An implementation strategy package (video education, HIV self-testing, and co-location) improves PrEP implementation for pregnant women in antenatal care clinics in western Kenya

Background

Pre-exposure prophylaxis (PrEP) is recommended by the World Health Organization and the Kenyan Ministry of Health for HIV prevention in pregnancy and postpartum for women at risk for HIV. Integration of PrEP into antenatal care is promising, but delivery gaps exist in the face of healthcare provider shortages in resource-limited settings.

Methods

Between May and November 2021, we conducted a difference-in-differences study (3 months pre-intervention data collection and 3 months post-intervention data collection) analyzing four intervention facilities, where the strategies were implemented, and four comparison facilities, where no strategies were implemented. We tested a combination of three implementation strategies-video-based PrEP information in the waiting bay, HIV self-testing, and dispensing of PrEP in the antenatal care rooms-to improve PrEP delivery. We compared absolute changes in the proportion of antenatal attendees screened for PrEP (PrEP penetration), the proportion receiving all PrEP-specific steps in a visit (HIV testing, risk screening, and PrEP counseling) (PrEP fidelity), and client PrEP knowledge, client satisfaction, and waiting time and service time (a priori outcomes); post hoc, we compared the proportion offered PrEP (PrEP offer) and completing HIV testing. We measured provider perceptions of the acceptability and appropriateness of the implementation strategies.

Results

We observed significant improvements in PrEP penetration, PrEP offer, satisfaction, and knowledge (p < 0.05) and improvements in fidelity that trended towards significance (p = 0.057). PrEP penetration increased 5 percentage points (p = 0.008), PrEP fidelity increased 8 percentage points (p = 0.057), and PrEP offer increased 4 percentage points (p = 0.003) in intervention vs. comparison facilities. Client PrEP knowledge increased by 1.7 out of 6 total points (p < 0.001) and client satisfaction increased by 0.7 out of 24 total points (p = 0.003) in intervention vs. comparison facilities. We observed no changes in service time (0.09-min decrease; p = 0.435) and a small increase in waiting time (0.33-min increase; p = 0.005). HIV testing among those eligible did not change (1.5 percentage point decrease, p = 0.800). Providers felt the implementation strategies were acceptable and appropriate (median acceptability: 20/20; median appropriateness: 19.5/20). However, absolute levels of each step of the PrEP cascade remained suboptimal.

Conclusions

An implementation strategy package with video information, HIV self-testing, and co-location of medication dispensing enhanced PrEP delivery across several implementation outcomes and client satisfaction, while not substantially increasing wait time or decreasing provider-client contact time.

Clinical trial registration

ClinicalTrials.gov , identifier, NCT04712994.

Advancing Trauma-Informed Care Education for Hospice and Palliative Staff: Development and Evaluation of Educational Videos

Nurses play an essential role in managing mental health conditions, such as posttraumatic stress disorder (PTSD), especially in rural areas where access to mental health care is limited. Posttraumatic stress disorder may emerge at the end of life and complicate health care and is a particular concern for aging Vietnam veterans. We describe the development of 3 videos that illustrate how to recognize PTSD, respond to trauma disclosures, and manage PTSD in cognitive impairment during an in-home hospice nurse visit. Through problem identification and needs assessment, we identified 6 goals and 28 specific content objectives presented through cinematic action with flashbacks or voice-over narration with graphics. Videos were evaluated through a survey (N = 155) and analysis of "chat" responses (N = 186) to targeted questions during a webinar presentation to clinicians (N = 345). Approximately 75% rated videos as "very much" relevant to needs, having helped learn something new, and realistic. Analysis of chat responses showed videos conveyed most content objectives (92%). In addition, participants stated videos were helpful in demonstrating nursing skills of listening, responding, and displaying empathy, as well as showing case presentations involving cognitive impairment and the patient experience. Participants expressed a desire for longer videos/more information including a wider range of PTSD presentations and comorbidities.

Video-Based Educational Interventions for Patients With Chronic Illnesses: Systematic Review

BACKGROUND

With rising time constraints, health care professionals increasingly depend on technology to provide health advice and teach patients how to manage chronic disease. The effectiveness of video-based tools in improving knowledge, health behaviors, disease severity, and health care use for patients with major chronic illnesses is not well understood.

OBJECTIVE

The aim of this study was to assess the current literature regarding the efficacy of video-based educational tools for patients in improving process and outcome measures across several chronic illnesses.

METHODS

A systematic review was conducted using CINAHL and PubMed with predefined search terms. The search included studies published through October 2021. The eligible studies were intervention studies of video-based self-management patient education for an adult patient population with the following chronic health conditions: asthma, chronic kidney disease, chronic obstructive pulmonary disease, chronic pain syndromes, diabetes, heart failure, HIV infection, hypertension, inflammatory bowel disease, and rheumatologic disorders. The eligible papers underwent full extraction of study characteristics, study design, sample demographics, and results. Bias was assessed with the Cochrane risk-of-bias tools. Summary statistics were synthesized in Stata SE (StataCorp LLC). Data reporting was conducted per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist.

RESULTS

Of the 112 studies fully extracted, 59 (52.7%) were deemed eligible for inclusion in this review. The majority of the included papers were superiority randomized controlled trials (RCTs; 39/59, 66%), with fewer pre-post studies (13/59, 22%) and noninferiority RCTs (7/59, 12%). The most represented conditions of interest were obstructive lung disease (18/59, 31%), diabetes (11/59, 19%), and heart failure (9/59, 15%). The plurality (28/59, 47%) of video-based interventions only occurred once and occurred alongside adjunct interventions that included printed materials, in-person counseling, and interactive modules. The most frequently studied outcomes were disease severity, health behavior, and patient knowledge. Video-based tools were the most effective in improving patient knowledge (30/40, 75%). Approximately half reported health behavior (21/38, 56%) and patient self-efficacy (12/23, 52%) outcomes were improved by video-based tools, and a minority of health care use (11/28, 39%) and disease severity (23/69, 33%) outcomes were improved by video-based tools. In total, 48% (22/46) of the superiority and noninferiority RCTs and 54% (7/13) of the pre-post trials had moderate or high risk of bias.

CONCLUSIONS

There is robust evidence that video-based tools can improve patient knowledge across several chronic illnesses. These tools less consistently improve disease severity and health care use outcomes. Additional study is needed to identify features that maximize the efficacy of video-based interventions for patients across the spectrum of digital competencies to ensure optimized and equitable patient education and outcomes.

Video education improves patients' knowledge and satisfaction in treatment of solar lentigines with picosecond 755-nm alexandrite laser: A retrospective study

Background

Picosecond lasers are widely used in dermatologic and cosmetic practice. In clinical practice, informed consent for laser treatments is critical to ensure patients' understanding of health information.

Objectives

To evaluate whether video-based informed consent improves patient comprehension and satisfaction.

Methods

The study was performed from August 1 to November 30, 2022. Solar lentigines patients who fulfilled the inclusion criteria were included. Before October 1, 2022, traditional informed consent methods were performed. In the subsequent 2 months, a video-based informed consent was used as an adjunct to traditional consenting methods. Finally, patient comprehension of relevant knowledge about laser treatment and client satisfaction were assessed.

Results

A total of 106 patients were included. The mean number of correct answers in the comprehension assessment in the video-based informed consent group was significantly higher than that in the traditional informed consent group (4.4 ± 1.2 vs. 3.4 ± 1.1, p < 0.001). Compared to the traditional informed consent group, more correct answers in the video-based informed consent group were provided by older patients (3.9 ± 1.2 vs. 2.9 ± 1.1, p = 0.004) and patients with lower education levels (4.1 ± 1.1 vs. 3.0 ± 1.2, p < 0.001). The mean satisfaction score in the video-based informed consent group was significantly higher than that in the traditional informed consent (27.8 ± 5.7 vs. 24.3 ± 6.2, p = 0.003).

Conclusion

Video-based informed consent helps patients learn clinical literacy more effectively and improves patient satisfaction, especially in those with lower education levels and older ages.

Effect of self-learning media based on 360° virtual reality for learning periodontal instrument skills

INTRODUCTION

Of 360° Virtual Reality (VR) is possibly produced and sufficiently effective as a consumer-friendly VR learning medium. Therefore, it is also expected to be useful in the dental practice field, as a self-learning medium for non-face-to-face skill training during the ongoing pandemic (COVID-19). Accordingly, this study was conducted to assess 360° VR self-learning media for a periodontal instrument operation.

MATERIALS AND METHODS

We recruited 30 participants who had never experienced instrument training. We offered basic education and initial assessment (IA), then divided them into three groups: 1) PAPER: trained only with paper handouts; 2) 2D: trained with 2D video; 3) VR: trained with 360° VR. Each group performed self-learning and mid-term assessment (MA). Subjects then implemented home self-learning with the same media for one week, which was then followed by a final assessment (FA).

RESULT

Analysis of IA-to-FA improvement scores showed that VR and 2D video were significantly higher than the PAPER groups. Meanwhile, analysis of MA-to-FA improvement scores showed that only VR was substantially higher than the PAPER group. Although VR and 2D video groups were not considerably different, VR scores were numerically higher than 2D video in all improvement score analyses.

DISCUSSION

Both 2D video and 360° VR training were helpful to participants for an effective self-learning and also had good portability and accessibility as online-based learning methods. 360° VR showed higher learning efficiency than regular 2D video, possibly due to its autonomy, 360° visual information and physical and immersive characteristics, which positively affected self-training.

CONCLUSION

Our findings showed the potential of 360° VR learning media and, further, suggest its usefulness as a novel self-learning method in future dental education.

Telehealth-guided provider-to-provider communication to improve rural health: A systematic review

INTRODUCTION

Telehealth may address healthcare disparities for rural populations. This systematic review assesses the use, effectiveness, and implementation of telehealth-supported provider-to-provider collaboration to improve rural healthcare.

METHODS

We searched Ovid MEDLINE®, CINAHL®, EMBASE, and Cochrane CENTRAL from 1 January 2010 to 12 October 2021 for trials and observational studies of rural provider-to-provider telehealth. Abstracts and full text were dual-reviewed. We assessed the risk of bias for individual studies and strength of evidence for studies with similar outcomes.

RESULTS

Seven studies of rural uptake of provider-to-provider telehealth documented increases over time but variability across geographic regions. In 97 effectiveness studies, outcomes were similar with rural provider-to-provider telehealth versus without for inpatient consultations, neonatal care, outpatient depression and diabetes, and emergency care. Better or similar results were reported for changes in rural clinician behavior, knowledge, confidence, and self-efficacy. Evidence was insufficient for other clinical uses and outcomes. Sixty-seven (67) evaluation and qualitative studies identified barriers and facilitators to implementing rural provider-to-provider telehealth. Success was linked to well-functioning technology, sufficient resources, and adequate payment. Barriers included lack of understanding of rural context and resources. Methodologic weaknesses of studies included less rigorous study designs and small samples.

DISCUSSION

Rural provider-to-provider telehealth produces similar or better results versus care without telehealth. Barriers to rural provider-to-provider telehealth implementation are common to practice change but include some specific to rural adaptation and adoption. Evidence gaps are partially due to studies that do not address differences in the groups compared or do not include sufficient sample sizes.

Schulungskonzepte mithilfe von Telemedizin in der pädiatrischen Diabetologie

Aufgrund der hohen Technologisierung der Behandlung des Diabetes mellitus Typ 1 konnte während der Coronapandemie die ambulante Versorgung mithilfe von Videosprechstunden sichergestellt werden. Die zunehmenden Erfahrungen der Familien, E‑Learning im Schul- oder Berufsalltag umzusetzen, und die geschaffenen Strukturen in Praxen und Kliniken, telemedizinische Kontakte durchzuführen, ließ die Entwicklung unterschiedlicher Schulungskonzepte in der pädiatrischen Diabetologie voranschreiten. Deren Einsatz ist vielfältig und individuell, und beinhaltet z. B. zusätzliche Betreuungspersonen an einer Präsenzschulung teilnehmen zu lassen, bei akuten Fragestellungen der Eltern durch die Datenanalyse gemeinsam eine zeitnahe Bearbeitung zu schaffen oder weite Fahrtstrecken für die Durchführung einer Beratung zu vermeiden.

Wichtig bei der Durchführung sind eine strukturierte Vorbereitung mit allen notwendigen Hilfsmitteln, ein ruhiger Arbeitsplatz und das Einkalkulieren des möglichen Auftretens technischer Probleme auf beiden Seiten. Eine Back-up-Kontaktaufnahme mit dem Telefon ist hilfreich. Telemedizinische Schulungskonzepte in der Diabetesberatung bedeuten eine neue spannende Erfahrung und ergänzen die Betreuung der gesamten Familie mit einem Kind oder Jugendlichen mit Diabetes mellitus und sollten auch in Zukunft genutzt und ausgebaut werden.

Video-Based Tracheostomy Care Education for Medical Students

Objective

Tracheostomy is a common procedure that requires management by a multidisciplinary team of health care providers across a range of surgical and nonsurgical specialties. Nonsurgical health care providers have demonstrated a lack of knowledge and confidence in tracheostomy care, which improve with tracheostomy education programs. However, tracheostomy care is rarely included in preresidency medical education. The purpose of this study is to evaluate the effectiveness of a tracheostomy care video on third-year medical students' knowledge of and confidence in performing tracheostomy care.

Methods

Prior to beginning clinical rotations, third-year medical students completed a 10-question tracheostomy care knowledge test (100 points total) and 11-question confidence survey (110 points total). After watching an 18-minute teaching video on tracheostomy care, students repeated the knowledge test and confidence survey.

Results

An overall 147 medical students completed the educational module. After they watched the tracheostomy education video, their average score on the knowledge test improved from 57.8 to 88.9 out of 100 (P < .0001), and their average rating in confidence improved from 12.7 to 49.1 out of 110 (P < .0001). Students rated the helpfulness of the video a 7.4 out of 10.

Discussion

Medical students' knowledge of tracheostomy care and confidence in caring for patients with tracheostomies improved after watching the video. Tracheostomy education should be included in early medical education so that future physicians of various specialties can better care for this patient population.

Implications for Practice

Internet-published videos are an accessible educational resource with great potential application to various topics within otolaryngology, including tracheostomy care.

Effectiveness of a rectal cancer education video on patient expectations

AIM

Discrepancy between patient expectations and outcomes can negatively affect patient satisfaction and quality of life. We aimed to assess patient expectations of bowel, urinary, and sexual function after rectal cancer treatments, and whether a preoperative education video changed expectations.

METHODS

A total of 45 patients were assessed between January 2018 and January 2021 in a tertiary care hospital in Vancouver, Canada. Patients included were rectal cancer patients who had neoadjuvant chemoradiation and were listed for low anterior resection but had not yet had surgery. Following surgical consultation but before surgery, a questionnaire assessing expectations of lifestyle after treatments was administered. Patients then watched an educational video and repeated the questionnaire to assess for changes in expectations.

RESULTS

Patient scores indicated expectation that control of bowel movements, urination, and sexual function would sometimes be problematic, but had a range from occasionally problematic to good function. Significant change after the video was seen in the expectation of needing medications for bowel control, and 44%-69% of individual patient answers changed from prevideo to post-video, depending on the question. The education video was scored as helpful or very helpful by 82% of patients.

CONCLUSIONS

Patients have varying expectations of problematic control of bowel, urinary, and sexual function following rectal cancer treatments. A pretreatment education video resulted in a trend toward changed expectations for functional outcomes in most patients. Further educational modalities for patients may provide more uniform expectations of function and increase patient satisfaction after rectal cancer treatments.

A Mixed Methods Assessment of Home-Based Video Pretransplant Lung Education

Introduction: Patients awaiting lung transplantation must learn new information to successfully navigate the transplant process. A supplemental video series was piloted to patients at home during the Covid-19 pandemic to improve pre-transplant education. Methods: A mixed methods study was undertaken to assess patient experiences with this method of education, confirm the ideal timing of the education, and identify gaps that require further attention. Semi-structured interviews were conducted with 17 one-on-one or dyadic (patients and caregivers) who viewed the video series at home. A third-party researcher (not involved in creation of the educational materials) conducted the interviews by phone, which were audio recorded and then transcribed verbatim. NVivo 12 Pro for Windows software was used to code the data and identify emerging themes. Results: Participants indicated that home-based videos were applicable, and informative and helpful (4.7 on 5-point Likert scale) and appreciated the advice and experiences of real patients. They were satisfied with their transplant education (4.2/5). While there were few aspects that the participants disliked about the videos, the interviews elicited outstanding questions about the transplant process (eg, logistical aspects of travel) and transplant concerns (eg, medications, expenses, and precautions in daily life). Conclusion: Patients being assessed or listed for lung transplant valued the novel electronic video education, and we will implement the home-based process into standard of care after the patient's initial visit with the transplant respirologist. Pre-transplant education will be tailored to help address the outstanding gaps identified in this program evaluation.

Patient Education and Sacubitril/Valsartan: A Randomized Comparative Trial

Objective: To compare video to pharmacist education for patients taking sacubitril/valsartan. Methods: We conducted a randomized controlled trial comparing video to pharmacist education with a second randomized intervention of education delivered through text or phone call at 14 days. The primary outcome compared the change in short term knowledge between groups and the secondary outcome was long term knowledge at 1 month. Results: Forty-three patients were included. Scores improved significantly (P < .05) in the pharmacist group from 54.1% to 85.9% and from 64.3% to 86.1% in the video education group, although there was no difference between groups (31.8% vs 22.9%, P = .13). At 30 days, scores were significantly higher than baseline (difference 16.5%, P < .05) although did decrease from the posttest (difference 7.4%, P < .05). There was no difference at 30 days between those that received text messages versus phone calls (-10% vs -5.5%, respectively; P = .36). Conclusion: We saw improvements in both short term and long term knowledge for patients receiving education through pharmacist or video education. Neither approach was more effective than the other. Clinicians can use either approach based on patient preference.

The Effect of Video Education on Skin-to-Skin Contact at the Time of Delivery: A Randomized Controlled Trial

Objective  The objective of this study was to measure the impact of video education at the time of admission for delivery on intent and participation in skin-to-skin contact (SSC) immediately after birth. Methods  This study was a randomized controlled trial of educational intervention in women ( N  = 240) of 18 years or older admitted in anticipation of normal spontaneous term delivery. Alternate patients were randomized into video ( N  = 120) and no video ( N  = 120) groups. Both groups received a survey about SSC. The video group watched an educational DVD and completed a postsurvey about SSC. Results  During the preintervention survey, 89.2% of those in the video group compared with 83.3% of those in the no video group indicated that they planned to use SSC ( p  = 0.396). After the video, 98.3% planned to do SSC after delivery ( p  < 0.001). However, only 59.8% started SSC within 5 minutes of delivery in the video group and only 49.4% started SSC within 5 minutes of delivery in the no video group ( p  = 0.17). Conclusion  Video education alters the intention and trends toward participation in SSC within 5 minutes of delivery. Despite the plans for SSC, however, there was no significant difference in rates between the two groups. These findings support that obstacles, other than prenatal education, may affect early SSC. Key Points Significant obstacles impact skin-to-skin rate.Video education alters skin-to-skin intent.Video education can improve skin-to-skin rate.Education can happen at the time of delivery.Video education can impact mothers and infants.

Formative Usability of the Kidneytime Online Live Donor Kidney Transplant Education Tool Among Transplant Candidates

BACKGROUND

Web-based education may be a powerful tool to support transplant candidates' learning and communication about live donor kidney transplantation. Few educational interventions are web-based and have education sharing for living donor transplant as a primary goal.

METHODS

Through user-centered design and iterative usability testing, we developed a web platform, called KidneyTIME, to support an educational intervention for adult transplant candidates. KidneyTIME delivers animated videos to improve candidate knowledge, motivation, and self-efficacy to pursue living donor transplantation and to promote outreach through video sharing. The animated-video educational content was previously produced by the researchers. We conducted a formative usability evaluation of the KidneyTIME web platform to enable users to find, view, and share the previously produced videos. A total of 30 kidney transplant candidates were involved in 4 rounds of testing at one transplant center, with amendments made after each round.

RESULTS

Transplant candidates were predominantly White non-Hispanic; 47% had incomes <$30 000 and >43% had vision or motor impairment. Readability, navigation, and failure to find videos were the main usability issues identified. Substantial improvements were found in the usability of most functions after implementing certain features, such as enlarging text and buttons, enhancing contrast, and simplifying presentation. Participants reported that the intervention was user friendly and easy to navigate.

CONCLUSION

Considering feedback from a wide spectrum of users has improved the usability of KidneyTIME. A salient concern for End stage kidney disease populations is ensuring online accessibility despite vision and motor impairments.

Video-Based, Patient-Focused Opioid Education in the Perioperative Period Increases Self-Perceived Opioid-Related Knowledge: A Pilot Study

Objective

The aim of this study was to evaluate whether a video-based, patient-focused opioid education tool delivered in the perioperative period would decrease acute and chronic post-operative opioid prescription dispensations and increase self-rated knowledge about opioids.

Methods

We enrolled 110 patients with no reported opioid use in the previous 30 days, undergoing ambulatory surgery for breast, orthopedic, gynecologic, or other outpatient procedures for which opioids would be prescribed. Patients were randomized to receive either post-operative opioid education by the surgical team (control arm) or pre-operative education via a novel 5-minute video plus post-operative education by the surgical team (intervention arm). All patients received follow-up phone calls on post-operative day (POD) 7 to assess self-rated knowledge of opioids on a scale of 1 to 10, 10 being most informed, and self-reported opioid use (primary outcome). Arkansas Prescription Drug Monitoring Program (AR PDMP) data were obtained to assess opioid dispensations at POD 90–150 days.

Results

Seventy-seven percent of participants completed POD7 survey. Participants in the intervention arm rated their knowledge of opioids after surgery significantly higher than those in the control arm (p=0.013). Data from the AR PDMP reveal trends (non-significant) that show increased use of opioids in the control group when compared to the video intervention group at POD 30 (88.7% vs 76%) and POD 90–150 (22.6% vs 10%).

Conclusion

Video-based, patient-focused opioid education can be effectively implemented in a large university hospital during the perioperative period and is effective for increasing a patient’s perception of opioid-related knowledge. A fully powered, randomized control trial is needed to further explore observed trends and determine if this novel tool can decrease chronic post-operative opioid dispensations.

The impact of video-assisted education on quality of life of women with breast cancer receiving chemotherapy treatment

BACKGROUND

The education given in cancer process will contribute to better cope with the problems that may be experienced and to improve self-management skills, thus to the improvement in the quality of life.

AIM/OBJECTIVES

This study aimed to determine the effect of video-assisted education on the quality of life of women with breast cancer who received chemotherapy treatment for the first time.

DESIGN

The control group pre-test/post-test study design was used.

METHODS

The study was conducted with women who applied to Outpatient Chemotherapy Unit of a university hospital in Turkey between September 2016 and March 2017 and who received chemotherapy for the first time. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires namely EORTC QLQ-C30 and EORTC QLQ-BR23 were used to obtain the data.

RESULTS

In the education group patients in the fourth cycle of chemotherapy; a decrease in general well-being and a significant increase in dyspnoea, nausea, vomiting and loss of appetite were observed. In control group patients in the fourth cycle of chemotherapy, a decrease in general well-being, physical and role functions and a significant increase in nausea, vomiting, loss of appetite, and fatigue. Breast symptoms and arm symptoms in the educational group patients decreased from the 1st to the 4th cycle.

CONCLUSIONS

It has been determined that the application of visual material in patients with breast cancer in the education and counselling process is effective in improving the quality of life.

Evaluation of an educational video providing key messages for doctors to counsel families following a first afebrile seizure

AIM

The aim was to evaluate an educational video in educating doctors on the key messages and follow-up pathways following a first afebrile seizure presentation. A multidisciplinary expert team developed the video (http://www.pennsw.org.au/families/resources/first-seizure-pack-and-video) based on available evidence and best-practice. It contains a role-play between the parent/child and physician. It addresses: key messages to impart following a first seizure, seizure first aid, safety messages including necessary precautions post-discharge, contents of the First Seizure Pack for families, follow-up pathway and issues for discussion with the paediatrician at a later appointment.

METHODS

Paediatric/Emergency department (ED) trainees across three Australian sites were recruited during terms 1 and 2, 2019. A repeated measures design was used. Multilevel modelling analyses were performed. The primary outcome was clinician knowledge. Secondary outcomes were confidence in answering questions and counselling families. Qualitative data on the utility, strengths and weaknesses of the video were evaluated.

RESULTS

A total of 127 participants consented, one withdrew prior to commencing. A total of 126 baseline surveys, 115 follow-up surveys and 45 1-month follow-up surveys were returned. Viewing the video significantly improved knowledge of key messages at immediate follow-up (P < 0.001) and 1-month follow-up (P = 0.048). Likewise, confidence was significantly improved; 96.5% of responders found the video useful, 90.3% were likely to use the resource in the future and 82% would change their approach to counselling. Most liked aspects of the resource were clarity/conciseness of the information (n = 70) and comprehensiveness (n = 38).

CONCLUSION

This education video significantly improved clinician knowledge and confidence in counselling families following first seizure.

A Randomized Controlled Trial Evaluating the Effectiveness of a Short Video-Based Educational Program for Improving Mental Health Literacy Among Schoolteachers

Background: Mental illness-related stigma represents a barrier to seeking and receiving appropriate mental health care. Mental health literacy (MHL) can improve mental health knowledge, decrease stigmatizing attitudes, and enhance help-seeking behavior. Starting from 2022, mental illness-related education is due to be introduced in high schools in Japan. For this current situation, we conducted a parallel group, randomized controlled trial to examine the effectiveness of MHL educational program for teachers. Methods: The educational program described in this study comprised a 50-min video lesson designed to improve teachers' MHL. All participants were schoolteachers and were assigned either to an educational group or a waitlist control group. The assessment was conducted for both groups twice: first at baseline and then at 1-h post-intervention. The outcome measures for this trial were changes in knowledge, attitudes, and intended behaviors. Results: The educational group showed a greater improvement in knowledge regarding mental health than did the control group. The program was not effective for decreasing stigma toward mental illness. However, the educational group showed an increased intention to assist students with depression. Limitations: No long-term follow-up was implemented, which means the persistence of the educational program's effect could not be determined. Further, we could not report whether the program induced a change in teachers' behaviors regarding providing support for their students. Conclusions: The short video-based MHL educational program could improve schoolteachers' MHL and increase their intention to assist students. These findings can help in the development of similar educational programs in countries/regions experiencing similar issues regarding mental health.

Video Education Reduces Pain and Anxiety Levels in Cancer Patients Who First Use Fentanyl Transdermal Patch: A Randomized Controlled Trial

Objective

We sought to evaluate the efficacy of using a quick response (QR) code within video education to guide proper use of fentanyl transdermal patches and control pain, depression, and anxiety levels in cancer patients.

Methods

Patients using a fentanyl transdermal patch for the first time were enrolled in the study and then given an information leaflet as well as an informed consent form. We asked them to complete the first questionnaire (Q1) prior to first use of the fentanyl transdermal patch, and then used a random number table to randomize those who completed it into two groups. Participants in group A received a QR code (to make it easier for them to obtain additional video information) and a traditional information leaflet, whereas those in group B (control group) only received a traditional information leaflet. Thereafter, we requested all participants to complete standard questionnaires, which comprised a Numeric Rating Scale (NRS), a Spielberger State-Trait Anxiety Inventory (STAI), as well as a Hospital Anxiety and Depression Scale (HADS). The resulting continuous (with a normal distribution) and categorical data were analyzed using Student’s t- and chi-square tests, respectively. We also recorded parameters such as NRS, STAI, and HADS, as well as the frequency of rescue medication in both groups.

Results

A total of 154 cancer patients who first used a fentanyl transdermal patch were recruited during the study period, from April to May 2020. Among these, 138 completed follow-up, with 70 and 68 in group A and B, respectively. Participants in both groups had similar baseline and clinical characteristics, whereas significant differences were observed between the groups with regard to the other parameters. Specifically, participants in group A recorded a lower STAI state (38.2 vs 38.9, P=0.027) and HADS (3.9 vs 4.2, P=0.001) anxiety scores, as well as NRS (2.1 vs 2.4, P=0.025) and frequency of rescue medication (0.4 vs 1.4, P<0.001) than those in group B, following 14 days of using a fentanyl transdermal patch.

Conclusion

Our results indicated that incorporating a QR code within additional video education leads to proper use of a fentanyl transdermal patch and relieves pain and anxiety levels in patients with cancer. Based on this, we recommend a new style of education during care of cancer patients who first use a fentanyl transdermal patch.

Video Education to Improve Preoperative Anxiety in the Bariatric Surgical Patient: A Quality Improvement Project

PURPOSE

Evidence supports that providing preoperative education using an audiovisual format is an effective method to reduce anxiety in the surgical patient. The purpose of this quality improvement project was to evaluate the effect of viewing a video tour of the perioperative division had on patient-perceived preoperative anxiety.

DESIGN

A quasi-experimental design using a pre-post survey method of two individual groups.

METHODS

Sixty bariatric surgery patients completed a visual analog scale for anxiety (VAS-A), consisting of 10 items, on arrival and at the end of their preassessment appointment. Thirty patients in the comparison group received preoperative education with the current process of written and verbal instructions. Thirty patients in the intervention group received education with written and verbal instructions as well as inclusion of an informational video tour of the perioperative division. A paired sample t test was used to compare VAS-A results of the comparison and intervention groups.

FINDINGS

Data supported that bariatric patients who received only verbal and written instructions preoperatively had a statistically significant reduction in anxiety levels in five of 10 items on the VAS-A. Bariatric patients who received education with verbal and written instructions, as well as inclusion of the informational video tour, had a statistically significant reduction in self-perceived anxiety in 9 of 10 items on the VAS-A.

CONCLUSIONS

Data supported that the addition of an audiovisual component in the form of an informational tour of the perioperative division is an effective method to reduce perceived preoperative anxiety in patients having bariatric surgery.

Impact of Preoperative Video Education for Cataract Surgery on Patient Learning Outcomes

Purpose

To assess the effect of an educational video on 1) patient knowledge about cataract surgery, 2) patient perception of preoperative assessment visit quality, 3) face-to-face time with the surgeon, and 4) choices regarding premium intraocular lenses (IOLs) or laser-assisted cataract surgery (LACS).

Setting

Eye clinic in an academic medical center.

Design

Prospective survey of patients who randomly viewed or did not view an educational video.

Methods

Patients of three cataract surgeons completed a survey during cataract surgery preoperative visits. One group viewed an educational video about cataract surgery, while the other did not. All patients received their surgeon’s typical preoperative counseling.

Results

A total of 101 patients were surveyed. Out of 101 patients, 58 viewed the educational video. Patients who viewed the video exhibited stronger learning outcomes; in particular, patients who viewed the video scored higher on cataract surgery educational assessments than those who did not (83% vs 76%, p=0.032), particularly on the assessment of postoperative visual expectations (98% vs 80%, p=0.003). Differences in educational assessment scores between groups were not affected by which surgeon patients saw (p=0.807). Patients who watched the video were more likely to agree their surgeon provided quality explanations (93% vs 74% strongly agreed, p=0.025) and trended toward greater perception the surgeon spent enough time with them (p=0.067). Video education did not affect face-to-face surgeon time with patients (p=0.212) or choices of multifocal IOLs (p=0.795), toric IOLs (p=0.321), or LACS (p=0.940).

Conclusion

Video education during preoperative cataract surgery assessments improved patient understanding of cataract surgery and perception of preoperative visits. Video education is easily integrated into preoperative visits and can enhance the preoperative experience.

Video Education to Promote Skin Cancer Awareness and Identification in Spanish-speaking Patients

Objective: We sought to evaluate the efficacy of a Spanish-language educational video in teaching primary Spanish speaking patients to recognize benign and malignant lesions and to increase their awareness about skin cancer. Materials and Methods: Thirty-seven subjects were enrolled in study. An instructional video was developed to increase knowledge of benign and malignant lesions, skin cancer awareness, and prevention among Spanish-speaking patients. Two examples each of six common skin lesions (e.g., malignant melanoma, cherry angioma, seborrheic keratosis, benign melanocytic nevus, basal cell carcinoma, and squamous cell carcinoma) were presented as high-quality images to the participants before and after watching the two-minute educational video. A pre- and postvideo survey was used to assess competency. Results: The prevideo baseline median score was six points (interquartile range [IQR]: 5-6 points); postviewing median score improved to 11 points (IQR: 11-12 points), which was statistically significant (Median=5 points, IQR: 4-6 points; p<.001). The ability of the participants to identify nonmelanoma skin cancers improved from 74 percent to 98 percent and from 35 percent to 99 percent for squamous cell carcinoma and basal cell carcinoma. Initially, only 30 percent of participants could identify melanoma prior to viewing the video. Afterwards, 97 percent of participants could identify this malignancy. However, the video format preferences were not statistically significant: 67.6 percent of the participants preferred the video format. Conclusion: These results suggest that this educational video is an effective and valuable method to enhance knowledge about skin health and improve identification of skin cancer among Spanish-speaking patients.

Development and preliminary evaluation of ilearnKAS: An animated video about kidney allocation to support transplant decision-making

BACKGROUND

We aimed to develop and feasibility test an educational video culturally targeted to African American (AA) patients regarding kidney allocation.

METHODS

We iteratively refined an animated video for AAs with multiple stakeholder input and conducted a one-group, pre-post study with 50 kidney transplant candidates to assess video feasibility and acceptability. A mixed population was chosen to obtain race-specific acceptability data and efficacy estimates for a larger study.

RESULTS

Median participant age was 56 years, and 50% were AA. Comparing pre-post video scores, large knowledge effect sizes were found for the cohort (r = 0.7) and in the context of AA race (r = 0.8), low health literacy (r = 0.6), low educational achievement (r = 0.7), age >55 years (r = 0.6), dialysis vintage ≥1 year (r = 0.8), low income (r = 0.7) and low technology access (r = 0.8). Over 87% of participants provided positive ratings on each of the seven acceptability items. The frequency of positive responses increased pre-post video for kidney allocation understanding (78% vs 94%, P = 0.008), decisional self-efficacy (64% vs 88%, P < 0.001) and belief in fairness (76% vs 90%, P = 0.02).

CONCLUSIONS

In collaboration with key stakeholders, a culturally targeted educational video was developed that was well received. Results are promising to impact kidney allocation knowledge among AA and non-AA kidney transplant candidates.

Possible Effect of Video and Written Education on Anxiety of Patients Undergoing Coronary Angiography

PURPOSE

The aim of this study was to investigate possible effects of video and written education on anxiety of patients undergoing coronary angiography.

DESIGN

The study design was quasi-experimental.

METHODS

This randomized controlled semitrial model included patients who underwent coronary angiography between October 2015 and May 2016 at the Department of Cardiology of a university hospital. The number of subjects determined by power analysis was 90 patients in three groups. Written education, video education, and control groups were included. Data were collected using personal information forms, State-Trait Anxiety Inventory, and physiological variables.

FINDINGS

There was a statistically significant difference in the mean scores of state anxiety, satisfaction, and physiological variables after education, compared with baseline, in both patient and control groups (P < .005).

CONCLUSIONS

Our study results suggest that education given by the nurse before the procedure reduces level of anxiety and affects physiological variables positively.

What to expect that you're not expecting: A pilot video education intervention to improve patient self-efficacy surrounding discharge medication barriers

The objective of this study was to test the feasibility of video discharge education to improve self-efficacy in dealing with medication barriers around hospital discharge. We conducted a single-arm intervention feasibility trial to evaluate the use of video education in participants who were being discharged home from the hospital. The scores of pre- and post-intervention self-efficacy involving medication barriers were measured. We also assessed knowledge retention, patient and nursing feedback, follow-up barrier assessments, and hospital revisits. A total of 40 patients participated in this study. Self-efficacy scores ranged from 5 to 25. Median pre- and post-intervention scores were 21.5 and 23.5, respectively. We observed a median increase of 2.0 points from before to after the intervention (p = 0.046). In total, 95 percent of participants reported knowledge retention and 90 percent found the intervention to be helpful. Video discharge education improved patient self-efficacy surrounding discharge medication challenges among general medicine inpatients. Patients and nurses reported satisfaction with the video discharge education.

Video education to improve recognition of common benign and malignant cutaneous lesions and skin cancer prevention in the public

OBJECTIVE

Although dermatologists strive to provide patient education on sun protection and skin cancer, approximately 90% of Americans have limited health literacy skills. Little has been written about the means to best teach all levels of learners to recognize common benign and malignant skin lesions. Earlier work found that with advancing age, adults were less able to identify concerning lesions, thus underscoring the need for accessible education.

METHODS

We showed subjects a brief video (7th grade level) about common cutaneous growths, reducing the risk of skin cancer, and the importance of early detection. Subjects were asked about their skin cancer history, educational format preference, and the perceived impact of the video. Comprehension of symptoms of skin cancer and the benefits of sunscreen use and the ability to identify a melanoma, nevus, angioma, and seborrheic keratosis were also assessed.

RESULTS

Of the 156 subjects, mean age 52.7 years (range, 18-88 years), 31% had a history of skin cancer. A total of 98.7% found the video to be helpful; 92% preferred having a video as part of their teaching versus 9% who preferred written materials alone, 99% knew that a new or changing lesion could signal skin cancer, and 100% correctly answered that wearing sunscreen is protective. Subjects correctly identified lesions as melanoma (99%), benign mole (97%), angiomas (96%), and seborrheic keratosis (91%). There was a nominal trend toward higher scores in people who preferred video learning, had no history of skin cancer, and were older than 60 years of age.

CONCLUSION

In this study, we found that a brief, plain-language video was effective at conveying understandable content to help subjects learn to identify common cancerous and benign skin growths while also teaching them strategies to protect against skin cancer.

A Randomized Controlled Trial of Video Education versus Skill Demonstration: Which Is More Effective in Teaching Sterile Surgical Technique?

BACKGROUND

Video education has many advantages over traditional education including efficiency, convenience, and individualized learning. Learning sterile surgical technique (SST) is imperative for medical students, because proper technique helps prevent surgical site infections (SSIs). We hypothesize that video education is at least as effective as traditional skill demonstration in teaching first-year medical students SST.

METHODS

A video series was created to demonstrate SST ( https://www.youtube.com/playlist?list=PLcRU-gvOmxE2mwMWkowouBkxGXkLZ8Uis ). A randomized controlled trial was designed to assess which education method best teaches SST: video education or skill demonstration. First-year medical students (n = 129) were consented and randomly assigned into two groups: those who attended a skill demonstration (control group; n = 70) and those who watched the video series (experimental group; n = 59). The control group attended a pre-existing 90-minute nurse educator-led skill demonstration. Participants then completed a 30-item multiple choice quiz to test their knowledge. Each group then received the alternate education method and completed a 23-item follow-up survey to determine their preferred method.

RESULTS

Seven 2- to 6-minute videos (30 minutes total) were created on surgical attire, scrubbing, gowning and gloving, and maintaining sterility. The experimental group (n = 51) scored higher on the quiz compared with the control group (n = 63) (88% ± 1% versus 72% ± 1%; p < 0.0001). Students preferred the videos when it came to convenience, accessibility, efficiency, and review, and preferred the skill demonstration when it came to knowledge retention, preparedness, and ease of completion.

CONCLUSIONS

Video education is superior to traditional skill demonstration in providing medical students with knowledge of SST. Students identified strengths to each method of teaching. Video education can augment medical students' knowledge prior to their operating room experience to ensure that a sterile environment is maintained for patients. The ultimate goal is to reduce SSIs.

Multi-centre, prospective evaluation of the Seldinger technique for difficult male urethral catheter insertions by non-urology trained doctors

OBJECTIVE

To evaluate the safety and effectiveness of the Seldinger technique by non-urology trained (NUT) doctors for difficult male indwelling urinary catheter (IDC) insertions.

PATIENTS AND METHODS

In all, 115 patients and 57 participating NUT doctors were recruited by the urologist or urology registrar, when contacted in regards to failed IDC insertion. The successful passage of an IDC by the NUT doctors using the Seldinger technique with a straight, hydrophilic guidewire was assessed in our prospective, multicentre evaluation. Instruction of this technique was via bedside teaching by the urology registrar or via video media.

RESULTS

The 115 patients, involving 57 NUT doctors, were prospectively evaluated across four sites; 93% (107/115) of cases had successful placement of an IDC with the Seldinger technique by a NUT doctor. No complications with the Seldinger technique were recorded. In 80 patients (69.6%), the technique was successfully performed by a NUT doctor without attendance by a urologist or urology registrar, with instruction provided from video media or prior bedside teaching by the urology registrar.

CONCLUSIONS

Our study is the first to validate the safety and effectiveness of the Seldinger technique for difficult male IDC insertion performed by NUT doctors. This technique can be taught via video education and thus has important implications for health services where urological support is not readily available.

Mobile Technology to Increase HIV/HCV Testing and Overdose Prevention/Response among People Who Inject Drugs

The United States faces dramatically increasing rates of opioid overdose deaths, as well as persistent ongoing problems of undiagnosed HIV and HCV infection. These problems commonly occur together in substance using populations that have limited, if any, access to primary care and other routine health services. To collectively address all three issues, we developed the Mobile Intervention Kit (MIK), a tablet computer-based intervention designed to provide overdose prevention and response training and to facilitate HIV/HCV testing in community settings. Intervention content was produced in collaboration with experienced street outreach workers who appear onscreen in a series of educational videos. A preliminary pilot test of the MIK in a Bronx, NY street outreach syringe exchange program found the MIK is feasible and highly acceptable to a population of people who inject drugs. Participants accepted HIV and HCV testing post-intervention, as well as naloxone training to reverse overdose events. Pre-post tests also showed significant increases in knowledge of overdose prevention, HIV testing procedures, and asymptomatic HCV infection. Future iterations of the MIK can be optimized for use in community as well as clinical settings nationwide, and perhaps globally, with a focus on underserved urban populations.

Visualising a rare and complex case of advanced hilar cholangiocarcinoma

The Toronto Video Atlas of Liver, Pancreas, Biliary, and Transplant Surgery (TVASurg) is a free online library of three-dimensional (3D) animation-enhanced surgical videos, designed to instruct surgical fellows in hepato-pancreato-biliary (HPB) and transplant procedures. The video 'Klatskin tumours: Extended left hepatectomy with complex portal vein reconstruction and in situ cold perfusion of the liver', which is available to watch at http://TVASurg.ca , is a unique and valuable visual resource for surgeons in training to assist them in learning this rare procedure. This paper describes the methodologies used in producing this 3D animation-enhanced surgical video.

Student Evaluation of Online Pharmaceutical Compounding Videos

Objective. To describe pharmacy students' views on the effectiveness of an expansion of the compounding laboratory website at the UNC Eshelman School of Pharmacy. Methods. Originally, there were 39 videos and three animations available. In 2011, an additional 59 videos and two animations were added. Concurrently, all of the interactive questions were updated to fully integrate with the expanded video library. Students were surveyed about the expanded video library regarding accessibility, functionality, and usefulness, and how using the library impacted their learning of compounding. Surveys were analyzed with descriptive statistics. Means and SDs were calculated for the rating scale questions; independent t tests and Wilcoxon nonparametric tests were used to find differences between professional classes and campuses. Analytical results were evaluated with a one-way analysis of variance (ANOVA), z test, and a homogeneity of variance (Levene's) test. Results. The response rate to the survey was 85%. Compounding videos were used by 386/391 students. Thirty-four percent of students used the videos an average of 30 minutes or less per week; 56% used the videos 1-2 hours per week. Approximately 80% of students were satisfied with the functionality and accessibility of the videos. All students, regardless of professional year or campus affiliation, put their confidence/competence at about 70% of the rating scale. Conclusions. As no standardized compounding curriculum was found in US schools of pharmacy and students reported being satisfied with the website, it could be an accessible, functional, and useful resource for pharmaceutical compounding in schools of pharmacy.

Effect of appearance-based education compared with health-based education on sunscreen use and knowledge: a randomized controlled trial

BACKGROUND

Appearance-based education shows promise in promoting sunscreen use although resource-intensive methods used in prior studies preclude wide dissemination. Appearance-based video education can be made easily accessible.

OBJECTIVE

We sought to compare the effectiveness of appearance-based video education with that of health-based video education in improving sunscreen use and knowledge.

DESIGN

In a randomized controlled trial, participants viewed either an appearance-based video on ultraviolet-induced premature aging or a health-based video emphasizing ultraviolet exposure and skin cancer risk.

RESULTS

Fifty high-school students participated in the study, conducted from February through March 2012. The health-based group had a nonstatistically significant increase in sunscreen use (0.9 ± 1.9 d/wk, P = .096), whereas the appearance-based group demonstrated a statistically significant increase in sunscreen use (2.8 ± 2.2, P < .001). Between-group comparisons revealed that the appearance-based group applied sunscreen at significantly greater frequencies compared with the health-based group (2.2 ± 1.4 vs 0.2 ± 0.6, P < .001). Knowledge scores significantly improved in both study groups. The difference in knowledge scores between the study groups was not significant.

LIMITATIONS

The study population may not reflect the general population.

CONCLUSION

Appearance-based video education appears to be effective in promoting sunscreen use and knowledge in adolescents.