The effectiveness of a computer-tailored e-learning program for practice nurses to improve their adherence to smoking cessation counseling guidelines: a randomized controlled trial

Ruijter, Dennis de; Candel, Math J. J. M.; Smit, Eline Suzanne; Vries, Hein de; Hoving, Ciska

doi:10.2196/preprints.9276.a

Cited by 10 publications

(31 citation statements)

References 34 publications

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“…PNs across the Netherlands were contacted through email, newsletters, and website messages via national organizations for PNs or primary care professionals in general, as well as via a project website [ 29 ] and social media platforms (ie, Twitter, LinkedIn, and Facebook). Additionally, individual PNs were contacted by the research team via telephone through their general practice.…”

Section: Methodsmentioning

confidence: 99%

The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial

Ruijter¹,

Candel²,

Smit³

et al. 2018

J Med Internet Res

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BackgroundImproving practice nurses’ (PN) adherence to smoking cessation counseling guidelines will benefit the quality of smoking cessation care and will potentially lead to higher smoking abstinence rates. However, support programs to aid PNs in improving their guideline uptake and adherence do not exist yet.ObjectiveThe aim of this study was to assess the effects of a novel computer-tailored electronic learning (e-learning) program on PNs’ smoking cessation guideline adherence.MethodsA Web-based randomized controlled trial (RCT) was conducted in which an intervention group (N=147) with full access to the e-learning program for 6 months was compared with a control group (N=122) without access. Data collection was fully automated at baseline and 6-month follow-up via online questionnaires, assessing PNs’ demographics, work-related factors, potential behavioral predictors based on the I-Change model, and guideline adherence. PNs also completed counseling checklists to retrieve self-reported counseling activities for each consultation with a smoker (N=1175). To assess the program’s effectiveness in improving PNs’ guideline adherence (ie, overall adherence and adherence to individual counseling guideline steps), mixed linear and logistic regression analyses were conducted, thus accommodating for the smokers being nested within PNs. Potential effect moderation by work-related factors and behavioral predictors was also examined.ResultsAfter 6 months, 121 PNs in the intervention group (82.3%, 121/147) and 103 in the control group (84.4%, 103/122) completed the follow-up questionnaire. Mixed linear regression analysis revealed that counseling experience moderated the program’s effect on PNs’ overall guideline adherence (beta=.589; 95% CI 0.111-1.068; PHolm-Bonferroni =.048), indicating a positive program effect on adherence for PNs with a more than average level of counseling experience. Mixed logistic regression analyses regarding adherence to individual guideline steps revealed a trend toward moderating effects of baseline levels of behavioral predictors and counseling experience. More specifically, for PNs with less favorable scores on behavioral predictors (eg, low baseline self-efficacy) and high levels of counseling experience, the program significantly increased adherence.ConclusionsResults from our RCT showed that among PNs with more than average counseling experience, the e-learning program resulted in significantly better smoking cessation guideline adherence. Experienced PNs might have been better able to translate the content of our e-learning program into practically applicable counseling strategies compared with less experienced colleagues. Less favorable baseline levels of behavioral predictors among PNs possibly contributed to this effect, as there was more room for improvement by consulting the tailored content of the e-learning program. To further substantiate the effectiveness of e-learning programs on guideline adherence by health care professionals (HCPs), it is important to assess how to support a...

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Section: Methodsmentioning

confidence: 99%

The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial

Ruijter¹,

Candel²,

Smit³

et al. 2018

J Med Internet Res

Self Cite

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“…1. The searches returned a total of 2240 results after duplicate removal, 78-studies were reviewed at full text and 12 studies were suitable for inclusion in this review (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Six studies (19,21,22,24,25,27) were included in the meta-analysis of behavioural outcomes.…”

Section: Search Resultsmentioning

confidence: 99%

“…presentations and workshops); additional practical elements were also included within nine studies (19,21,(24)(25)(26)(27)(28)(29)(30). Face-to-face training was used most commonly, however online e-learning was provided in two-studies (23,26) while one study used an audio-conference (20). Eight-studies performed cluster sampling while five used stratified cluster sampling; five were performed in USA/Canada, three in the UK, two in the Netherlands, one in Regarding health behaviour outcomes, eight-studies provided patient level data, with only six studies providing data suitable for meta-analysis.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Across the three-studies (23,24,29), that assessed the medium-term effect of healthcare professional training on delivery of intended content, 66% of outcomes significantly improved. The two most effective training interventions (24,29), which improved 79% (22 of 28) and 100% (two of two) of outcomes, respectively, included both educational and practical elements.…”

Section: Effect On Delivery Of Intended Intervention Content Medium-termmentioning

confidence: 99%

“…Regarding delivery quality outcomes, eight-studies reported changes in communication style while seven reported changes in content-delivery. Outcomes were assessed either short-term(19,20,25,26,28) (median: one-month; range: instantaneous assessment to threemonths), medium-term(19,23,24,29) (median: six-months) or long-term(21,22,27,30), (median: 12-months; range: 12-months to 48-months).…”

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Systematic Review on the Effect of Training Interventions to Improve the Skills of Health Professionals in Promoting Health Behaviour Change, with Meta-Analysis of Behavioural Outcomes.

Hatfield¹,

Withers²,

Greaves³

2020

Preprint

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Abstract Background We aimed to identify, synthesise and evaluate randomised control trial evidence on the effects of healthcare professional training on the delivery quality of health behaviour change interventions and, subsequently, on patient health behaviours.Methods Systematic review with narrative synthesis of effects on delivery quality and meta-analysis of health behaviour outcomes. We searched: Medline, EMBASE, PsychInfo, AMED, CINAHL Plus and the Cochrane Central Register of Control Trials up to March 2019. Studies were included if they were in English and included intervention delivery quality as an outcome. The systematic review was registered on PROSPERO (registration: CRD42019124502).Results Twelve-studies were identified as suitable for inclusion. All studies were judged as being high risk of bias with respect to training quality outcomes. However with respect to behavioural outcomes, only two of the six studies included in the meta-analysis had a high risk and four had some concerns. Educational elements (e.g. presentations) were used in all studies and nine included additional practical learning tasks. In eight studies reporting delivery quality, 54% of healthcare professional communication outcomes and 55% of content delivery outcomes improved in the intervention arm compared to controls. Training that included both educational and practical elements tended to be more effective. Meta-analysis of patient health behavioural outcomes in six-studies found significant improvements (Standardised mean difference (SMD): 0.20, 95% confidence interval: 0.11 to 0.28, P<0.0001, I 2 = 0%). No significant difference was found between short (≤6-months) and long-term (>6-months) outcomes (SMD: 0.25 vs 0.15; P=0.31).Conclusions Delivery quality of health behaviour change interventions appears to improve following training and consequently to improve health behaviours. Future studies should develop more concise /integrated measures of delivery quality and develop optimal methods of training delivery.

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Effects of computer-based education on health professionals’ knowledge, skills, and behavior: A scoping review

Hussein¹,

Lin²,

Grindrod³

2021

Journal of the American Pharmacists Association

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The effectiveness of a computer-tailored e-learning program for practice nurses to improve their adherence to smoking cessation counseling guidelines: a randomized controlled trial

Abstract: UvA-DARE (Digital Academic Repository) The effectiveness of a computer-tailored e-learning program for practice nurses to improve their adherence to smoking cessation counseling guidelines randomized controlled trial

Cited by 10 publications

References 34 publications

The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial

The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial

Systematic Review on the Effect of Training Interventions to Improve the Skills of Health Professionals in Promoting Health Behaviour Change, with Meta-Analysis of Behavioural Outcomes.

Effects of computer-based education on health professionals’ knowledge, skills, and behavior: A scoping review

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