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Effect of an E-learning Intervention on Knowledge, Attitudes and Beliefs of Healthcare Professionals Managing Low Back Pain.

Primary Purpose

Knowledge, Attitudes, Practice, Low Back Pain, Physical Therapy

Status
Completed
Phase
Not Applicable
Locations
Belgium
Study Type
Interventional
Intervention
Experimental e-learning
Traditional e-learning
Sponsored by
Antoine Fourré
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Knowledge, Attitudes, Practice focused on measuring Distance education, Musculoskeletal pain, Guideline adherence, First-line care

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • To be an healthcare practitioner (general practitioner, physiotherapist, specialist physician, student in medicine including specialization, student in physiotherapy)
  • Working or studying in Belgium or France
  • Being in possession of an internet connected device (e.g. computer, tablet or smartphone) with speaker

Sites / Locations

  • Online study

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Experimental e-learning

Traditional e-learning

Arm Description

The experimental interactive intervention is based on international guidelines for the management of LBP and includes multiple interactions with the participant in a virtual environment. Metaphors and concrete clinical situations are presented to translate the knowledge (i.e. the management of low back pain from a biopsychosocial point of view) to clinical practice. Interactions consists of videos, open and closed questions and audio records.

The traditional intervention consists of a traditional online lecture based on international guidelines for the management of LBP without any interaction. The focus is more fundamental (theoretical) without metaphors or clinical cases.

Outcomes

Primary Outcome Measures

The Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS)
The HC-PAIRS assesses attitudes and beliefs about functional expectations for patients with chronic LBP. It consists of 13 statements that must be rated on a seven-point Likert scale, ranging from 'totally disagree' to 'totally agree'. A high score on the HC-PAIRS reflects a belief with a strong relationship between pain and impairment. Psychometric properties of this questionnaire have been established.
Vignette of Rainville
The clinical vignette described a patient with non-specific LBP. This vignette was developed by Rainville. Participants were asked to assess the patient's ability to work, from 1 (full-time) to 5 (remain out of work) and gave their opinion on the appropriate level of activity, with choices graded from 1 (no limitations on activity) to 5 (limit all physical activity). If the score of the participant was between 1 and 2 it was considered guideline adherent. If the score was between 3 and 5 it was considered guidelines discordant.

Secondary Outcome Measures

The Back Pain and Attitudes Questionnaire (Back-PAQ ; 10-items version)
The Back-PAQ questionnaire (10 items version) assesses attitudes and underlying beliefs about back pain on a 5-point Likert scale. The scoring of the answers ranges from -2 to +2. A negative score reflects beliefs that are unhelpful and vice-versa. All items were written in the second person to personalize the questionnaire. The purpose of this personalization is that HCPs or students present their own beliefs rather than projecting their beliefs onto people with LBP or presenting their beliefs about people with LBP.
The Neurophysiology of Pain Questionnaire (NPQ)
The Neurophysiology of pain questionnaire (NPQ) assesses how an individual conceptualizes biological mechanisms underpinning pain. The NPQ includes 19 questions with three answer options (true; undecided; false). The scoring is 1 for a correct answer and 0 if the participant was wrong or undecided. This questionnaire was included to reflect recommendations of the guidelines for the management of LBP that encourages clinicians to explain and reassure the patient about their personal experience of pain.
Fictive clinical cases of patients with LBP
4 clinical cases were developed by a multidisciplinary team of experts in the field (general practitioners, orthopedic surgeons, physiotherapists, and academics). Two cases described the symptoms of a patient with specific LBP and the two others described the symptoms of a patient with non-specific LBP. A specific and non-specific clinical case were presented at baseline and post-intervention assessment. Participants answered 3 open questions related to the clinical case: "In your opinion, what are the causes/contributing factors to the pain of this patient?"; "As an healthcare practitioners what would be your first approach to manage this patient?"; "Which advices would you give to this patient concerning physical activity". Coding of the answers in a matrix using keywords and themes will be used to analyse the orientation of the healthcare practitioners (guideline adherent or guideline discordant).
Experiences of HCPs with the e-learning (quantitative)
A Likert scale (1-7) will be used to examine the participants experiences regarding the content and quality of the intervention and the Technology acceptance. The questions of this survey are based on Cheng et al. 2012 and cover global system quality and technology acceptance of the e-learning. Higher score reflects a better experience with the e-learning intervention.
Experiences of HCPs with the e-learning (qualitative)
A purposive sample of participants agreeing to take part in a phone interview will be invited to an in-depth interview. We foresee to start with 10 HCPs of each group (experimental and traditional e-learning intervention) to provide depth and breadth of experiences and will continue until no new themes emerge (Bowen 2008). The principles of qualitative research will be used to explore how participants experienced the e-learning intervention and which impact had the e-learning on their clinical practice.

Full Information

First Posted
March 10, 2022
Last Updated
May 9, 2023
Sponsor
Antoine Fourré
Collaborators
University of Mons, Universiteit Antwerpen, University of Picardie Jules Verne
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1. Study Identification

Unique Protocol Identification Number
NCT05284669
Brief Title
Effect of an E-learning Intervention on Knowledge, Attitudes and Beliefs of Healthcare Professionals Managing Low Back Pain.
Official Title
Effect of an E-learning Intervention on Knowledge, Attitudes and Beliefs of Healthcare Professionals Managing Low Back Pain: a Randomized Controlled Trial With Nested Process Evaluation.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
August 27, 2021 (Actual)
Primary Completion Date
December 31, 2022 (Actual)
Study Completion Date
March 1, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Antoine Fourré
Collaborators
University of Mons, Universiteit Antwerpen, University of Picardie Jules Verne

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the current research project is to examine if the healthcare professionals (HCPs) knowledge, attitudes, beliefs and behavior about the management of low back pain (LBP) patients changes following an e-learning intervention (experimental interactive e-learning versus traditional non-interactive e-learning)
Detailed Description
The purpose of the current research project is to use an e-learning educational approach to implement guideline-adherent care in first line HCPs. We aim to enhance the knowledge, attitudes, beliefs and behavior of HCPs towards a biopsychosocial approach in the management of LBP patients. We will compare the effect of an interactive e-learning intervention (i.e. experimental intervention) to an e-learning intervention without interaction (i.e. traditional intervention). Both interventions will be based on the most recent scientific literature regarding the management of LBP, but both the focus and the didactical approach will slightly differ between the interventions. We will use a mixed methods approach to gain an in-depth understanding of HCPs behavior in clinical practice.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knowledge, Attitudes, Practice, Low Back Pain, Physical Therapy, Physicians
Keywords
Distance education, Musculoskeletal pain, Guideline adherence, First-line care

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
2720 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Experimental e-learning
Arm Type
Experimental
Arm Description
The experimental interactive intervention is based on international guidelines for the management of LBP and includes multiple interactions with the participant in a virtual environment. Metaphors and concrete clinical situations are presented to translate the knowledge (i.e. the management of low back pain from a biopsychosocial point of view) to clinical practice. Interactions consists of videos, open and closed questions and audio records.
Arm Title
Traditional e-learning
Arm Type
Other
Arm Description
The traditional intervention consists of a traditional online lecture based on international guidelines for the management of LBP without any interaction. The focus is more fundamental (theoretical) without metaphors or clinical cases.
Intervention Type
Other
Intervention Name(s)
Experimental e-learning
Intervention Description
Interactive lecture based on the guidelines for the management of LBP with a focus on self-management and patient's reassurance
Intervention Type
Other
Intervention Name(s)
Traditional e-learning
Intervention Description
Traditional lecture based on the guidelines for the management of LBP with a focus on diagnostic triage and specific cause of LBP
Primary Outcome Measure Information:
Title
The Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS)
Description
The HC-PAIRS assesses attitudes and beliefs about functional expectations for patients with chronic LBP. It consists of 13 statements that must be rated on a seven-point Likert scale, ranging from 'totally disagree' to 'totally agree'. A high score on the HC-PAIRS reflects a belief with a strong relationship between pain and impairment. Psychometric properties of this questionnaire have been established.
Time Frame
Baseline assessment and post-intervention assessment (between 2 and 4 weeks after baseline)
Title
Vignette of Rainville
Description
The clinical vignette described a patient with non-specific LBP. This vignette was developed by Rainville. Participants were asked to assess the patient's ability to work, from 1 (full-time) to 5 (remain out of work) and gave their opinion on the appropriate level of activity, with choices graded from 1 (no limitations on activity) to 5 (limit all physical activity). If the score of the participant was between 1 and 2 it was considered guideline adherent. If the score was between 3 and 5 it was considered guidelines discordant.
Time Frame
Baseline assessment and post-intervention assessment (between 2 and 4 weeks after baseline)
Secondary Outcome Measure Information:
Title
The Back Pain and Attitudes Questionnaire (Back-PAQ ; 10-items version)
Description
The Back-PAQ questionnaire (10 items version) assesses attitudes and underlying beliefs about back pain on a 5-point Likert scale. The scoring of the answers ranges from -2 to +2. A negative score reflects beliefs that are unhelpful and vice-versa. All items were written in the second person to personalize the questionnaire. The purpose of this personalization is that HCPs or students present their own beliefs rather than projecting their beliefs onto people with LBP or presenting their beliefs about people with LBP.
Time Frame
Baseline assessment and post-intervention assessment (between 2 and 4 weeks after baseline)
Title
The Neurophysiology of Pain Questionnaire (NPQ)
Description
The Neurophysiology of pain questionnaire (NPQ) assesses how an individual conceptualizes biological mechanisms underpinning pain. The NPQ includes 19 questions with three answer options (true; undecided; false). The scoring is 1 for a correct answer and 0 if the participant was wrong or undecided. This questionnaire was included to reflect recommendations of the guidelines for the management of LBP that encourages clinicians to explain and reassure the patient about their personal experience of pain.
Time Frame
Baseline assessment and post-intervention assessment (between 2 and 4 weeks after baseline)
Title
Fictive clinical cases of patients with LBP
Description
4 clinical cases were developed by a multidisciplinary team of experts in the field (general practitioners, orthopedic surgeons, physiotherapists, and academics). Two cases described the symptoms of a patient with specific LBP and the two others described the symptoms of a patient with non-specific LBP. A specific and non-specific clinical case were presented at baseline and post-intervention assessment. Participants answered 3 open questions related to the clinical case: "In your opinion, what are the causes/contributing factors to the pain of this patient?"; "As an healthcare practitioners what would be your first approach to manage this patient?"; "Which advices would you give to this patient concerning physical activity". Coding of the answers in a matrix using keywords and themes will be used to analyse the orientation of the healthcare practitioners (guideline adherent or guideline discordant).
Time Frame
Baseline assessment and post-intervention assessment (between 2 and 4 weeks after baseline)
Title
Experiences of HCPs with the e-learning (quantitative)
Description
A Likert scale (1-7) will be used to examine the participants experiences regarding the content and quality of the intervention and the Technology acceptance. The questions of this survey are based on Cheng et al. 2012 and cover global system quality and technology acceptance of the e-learning. Higher score reflects a better experience with the e-learning intervention.
Time Frame
Post-intervention assessment (between 2 and 4 weeks after baseline)
Title
Experiences of HCPs with the e-learning (qualitative)
Description
A purposive sample of participants agreeing to take part in a phone interview will be invited to an in-depth interview. We foresee to start with 10 HCPs of each group (experimental and traditional e-learning intervention) to provide depth and breadth of experiences and will continue until no new themes emerge (Bowen 2008). The principles of qualitative research will be used to explore how participants experienced the e-learning intervention and which impact had the e-learning on their clinical practice.
Time Frame
Between 4 and 6 weeks after baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: To be an healthcare practitioner (general practitioner, physiotherapist, specialist physician, student in medicine including specialization, student in physiotherapy) Working or studying in Belgium or France Being in possession of an internet connected device (e.g. computer, tablet or smartphone) with speaker
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nathalie Roussel, PhD
Organizational Affiliation
Universiteit Antwerpen
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Laurence Ris, PhD
Organizational Affiliation
University of Mons
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Antoine Fourré, MSc
Organizational Affiliation
University of Mons / University of Antwerp
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Rob Vanderstraeten, MSc
Organizational Affiliation
Universiteit Antwerpen
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jef Michielsen, MD, PhD
Organizational Affiliation
Universiteit Antwerpen
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Hilde Bastiaens, MD, PhD
Organizational Affiliation
Universiteit Antwerpen
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Sybil Anthierens, PhD
Organizational Affiliation
Universiteit Antwerpen
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Frédéric Telliez, PhD
Organizational Affiliation
Université de Picardie Jules Verne
Official's Role
Study Director
Facility Information:
Facility Name
Online study
City
Brussels
Country
Belgium

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
34678129
Citation
Fourre A, Fierens A, Michielsen J, Ris L, Dierick F, Roussel N. An interactive e-learning module to promote bio-psycho-social management of low back pain in healthcare professionals: a pilot study. J Man Manip Ther. 2022 Apr;30(2):105-115. doi: 10.1080/10669817.2021.1988397. Epub 2021 Oct 22.
Results Reference
result
Links:
URL
http://nomadeproject.eu
Description
Website of the European project (Interreg FWVl NOMADe - N° 4.7.360)

Learn more about this trial

Effect of an E-learning Intervention on Knowledge, Attitudes and Beliefs of Healthcare Professionals Managing Low Back Pain.

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