Patient-oriented research methods to inform and evaluate a digital knowledge translation tool for parents about pediatric acute gastroenteritis: A pragmatic approach to evidence-based, health education

• Author / Creator

  Albrecht, Lauren

• Pediatric acute gastroenteritis is a common illness with a large burden on children, families, and health care systems. Connecting parents to evidence-based, child health information is essential to minimize this burden. There has been significant research on effective treatments for children with acute gastroenteritis, yet care varies by healthcare provider and across hospitals. This indicates an urgent need for knowledge translation, that is, evidence-based strategies to align what is known from research with what is done in health care practice. Actively involving parents in health care has the potential to optimize knowledge translation; however, the best opportunities and approaches for this engagement are unclear. Prior research indicates that parents look for information about their child’s health online, thus digital knowledge translation tools are a promising approach to provide complex, child health information. Rigorous effectiveness evaluation of child health digital tools for parents is a critical next step in the emerging field of knowledge translation for health consumers.
  A pragmatic paradigm, patient-oriented research, integrated knowledge translation, and the Knowledge-to-Action Framework guided this research. Four main projects were conducted to inform and evaluate a digital, knowledge translation tool – a whiteboard animation video - for parents about pediatric acute gastroenteritis. A scoping review (project 1) examined existing research on methods used to evaluate the effectiveness of a variety of knowledge translation tools for parents on child health topics. This knowledge synthesis study determined that a diverse set of child-health related knowledge translation tools were available, but effectiveness had not been demonstrated. Specific recommendations to improve methodological rigor and research reporting were detailed. Next, a qualitative study (project 2) described parental experiences of managing pediatric acute gastroenteritis and seeking health care in the emergency department. Key information needs were identified. The findings of this study illuminated factors reflecting real-life complexity that influenced parents’ health care decisions. These findings informed the storyline of the digital knowledge translation tool for parents about this illness. Following this, a pragmatic pilot study protocol was developed to determine the feasibility of methods to evaluate the effectiveness of the digital knowledge translation tool (project 3). Feasibility outcomes were developed in four key domains: 1) process (i.e., What elements are key to study success?); 2) scientific (i.e., Is the intervention effective?); 3) management (i.e., Are the human and data needs optimized?); and, 4) resource (i.e., Are the time and budget allocations reasonable?). Finally, the pragmatic pilot randomized controlled trial, which incorporated qualitative components, was conducted in one pediatric emergency department over a 3-month period (project 4). The goal of this pilot study was to determine the feasibility of pragmatic randomized controlled trial methods to inform a future, full-scale trial. The results confirmed successful study design elements, including a novel electronic data collection platform and data collection efforts in the emergency department waiting room. Areas for improvement were also identified, as well as potential solutions to address these gaps. In future, intermediate mixed methods and/or qualitative research were recommended to improve the functionality of the digital knowledge translation tool to optimize cognitive load and meaningful learning. Future methodological improvements key to the success of a full-scale trial were also described, including the identification of an improved intervention delivery setting, more appropriate scientific outcomes and measures, a comparator condition reflective of standard care, as well as more effective qualitative component recruitment and follow-up data collection methods.
  This dissertation addressed current knowledge gaps through the active engagement of parents in the development and pragmatic evaluation of a digital knowledge translation tool on pediatric acute gastroenteritis. Results of this research have widespread applications in three key areas. First, the state of the science for knowledge translation tools for parents in child health is described, including gaps in the literature and recommendations for future research. Second, this research informed the development of a digital knowledge translation tool, a whiteboard animation video, about pediatric acute gastroenteritis through integrated knowledge translation methods. Third, knowledge translation science was enhanced by developing and piloting methods for pragmatic effectiveness evaluation of digital knowledge translation tools for parents. The findings of this research will advance the pursuit of the best mode of providing and evaluating pragmatic digital health education for parents on acute childhood illnesses.

• Subjects / Keywords

  • digital health education
  • pilot randomized trial
  • child health
  • knowledge translation
  • health information needs
  • patient-oriented research
  • scoping review
  • pediatric acute gastroenteritis
  • feasibility study
  • integrated knowledge translation
  • pragmatic randomized controlled trial
  • knowledge-to-action framework
  • multi-methods research

• Graduation date

  Fall 2020

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/r3-xeyn-2f38

• License

  Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.