Evaluation of an e-Learning Program for Community Pharmacists for Dispensing Emicizumab (Hemlibra) in France: Nationwide Cross-Sectional Study.

BACKGROUND: Since June 2021, patients with hemophilia A with antifactor VIII inhibitors and those with severe hemophilia A without antifactor VIII inhibitors treated with Hemlibra have had to choose between a community or hospital pharmacy. The French reference center for hemophilia developed the HEMOPHAR e-learning program for community pharmacists for dispensing emicizumab. OBJECTIVE: This study aims to evaluate the efficiency and safety of this new care pathway by assessing the HEMOPHAR e-learning program. METHODS: The methodology is based on Kirkpatrick's model for evaluating the immediate reaction of trained community pharmacists (level 1), their level of acquired knowledge (level 2), and their professional practice after 3 months of dispensation (level 3). RESULTS: The HEMOPHAR e-learning program reached a large audience, with 67% (337/502) of the eligible community pharmacists following it. The immediate reaction was overall satisfying. High rates of engagement were reported with 63.5% (214/337) to 73.3% (247/337) of completed training modules, along with high rates of success with quizzes of 61.5% (174/337) to 95.7% (244/337). We observed that 83.9% (193/230) of the community pharmacists needed less than 2 attempts to pass the quiz of the module related to professional practice, while the other quizzes required more attempts. Advice on compliance and drug interactions were most frequently provided to patients by the community pharmacists. CONCLUSIONS: This study suggests ways to improve the training of community pharmacists and to optimize coordination with treatment centers. This study also reports on the feasibility of switching to a community pharmacy in a secure pharmaceutical circuit, including in the context of a rare bleeding disease. TRIAL REGISTRATION: ClinicalTrials.gov NCT05449197; https://clinicaltrials.gov/study/NCT05449197. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/43091.

Development and feasibility of an oral health e-learning program for long-term Japanese overseas workers: a pilot randomized controlled trial.

BACKGROUND: This study aimed to assess the feasibility and acceptability of an oral health self-care e-learning intervention for overseas workers as well as the research procedures for a future controlled trial. METHODS: We randomly allocated participants to either the intervention (n = 48) or control (n = 51) group. The intervention group received a standardized leaflet plus a theory-based oral health e-learning program. The control group received only the standardized leaflet. We assessed health behaviour related to fluoride toothpaste use, oral care knowledge, motivation, oral care self-efficacy, and oral health related quality of life (QoL). Chi-square and t test analyses were performed to make comparisons between the two groups. To evaluate the research process, participants in the intervention group were asked open-ended questions to assess the acceptability and feasibility of the research procedures in practice. RESULTS: A total of 82 participants (Intervention = 36, Control = 46) were included in the analysis. The dropout rate was 17.2%. The modal time taken to complete the e-learning intervention was more than 30 min (33.3%). Of the 36 respondents in the intervention group, 27 (70.4%) said that the e-learning intervention had changed their behaviour. At the three months follow-up, oral care knowledge alone was improved in the e-learning group. CONCLUSION: This pilot study provides evidence that the theory-based self-care for oral health e-learning intervention is feasible in overseas workers. Next, this feasible and acceptable pilot study should be used with an appropriate sample size in a randomized controlled trial. TRIAL REGISTRATION: The trial protocol was registered with UMIN-CTR (ID: UMIN000045883) on 27/10/2021.

Video-based e-learning program for schoolteachers to support children of parents with mental illness: a cluster randomized trial.

BACKGROUND: Some children of parents with mental illness need support. This study aimed to develop and test the effectiveness of an e-learning program for training elementary schoolteachers to support children of parents with mental illness. METHODS: The program, which included a 30-min video-based e-learning program, aimed to help schoolteachers gain basic knowledge about mental illness and children of parents with mental illness, recognize children in need of support, and gain confidence in supporting them. A school-based cluster randomized controlled trial was conducted, and the schools were randomly divided into intervention and control groups. The teachers at these schools signed up for the program and participated individually. The outcome measures for the schoolteachers were evaluated at three time points: baseline (T1), post (T2), and one month later (T3). Along with the Sense of Coping Difficulty subscale (primary outcome measure), the following self-developed outcome measures were used: actual behaviors and attitude toward supporting children, knowledge, and self-assessment of program goals achievement. The Sense of Coping Difficulty subscale results at T3 were compared between the groups. Effectiveness over time was assessed for all the outcome measures. The interaction between baseline and intervention effects on the Sense of Coping Difficulty subscale was analyzed. As a part of the process evaluation, open-ended text responses were analyzed qualitatively. RESULTS: Baseline responses were collected from 87 participants in the intervention group and 84 in the control group. The total score of the Sense of Coping Difficulty subscale at T3 was significantly lower in the intervention group than in the control group (p = 0.007). Over time, a significant effect was observed on the Sense of Coping Difficulty subscale, actual behavior, knowledge of onset timing and probability of onset, and achievement of all program goals. Exploratory analysis was particularly effective for those who encountered a high level of difficulty in supporting children. The participants' text responses indicated that they planned to look carefully at children's backgrounds and stay close to them in the future. CONCLUSIONS: The program was effective for schoolteachers in supporting children of parents with mental illness. TRIAL REGISTRATION: UMIN000045483; 14/09/2021.

A randomized controlled study of an e-learning program (YURAIKU-PRO) for public health nurses to support parents with severe and persistent mental illness and their family members.

BACKGROUND: Supporting parents with severe and persistent mental illness (SPMI) requires knowledge, skills, and a positive attitude toward parenthood. We developed a Japanese e-learning program for public health nurses (PHNs) to enable them to support parents with SPMI and their family members. This study aimed to evaluate the effectiveness of the program in improving the knowledge, skills, attitudes, and self-efficacy of PHNs in supporting them. METHODS: A three-hour video-based e-learning program was developed. A randomized controlled trial was conducted with 176 PHNs responsible for maternal and child health in Japan. The outcome measures included the Sense of Coping Difficulty/Possibility Scale, skills to support people with SPMI, and achievement of program goals. Outcome data were collected at three time points during the study: baseline (T1), post-intervention (T2), and one month after T2 (T3) using self-administered electronic questionnaires. Outcome measures were assessed by comparing the two groups at the endpoint (T3) using t-tests and ANOVA. Effectiveness over time was assessed using a mixed model for repeated measures, with group and time interactions as fixed effects. RESULTS: The study participants were randomly allocated to two groups:89 in the intervention group, and 87 in the control group. The total score and the scores in the two subscales of the Sense of Coping Difficulty/Possibility Scale in the intervention group at T3 were significantly higher than those in the control group, as shown by the t-test and ANOVA (all p<0.001). The Sense of Coping Difficulty subscale had a large effect size (Cohen's d=1.27). The analysis of the results of a mixed model for repeated measures showed that the group and time interactions on all outcome measures were not significantly different at T1 but were significantly different at T2 and T3. CONCLUSIONS: The program was effective one month after its completion, particularly in reducing PHNs' difficulties in supporting parents with SPMI. TRIAL REGISTRATION: UMIN000045765, November 1, 2021.

Implementing the adapted physical education E-learning program into physical education teacher education program.

According to the Ministry of Education Korea (2014), the approximately 70.4% of all students with disabilities are included in general schools in Korea. However, studies show that Korean GPE teachers do not feel comforatble or prepared to include students with disabilities (Oh & Lee, 1999; Roh, 2002; Roh & Oh, 2005). The purpose of this study was to explore whether an APE e-learning supplement would have an impact on the level of self-efficacy and content knowledge of pre-service teachers related to including students with intellectual disabilities. An APE supplement was developed based on the Instructional Design Model (Dick, Carey, & Carey, 2005) to provide three sources of self-efficacy, mastery experience, vicarious experience, and social persuasions. Three groups of pre-service teachers (N=75) took the same content supplement with different delivery system, E-learning group (n=25) with online, traditional group (n=25) with printed handout, and control group (n=25) without supplement. Two instruments, the Physical Educators' Situation-Specific Self-efficacy and Inclusion Student with Disabilities in Physical Education (SE-PETE-D) and the content knowledge test, were given to all participants twice (i.e., pretest and posttest). A 3×2 mixed effect ANOVA revealed that pre-service teachers' perceived self-efficacy (p=0.023) improved after taking the e-learning supplement. However, there was no significant difference in the level of content knowledge (p=0.248) between the learning group and tranditional group.

Effectiveness of an individual, online e-learning program about sexually transmitted infections: a prospective cohort study.

BACKGROUND: Primary health-care professionals play an important role in the treatment and prevention of Sexually Transmitted Infections (STI). Continuing Medical Education (CME)-courses can influence the knowledge and behavior of health-care professionals concerning STI. We performed a prospective cohort study to evaluate if the individual and online e-learning program "The STI-consultation", which uses the Commitment-to-Change (CtC)-method, is able to improve the knowledge, attitude and behavior of Dutch General Practitioners (GPs), concerning the STI-consultation. This e-learning program is an individual, accredited, online CME-program, which is freely available for all GPs and GP-trainees in the Netherlands. METHODS: In total 2192 participants completed the questionnaire before completing the e-learning program and 249 participants completed the follow-up questionnaire after completing the e-learning program. The effect of the program on their knowledge, attitude and behavior concerning the STI-consultation was evaluated. RESULTS: In total 193 participants formulated 601 learning points that matched the learning objectives of the program. The knowledge and attitude of the participants improved, which persisted up to two years after completing the program. Another 179 participants formulated a total of 261 intended changes concerning the sexual history taking, additional investigation and treatment of STI, 97.2% of these changes was partially or fully implemented in daily practice. Also, 114 participants formulated a total of 180 "unintended" changes in daily practice. These changes concerned the attitude of participants towards STI and the working conditions concerning the STI-consultation. CONCLUSION: The individual, online e-learning program "The STI-consultation", which uses the CtC-method, has a small but lasting, positive effect on the knowledge, attitude, and behavior of GPs concerning the STI-consultation.