total of 6 items (Council of Europe, 2004; Su, , Richardson & Wang, 2010), and after four sessions After the expert meeting, it was confirmed that it conforms to the measurement concept of gender mainstreaming construction (Industrial Bureau, Ministry of Economic Affairs, 2012). In addition, it was found to have good internal consistency in the study of gender equality, and the Cronbach's α value was .82 (Hsieh et al., 2022), the higher the score of this scale, the better the individual's gender awareness; and as mentioned above, the expert validity will be checked again, and the internal consistency analysis of the tool use of the research objects will be carried out. | from enrollment to end of treatment at one month | 
| Gender Awareness toward Health Care | This scale is mainly developed after referring to the literature of Attitudes towards Women Scale, with a total of 5 items (Spence, Helmreich & Stapp, 1978). It is better to verify the reliability and validity of domestic scholars surnamed Lu (1988). And this study also cites this scale in the field of health care. The higher the score of this scale, the more serious the gender awareness bias in health care. The scale itself has good expert content validity, and Cronbach's α value is .90 (Hsieh et al., 2022) | from enrollment to end of treatment at one month | 
| Clinical Executive Confidence Scale (Visual Analog Scale) | Based on the effectiveness evaluation of past literature courses, the research subjects are evaluated based on their own handling of clinical cases or the actual situation of event items, and self-assessment of the degree of confidence in mastering the situation, measured by Visual Analogue Scale (VAS) 0-100mm 0 means the lowest level of confidence in mastering the care, and 100 means the highest level of confidence in mastering the care (Xu, Wang, Liu, Zheng, Yang, 2018). | from enrollment to end of treatment at one month | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
augmented reality, e-Learning, gender empowerment, gender awareness and attitude of gender, gender equality, long-term care