Evaluation of an E-Learning Training Program to Support Implementation of a Group-Based, Theory-Driven, Self-Management Intervention For Osteoarthritis and Low-Back Pain: Pre-Post Study

• Published in: Journal of medical Internet research 2019-03, Vol.21 (3), p.e11123-e11123
• Main Authors: Hurley, Deirdre A, Keogh, Alison, Mc Ardle, Danielle, Hall, Amanda M, Richmond, Helen, Guerin, Suzanne, Magdalinski, Tara, Matthews, James
• Format: Article
• Language: English
• Subjects: Arthritis; Back pain; Behavior; Climate; Clinical outcomes; Communication; Communication strategies; Computer-Assisted Instruction - methods; Confidence; Distance learning; Education; Exercise; Feasibility; Feedback; Female; Fidelity; Health care; Health services; Humans; Implementation; Internet; Intervention; Interviews; Low back pain; Low Back Pain - therapy; Male; Multimedia; Online instruction; Original Paper; Osteoarthritis; Osteoarthritis - therapy; Physical fitness; Physical therapists; Primary care; Questionnaires; Self determination; Self-Management - methods; Selfmanagement; Sustainability; Training; Universal Serial Bus
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/11123

By adaptation of the face-to-face physiotherapist-training program previously used in the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) feasibility trial, an asynchronous, interactive, Web-based, e-learning training program (E-SOLAS) underpinned by behavior and learning theories was developed. This study investigated the effect of the E-SOLAS training program on relevant outcomes of effective training and implementation. Thirteen physiotherapists from across Ireland were trained via E-SOLAS by using mixed methods, and seven physiotherapists progressed to implementation of the 6-week group-based SOLAS intervention. The effectiveness of E-SOLAS was evaluated using the Kirkpatrick model at the levels of reaction (physiotherapist engagement and satisfaction with E-SOLAS training methods and content), learning (pre- to posttraining changes in physiotherapists' confidence and knowledge in delivering SOLAS content and self-determination theory-based communication strategies, administered via a SurveyMonkey questionnaire), and behavior (fidelity to delivery of SOLAS content using physiotherapist-completed weekly checklists). During implementation, five physiotherapists audio recorded delivery of one class, and the communication between physiotherapists and clients was assessed using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behaviour Scale (CCBS), and an intervention-specific measure (ISM; 7-point Likert scale). A range of implementation outcomes were evaluated during training and delivery (ie, acceptability, appropriateness, feasibility, fidelity, and sustainability of E-SOLAS) using a posttraining feedback questionnaire and individual semistructured telephone interviews. With regard to their reaction, physiotherapists (n=13) were very satisfied with E-SOLAS posttraining (median 5.0; interquartile range 1.0; min-max 4.0-5.0) and completed training within 3-4 weeks. With regard to learning, there were significant increases in physiotherapists' confidence and knowledge in delivery of all SOLAS intervention components (P.05). In terms of behavior, physiotherapists delivered SOLAS in a needs supportive manner (HCCQ: median 5.2, interquartile range 1.3, min-max 3.7-5.8;