Evaluation of ImpENSA technology-enabled behaviour change module delivered to healthcare professionals in South Africa to improve micronutrient nutrition during the first 1000 days.
behaviour change support
eLearning
early nutrition
first thousand days
health behaviour change
micronutrient nutrition
technology‐enabled learning
Journal
Maternal & child nutrition
ISSN: 1740-8709
Titre abrégé: Matern Child Nutr
Pays: England
ID NLM: 101201025
Informations de publication
Date de publication:
09 Jun 2024
09 Jun 2024
Historique:
revised:
03
05
2024
received:
06
03
2024
accepted:
22
05
2024
medline:
10
6
2024
pubmed:
10
6
2024
entrez:
9
6
2024
Statut:
aheadofprint
Résumé
Healthcare professionals (HCPs) have vital roles in providing evidence-based care to promote healthy micronutrient nutrition in early life. Providing such care requires scalable training to strengthen knowledge and confident application of effective behaviour change skills. Among 33 public and private HCPs (primarily dietitians) in South Africa, we evaluated the behaviour change aspects of a technology-enabled National Qualification Sub-Framework level 6 programme, Improving Early Nutrition and Health in South Africa ('ImpENSA'). This programme comprises two self-directed micronutrient and behaviour change knowledge-based eLearning and one facilitated online practical skills modules to improve maternal and infant micronutrient nutrition. Using assessments, questionnaires and interviews, we collected data at baseline, after module completion and at 3-month follow-up after programme completion. Questionnaire and interview data showed major improvements in understanding of and attitudes towards person-centred behaviour change support immediately following the eLearning module on behaviour change. The assessment pass rate increased from 38% at baseline to 88% postmodule, demonstrating significant knowledge gain in behaviour change support. Intention to change practice towards a person-centred approach was high and many had already started implementing changes. Three months postprogramme, support was centred around patients' needs. Open relationships with patients, improved patient outcomes and increased job satisfaction were among reported outcomes. Many reported becoming better change facilitators and reflective practitioners. Additional improvements in understanding and attitudes to behaviour change support were evident, reinforced by making changes and experiencing positive outcomes. The findings suggest that technology-enabled learning can equip HCPs with knowledge and skills to effectively support behaviour change for healthy micronutrient nutrition during pregnancy and infancy.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13678Subventions
Organisme : EU Erasmus+
ID : 2018-3915/001-001
Organisme : UK Medical Research Council
ID : MC_UU_12011/4
Organisme : National Institute for Health Research (NIHR)
ID : NF-SI-0515-10042
Organisme : NIHR Southampton 1000DaysPlus Global Nutrition Research Group
ID : 17/63/154
Organisme : NIHR Southampton Biomedical Research Centre
ID : IS-BRC-1215-20004
Organisme : British Heart Foundation
ID : RG/15/17/3174
Pays : United Kingdom
Organisme : British Heart Foundation
ID : SP/F/21/150013
Pays : United Kingdom
Informations de copyright
© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
Références
Adam, L. M., Jarman, M., Barker, M., Manca, D. P., Lawrence, W., & Bell, R. C. (2020). Use of healthy conversation skills to promote healthy diets, physical activity and gestational weight gain: Results from a pilot randomised controlled trial. Patient Education and Counseling, 103(6), 1134–1142. https://doi.org/10.1016/j.pec.2020.01.001
Anderson, R. M., & Funnell, M. M. (2005). Patient empowerment: Reflections on the challenge of fostering the adoption of a new paradigm. Patient Education and Counseling, 57, 153–157. https://doi.org/10.1016/j.pec.2004.05.008
Arrish, J., Yeatman, H., & Williamson, M. (2017). Midwives' role in providing nutrition advice during pregnancy: Meeting the challenges? A qualitative study. Nursing Research and Practice, 2017, 1–11. https://doi.org/10.1155/2017/7698510
Bodenheimer, T. (2002). Patient self‐management of chronic disease in primary care. Journal of the American Medical Association, 288(19), 2469–2475. https://doi.org/10.1001/jama.288.19.2469
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Cane, J., O'Connor, D., & Michie, S. (2012). Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science, 7, 37. https://doi.org/10.1186/1748-5908-7-37
Damian, D. J., Njau, B., Lisasi, E., Msuya, S. E., & Boulle, A. (2019). Trends in maternal and neonatal mortality in South Africa: A systematic review. Systematic Reviews, 8(1), 76. https://doi.org/10.1186/s13643-019-0991-y.Davis
Davis, R., Campbell, R., Hildon, Z., Hobbs, L., & Michie, S. (2015). Theories of behaviour and behaviour change across the social and behavioural sciences: A scoping review. Health Psychology Review, 9, 323–344. https://doi.org/10.1080/17437199.2014.941722
Draper, C. E., Mabena, G., Motlhatlhedi, M., Thwala, N., Lawrence, W., Weller, S., Klingberg, S., Ware, L. J., Lye, S. J., & Norris, S. A. (2022). Implementation of healthy conversation skills to support behaviour change in the Bukhali trial in Soweto, South Africa: A process evaluation. SSM‐Mental Health, 2, 100132. https://doi.org/10.1016/j.ssmmh.2022.100132
Duvivier, H., Decroo, T., Nelson, A., Cassidy, T., Mbakaz, Z., Duran, L. T., de Azevedo, V., Solomon, S., & Venables, E. (2020). Knowledge transmission, peer support, behaviour change and satisfaction in post natal clubs in Khayelitsha, South Africa: A qualitative study. Reproductive Health, 17(1), 107. https://doi.org/10.1186/s12978-020-00957-0
Fouche, J., Mash, R., & Malan, Z. (2020). The psychometric properties of a tool to assess brief behaviour change counselling in South Africa. African Journal of Primary Health Care & Family Medicine, 12(1), 1–9. https://doi.org/10.4102/phcfm.v12i1.2540
Gluyas, H. (2015). Patient‐centred care: Improving healthcare outcomes. Nursing Standard, 30(4), 50–59. https://doi.org/10.7748/ns.30.4.50.e10186
Hatfield, T. G., Withers, T. M., & Greaves, C. J. (2020). Systematic review of the effect of training interventions on the skills of health professionals in promoting health behaviour, with meta‐analysis of subsequent effects on patient health behaviours. BMC Health Services Research, 20, 593. https://doi.org/10.1186/s12913-020-05420-110.1186/s12913-020-05420-1
Jarman, M., Adam, L., Lawrence, W., Barker, M., Bell, R. C., & The ENRICH Team. (2019). Healthy conversation skills as an intervention to support healthy gestational weight gain: Experience and perceptions from intervention deliverers and participants. Patient Education and Counseling, 102(5), 924–931. https://doi.org/10.1016/j.pec.2018.12.024
Kirkpatrick, J. D., & Kirkpatrick, W. K. (2016). Kirkpatrick's four levels of training evaluation. ATD Press.
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Prentice‐Hall.
Kredo, T., Cooper, S., Abrams, A., Muller, J., Volmink, J., & Atkins, S. (2018). Using the behavior change wheel to identify barriers to and potential solutions for primary care clinical guideline use in four provinces in South Africa. BMC Health Services Research, 18(1), 1–12. https://doi.org/10.1186/s12913-018-3778-2
Laurillard, D. (2013). Rethinking university teaching: A conversational framework for the effective use of learning technologies (2nd ed.). Routledge Falmer.
Lawrence, W., & Barker, M. (2016). Improving the health of the public: What is the role of health psychologists? Journal of Health Psychology, 21(2), 135–137. https://doi.org/10.1177/1359105314523304
Malan, Z., Mash, B., & Everett‐Murphy, K. (2015). A situational analysis of training for behaviour change counselling for primary care providers, South Africa. African Journal of Primary Health Care & Family Medicine, 7(1), 1–10. https://doi.org/10.4102/phcfm.v7i1.731
Marton, F., Dall'Alba, G., & Beaty, E. (1993). Conceptions of learning. International Journal of Educational Research, 19, 227–300.
Marton, F., & Säljö, R. (1976). On qualitative differences in learning: I: Outcome and process. British Journal of Educational Psychology, 46(1), 4–11. https://doi.org/10.1111/j.2044-8279.1976.tb02980.x
Michie, S., Johnston, M., Abraham, C., Lawton, R., Parker, D., Walker, A., & The “Psychological Theory” Group. (2005). Making psychological theory useful for implementing evidence based practice: A consensus approach. Quality & Safety in Health Care, 14(1), 26–33. https://doi.org/10.1136/qshc.2004.011155
Mogre, V., Dery, M., & Gaa, P. K. (2016). Knowledge, attitudes and determinants of exclusive breastfeeding practice among Ghanaian rural lactating mothers. International Breastfeeding Journal, 11, 12. https://doi.org/10.1186/s13006-016-0071-z
Murphy, K., Mash, R., & Malan, Z. (2016). The case for behavioural change counselling for the prevention of NCDs and improvement of self‐management of chronic conditions. South African Family Practice, 58(6), 249–252. https://doi.org/10.1080/20786190.2016.1187885
Olaniran, A., Madaj, B., Bar‐Zev, S., & Van Den Broek, N. (2019). The roles of community health workers who provide maternal and newborn health services: Case studies from Africa and Asia. BMJ Global Health, 4(4), e001388. https://doi.org/10.1136/bmjgh-2019-001388
Parker, W., Steyn, N. P., Levitt, N. S., & Lombard, C. J. (2011). They think they know but do they? Misalignment of perceptions of lifestyle modification knowledge among health professionals. Public Health Nutrition, 14(8), 1429–1438. https://doi.org/10.1017/S1368980009993272
Pettit, R. K., McCoy, L., Kinney, M., & Schwartz, F. N. (2015). Student perceptions of gamified audience response system interactions in large group lectures and via lecture capture technology. BMC Medical Education, 15, 92. https://doi.org/10.1186/s12909-015-0373-7
Ramsden, P. (1992). Learning to teach in higher education (2nd ed.). Routledge. https://doi.org/10.4324/9780203507711
Säljö, R. (1979). Learning about learning. Higher Education, 8, 443–451. https://doi.org/10.1007/BF01680533
Sen, A., & Leong, C. K. C. (Eds.). (2020). Technology‐enhanced learning. In Encyclopedia of Education and Information Technologies. Springer (pp 1–8). https://doi.org/10.1007/978-3-319-60013-0_72-1
Sladdin, I., Ball, L., Bull, C., & Chaboyer, W. (2017). Patient‐centred care to improve dietetic practice: An integrative review. Journal of Human Nutrition and Dietetics, 30(4), 453–470. https://doi.org/10.1111/jhn.12444
Smajic, E., Avdic, D., Pasic, A., Prcic, A., & Stancic, M. (2022). Mixed methodology of scientific research in healthcare. Acta Informatica Medica, 30(1), 57–60. https://doi.org/10.5455/aim.2022.30.57-60
Virtanen, L., Kaihlanen, A. M., Laukka, E., Gluschkoff, K., & Heponiemi, T. (2021). Behavior change techniques to promote healthcare professionals' eHealth competency: A systematic review of interventions. International Journal of Medical Informatics, 149, 104432. https://doi.org/10.1016/j.ijmedinf.2021.104432
World Health Organization. (2017). WHO strategic communications framework. World Health Organization.
World Health Organization & the United Nations Children's Fund. (2018). A vision for primary health care in the 21st century. World Health Organization.
World Health Organization. (2015). People‐centred and integrated health services: An overview of the evidence: Interim report. World Health Organization.