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 trialReport as inadecuate




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 - Download this document for free, or read online. Document in PDF available to download.

Trials

, 15:216

First Online: 10 June 2014Received: 25 June 2013Accepted: 23 May 2014DOI: 10.1186-1745-6215-15-216

Cite this article as: Buchanan, H., Siegfried, N., Jelsma, J. et al. Trials 2014 15: 216. doi:10.1186-1745-6215-15-216

Abstract

BackgroundDespite efforts to identify effective interventions to implement evidence-based practice EBP, uncertainty remains. Few existing studies involve occupational therapists or resource-constrained contexts. This study aimed to determine whether an interactive educational intervention IE was more effective than a didactic educational intervention DE in improving EBP knowledge, attitudes and behaviour at 12 weeks.

MethodsA matched pairs design, randomised controlled trial was conducted in the Western Cape of South Africa. Occupational therapists employed by the Department of Health were randomised using matched-pair stratification by type clinician or manager and knowledge score. Allocation to an IE or a DE was by coin-tossing. A self-report questionnaire measuring objective knowledge and subjective attitudes and audit checklist measuring objective behaviour were completed at baseline and 12 weeks. The primary outcome was EBP knowledge at 12 weeks while secondary outcomes were attitudes and behaviour at 12 weeks. Data collection occurred at participants’ places of employment. Audit raters were blinded, but participants and the provider could not be blinded.

ResultsTwenty-one of 28 pairs reported outcomes, but due to incomplete data for two participants, 19 pairs were included in the analysis. There was a median increase of 1.0 points 95% CI = -4.0, 1.0 in the IE for the primary outcome knowledge compared with the DE, but this difference was not significant P = 0.098. There were no significant differences on any of the attitude subscale scores. The median 12-week audit score was 8.6 points higher in the IE 95% CI = -7.7, 27.0 but this was not significant P = 0.196. Within-group analyses showed significant increases in knowledge in both groups IE: T = 4.0, P <0.001; DE: T = 12.0, P = 0.002 but no significant differences in attitudes or behaviour.

ConclusionsThe results suggest that the interventions had similar outcomes at 12 weeks and that the interactive component had little additional effect.

Trial registrationPan African Controlled Trials Register PACTR201201000346141, registered 31 January 2012. Clinical Trials NCT01512823, registered 1 February 2012. South African National Clinical Trial Register DOH2710093067, registered 27 October 2009. The first participants were randomly assigned on 16 July 2008.

KeywordsPragmatic trial Randomised controlled trial Educational intervention Occupational therapy Evidence-based practice South Africa AbbreviationsAFTAdapted Fresno Test of Competence in Evidence-based Practice

DEdidactic educational intervention

DOHDepartment of Health

EBPevidence-based practice

EOVseducational outreach visits

ICCintra-class correlation coefficient

ICFInternational Classification of Functioning, Disability and Health

IEinteractive educational intervention

IRRinter-rater reliability

KABQknowledge, attitude and behaviour questionnaire

OTEBP trialOccupational Therapy Evidence-Based Practice Trial

PIprincipal investigator

PICOparticipant, intervention, comparison, outcome

RCTrandomised controlled trial

SAFTShortened Adapted Fresno Test of Competence in Evidence-based Practice.

Electronic supplementary materialThe online version of this article doi:10.1186-1745-6215-15-216 contains supplementary material, which is available to authorized users.

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Author: Helen Buchanan - Nandi Siegfried - Jennifer Jelsma - Carl Lombard

Source: https://link.springer.com/







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