A systematic review of web-based educational interventions

A HIFA member has kindly emailed to me the full text of this restricted-access paper (demonstrating that the ability to access free full text is inequitable – it depends on one’s contacts). Below are some key points from the full text:

1. A total of 19 studies met the selection criteria and were included in the systematic review. It was not clear where the studies were conducted. The focus was on patients recovering from heart surgery, such as corinary artery bypass graft and valve surgery.

2. Generally, the control group received a structured educational brochure, while most of the interventions comprised ‘a structured web-based patient education  intervention that consisted of pre-designed screens. This type of web-based education required the study participant to review each screen, in sequential order, prior to moving to the next educational screen. The content areas addressed throughout the structured web-based education were similar to those presented in the education brochure received by the control group study participants. … more than half (60%) of the websites contained information related to additional resources and references, 40% provided their study participants with access to an ask an expert chat forum, 30% created online discussion groups, and approximately 10% had an online skills workshop that could be accessed upon review of the education’.

3. ‘A statistically significant difference [in self care behaviour] between individuals who received the web-based intervention and those who received standard

patient education (i.e., structured educational brochure) in terms of number of self-care behaviors performed during post-discharge recovery is noted’ [see full paper for details, which vary according to study]

4. The findings suggest: ‘using an individualized web-based patient education intervention may be more effective than a booklet or standardized patient education website’ and ‘the most effective form of web-based patient education is one that is interactive and allows patients to navigate the online system on their own’.

Perhaps the most important conclusion (which is captured in the Abstract) is that ‘the most effective form of web-based patient education is one that is interactive and allows patients to navigate the online system on their own’. This suggests that the way in which content is developed and presented is critical. As we have discussed before on HIFA, the challenge of the coming decade is likely to shift from access to content. The development of reliable, appropriate and effective content (where possible open-access) and helping people to find it will be key to the realisation of healthcare information for all. It’s vital that global health funders recognise this and support it accordingly, both to sieze the opportunity and to mitigate the negative impact of commercial advertising (big pharma already spends 373 million US dollars per year worldwide on mobile phone advertising).

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org

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The global met need for emergency obstetric care: a systematic review

Systematic Review: The global met need for emergency obstetric care: a systematic review

The January 2015 issue of BJOG – An International Journal of Obstetrics and Gynaecology – is a Special Issue on the theme of ‘Beyond 2015: The future of women’s health globally’. All the papers in this issue are freely available here:

http://onlinelibrary.wiley.com/doi/10.1111/bjo.2014.122.issue-2/issuetoc?utm_source=MHTF+Subscribers&utm_campaign=51df2c5448-MH_Buzz_January_13_2015&utm_medium=email&utm_term=0_8ac9c53ad4-51df2c5448-183741561

Below is the citation and abstract of one of the papers.

CITATION: Systematic Review: The global met need for emergency obstetric care: a systematic review

H Holmer, K Oyerinde, JG Meara1, R Gillies, J Liljestrand, and L Hagander

Article first published online: 26 DEC 2014

DOI: 10.1111/1471-0528.13230

ABSTRACT

Background: Of the 287 000 maternal deaths every year, 99% happen in low- and middle-income countries. The vast majority could be averted with timely access to appropriate emergency obstetric care (EmOC). The proportion of women with complications of pregnancy or childbirth who actually receive treatment is reported as ‘Met need for EmOC’.

Objective: To estimate the global met need for EmOC and to examine the correlation between met need, maternal mortality ratio and other indicators.

Search strategy: A systematic review was performed according to the PRISMA guidelines. Searches were made in PubMed, EMBASE and Google Scholar.

Selection criteria: Studies containing data on met need in EmOC were selected.

Data collection and analysis: Analysis was performed with data extracted from 62 studies representing 51 countries. World Bank data were used for univariate and multiple linear regression.

Main results: Global met need for EmOC was 45% (IQR: 28–57%), with significant disparity between low- (21% [12–31%]), middle- (32% [15-56%]), and high-income countries (99% [99–99%]), (P = 0.041). This corresponds to 11.4 million (8.8–14.8) untreated complications yearly and 951 million (645–1174 million) women without access to EmOC. We found an inverse correlation between met need and maternal mortality ratio (r = -0.42, P < 0.001). Met need was significantly correlated with the proportion of births attended by skilled birth attendants (ß = 0.53 [95% CI 0.41–0.65], P < 0.001).

Authors’ conclusions: The results suggest a considerable inadequacy in global met need for EmOC, with vast disparities between countries of different income levels. Met need is a powerful indicator of the response to maternal mortality and strategies to improve EmOC act in synergy with the expansion of skilled birth attendance.

Best wishes,

Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

WHO publishes systematic review of eLearning in health professional education

WHO has just published eLearning for undergraduate health professional education – a systematic review informing a radical transformation of health workforce development.

You can download a copy of the report from: http://whoeducationguidelines.org/content/elearning-report

The World Health Organization (WHO) Department of Health Workforce in collaboration with the Department of Knowledge, Ethics and Research commissioned the Global eHealth Unit (GeHU) at Imperial College London to conduct a systematic review of the scientific literature to evaluate the effectiveness of eLearning for undergraduate health professional education. The review is based on a rigorous search, analysis and presentation of data that provides decision-makers with an up-to-date picture of current knowledge on eLearning for undergraduate professional education. It responds to a need at the country level for evidence to inform and guide health professional education as an important vehicle in preparing health professionals to be ‘fit-for-purpose’.

At a global level, it will assist in the implementation of the WHO’s global human resources for health strategy by providing the best evidence of how and where eLearning can best be used in country settings. The report also provides a foundation for the development of future WHO guidelines for pre-service training and the direction for  future research.

Kind regards,

Rebecca

Rebecca Bailey | Health Workforce Development Team Lead

IntraHealth International | Because Health Workers Save Lives.

6340 Quadrangle Drive, Suite 200 | Chapel Hill, NC 27517

m. +1 (919) 360-3339

rbailey@intrahealth.org