Clinical trial NCT01512823: Randomised Trial of Two Educational Intervention for Improving Evidence-based Practice Knowledge, Atttitudes and Practice
Official title: Randomised Trial of the Effectiveness of Two Educational Interventions to Improve Evidence-based Practice Knowledge, Attitudes and Behaviour in Occupational Therapists
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Health Knowledge, Attitudes, Practice
Keywords: randomised controlled trial
educational intervention
occupational therapy
Lead sponsor: University of Cape Town
Sponsor class: OTHER
Collaborators: name: National Research Foundation of South Africa
First posted: 2012-01-19
Enrollment: 58
Sex: ALL
Minimum age (years): 21
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL

Brief summary: This pragmatic randomised controlled trial (RCT) used a two-group parallel design with matched-pair stratification by type (clinician/manager) and knowledge score. The trial aimed to: 1) determine whether an IE was more effective than a DE for improving EBP knowledge, skills and use at 12 weeks, and 2) to investigate the feasibility of conducting a RCT with occupational therapists in a public health setting. Occupational therapists employed by the Western Cape Department of Health (DOH) form,ed the study population(N=98). Fifty-eight consented to participate and were randomly allocated to either an interactive (IE) or a didactic (DE) educational intervention using coin tossing. Data was collected at baseline and 12 weeks The primary outcome was increased EBP knowledge at 12 weeks shown by an improved total knowledge score. Secondary outcomes were improved attitudes and behaviour. Data were collected at the health facilities where participants were employed. Raters for the audit were blinded but participants and the provider could not be blinded.

Thirty participants were allocated to receive the IE and 28 the DE. Twenty-five participants in the IE and 21 in the DE completed the trial and were included in the 12 week analysis. Results revealed no significant difference between the groups in the primary knowledge outcome at 12 weeks. Examination of within-group changes revealed significant improvements in knowledge in both groups (IE: T=4.0, p\<0.001; DE: T=12.0, p=0.002), but the IE also showed a significant increase in behaviour (T=64.5, p=0.044) and attitudes on one sub-scale (T=33.0, p=0.039). As the study was powered at 43%, it may have failed to detect significant differences at 12 weeks. Conducting a high-quality RCT was feasible and the risk of bias was assessed as low. The OTEBP trial adds strength to the existing evidence that both didactic and interactive educational interventions can improve knowledge, but it seems that interactive interventions may be more effective for changing behaviour. High-quality pragmatic trials can feasibly be conducted within the public health service


Eligibility criteria: Inclusion Criteria:

* Occupational therapists employed by the Western Cape Department of Health (DOH)
* Working at least 20 hours per week

Exclusion Criteria:

* Working at a distance of more than 1½ hours from Cape Town
* Therapists who would be leaving the DOH before December 2008 or taking leave during the time of the intervention

Primary outcomes:
measure: Shortened Fresno Test of Competence in Evidence-based Practice (SAFT)
timeFrame: 12 weeks
Secondary outcomes:
measure: Audit checklist
timeFrame: 12 weeks
Other outcomes:
Locations:
city: Cape Town
country: South Africa
facility: University of Cape Town
state: Western Cape
Study officials:
affiliation: University of Cape Town
name: Helen Buchanan, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: South African Cochrane Centre & University of Cape Town
name: Nandi Siegfried, PhD
role: STUDY_DIRECTOR
affiliation: University of Cape Town
name: Jennifer Jelsma, PhD
role: STUDY_DIRECTOR
References:
citation: Buchanan H, Jelsma J, Siegfried N. Measuring evidence-based practice knowledge and skills in occupational therapy--a brief instrument. BMC Med Educ. 2015 Oct 30;15:191. doi: 10.1186/s12909-015-0475-2.
citation: Buchanan H, Siegfried N, Jelsma J, Lombard C. Comparison of an interactive with a didactic educational intervention for improving the evidence-based practice knowledge of occupational therapists in the public health sector in South Africa: a randomised controlled trial. Trials. 2014 Jun 10;15:216. doi: 10.1186/1745-6215-15-216.