Table 1.
Study characteristics and key findings.
| Study (reference, country, study design) | Population: type of participant, sample size, mean age and gender of participants, industry experience | Intervention description; duration of intervention; comparator | Outcomes and measures | Key findings |
| Albright et al [23]; United States; RCTa | 227 nurses, nurse practitioners, and physicians; 81.9% female; 65.6% nurses; Industry experience: mean 10.89 (SD 11.01) years; Age not reported | Description: At risk in primary care web-based simulation role-playing game. Provides learners opportunities to practice role playing with emotionally responsive virtual patients that are experiencing mental health disorders; Duration: Simulation takes 1-1.5 hours to complete. Comparator: control | Outcome: knowledge and skills; Measure: 6-item Gatekeeper Behavior Scale web-based questionnaire; Outcome: likelihood to screen and manage mental health issues; Measure: single item, 4-point Likert-type scale web-based questionnaire | The score for the treatment group, postsimulation (mean 3.40, SD 0.89) was significantly higher than the control group at presimulation (mean 2.91, SD 0.69), P<.001; Likelihood of engaging in screening behavior for the treatment group (mean 3.27, SD 0.74) was significantly higher than the control group (mean 2.90, SD 0.87), P<.01 |
| Benjamin et al [24]; United States; RCT | 51 CCHCsb; Control (n=17): 6.9 years old; 94% female; 88% nursing degree. Web-based (n=17): 41.9 years old; 100% female; 94% nursing degree. In-person (n=16): 39.8 years old; 100% female; 87% nursing degree. Industry experience not reported | Description: web-based (group 1) and in-person trained (group 2) CCHCs. Each training included 4 modules: intervention overview, introduction to childhood overweight, nutrition and physical activity, and providing consultation to child care centers. In-person training and web-based training were designed to be similar in both content and structure. Duration: training took 3 hours; Comparator: control | Outcome: nutrition knowledge related to childhood overweight. Measure: 28 multiple choice questions (childhood overweight=4, nutrition for children=10, physical activity for children=8, and nutrition and physical activity for adults=6) with 2-5 possible response options | Participants from the web-based trained group (difference in pre/post score=16.18) did not perform better than the in-person trained group (difference in pre/post score=16.53). Both training groups improved significantly more than controls (difference in pre/post score=1.89; P<.001 for each group) |
| de Ruijter et al [26]; the Netherlands; RCT | 269 PNsc across the Netherlands. Mean 47.3 years old; 97.8% female. PN counseling experience was mean 5.6 years | Description: Guideline adherence to smoking cessation counseling. Computer-tailored, web-based program relating to smoking cessation. Consisted of web-based modules, tailored advice, forum, and smoking cessation counseling materials. Duration: 6 months to access and use the program. Comparator: control group engaged in normal smoking cessation counseling practices | Outcome: adherence to STIMEDICd guidelines. Measure: questions on guideline adherence concerned the 9 evidence-based counseling steps, as described in the STIMEDIC guideline. PNs adherence at baseline was assessed by asking PNs to self-report their adherence to each guideline step during complete smoking cessation trajectories of their last 10 patients (range 0-10). Additionally, during the trial period, guideline adherence was assessed by asking PNs to self-report their adherence to each guideline step after every consultation with a smoking patient using the counseling checklist | Overall intervention effect not reported. Significant interaction between groups based on the average years of counseling experience (P=.045) |
| Di Noia et al [25]; United States; RCT | 188 school, community agency, and policy-making professionals; 68.6% females; 25% 30-39 years, 23% 40-49 years, 19% 50-59 years (mean age not reported); 48% some graduate school, 22.3% college, 10.6% some college. Industry experience not reported | Description: illustrative dissemination materials for 3 youth-oriented substance abuse prevention programs. Materials for each program were tailored for each setting (school, community agencies, and policy makers) and disseminated by: Group 1: accessed resource materials via CD-ROM (n=64); Group 2: accessed resource materials via the internet (n=69). Duration: 2 years. Comparator: resource materials accessed via printed pamphlets (n=55) | Outcome: self-efficacy. Measuree: via survey assessing professionals' self-efficacy for identifying and obtaining prevention programs to serve the needs of youth; confidence in ability to recommend programs to their constituents. Outcome: intention to apply prevention program materials; likelihood of their future applications of materials disseminated in the trial; likelihood of request program materials, implementing a prevention program and recommending programs to their constituents. Measure: via survey | No significant differences between groups for self-efficacy for the ability to identifying programs or recommend programs. Significant between channel effects in ability to obtain programs for pamphlet (mean 1.37, SD 0.93) versus internet (mean 0.87, SD 0.79) and pamphlet versus CD-ROM (mean 0.94, SD 0.84) at P<.05 at follow-up; No significant differences between groups for likelihood of requesting program or likelihood of implementing program. Significant difference between CD-ROM (mean 1.41, SD 1.13) and pamphlet (mean 1.55, SD 1.13) for likelihood of recommending program at P<.05 and significant difference between CD-ROM and internet (mean 1.06, SD 1.05) for likelihood of recommending program at P<.05 at follow-up |
| Dobbins et al [27]; Canada; RCT | 108 public health departments with program managers and/or coordinators and/or program directors responsible for making program decisions related to healthy body weight promotion in children; 35% frontline staff; 26% manager; 47% nursing discipline; Mean 5 years in current position; Mean years in a public health role=13. Age and gender not reported | Description: the 3 interventions included access to a web-based registry of research evidence, tailored messaging, and a knowledge broker. Moderate interactive intervention (digital TEKTf strategy): tailored targeted messages plus access to a health evidence repository (TM). Most interactive intervention: access to a knowledge broker, tailored targeted messages plus access to health evidence repository (KB). Least interactive intervention: access to health evidence repository (HE). Duration: program implemented over 1 year | Outcome: public health policies and programs; Measure: This measure was derived as the sum of actual strategies, policies, and/or interventions for health body weight promotion in children being implemented by the health department. Participants were asked whether the public health policies and programs were being implemented by their health department (yes/no); Outcome: global evidence-based decision making. Measure: in a telephone-administered survey, participants were asked to report on the extent to which research evidence was considered in a recent program planning decision (previous 12 months) related to healthy body weight promotion | TM group improved significantly from baseline to follow-up in comparison to the HE and KB groups that showed no significant change (P<.01); Intervention had no significant effect on global evidence-based decision making (P<.45), although all groups improved to some extent (HE group: 0.74; TM group: −0.42; KB group: −0.09) |
| McVey et al [30]; Canada; RCT | 89 public health practitioners (100% female) from 2 Canadian provinces; Public health participants: public health nurses (n=62) and nutritionists (n=27), with average number of years 12.72; 84.4% identified as white. Age not reported | Description: the student body Promoting Health at Any Size web-based program; 6 learning modules: (1) media and peer pressure (2) healthy eating, (3) active living, (4) teasing, (5) adult role models, and (6) school climate including case studies, background information, additional resources, and classroom activities. Duration: the intervention group had 60-day access to the web-based intervention. Comparator: waitlist control |
Outcome: knowledge of the physical changes associated with puberty, facts concerning restrictive dieting, peer and adult influences, and the influence of the media on weight loss. Measure: assessed via a survey using true-false questions and Likert scales; Outcome: efficacy to fight weight bias. Measure: 6-item subscale used to assess self-efficacy expectations for fighting weight bias in their schools. On the basis of a 4-point Likert scale (Cronbach α=.44) |
Physical changes associated with puberty: there was no significant interaction effect, F1,77=.486, P=.488. Facts concerning restrictive dieting: there were no significant interactions or time effects found for any of the items that tapped knowledge about dieting. Peer or adult influences: there were no significant interactions or time effects. Influence of the media on weight loss: there were no significant interactions or time effects; There was a significant interaction effect found for the variable efficacy to fight weight bias, F1,77=10.81, P=.002. Participants in the intervention group only reported significant improvements in efficacy scores between baseline and the postintervention periods, P<.001 |
| Sassen et al [28]; the Netherlands; RCT | 69 health care professionals with at least a bachelor’s degree in nursing or physiotherapy and who had regular consultations with patients with CVg risk factors and low levels of PA. Control group: 78% female, mean 39.7 years old; 68% bachelor's degree, mean 9.58 years professional experience. Intervention group: 69% female, mean 38.6 years old; 79% bachelor's degree, mean 9.76 years professional experience | Description: web-based intervention to increase health care professionals’ intention and encouraging behavior toward patient self-management, following CV risk management guidelines. Website contained modules to help the health professionals improve their professional behavior, support the health professional, improve patients' intention, and risk reduction. The website also included a forum directed at health professionals to share experiences with other professionals. Duration: not reported. Comparator: waitlist control |
Outcome: intention to encourage CV patients to become physically active. Measure: self-assessed through a questionnaire (3 items on intention); Outcome: attitude to encourage PAh in CV patients. Measure: self-assessed through a questionnaire of a series of 8 questions regarding the usefulness of assessing patients’ motivation, pros and cons of PA, teaching patients : resisting social pressure, teaching specific PA skills, teaching patients how to handle barriers, formulating PA goals, teaching patients to handle relapses, and helping patients understand the relationship between health problems and PA; Outcome: perceived behavior control. Measure: self-assessed through a questionnaire (23 items on behavior outcomes); Outcome: behavior change in encouraging CV patients to PA. Measure: assess via 2 items by asking whether professionals encourage CV patients to increase PA and how often do they encourage CV patients to become physically active |
No significant differences in both the intervention and the control groups between baseline (mean: 6.25, SD: 1.00 and mean: 5.87, SD: 1.15) and follow-up (mean: 6.06, SD: 1.11 and mean: 6.02, SD: 091) for intention |
| No significant differences in both the intervention and the control groups between baseline (mean: 6.30SD: 0.44 and men: 6.23, SD: 0.69) and follow-up for attitude (mean: 6.30 SD:0.56 and mean: 6.31SD: 0.68); Significant difference in perceived behavior control between baseline and follow-up for the intervention group (t26=−2.954, P<.001, effect size=0.50) and a significant increase for the control group (t19=−2.651, P=.02, effect size=0.54). No significant difference between intervention and control group; No significant differences in both the intervention and the control groups between baseline (mean 4.54, SD: 1.02 and mean: 4.83 SD: 0.69) and follow-up for behavior (mean: 4.63, SD: 0.85 and mean:4.79, SD: 0.82) | ||||
| Zhan et al [29]; China; RCT | 1237 primary health care workers. Blended learning group (n=569): Mean 41.67 years old, 48.9% female, 9.6% technical secondary school or below; Pure web-based learning group (n=563): mean 41.98 years old, 43.2% female, 77.3% technical secondary school or below | Description: the blended learning (intervention) and pure web-based learning (control) groups had the same course materials to improve basic public health services knowledge. Participants in the blended learning group studied PowerPoint-based theoretical materials, received the handouts of case study materials for self-studying and attended 1-day (8 hour) face-to-face case study training. Duration: overall study period was 5 weeks. Comparator: control (pure web-based learning group–digital TEKT strategy); received via a web-based platform: Microsoft PowerPoint; case studies consisted of 3 video sessions, and 2 discussion forums were developed on the training platform | Outcome: knowledge for course module components. Measure: a total of 3 knowledge MCQi tests were developed, consisting of a 10-item MCQ test in course module 1, a 15-item MCQ test in course module 2, and a 20-item MCQ test in course module 3 | Baseline knowledge scores of the 3 course modules between experimental and control group were similar. Higher gains in the experimental group than in the control group; module 1: adjusted mean difference=4.92, P<.001; module 2: adjusted mean difference=3.67, P=.004; module 3: adjusted mean difference=4.63, P<.001 |
aRCT: randomized controlled trial.
bCCHC: child care health consultants.
cPN: practice nurses.
dSTIMEDIC: A registered trademark that stands for smoking cessation (SMR) in health care.
eLower scores indicate more favorable ratings.
fTEKT: technology-enabled knowledge translation.
gCV: cardiovascular.
hPA: physical activity.
iMCQ: multiple choice questions.