Fontaine Guillaume, Cossette Sylvie, Gagnon Marie-Pierre, Dubé Véronique, Côté José
Research Center, Montreal Heart Institute, Montréal, QC, Canada.
Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.
JMIR Res Protoc. 2020 Jul 31;9(7):e18894. doi: 10.2196/18894.
Brief counseling can motivate patients to initiate health behavior change. However, increasing the provision of brief counseling by nurses is difficult due to contextual and practitioner-level factors impeding nurses' motivation and intentions to provide brief counseling (eg, unfavorable attitude toward brief counseling, lack of perceived control linked to barriers). Theory-based implementation interventions could address these practitioner-level factors and support evidence-based practice in the context of brief counseling. Web-based, adaptive e-learning (electronic learning) programs are a novel type of implementation intervention that could address the limitations of current brief counseling training programs, such as accessibility and personalization.
This paper presents a study protocol for evaluating the effectiveness of the E_MOTIV implementation intervention-a theory- and web-based adaptive e-learning program-to increase nurses' and nursing students' intentions to provide brief counseling for smoking, an unbalanced diet, and medication nonadherence.
A two-group, single-blind, randomized controlled trial will be conducted with nurses and nursing students enrolled in a Bachelor of Science in Nursing program in Quebec, Canada. Participants in the experimental group will be allocated to the E_MOTIV intervention-a theory- and web-based adaptive e-learning program-while participants in the active control group will be allocated to the E_MOTIV intervention, a knowledge- and web-based standardized e-learning program. The E_MOTIV intervention was designed to influence the constructs of the Theory of Planned Behavior (eg, attitude, subjective norms, and perceived behavioral control) in the context of brief counseling. The Cognitive Load Index and User Engagement Scale will be used to assess participants' cognitive load and engagement related to e-learning. Participants will complete the Brief Counseling Nursing Practices Questionnaire-Abridged Version at baseline and follow-up. All study measures will be completed online.
The study is ongoing. The results of the study will provide answers to the primary hypothesis (H1) that experimental group participants will demonstrate a greater change in the score of intentions to provide brief counseling between baseline (-T1) and follow-up (T4). Secondary hypotheses include greater improvements in scores of attitude (H2), subjective norms (H3), perceived control (H4), behavioral beliefs (H5), normative beliefs (H6), and control beliefs (H7) regarding brief counseling in the experimental group between baseline and follow-up. We also anticipate lower intrinsic and extrinsic cognitive loads (H8, H9), higher germane cognitive load (H10), and higher engagement (H11, H12) in the experimental group.
This study will be among the first in evaluating a novel type of implementation intervention, a theory- and web-based adaptive e-learning program, in nurses and nursing students. This type of intervention has the potential to support evidence-based practice through accessible, personalized training in wide-ranging domains in nursing.
ISRCTN Registry ISRCTN32603572; http://www.isrctn.com/ISRCTN32603572.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/18894.
简短咨询可促使患者开始改变健康行为。然而，由于情境因素和从业者层面的因素阻碍护士提供简短咨询的积极性和意愿（例如，对简短咨询态度不佳、与障碍相关的感知控制不足），增加护士提供简短咨询的比例存在困难。基于理论的实施干预措施可以解决这些从业者层面的因素，并在简短咨询的背景下支持循证实践。基于网络的适应性电子学习项目是一种新型的实施干预措施，可以解决当前简短咨询培训项目的局限性，如可及性和个性化问题。
本文介绍一项研究方案，以评估E_MOTIV实施干预措施（一种基于理论和网络的适应性电子学习项目）的有效性，该措施旨在增强护士和护理专业学生针对吸烟、不均衡饮食和药物治疗不依从问题提供简短咨询的意愿。
将对加拿大魁北克省注册护理学学士项目的护士和护理专业学生进行一项两组、单盲、随机对照试验。实验组参与者将被分配到E_MOTIV干预措施（一种基于理论和网络的适应性电子学习项目），而积极对照组的参与者将被分配到E_MOTIV干预措施（一种基于知识和网络的标准化电子学习项目）。E_MOTIV干预措施旨在在简短咨询的背景下影响计划行为理论的相关要素（例如，态度、主观规范和感知行为控制）。认知负荷指数和用户参与度量表将用于评估参与者与电子学习相关的认知负荷和参与度。参与者将在基线和随访时完成《简短咨询护理实践问卷简版》。所有研究测量均将在线完成。
研究正在进行中。研究结果将为主要假设（H1）提供答案，即实验组参与者在基线（-T1）和随访（T4）之间提供简短咨询的意愿得分变化更大。次要假设包括实验组在基线和随访之间关于简短咨询的态度得分（H2）、主观规范得分（H3）、感知控制得分（H4）、行为信念得分（H5）、规范信念得分（H6）和控制信念得分（H7）有更大改善。我们还预计实验组的内在和外在认知负荷较低（H8、H9），关联认知负荷较高（H10），参与度较高（H11、H12）。
本研究将是首批评估一种新型实施干预措施（一种基于理论和网络的适应性电子学习项目）对护士和护理专业学生效果的研究之一。这种干预措施有可能通过在护理广泛领域提供可及的、个性化的培训来支持循证实践。
国际标准随机对照试验编号ISRCTN32603572；http://www.isrctn.com/ISRCTN32603572。
国际注册报告识别号（IRRID）：PRR1-10.2196/18894。
