Effects of Improving Primary Health Care Workers’ Knowledge About Public Health Services in Rural China: A Comparative Study of Blended Learning and Pure E-Learning

Abstract

Background Primary health care workers (PHCWs) are a major force in delivering basic public health services (BPHS) in rural China. It is necessary to take effective training approaches to improve PHCWs’ competency on BPHS. Both electronic learning (e-learning) and blended learning have been widely used in the health workers’ education. However, there is limited evidence on the effects of blended learning in comparison with pure e-learning.ObjectiveThe aim of this study was to evaluate the effects of a blended-learning approach for rural PHCWs in improving their knowledge about BPHS as well as training satisfaction in comparison with a pure e-learning approach.MethodsThe study was conducted among PHCWs in 6 rural counties of Hubei Province, China, between August 2013 and April 2014. Three counties were randomly allocated blended-learning courses (29 township centers or 612 PHCWs—the experimental group), and three counties were allocated pure e-learning courses (31 township centers or 625 PHCWs—the control group). Three course modules were administered for 5 weeks, with assessments at baseline and postcourse. Primary outcomes were score changes in courses’ knowledge. Secondary outcome was participant satisfaction (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]).ResultsThe experimental group had higher mean scores than the control group in knowledge achievement in three course modules: (1) module 1: 93.21 (95% CI 92.49-93.93) in experimental group versus 88.29 (95% CI 87.19-89.40) in the control group; adjusted difference, 4.92 (95% CI 2.61-7.24; P<.001); (2) module 2: 94.05 (95% CI 93.37-94.73) in the experimental group vs 90.22 (95% CI 89.12-91.31) in the control group; adjusted difference, 3.67 (95% CI 1.17-6.18; P=.004); (3) module 3: 93.88 (95% CI 93.08-94.68) in the experimental group versus 89.09 (95% CI 87.89-90.30) in control group; adjusted difference, 4.63 (95% CI 2.12-7.14; P<.001). The participants in the experimental learning group gave more positive responses with the four issues than control group participants: (1) the increase of interest in learning, 1.85 (95% CI 1.22-2.80; P=.003); (2) the increase of interaction with others, 1.77 (95% CI 1.20-2.60; P=.004); (3) the satisfaction with learning experience, 1.78 (95% CI 1.11-2.88; P=.02); and (4) achievement of learning objectives, 1.63 (95% CI 1.08-2.48; P=.02).ConclusionsAmong PHCWs in rural China, a blended-learning approach to BPHS training could result in a higher knowledge achievement and satisfaction level compared with a pure e-learning approach. The findings of the study will contribute knowledge to improve the competency of PHCWs in similar settings.

Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review

“…A summary of the study characteristics and outcomes of the 8 included studies is provided in Table 1 . All 8 studies were RCTs, of which 4 were cluster RCTs [ 25 , 27 , 29 , 30 ]. A total of 3 studies were conducted in the United States [ 23 - 25 ], 2 in the Netherlands [ 26 , 28 ], 2 in Canada [ 27 , 30 ], and the remaining study was conducted in China [ 29 ].…”

“…Health professionals recruited in the included studies comprised nurses [ 23 , 26 , 30 ], nurse practitioners [ 23 ], physicians [ 23 ], child care health consultants [ 24 ], physiotherapists [ 30 ], primary health care workers [ 29 ], and public health practitioners [ 30 ]. A further study recruited program managers or coordinators of public health departments [ 27 ] and the remaining study recruited professionals employed in schools, community agencies, and policy-making bodies [ 25 ].…”

Preparing Public Health Professionals to Make Evidence-Based Decisions: A Comparison of Training Delivery Methods in the United States

“…Scaling up capacity building approaches is a significant issue in implementation science ( 33 ). Much of the literature on public health workforce training in distance or blended learning (combination of in-person and distance) formats focuses on single topics or specific skills ( 31 , 32 , 34 – 43 ), with few focusing on the utility of training modes for scale-up potential ( 44 , 45 ).…”

Job burnout and correlated factors of three‐tiered public health workers: A cross‐sectional study in China

“…According to organisational support theory, effective training from organisations' support could promote personal development, increase employee satisfaction, reduce employee absenteeism and turnover, and relieve the burnout level (Eisenberger, Armeli, Rexwinkel, Lynch, & Rhoades, ). This study shows that nearly half of public health workers have middle and low levels of training satisfaction, possibly due to inadequate and ineffective training (Zhan et al, ). From the training contents of public health workers, training programmes still focus on professional and technical abilities in China (Shi et al, ).…”

“…The importance of these factors to public health workers' burnout is different. For example, there was a large number of health workers with middle level and below of education level in rural China (Zhan et al, ), and the education difference is relatively small. On the contrary, the education level of health workers in urban areas is quite different.…”