Efficacy of a web-based intervention to improve and sustain knowledge and screening for amblyopia in primary care settings.
Efficacy of a web-based intervention to improve and sustain knowledge and screening for amblyopia in primary care settings.
复制标题
基于网络的干预措施在初级保健机构中改善和维持弱视知识和筛查的有效性。
DOI：
10.1167/iovs.10-6566
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发表时间：
2011
影响因子：
4.4
通讯作者：
Wall,TerryC
中科院分区：
文献类型：
--
作者：
Marsh-Tootle,WendyL;McGwin,Gerald;Kohler,ConnieL;Kristofco,RobertE;Datla,RajuV;Wall,TerryC
目的：评估以医生为目标的网站在初级保健环境中改善与斜视和弱视(视力)相关的知识和自我报告行为的有效性。方法：符合条件的提供者(在研究登记前1年，在3岁或4岁时提交至少8次健康儿童检查的医疗补助申请)，随机分配到对照组(衣原体和血压)或视力组，访问四个基于网络的教育模块，编程为呈现带有嵌入的问题和反馈的互动案例片段。每个正确的回答都被分配了+1到最大+7的值，用于计算每个提供者的汇总分数。将干预提供者(IP)在基线和两个随访点的反应与对照提供者(CP)在研究结束时对视力问题的反应进行比较。结果：大多数IP(57/65)在基线和短暂延迟后(38个IP在基线后1小时内)有反应。一个小组(27名IP和42名CP)在平均1.8年的长期延迟后完成了所有视力问题。IP评分在短时间延迟后有所改善(中位数，3分对6分；P=0.0065)。与CP相比，IP的得分在基线时相似(P=0.6473)，在短期(P<；0.0001)和长期(P<；0.0001)延迟后得分更高。结论：短期延迟后的显著改善表明了网站的有效性和可访问性、标准化视力教育的潜力。尽管改善随着时间的推移逐渐消退，但IP的得分并没有恢复到基线水平，而且与1到3年后测试的CPS相比明显更好。(临床试验。政府编号：NCT01109459。)
Purpose.: To evaluate the efficacy of a physician-targeted website to improve knowledge and self-reported behavior relevant to strabismus and amblyopia (“vision”) in primary care settings.Methods.: Eligible providers (filing Medicaid claims for at least eight well-child checks at ages 3 or 4 years, 1 year before study enrollment), randomly assigned to control (chlamydia and blood pressure) or vision groups, accessed four web-based educational modules, programmed to present interactive case vignettes with embedded questions and feedback. Each correct response, assigned a value of+ 1 to a maximum of+ 7, was used to calculate a summary score per provider. Responses from intervention providers (IPs) at baseline and two follow-up points were compared to responses to vision questions, taken at the end of the study, from control providers (CPs).Results.: Most IPs (57/65) responded at baseline and after the short delay (within 1 hour after baseline for 38 IPs). A subgroup (27 IPs and 42 CPs) completed all vision questions after a long delay averaging 1.8 years. Scores from IPs improved after the short delay (median score, 3 vs. 6; P= 0.0065). Compared to CPs, scores from IPs were similar at baseline (P= 0.6473) and higher after the short-term (P< 0.0001) and long-term (P< 0.05) delay.Conclusions.: Significant improvements after the short delay demonstrate the efficacy of the website and the potential for accessible, standardized vision education. Although improvements subsided over time, the IPs' scores did not return to baseline levels and were significantly better compared to CPs tested 1 to 3 years later.(ClinicalTrials. gov number, NCT01109459.)