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

Carl Lombard³  Jennifer Jelsma²  Nandi Siegfried¹  Helen Buchanan² 

[1] During the study: School of Public Health and Family Medicine, Falmouth Building, University of Cape Town, Observatory, 7925 Cape Town, South Africa;Department of Health & Rehabilitation Sciences, F45 Old Groote Schuur Hospital Building, University of Cape Town, Observatory, 7925 Cape Town, South Africa;Biostatistics Unit, Medical Research Council, PO Box 19070 Tygerberg, 7505 Cape Town, South Africa

关键词: South Africa;    Evidence-based practice;    Occupational therapy;    Educational intervention;    Randomised controlled trial;    Pragmatic trial;   

Others  :  805115
DOI  :  10.1186/1745-6215-15-216

 received in 2013-06-25, accepted in 2014-05-23,  发布年份 2014

【 摘 要 】

Background

Despite 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.

Methods

A 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.

Results

Twenty-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.

Conclusions

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

Trial registration

Pan 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.

【 授权许可】

   
2014 Buchanan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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