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Objective to assess the effectiveness of an education intervention associated with an exercise program in improving knowledge and health behaviours among diabetes patients. Methods Diabetes and prediabetes patients were exposed to an evidence- and theoretically-based comprehensive education intervention over 24 weeks. Patients completed surveys assessing knowledge, physical activity, food intake, self-efficacy, and health literacy. Functional capacity was measured by oxygen uptake. All outcomes were assessed pre- and post-CR. Satisfaction about the education provided was assessed at post-CR. Paired t-tests, Pearson correlation coefficients, and linear regression models were computed to investigate the effectiveness of this intervention. Results 84 patients consented to participate, of which 47(56.0%) completed post-CR assessments. There was a significant improvement in patients’ overall knowledge pre- to post-CR, as well as in physical activity, food intake, self-efficacy, and health literacy (p Conclusion The benefits of an education intervention designed for diabetes and prediabetes patients associated with an exercise program have been supported. Practice Implications This work shows one effective education strategy taken in place that can be replicated in different settings.

Introduction While child restraint systems are effective in protecting children from crash-related injuries and deaths, their use in China is extremely low. This study assessed the effectiveness of child restraint system education with and without behavioral skills training on improved use and explored participants’ views regarding content and delivery of an onsite intervention and online (WeChat) boosters. Study design A randomized trial was conducted in 6 kindergartens from May 2017 to January 2018 in Shantou and Chaozhou, China. Selected kindergartens were randomly assigned to 3 groups: (1) control, (2) child restraint system education‒only, and (3) child restraint system education plus behavioral skills training. Analysis was conducted in May 2018. Setting/participants Participants were parents from the selected kindergartens. Intervention Both intervention groups received child restraint system education that included one-time onsite education and biweekly online boosters for 3 months using an app to deliver education messages. Main outcome measures Survey questions included parent knowledge, attitude and behaviors of child restraint system use, and opinions related to the content and delivery of the onsite intervention and online boosters. Results Child restraint system use in both intervention groups was higher than that of the control group post-intervention (27.3% and 31.7%, respectively). Compared with the control group, the intervention groups had a higher percentage of correct answers to all 9 items, except Item 7 measuring the parents’ knowledge, attitude, and behaviors of child passenger safety after the intervention. Lower parent's level of education (OR=7.00, 95% CI=2.62, 18.70) and older child age (4 years: OR=3.92, 95% CI=1.08, 5.28; 5 years: OR=2.08, 95% CI=1.52, 5.31) were associated with lower rates of child restraint system use. Most parents (92.3%) preferred the online over the onsite intervention component. Conclusions An education intervention was effective in improving parents’ knowledge, attitude, and practice of child restraint system use. A social media intervention booster (WeChat) may provide a new channel to help promote child passenger safety in China.

Background: Although patient education is considered a core component of cardiac rehabilitation (CR) programs, to our knowledge, no educational program designed for CR has been standardized in Canada. This absence of standardization may be due to a lack of reliable resources to educate these patients. The objective of this study was to assess the effectiveness of an education intervention in improving knowledge and health behaviours among CR patients in 3 sites in Canada. Methods: CR patients were exposed to an evidence- and theoretically based comprehensive education intervention. Patients completed surveys assessing knowledge, physical activity, food intake, self-efficacy, and health literacy. All outcomes were assessed pre- and post-CR. Paired t tests were used to investigate variable changes between pre- and post-CR, Pearson correlation coefficients were used to determine the association between knowledge and behaviours, and linear regression models were computed to investigate differences in overall post-CR knowledge based on participant characteristics. Results: A total of 252 patients consented to participate, of whom 158 (63.0%) completed post-CR assessments. There was a significant improvement in patients’ overall knowledge pre- to post-CR, as well as in exercise, food intake, and self-efficacy (P < 0.05). Results showed a significant positive correlation between post-CR knowledge and food intake (r = 0.203; P = 0.01), self-efficacy (r = 0.201; P = 0.01), and health literacy (r = 0.241; P = 0.002). Education level (unstandardized beta = −2.511; P = 0.04) and pre-CR knowledge (unstandardized beta = 0.433; P < 0.001) were influential in changing post-CR knowledge. Conclusion: In this first-ever multi-site study focusing on patient education for CR patients in Canada, the benefits of an education intervention have been supported. Résumé: Contexte: Bien que l’éducation du patient soit considérée comme un élément essentiel des programmes de réadaptation cardiaque (RC), il n’existe, à notre connaissance, aucun programme éducatif standardisé en RC au Canada. Cette absence de standardisation peut être attribuable à un manque de ressources fiables en matière d’éducation des patients. Cette étude visait à évaluer l’efficacité réelle d’une intervention éducative au regard de l’amélioration des connaissances et des comportements touchant la santé chez des patients en RC dans trois établissements au Canada. Méthodologie: Une intervention éducative globale fondée sur des données probantes et théoriques a été menée auprès de patients en RC. Les patients ont répondu à des questionnaires d’évaluation des connaissances, de l’activité physique, de l’apport alimentaire, de l’autoefficacité et de la littératie en matière de santé. Tous les résultats ont été évalués avant et après la RC. Des tests t pour échantillons appariés ont été utilisés pour étudier les changements touchant les variables évaluées avant et après la RC, des coefficients de corrélation de Pearson ont servi à déterminer l’association entre les connaissances et les comportements, et des modèles de régression linéaire ont été calculés pour étudier les différences dans les connaissances globales après la RC en fonction des caractéristiques des participants. Résultats: Au total, 252 patients ont accepté de participer; de ce nombre, 158 (63,0 %) ont pris part aux évaluations postérieures à la RC. Les connaissances globales des patients se sont améliorées de façon significative d’avant à après la RC, tout comme l’activité physique, l’apport alimentaire et l’autoefficacité (p < 0,05). Les résultats ont montré une corrélation positive significative entre les connaissances et l’apport alimentaire (r = 0,203; p = 0,01), l’autoefficacité (r = 0,201; p = 0,01) et la littératie en matière de santé (r = 0,241; p = 0,002) après la RC. Le niveau d’éducation (B = -2,511; p = 0,04) et les connaissances avant la RC (B = 0,433; p < 0,001) ont influé sur les changements touchant les connaissances après la RC. Conclusion: Cette toute première étude multicentrique axée sur l’éducation des patients en RC au Canada a permis de confirmer les avantages d’une intervention éducative.

Aim/background To assess the effectiveness of mobile SMS as a tool for behavior and life style modification in management of diabetes. Methods This interventional study was conducted from July 2014 to April 2015 at Baqai Institute of Diabetology and Endocrinology (BIDE). Demographical and clinical information of subjects (patients and relatives) along with their knowledge and beliefs regarding diabetes was recorded using questionnaire. In Short Message Service (SMS) and non-SMS groups, education regarding diabetes was given. Two messages per day were sent to SMS group for two months. Results Total 648 subjects, SMS (n = 376) and non-SMS (n = 276) groups, were included in study. Mean age of patients and relatives was 45.41 ± 15.13 and 34.58 ± 11.91 in SMS group, while 47.06 ± 14.83 and 31.02 ± 11.51 in non-SMS group, respectively. No significant difference regarding level of knowledge and beliefs among both groups was observed at baseline. After SMS intervention, level of knowledge (p ≤ 0.0001) and beliefs (p ≤ 0.0001) were found to be significantly higher in SMS groups Non-SMS group. Conclusion Mobile SMS are an effective tool to deliver behavior and lifestyle modification advice and support for better management of diabetes and its prevention in people who are at high risk. Education intervention through SMS is found to be an important variable which enhances the knowledge and beliefs of the subjects.

The purpose of this project was to assess and increase nursing staff knowledge and comfort when providing education to families with a diagnosis of adrenal insufficiency. An evidenced-based educational resource was developed and provided the framework for a PowerPoint presentation provided to neonatal intensive care nursing staff and ancillary staff from the endocrine clinic. The intention was to improve knowledge, understanding, and comfort when addressing caregiver education. Nursing staff knowledge was measured pre and post education intervention to evaluate for change. There was a significant difference in the scores for adrenal insufficiency knowledge from pre (M = 5.18, SD = 1.501) to the post education (M = 7.37; SD = 0.775) [t(77) = -10.919; p = 0.000]. Nursing staff also reported an increase in comfort level with providing caregiver education regarding adrenal insufficiency management. The educational session proved beneficial to increase knowledge and comfort with caregiver education regarding adrenal insufficiency pathophysiology and management.

This study aimed to determine the effect of education intervention, based on social cognitive theory, on self-care behaviors in patients with type 2 diabetes.This study was conducted in descriptive and interventional stages. The effective factors and constructs of social cognitive theory were identified in a descriptive study (n = 320). After that, a quasi-experimental study was conducted to determine the effect of intervention on 120 diabetic patients whom were randomly assigned to experimental and control groups. The educational intervention was implemented in six 40 -minute sessions for the experimental group. The questionnaires were completed before, immediately after and three months after the intervention.The results of regression showed that emotional adaptation (P 0.05), self-efficacy to overcome barriers (P 0.05) and self-regulation (P 0.05) could predict self-care. There was no significant difference between the experimental and control groups before the educational intervention, however, after the intervention, there was a significant difference in self-care (p 0.001), knowledge (p 0.001), outcome expectations (p 0.001), outcome value (p 0.001), self-efficacy (p 0.001), self-efficacy to overcome barriers(P 0.001) p), environment (p 0.001), observational learning (P 0.05), situational perception (p 0.001), self-regulation (p 0.001) and emotional adaptation (p 0.001)) in the intervention group.The results of this study showed that intervention, based on social cognitive model, has a positive effect on diabetes self-care in the patients. Emotional adaptation, self-efficacy to overcome barriers and self-regulation have the biggest impact on diabetes self-care.

Background Increasing evidence suggests that the stigma associated with mental illness is a powerful barrier to accessing mental health care worldwide. Consistent findings in high-income countries have shown that contact with people with mental illness is the most effective intervention to reduce stigma. However, little evidence is available at present on how to reduce stigma in low- and middle-income countries, including China. In this context the aim of this paper is to report the findings of a pilot study to assess the feasibility of an intervention to reduce stigma among primary care and community healthcare staff in Beijing, China through a contact-based education intervention. Methods Community healthcare staff were recruited including primary health care staff and community administrators. They were randomly assigned to: (i) “education only” group, a lecture-based education (the control condition); or (ii) “education and contact” group, lectures plus contact with people with mental illness (the experimental condition). Each participant completed an assessment of mental health stigma related: knowledge (mental health knowledge schedule, MAKS); attitudes (mental illness: clinicians’ attitudes scale, MICA-4); and behavior (Reported and intended behavior scale, RIBS) before and after the intervention, with follow up at 1 month and 3 months after the intervention.Results A total of 121 community staff were recruited, including 67 workers in primary health care and 54 community workers. Both “education only” group and “education and contact” group showed improved knowledge after the intervention, MAKS scores increased by 1.77± 3.15 VS 2.46±2.49, respectively. There was no between–group difference in MAKS score. The “education and contact” group showed a significantly greater improvement for MICA and RIBS score than the “education only” group: the MICA score decreased by 4.07± 8.38 VS 8.41±7.48 (p=0.003), and the RIBS score increased by 2.28± 3.89 VS 4.57±3.53 (p=0.001), in the “education only” and the “education and contact” groups respectively, but the between group differences disappeared at 1 month and 3 months follow-up points. The positive effects on behaviour in both groups were sustained at 3 months.Conclusion The intervention to reduce stigma among the primary and community healthcare staff through a contact-based education intervention was feasible in Beijing. There is initial evidence from this study that contact based education with people with mental illness (including using recovery stories) appears to be an effective intervention for stigma-related attitudes and behavior. This approach needs to be replicated with longer follow-up to examine sustained changes over time. Trial Registration: ISRCTN13779136, https://doi.org/10.1186/ISRCTN13779136, Effect of a contact-based education intervention on reducing stigma among community health and care staff in Beijing, China

Background: Registered nurses (RNs) receive didactic training regarding caring for patients receiving epidural analgesia. Although RNs are tested on their knowledge after this training, their ability to critically think through adverse events has not been assessed at our institution. Aim: The aim of this study was to examine the feasibility and effectiveness of simulation education for RNs regarding the assessment and management of patients receiving epidural analgesia. Method: The study included an education intervention, which consisted of a 4-hour workshop. After obtaining informed consent, RNs completed a preworkshop evaluation of skill performance where they completed an Objective Structured Clinical Examination (OSCE) in which they demonstrated an epidural assessment of a standardized patient. RNs then completed a demographic and knowledge questionnaire followed by a lecture regarding care, management, and assessment of patients who are receiving epidural analgesia. After the lecture, RNs practiced epidural assessments within small groups. A postworkshop OSCE, questionnaire, and debriefing were completed before the end of the workshop. Results: Thirty-seven RNs completed the workshop. The mean age of participants was 43 years. For the pre- and postworkshop knowledge questionnaire, there was significant improvement in answers related to epidural pharmacology and assessment of blockade questions. For the pre- and postworkshop OSCE, there was a significant increase in the number of correct procedures performed in all categories, with the exception of assessment of equipment. There was also a significant change in the proportion of RNs who stated that they felt confident in their assessment of a patient receiving epidural analgesia.

Youth are a key audience for food safety education. They often engage in risky food handling behaviors, prepare food for others, and have limited experience and knowledge of safe food handling practices. Our goal was to investigate the effectiveness of an existing food handler training program for improving safe food handling behaviors among high school students in Ontario, Canada. However, because no schools agreed to provide control groups, we evaluated whether behaviors changed following delivery of the intervention program and whether changes were sustained over the school term. We measured 32 food safety behaviors, before the intervention and at 2-week and 3-month follow-up evaluations by in-person observations of students ( n = 119) enrolled in grade 10 and 12 Food and Nutrition classes ( n = 8) and who individually prepared recipes. We examined within-student changes in behaviors across the three time points, using mixed effects regression models to model trends in the total food handling score (of a possible 32 behaviors) and subscores for "clean" (17 behaviors), "separate" (14 behaviors), and "cook" (1 behavior), adjusting for student characteristics. At baseline, students ( n = 108) averaged 49.1% (15.7 of 32 behaviors; standard deviation = 5.8) correct food handling behaviors, and only 5.5% (6) of the 108 students used a food thermometer to check the doneness of the chicken (the "cook" behavior). All four behavior score types increased significantly ∼2 weeks postintervention and remained unchanged ∼3 months later. Student characteristics (e.g., having taken a prior food handling course) were not significant predictors of the total number of correctly performed food handling behaviors or of the "clean" or "separate" behaviors, working or volunteering in a food service establishment was the only characteristic significantly associated with food thermometer use (i.e., "cook"). Despite the significant increase in correct behaviors, students continued to use risky practices postintervention, suggesting that the risk of foodborne disease remained.

Background/Purpose: The prevalence of Gastroesophageal reflux disease (GERD) is increasing worldwide, including Asia. Although several consensus reports have been published, little is known regarding the adherence of the physicians on the consensus of GERD. We aimed to survey the agreements and adherence of physicians to the Taiwan GERD consensus before and after the continual medical education (CME) courses. Methods: Two-hundred and twenty-seven physicians, including 81 fellows of gastroenterology, 135 qualified gastroenterologists, and 11 non-gastroenterologist attending physicians were invited to the CME course. Their agreements and adherence to the statements before and after the CME course were assessed by the pre-defined questionnaire with the aid of electronic keypads. The adherence rate before and after the CME course were compared by the McNemar test to indicate the changes in their willingness to follow the statements in clinical practice. Results: The rates of agreement of the 227 participating physicians were uniformly greater than 80% for all of the 22 statements. However, the adherence rates were lower than 80% in 16 statements before the CME intervention. The adherence rates were significantly (p

Fundamental care has come under increased scrutiny due to high-profile reports globally of poor nursing care. The reasons for these documented care failures are widely debated, with some scholars identifying issues with how fundamental care is valued within healthcare systems and by nurses. During focus groups designed to evaluate a fundamental care education intervention, we identified a perception commonly held by first-year pre-registration (pre-licensure) students that appeared indicative of a de-valuing of fundamental care: students routinely described fundamental care as ‘common sense’ and doubted that such care should form a key part of their education. In this paper, we explore this perception and its potential consequences for nursing education, clinical practice, and research. We argue that a perception of fundamental care as ‘common sense’ is a myth; it undermines the inherent complexity of providing such care to a consistently high standard and has negative implications for nursing education and continuing professional development, patient experiences and outcomes, and the advancement of nursing science. It is a perception that must be challenged.

Social Cognitive Theory-based cooking workshops were offered to student-athletes enrolled in a Life Skills college course. The workshops were hands-on and emphasized the Performance Plate and basic cooking skills. Student-athletes reported increased self-efficacy for healthy food choices and cooking skills (P

Introduction The aim of this study was evaluating if the presence of a humanoid robot could improve the efficacy of a game-based, nutritional education intervention. Study design This was a controlled, school-based pilot intervention carried out on fourth-grade school children (8–10 years old). A total of 112 children underwent a game-based nutritional educational lesson on the importance of carbohydrates. For one group ( n = 58), the lesson was carried out by a nutritional educator, the Master of Taste (MT), whereas for another group, ( n = 54) the Master of Taste was supported by a humanoid robot (MT + NAO). A third group of children ( n = 33) served as control not receiving any lesson. Methods The intervention efficacy was evaluated by questionnaires administered at the beginning and at the end of each intervention. The nutritional knowledge level was evaluated by the cultural-nutritional awareness factor (AF) score. Results A total of 290 questionnaires were analyzed. Both MT and MT + NAO interventions significantly increased nutritional knowledge. At the end of the study, children in the MT and MT + NAO group showed similar AF scores, and the AF scores of both intervention groups were significantly higher than the AF score of the control group. Conclusions This study showed a significant increase in the nutritional knowledge of children involved in a game-based, single-lesson, educational intervention performed by a figure that has a background in food science. However, the presence of a humanoid robot to support this figure's teaching activity did not result in any significant learning improvement.

The urolithiasis, with a high incidence nowadays, including formations caused by gallstone of uric acid, has a high correlation to our lifestyles and dietary habits. Through a clinic case, it is intended to review the main nursing actions that may occur with this pathology. To achieve this, the data collected on physical examination and nursing assessment on the model of Virginia Henderson, while the full care plan is developed. The results show the need to establish a standardized healthy education intervention, related to a low-pruine healthy diet for people that suffer this disease. The amount of complications and problems associated with recidivism of hospital accommodation because of the ignorance of gallstone cases increase the risk of reducing the quality of life of the patients.

Objective Compare the effectiveness of simulation to a self-study article on short- and long-term knowledge retention among critical care health care providers. Methodology This study used a two-group single-blinded randomized controlled design and was conducted at seven community hospitals in the Midwest United States. Participants answered a demographic questionnaire and completed a knowledge test related to sepsis care management. Participants were randomized to either the treatment intervention (simulation) or the standard intervention (self-study article). Immediately after the education intervention and again at 3 months after the education intervention, participants completed the same knowledge test. Conclusion Overall, there was no significant difference in knowledge test scores between groups of participants who received simulation and self-study. Knowledge scores for both groups improved after the educational intervention.

Summary Background Cleaning is a critical tool for infection prevention and control, and is a key intervention for preventing healthcare associated infections (HCAIs) and controlling intermediate transmission routes between patient and environment. This study sought to identify potential areas of weakness in clinical surface cleaning, and assess the effectiveness of a staff group specific training intervention. Observations One-hundred hours of audit observations in a paediatric cardiac intensive care unit (CICU) assessed surface cleaning technique of healthcare staff within bedspaces. Cleaning was assessed with a 5-component bundle, with each cleaning opportunity scored out of five. Training Intervention Fifty hours of audit observations before and after a training intervention tested the efficacy of a staff group specific education intervention. The intervention was developed and implemented for 69% of nurses and 100% of cleaners. Results One hundred and eighteen cleaning opportunities were observed before training, and scored an average of 2.4. One hundred and twenty-one cleaning opportunities were observed after training and scored an average 3.0. On average, before training, each cleaning opportunity by nurses and cleaners fulfilled 2.4 and 2.5, respectively, of the 5 bundle components. Following training, this improved to 3.3 and 2.9 respectively. There was a statistically significant improvement in bundle scores for nurses (P=.004) and cleaners (P=.0003). Conclusions Surface wipe methods were inconsistent between all staff groups. The education based intervention resulted in a small improvement in most of the cleaning components. This study has identified how a small but targeted cleaning training intervention can have a significant (P=

Background Pediatric mock code simulation plays a critical role in the development of a trainee's decision making ability for high-stakes, low frequency situations. To ensure trainees receive maximal benefit from these simulations, it is important that they receive optimal, timely feedback. Objective The aim of this study is to characterize the implementation and pilot use of the American Board of Pediatrics’ (ABP) Entrustable Professional Activities (EPAs) for mock code feedback. Methods We designed a simulation-based education intervention study of pediatric trainees at a large pediatric residency program. To ensure consistency and breadth of experience, a standardized mock code curriculum of 13 cases was created. An online assessment tool was created based on the ABP's EPA 10 (resuscitation and initial stabilization) incorporating objective clinical behaviors that the learner must display during the simulation. EPAs and communication were rated based on narrative anchors with seven and five possible levels, respectively. The tool was used to facilitate and record feedback between the instructor and trainee. In addition, other mock code participants evaluated the trainee using the tool in real time. Results 6 months since implementation, 21 residents (45% of PGY-2, PGY-3 classes) have received one-to-one verbal and written feedback using our tool following a mock code. 90 evaluations were completed by faculty and observers. The average EPA rating and communication score of residents was 5.4 (SD 1.27) and 3.66 (SD 0.75), respectively. There were no significant differences observed in the EPA or communication scores between the observers and faculty (P = 0.46 and 0.8, respectively). In the post-simulation survey, 93% (13/14) of trainees indicated the feedback process would improve their future performance. Conclusions An EPA-based, online assessment tool was feasible and easily incorporated into mock code simulations. We found that observers with varying levels of expertise gave similar ratings, suggesting future possibilities of using peers for feedback in mock code settings.

We study the effect of a financial education intervention on the propensity to delegate financial decision-making to a digital asset management tool (robo-advisor). Our results suggest that investors are more inclined to delegate financial decision-making when they receive detailed information on the investment principles underlying the robo-advisory algorithm. The intervention also affects investors’ independent investment behavior as it increases diversification and revealed risk aversion, while it decreases self-reported risk aversion. Our findings imply that robo-advisors benefit from providing financial education to prospective investors and that financial education may indirectly affect investment outcomes by encouraging the use of financial advice.

Objective Patients and physicians identify communication of bad news as a skill in need of improvement. Our objectives were to measure change in performance of first-year pediatric residents in the delivery of bad news after an educational intervention and to measure if changes in performance were sustained over time. Methods Communication skills of 29 residents were assessed via videotaped standardized patient (SP) encounters at 3 time points: baseline, immediately post-intervention, and 3 months post-intervention. Educational intervention used was the previously published “GRIEV_ING Death Notification Protocol.” Results The intraclass correlation coefficient demonstrated substantial inter-rater agreement with the assessment tool. Performance scores significantly improved from baseline to immediate post-intervention. Performance at 3 months post-intervention showed no change in two subscales and small improvement in one subscale. Conclusions We concluded that breaking bad news is a complex and teachable skill that can be developed in pediatric residents. Improvement was sustained over time, indicating the utility of this educational intervention. Practice implications This study brings attention to the need for improved communication training, and the feasibility of an education intervention in a large training program. Further work in development of comprehensive communication curricula is necessary in pediatric graduate medical education programs.

Background Nurses often do not adhere to health-promoting lifestyles, compromising their health status and quality of care. This study aimed to evaluate health-promoting effects of an eHealth intervention among nurses compared with conventional handbook learning. Methods This controlled before/after study enrolled 105 nurses, 55 in an experimental group and 60 in a control group, for 3 months of intervention. Both groups completed pre- and postintervention questionnaires of the Health-Promoting Lifestyle Profile and Short-Form Health Survey. Subjects’ height, weight, and body mass index were recorded. Discussion The eHealth education intervention had the effect of significantly increasing nurses' postintervention Health-Promoting Lifestyle Profile total scores. No significant changes were observed in the postintervention scores of the control group subjects. The experimental group also had significant postintervention decreases in BMI, but no similar changes were observed in the control group. Conclusions Tailored eHealth education is an effective and accessible intervention for enhancing health-promoting behavior among nurses.

Improved hand hygiene efficiently prevents the major killers of children under the age of five years in Ethiopia and globally, namely diarrhoeal and respiratory diseases. Effective handwashing interventions are thus in great demand. Evidence- and theory-based interventions, especially when matched to the target population's needs, are expected to perform better than common practice. To test this hypothesis, we selected two interventions drawing on a baseline questionnaire-study that applied the RANAS (Risk, Attitudes, Norms, Abilities, Self-regulation) approach and focused on the primary caregivers of households in four rural, water-scarce kebeles (smallest administrative units of Ethiopia) in southern Ethiopia (N = 462). The two interventions were tested in combination with a standard education intervention in a quasi-experiment, as follows: kebele 1, education intervention, namely an f-diagram exercise, (n = 23); kebele 2, education intervention and public-commitment (n = 122); kebele 3, education intervention and tippy-tap-promotion (i.e. handwashing-station-promotion; n = 150); kebele 4, education intervention, public-commitment and tippy-tap-promotion (n = 113). In kebeles 3 and 4, nearly 100% of the households followed the promotion and invested material and time to construct for themselves a tippy-tap. Three months after intervention termination, the tippy-taps were in use with water and soap being present in up to 83% of the households (kebele 4). Pre-post data analysis on self-reported handwashing revealed that the population-tailored interventions, and especially the tippy-tap-promotion, performed better than the standard education intervention. Tendencies in observed behaviour and a recently developed implicit self-measure pointed to similar results. Changing people's hand hygiene is known to be a challenging task, especially in a water-scarce environment. The present project suggests not only to apply theory and evidence to improve handwashing interventions' effectiveness, but also emphasizes the relevance of tailoring interventions to the target population.

Research identifying associations between parental behaviors and children's food and activity choices and weight suggests that the integration of parenting and nutrition education holds promise for promoting healthful eating and activity in families. However, translational research leading to sustainable interventions lags behind. Development and testing of interventions within actual program contexts is needed to facilitate translation to full-scale implementation. Therefore, the goal of this pilot study was to develop and test an integrated nutrition and parenting education intervention for low-income families within the Expanded Food and Nutrition Education Program in New York State. During a 21-month period, low-income parents of 3- to 11-year-olds were recruited through usual programmatic channels by nutrition program staff to participate in a series of eight workshops delivered to small groups. A validated self-administered questionnaire was used to assess behavior change outcomes among 210 parents who completed the program. Mean scores improved significantly for most behaviors, including adult fruit and vegetable intake; adult and child low-fat dairy and soda intake; and child fast-food intake, activity, and screen time (P0.001). Many parents reported eating together with children at program entry, leaving little room to improve, but about 20% reported at least a 1-point improvement (on a 5-point scale). The most frequent change was reducing how often children ate fast food and was reported by50% of parents. Design and testing through practice-based research can facilitate development of interventions that are both feasible and likely to improve eating and activity behaviors among low-income families.

The concept of psychoeducation is close to the concept of therapeutic education and refers to a kind of education intervention targeting people with a mental health condition. In the framework of psychosis, psychoeducation can be offered to patients, family members or both. The efficacy of patient psychoeducation on treatment adherence or social functioning is well-established but only if the family benefits of a joint psychoeducational intervention. Family psychoeducation, even without patient psychoeducation has proven efficacy in reducing relapse rate. This reduction is of the same order of magnitude as that obtained with an antipsychotic medication.

Introduction Role expansion of the radiation therapist into areas such as organ at risk (OAR) delineation is currently being discussed. Any role expansion into this area, however, must be carefully monitored and evaluated before it should occur. OAR delineation is a vital link in an effective Image Guided Radiation Therapy (IGRT) and Intensity Modulated Radiation Therapy (IMRT) program. The uniformity of OAR delineation must be proven between radiation therapists and with their radiation oncologist colleagues before role expansion can occur. Methods Six radiation therapists were required to contour prostate, bladder and rectum on three CT datasets twice before undertaking a radiation oncologist guided education session. After this education intervention the process was repeated. Variance between the six radiation therapists (inter-observer) was calculated and also a comparison made to the radiation oncologist derived ‘gold standard'. Results There was little uniformity between the radiation therapist derived volumes for prostate, bladder and rectum. The education intervention had minimal impact on the variance between radiation therapist derived contours. When compared to the ‘gold standard' there was minimal consistency shown by the radiation therapist led OAR delineation. Conclusion The introduction of an education intervention had minimal impact on the variance in OAR delineation between individual radiation therapists (inter-observer) and in comparison with the gold standard. Role expansion of the radiation therapist into this area will need to be a framework of continuous education and evidence-based practise.

Summary The aim of this study is to describe the impact of an education intervention programme on nurses' willingness to care for HIV-positive people in Lithuania. Methods The study utilizes a randomized controlled trial design (RCT). The total sample comprises 185 nurses working in medical, surgical and gynaecological units, and primary health care centres from the same hospital areas in three Lithuanian hospitals. The data were analyzed using SPSS 12.0 and descriptive statistics. Findings Our educational intervention did not have an impact on the nurses' willingness to take care of people living with HIV (PLHIV), as their level of willingness was high already before the education intervention. Conclusions Further research on this issue is needed to try to understand the forces acting on our nursing staff in order to ensure appropriate care for PLHIV.

To conduct a cancer education intervention with racially diverse communities in South Carolina.The study was conducted at eight different sites in six counties in SC. The intervention included a 3-h general cancer knowledge and 30-min prostate cancer knowledge component. Pre- and post-intervention surveys were administered. Maximum scores were 31, 10 and 5 for the general cancer knowledge, prostate cancer knowledge and perceived self-efficacy in patient-physician interaction instruments, respectively. Analyses were completed using SPSS 16.0, SAS 9.1.3, and R v2.6.1.The study sample consisted of 164 predominantly African American participants. Most of the participants who reported age were 50+ years (62.5%). Among those who reported income, 46.1% had an annual household income$40,000. The mean general cancer knowledge pre-test score was 26.2 (standard deviation (SD) 3.7) with a mean post-intervention increase of 2.15 points (p0.01). The mean pre-test prostate cancer knowledge score was 7.3 (SD 2.0) with a post-intervention increase of 0.48 points (p0.01). Perceived self-efficacy in patient-physician interaction scores had a ceiling effect.General cancer knowledge and prostate cancer knowledge scores increased following the intervention.The intervention was successful in the short-term. It could be continued by community members.

Accurate calculations of flow rate of intravenous medication are crucial to safe patient care. Flow rate of these medications can be calculated using either the formula or dimensional analysis method. However, few studies have assessed the effectiveness of this teaching method or any other method of calculating drug dosages. The purpose of this study was to compare the effects of formula and dimensional analysis educational methods of intravenous drug rate calculations on nursing students' rapid and sustained learning. This was an experimental study in which 42s year nursing students participated. They were divided randomly into two groups, control and experimental and the drug calculating skills were taught to them through formula method (control group) and dimensional analysis method (experimental group), respectively. Before the education, immediately, and three months after the teaching intervention, the students' skills were examined using a drug calculation test. The results showed that no significant difference between the two groups in pre-test and post-test 1 scores (P>0.05), but did show a significant difference between the two groups in post-test 2 scores (P

To determine the effect of a year-long, multifaceted diabetes curriculum on the knowledge of internal medicine residents.In this controlled, prospective study, diabetes knowledge assessment was performed with a published questionnaire to measure baseline knowledge, determine change in knowledge at 1 year, and compare resident knowledge with attending knowledge. The questionnaire was administered to residents at the beginning and end of the 2007-2008 academic year. As controls, internal medicine attendings and diabetes care providers were also given the questionnaire. The educational curriculum over the course of the year included order sets, pocket cards, lectures, and rounds. Although all residents were exposed to the education intervention, teaching targeted the postgraduate year (PGY)-1 residents.Of 91 participating residents, 85 (93%) completed at least 1 questionnaire for a total of 103 questionnaires. Baseline and year-end assessments were completed by 18 residents. Among 25 attendings, 22 (88%) completed questionnaires. Eleven diabetes care providers participated. PGY-3 residents scored 72 +/- 10% and PGY-2 residents scored 72 +/- 8%, which was significantly greater than the PGY-1 residents' score of 62 +/- 12% (P = .004 and P = .006, respectively). Lectures were associated with knowledge improvement over time (P = .04). The mean attending score of 67 +/- 13% was not significantly different from the residents' scores. Diabetes care providers had the highest score (92 +/- 7%).Inpatient diabetes education targeted to PGY-1 residents modestly improves resident knowledge, especially in the targeted population. Traditional educational methods may not be adequate, and improved education is needed for trainees and attendings to provide optimal diabetes care. Strategies to improve resident education may include developing more comprehensive lectures that address fundamental concepts, focusing on all PGY levels, frequent consultation with diabetologists, and case-based discussions.

Changes in shift work patterns have meant that patients presenting to a hospital fracture clinic for follow-up may see a different doctor on each visit. Clear clinical notes are essential in this setting, for both clinical and medico-legal reasons. We tried to improve documentation in the fracture clinic by using an education intervention followed by the introduction of a fracture clinic template. Audits were performed at baseline in January 2002, then in July 2002 after the education intervention, in October 2002 after the template introduction, and finally in March 2005. The combined approach of education and involving staff in design of the template followed by introduction of the template, resulted in a significant and sustained improvement in fracture clinic documentation.

Acceptance and commitment therapy (ACT) has previously been shown to alter stigmatizing attitudes and to be relatively useful for psychologically inflexible participants. The present study is the first to bring those two findings together by comparing ACT to an education intervention for reducing stigma toward people with psychological disorders, and examining whether results differ for psychologically inflexible versus flexible individuals. A sample of college students (N =95) was randomly assigned to a 2(1)2h ACT or educational workshop. Measures were taken before and after the workshop and at a 1-month follow-up. ACT reduced mental health stigma significantly regardless of participants' pre-treatment levels of psychological flexibility, but education reduced stigma only among participants who were relatively flexible and non-avoidant to begin with. Acceptance could be an important avenue of exploration for stigma researchers.

To evaluate the cost-effectiveness of academic detailing programs to improve immunization coverage in communities through implementation and evaluation of the Raising Immunizations Thru Education (RITE) program in the Greater Houston area.RITE was a preintervention and postintervention pilot study with randomized intervention and control sites implemented in private practices in pediatrics and family medicine. Changes in self-reported provider behaviors (n = 186) and comparisons of immunization coverage levels between intervention (n = 61) and control (n = 62) practices were evaluated. Intervention costs, computed from the perspective of an agency wanting to replicate the intervention, included direct expenses and time costs, based on time logs and compensation. Sensitivity analysis describes variations in costs. The cost-effectiveness ratio was computed as dollars per additional outcome unit.The RITE intervention improved self-reported provider behavior. The immunization rates in the intervention group increased by 1 per cent, whereas immunization rates in the control group decreased by 2 per cent -3 per cent, but the 3 per cent - 4 per cent difference was not significant. A 1 per cent increase in practice immunization rates costs $424-$550, depending on the up-to-date criteria used and the targeted age group.The costs for 1 additional child with up-to-date immunization status are higher than potential societal savings, as reported in the literature. This intervention does not have a favorable cost-benefit ratio.

This study investigated the effectiveness of a brief Distraction Education intervention for parents prior to their preschool children's medical procedures. Forty-four preschool children with chronic non-life-threatening conditions were having intravenous catheters (IVs) placed for medical tests. Parent-child dyads were randomized into two groups. The experimental group received Distraction Education prior to IV insertion; the control group received standard care. Data were analyzed for two phases of the IV procedure. Phase 1 was the preparation for needle insertion; Phase 2 began with needle insertion. Experimental group parents used significantly more distraction than did control group parents during both phases (P < 0.001). There were no group differences for child behavioral distress or self-report of pain. There was a trend toward a group by phase interaction for behavioral distress (P = 0.07); more experimental group children showed decreased behavioral distress over time (from phase 1 to phase 2) than did control group children (P = 0.02).

This study investigated the effects of school mobility on reading and math achievement for 1,087 low-income Black children in the Chicago Longitudinal Study. Between kindergarten and seventh grade, 73% of the students changed schools at least once during elementary school and 21% changed schools three or more times. The prospective longitudinal design of the Chicago Longitudinal Study allowed for controlled analyses of both the predictors and the consequences of school mobility. The significant predictors of the number of moves included prior achievement, the number of years of preschool participation in an education intervention program, and parent education. Although the students who changed schools frequently between kindergarten and seventh grade performed approximately one year behind their nonmobile peers on reading and mathematics achievement tests taken at the end of seventh grade, only one half of this difference appears attributable to frequent mobility. The remaining portion is due to the fact that the mobile students were lower achieving even before they started to change schools. The negative consequences of past school mobility are lower for students who moved into better quality schools such as magnets or academic academies. Findings indicate that it is frequent, rather than occasional, mobility that significantly increases the risk of underachievement.

Study objective: To describe the effectiveness of an emergency medical education program in a postwar developing country. Methods: A prospective, nonrandomized interrupted time-series study was conducted in an emergency department at a national referral hospital in Rwanda immediately after the 1994 civil war. Participants included 11 medical personnel staffing the ED comprising physicians, nurses, and medical assistants. International medical relief workers in the ED identified deficiencies by directly observing routine clinical practices. On the basis of this assessment, formal training programs in trauma resuscitation, airway management, wound care, and blood/fluid precautions were conducted. Subjects were then observed 1 week and 2 months after the educational programs and scored on a standardized data-collection form. Scores before and after intervention were compared with the use of Fisher's exact test to determine program effectiveness. Results: Educational interventions with statistically significantly longer term effects included wound management principles and blood/fluid precautions (before versus after intervention, P Conclusion: Educational seminars proved to have the greatest sustained effect on those behaviors requiring minimal equipment and noncomplex medical decisionmaking. [Erickson TB, VanRooyen MJ, Werbiski P, Mycyk M, Levy P: Emergency medicine education intervention in Rwanda. Ann Emerg Med December 1996;28:648-651.]

Background Patients are commonly provided tools in the hospital to overcome poor sleep. Whether education on use of sleep tools can impact health outcomes from a patient perspective is not known. Methods We recruited 120 adults admitted to a nonintensive care unit cardiac-monitored floor. All patients received a set of sleep-enhancing tools (eye mask, ear plugs, and a white noise machine) and were randomized to receive direct education on use of and benefit of these sleep-enhancing tools (intervention), or an equal amount of time was spent discussing general benefits of sleep (control). Measurement of several symptom domains was assessed daily by health outcome survey responses, and change from baseline was assessed for differences between groups. Inpatient opioid use and length of stay were also measured. Results Participants randomized to receive the education intervention had a significantly greater decrease in fatigue scores over the 3 days, compared with controls (5.30 ± 6.93 vs 1.81 ± 6.96, t = 2.32, P = .028). There was a trend toward improvements in multiple other sleep-related domains, including sleep disturbance, sleep-related impairment, physical functioning, pain severity, or pain interference (all P >.140). There was no difference in length of stay between intervention and control groups (7.40 ± 7.29 vs 7.71 ± 6.06 days, P = .996). The change in number of opioid equivalents taken did not differ use between the groups ( P = .688). Conclusion In a randomized trial of education in the use of sleep-enhancing tools while hospitalized, patient fatigue was significantly improved, whereas several other patient-reported outcomes showed a trend toward improvements. Implementation of this very low-cost approach to improving sleep and well-being could substantially improve the patient care experience.

We present data on the effects of a heart health education intervention targeted at adult Southeast Asians. Within each of the Cambodian, Laotian, and Vietnamese groups who received the intervention, we obtained random samples approximately three to 18 months postintervention. Comparisons were made between preintervention and postintervention knowledge of blood pressure and awareness of behaviors to prevent heart disease. Within all three ethnic samples, we found significant increases in the pre-to-post percentages of individuals who could define blood pressure and identify ways to prevent heart diseases. [Am J Prev Med 1994;10:205–8]

Background. Trends in blood pressure, smoking, and cholesterol were examined from 1979–1980 through 1985–1986 in four cities in California by level of education (

To evaluate the effectiveness of asthma education delivered by student pharmacists and to assess the impact of child and caregiver baseline asthma knowledge on asthma control in children.Student pharmacists developed and implemented asthma self-management education interventions for children and their caregivers and performed asthma screenings for children at a series of asthma camps.Eighty-seven children, ages 5-17 years, and their caregivers were enrolled in this study. A previously validated asthma questionnaire was modified to assess asthma knowledge among children and adults. Asthma knowledge increased significantly in children following participation in the education intervention (p0.001). The education intervention, however, did not increase caregiver knowledge of asthma. A significant association was observed between caregiver baseline asthma knowledge and better asthma control in their children (p=0.019).The results of this study demonstrate that student pharmacist-delivered asthma education can positively impact asthma knowledge in children, and that caregivers' knowledge of asthma is strongly correlated with better asthma control in their children.