Effectiveness of Web-Based Versus Face-To-Face Delivery of Education in Prescription of Falls-Prevention Exercise to Health Professionals: Randomized Trial
Effectiveness of Web-Based Versus Face-To-Face Delivery of Education in Prescription of Falls-Prevention Exercise to Health Professionals: Randomized Trial
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DOI：
10.2196/jmir.1680
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发表时间：
2011-10-01
影响因子：
7.4
通讯作者：
Haines, Terry
中科院分区：
文献类型：
--
作者：
Maloney, Stephen;Haas, Romi;Haines, Terry
背景资料：运动是预防福尔斯的有效干预措施;然而，某些形式的运动已被证明比其他形式更有效。有必要确定有效和高效的方法，培训卫生专业人员在运动处方预防福尔斯prevention.Objective：我们研究的目的是比较两种方法，培训临床医生在处方运动，以防止福尔斯.Methods：本研究是一个头对头随机试验设计。参与者是在澳大利亚维多利亚工作的物理治疗师、职业治疗师、护士和运动生理学家。随机分配到一组的参与者接受面对面的传统教育，采用为期一天的研讨会形式，并提供额外的视频和书面支持材料。其他参与者在4周的时间内接受了基于网络的同等教育材料的远程辅导。在柯克帕特里克的教育成果层次结构的第1至第3级对成果进行了测量，包括出勤率、坚持率、满意度、知识和实践中自我报告的变化。在最初招募的166名参与者中，从随机化到参与试验，（n = 67基于网络，n = 68面对面），完成教育内容（n = 44基于网络，n = 50面对面），完成教育后考试（n = 43基于网络，n = 49面对面）。参与者满意度在干预组之间没有显著差异：对课程内容和相关性的平均（SD）满意度为25.73（5.14）在网上和26.11（5.41）面对面组;线性回归P = 0.75;网络组和面对面组对课程促进和支持的平均（SD）满意度分别为11.61（2.00）和12.08（1.54）：线性回归P = 0.25。网络组和面对面组的知识测试结果具有可比性：网络组的中位数（四分位距[IQR]）为90.00（70.89-90.67），面对面组为80.56（70.67-90.00）;秩和P = 0.07。运动分配的中位数（IQR）评分也相当：基于网络的，78.6（68.5-85.1），面对面的，78.6（70.8-86.9）;秩和P = 0.61。在实践中，柯克帕特里克的层次结构域变化没有发现显著差异：平均（SD）基于Web的，21.75（4.40）和面对面，21.88（3.24）;线性回归P =.89。结论：基于网络和面对面对临床医生进行福尔斯预防运动处方教育的面对面方法在所有的结果域。实际的考虑可以说是驱动选择的交付方法，这可能有利于基于Web的规定，其能力，以克服访问问题的卫生专业人员在区域和远程设置。
Background: Exercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others. There is a need to identify effective and efficient methods for training health professionals in exercise prescription for falls prevention.Objective: The objective of our study was to compare two approaches for training clinicians in prescribing exercise to prevent falls.Methods: This study was a head-to-head randomized trial design. Participants were physiotherapists, occupational therapists, nurses, and exercise physiologists working in Victoria, Australia. Participants randomly assigned to one group received face-to-face traditional education using a 1-day seminar format with additional video and written support material. The other participants received Web-based delivery of the equivalent educational material over a 4-week period with remote tutor facilitation. Outcomes were measured across levels 1 to 3 of Kirkpatrick's hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice.Results: Of the 166 participants initially recruited, there was gradual attrition from randomization to participation in the trial (n = 67 Web-based, n = 68 face-to-face), to completion of the educational content (n = 44 Web-based, n = 50 face-to-face), to completion of the posteducation examinations (n = 43 Web-based, n = 49 face-to-face). Participant satisfaction was not significantly different between the intervention groups: mean (SD) satisfaction with content and relevance of course material was 25.73 (5.14) in the Web-based and 26.11 (5.41) in the face-to-face group; linear regression P = .75; and mean (SD) satisfaction with course facilitation and support was 11.61 (2.00) in the Web-based and 12.08 (1.54) in the face-to-face group: linear regression P = .25. Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89-90.67) and for the face-to-face group was 80.56 (70.67-90.00); rank sum P = .07. The median (IQR) scores for the exercise assignment were also comparable: Web-based, 78.6 (68.5-85.1), and face-to-face, 78.6 (70.8-86.9); rank sum P = .61. No significant difference was identified in Kirkpatrick's hierarchy domain change in practice: mean (SD) Web-based, 21.75 (4.40), and face-to-face, 21.88 (3.24); linear regression P = .89.Conclusion: Web-based and face-to-face approaches to the delivery of education to clinicians on the subject of exercise prescription for falls prevention produced equivalent results in all of the outcome domains. Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings.