Summary of findings 7. Culturally and literacy adapted audio‐/visual education without personal feedback versus another culturally and literacy adapted audio‐/visual education without personal feedback.
| Culturally and literacy adapted audio‐/visual education without personal feedback versus another culturally and literacy adapted audio‐/visual education without personal feedback | ||||||
| Patient or population: migrants Setting: community Intervention: audio‐/visual education without personal feedback (narrative video) Comparison: another audio‐/visual education without personal feedback (factual knowledge video) | ||||||
| Outcome category – outcome(s)* | Anticipated absolute effects** (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with factual knowledge video | Risk with narrative educational video | |||||
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Health literacy – (1) Competencies (inhaler use technique) Assessed with:
Higher score is better (2) Understanding health information (understanding physician's instruction) Assessed with:
Higher score is better Time point: medium‐term (3 months post‐intervention) (3) Applying health information (intention for cervical cancer screening using Pap test) Assessed with:
Higher score is better Time point: medium‐term (6 months post‐intervention) |
1) Competences (inhaler use technique) | — | 91 (2 RCTs) | ⊕⊝⊝⊝ Very lowa,b | We are uncertain whether educational videos compared to factual knowledge videos improve competencies (inhaler use technique) 3 months post‐intervention. | |
| The mean inhaler use technique score in the control group was 7 points | The mean inhaler use technique in the group who watched the narrative video was 0.89 lower (1.84 lower to 0.07 higher) than in the group who watched the knowledge video | |||||
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(2) Understanding health information One RCT (n = 43) reported that the mean understanding of physician's instruction in the group who watched the narrative video was 0.15 lower (0.72 lower to 0.42 higher) than in the group who watched the knowledge video |
— | 43 (1 RCT)1 |
⊕⊝⊝⊝ Very lowa,b | We are uncertain whether educational videos compared to factual knowledge videos improve the understanding of health information 3 months post‐intervention. | ||
| (3) Applying health information | RR 1.97 (0.83 to 4.69) | 109 (1 RCT) |
⊕⊝⊝⊝ Very lowa,b | We are uncertain whether narrative educational videos compared to factual knowledge videos improve the application of health information 6 months post‐intervention. | ||
| 125 per 1000 | 246 per 1000 (104 to 586) |
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| Quality of life – not measured | — | — | — | — | — | The effect of a narrative educational video compared to a factual knowledge video on quality of life is unknown as there was no direct evidence identified. |
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Health‐related knowledge – Any health‐related knowledge
Higher scores are better. Time point: medium‐term (3 to 6 months post‐intervention) |
One RCT (n = 109) found that the mean heath‐related knowledge score in the group who watched the narrative video was 1.12 points higher (4.63 lower to 6.87 higher). The mean cervical cancer knowledge score in the control group was 66%. One RCT (n = 43) found that the mean asthma knowledge score in the group who watched the narrative video was higher than in the group who watched the physician‐led knowledge video (MD 0.85 higher (1.07 lower to 2.76 higher).2 |
— | 152 (2 RCTs) | ⊕⊝⊝⊝ Very lowa,b | We are uncertain whether narrative educational videos compared to factual knowledge videos improve health‐related knowledge up to 6 months post‐intervention. | |
| Health outcome – not measured | — | — | — | — | — | The effect of narrative educational videos compared to a factual knowledge video on health outcomes is unknown as there was no direct evidence identified. |
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Health behaviour – Cervical cancer screening Assessed with:
Time point: medium‐term (6 months post‐intervention) |
292 per 1000 | 376 per 1000 (219 to 651) | RR 1.29 (0.75 to 2.23) | 109 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b | We are uncertain whether narrative educational videos compared to factual knowledge videos improve cervical cancer screening behaviour 6 months post‐intervention. |
| Self‐efficacy – not measured | — | — | — | — | — | The effect of a narrative educational video compared to a factual knowledge video on self‐efficacy is unknown as there was no direct evidence identified. |
| Health service use – not measured | — | — | — | — | — | The effect of a narrative educational video compared to a factual knowledge video on health service use is unknown as there was no direct evidence identified. |
| Adverse events – not measured | — | — | — | — | — | The effect of a narrative educational video compared to a factual knowledge video on adverse events is unknown as there was no direct evidence identified. |
| *We report on our predefined outcome categories and assigned all outcomes that we considered eligible for this review to one of these categories (see Types of outcome measures). More detail on scoring and direction for each outcome measure is provided in Table 5; Table 11; Table 4); **The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI); ***Short‐term: immediately up to 6 weeks after the total intervention programme was completed; medium‐term: from 6 weeks up to and including 6 months after the total intervention programme was completed; long‐term: longer than 6 months after the total intervention programme was completed. CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
1One RCT could not be included in the narrative synthesis as the participants who watched the narrative video and those who watched the knowledge video were not directly compared to each other, but both were compared to a control group who read a pictorial pamphlet (Poureslami 2016b). Details are shown in Table 19.
2No score range was reported, but subgroup analyses adjusted for age, gender, educational level and ethnicity per study group and knowledge item only. Therefore, we could not standardise the reported values on a scale ranging from 0 to 100. However, the three knowledge items were combined to calculate an MD across the items.
aDowngraded by ‐1 for risk of bias: unclear risk of bias for random sequence generation and/or allocation concealment in all studies.
bDowngraded by ‐2 for imprecision: small sample size and/or the results stemmed from a single study. In addition, the CI included values that encompassed both an improvement and a worsening.