Supporting Parents to Choose Wisely

NCT06005337 | Completed

• 1 other identifier: Pro00116449
• Study Type: interventional
• Target: 174
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this multi-method study including a randomized control trial and qualitative interviews is to see how useful blogshots (an image that summarizes information) are at helping parents increase their knowledge and manage their expectations for common acute childhood conditions (e.g. sore throat, ear infection) with respect to Choosing Wisely Canada recommendations. Participants will be randomly assigned to Group A or Group B in this study. Group A will receive three of six blogshots over a 4-week period (a different blogshot will be sent by email to them each week for three weeks, then in the final week they will receive the same three blogshots in one summary email to review). Group B will receive the other three of six blogshots, following the same email sequence and timing. All participants from both groups will be asked to complete one baseline questionnaire at the start of the study and a follow-up questionnaire at week 5, month 3 and month 6 about different common acute childhood conditions, the blogshots and their content. All participants also have the option to participate in an optional semi-structured interview to give their thoughts on the blogshots and their experience in the study. Researchers will compared each participant's baseline score to their follow up scores to see if there was a change in their knowledge and expectations. By developing and evaluating evidence-based Choosing Wisely Canada resources, the researchers aim to make it easier for parents to choose wisely. Empowering parents to be part of conversations with their child's healthcare provider can improve health decision-making and reduce health system costs.

Conditions

Common Cold; Pharyngitis; Acute Otitis Media; Acute Asthma; Bronchiolitis; Pediatric ALL; Parents

Keywords

Common Acute Childhood Conditions; Choosing Wisely Canada; Blogshots

Outcome Measures

Primary Outcomes (5)

• Knowledge - Quantitative true/false

  Primary outcome will be knowledge. Change will be compared from baseline between groups (i.e. average change in knowledge scores specific to Choosing Wisely recommendations, expecting that knowledge will improve with respect to the content received). There will be 8 'true/false' questions to assess knowledge. Each question is worth 2 points. Knowledge will be assessed by comparing participant's scores on baseline to follow-up 1 (knowledge change) and comparing scores to follow-up 2 and 3 (knowledge retention).

  baseline (week 0), follow-up 1 (week 5), follow-up 2 (month 3), follow-up 3 (month 6)

• Knowledge - Quantitative Multiple Choice

  Primary outcome will be knowledge. Change will be compared from baseline between groups (i.e. average change in knowledge scores specific to Choosing Wisely recommendations, expecting that knowledge will improve with respect to the content received). There will be 7 'multiple choice' questions to assess knowledge. Each question is worth 2 points. Knowledge will be assessed by comparing participant's scores on baseline to follow-up 1 (knowledge change) and comparing scores to follow-up 2 and 3 (knowledge retention).

  baseline (week 0), follow-up 1 (week 5), follow-up 2 (month 3), follow-up 3 (month 6)

• Knowledge - Quantitative Select all that apply

  Primary outcome will be knowledge. Change will be compared from baseline between groups (i.e. average change in knowledge scores specific to Choosing Wisely recommendations, expecting that knowledge will improve with respect to the content received). There will be 6 'select all that apply' questions to assess knowledge. Each question is worth 2 points. Knowledge will be assessed by comparing participant's scores on baseline to follow-up 1 (knowledge change) and comparing scores to follow-up 2 and 3 (knowledge retention).

  baseline (week 0), follow-up 1 (week 5), follow-up 2 (month 3), follow-up 3 (month 6)

• Knowledge - Quantitative

  Primary outcome will be knowledge. Change will be compared from baseline between groups (i.e. average change in knowledge scores specific to Choosing Wisely recommendations, expecting that knowledge will improve with respect to the content received). The outcome will be assessed two ways: 1\. Quantitatively via questionnaires: 21 knowledge questions with about 8 'true/false', 7 'multiple choice' and 6 'select all that apply' in each questionnaire (baseline, follow-up 1, 2 \& 3). Each question is worth 2 points, total score per questionnaire ranging from 0-42 pts. Knowledge will be assessed by comparing participant's scores on baseline to follow-up 1 (knowledge change) and comparing scores to follow-up 2 and 3 (knowledge retention).

  baseline (week 0), follow-up 1 (week 5), follow-up 2 (month 3), follow-up 3 (month 6)

• Knowledge - Qualitative

  Interviews will be used to clarify, expand on and provide to context to the questionnaire responses - two open-ended questions addressing knowledge and will undergo thematic analysis.

  interviews will be conducted between week 5 - month 3

Secondary Outcomes (8)

• Intentions - Quantitative Likert

  week 0 (baseline), week 5 (follow-up 1)

• Intentions - Quantitative Multiple Choice

  week 0 (baseline), week 5 (follow-up 1)

• Intentions - Qualitative

  interviews will be conducted between week 5 - month 3

• Expectations of care - quantitative

  week 0 (baseline), week 5 (follow-up 1)

• Expectations of care - qualitative

  interviews will be conducted between week 5 - month 3

Study Arms (2)

Group A - Sore Throat Swab, Cough and Cold, Asthma

ACTIVE COMPARATOR

Group A will receive three of six blogshots (different to Group B) over a 4-week period (a different blogshot will be sent by email to them each week for three weeks, then in the final week they will receive the same three blogshots in one summary email to review). They will act as their own control group. All participants from both groups will be asked to complete one baseline questionnaire at the start of the study and a follow-up questionnaire at week 5, month 3 and month 6 about different common acute childhood conditions, the blogshots and their content. All participants can also participate in an optional semi-structured interview to give their thoughts on the blogshots and their experience in the study.

Behavioral: Blogshots 1-3

Group B - Ear Infection, Bronchiolitis, Antibiotics for Sore Throat

ACTIVE COMPARATOR

Group B will receive three of six blogshots (different to Group A) over a 4-week period (a different blogshot will be sent by email to them each week for three weeks, then in the final week they will receive the same three blogshots in one summary email to review). They will act as their own control group. All participants from both groups will be asked to complete one baseline questionnaire at the start of the study and a follow-up questionnaire at week 5, month 3 and month 6 about different common acute childhood conditions, the blogshots and their content. All participants can also participate in an optional semi-structured interview to give their thoughts on the blogshots and their experience in the study.

Behavioral: Blogshots 4-6

Interventions

Blogshots 1-3 BEHAVIORAL

1. Don't routinely do a throat swab when children present with a sore throat if they have a cough, rhinitis, or hoarseness 2. Don't recommend the use of cough and cold remedies in children under six years of age 3. Don't use antibiotics for acute asthma exacerbations without clear signs of bacterial infection

Group A - Sore Throat Swab, Cough and Cold, Asthma

Blogshots 4-6 BEHAVIORAL

1. Don't routinely use antibiotics in children with uncomplicated sore throats 2. Don't prescribe antibiotics in adults with bronchitis/asthma and children with bronchiolitis 3. Don't use antibiotics in adults and children with uncomplicated acute otitis media

Group B - Ear Infection, Bronchiolitis, Antibiotics for Sore Throat

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Over the age of 18 years
• Parent or legal guardian of a child under 5 years of age
• Live in Canada
• Able to complete the questionnaire and interview in English (speak/read)
• Access to an electronic device (e.g. computer, tablet or smart phone), Internet and email.

You may not qualify if:

• Under the age of 18 years
• Does not identify as a parent or legal guardian of a child under 5 years of age
• Does not live in Canada
• Unable to complete the interview and questionnaire in English (speak/read)
• No access to an electronic device (e.g. computer, tablet or smart phone), Internet and email.

Sponsors & Collaborators

• University of Alberta: lead
• Women and Children's Health Research Institute, Canada: collaborator
• Pediatric Parent Advisory Group (ARCHE and ECHO): collaborator

Study Sites (1)

University of Alberta

Edmonton, Alberta, T6G 2R3, Canada

Location

Related Publications (22)

• Anzinger H, Elliott SA, Hartling L. Comparative Usability Analysis and Parental Preferences of Three Web-Based Knowledge Translation Tools: Multimethod Study. J Med Internet Res. 2020 Mar 13;22(3):e14562. doi: 10.2196/14562.

  PMID: 32167478 BACKGROUND

• Born KB, Coulter A, Han A, Ellen M, Peul W, Myres P, Lindner R, Wolfson D, Bhatia RS, Levinson W. Engaging patients and the public in Choosing Wisely. BMJ Qual Saf. 2017 Aug;26(8):687-691. doi: 10.1136/bmjqs-2017-006595. Epub 2017 Jun 9. No abstract available.

  PMID: 28600453 BACKGROUND

• Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3(2): 77-101.

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• Britten N. Qualitative interviews in medical research. BMJ. 1995 Jul 22;311(6999):251-3. doi: 10.1136/bmj.311.6999.251.

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• Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Directions for Program Evaluation. 1986; 1986(30): 73-84.

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• Montori VM, Guyatt GH. Intention-to-treat principle. CMAJ. 2001 Nov 13;165(10):1339-41. No abstract available.

  PMID: 11760981 BACKGROUND

• Nisson C, Earl A. The Theories of Reasoned Action and Planned Behavior, in The Wiley Encyclopedia of Health Psychology. 2020. p. 55-761.

  BACKGROUND

• Ogden J, Karim L, Choudry A, Brown K. Understanding successful behaviour change: the role of intentions, attitudes to the target and motivations and the example of diet. Health Educ Res. 2007 Jun;22(3):397-405. doi: 10.1093/her/cyl090. Epub 2006 Sep 13.

  PMID: 16971672 BACKGROUND

• Michie S, Johnson BT, Johnston M. Advancing cumulative evidence on behaviour change techniques and interventions: a comment on Peters, de Bruin, and Crutzen. Health Psychol Rev. 2015;9(1):25-9. doi: 10.1080/17437199.2014.912538. Epub 2014 May 2. No abstract available.

  PMID: 25793487 BACKGROUND

• Albrecht L, Scott SD, Hartling L. Knowledge translation tools for parents on child health topics: a scoping review. BMC Health Serv Res. 2017 Sep 29;17(1):686. doi: 10.1186/s12913-017-2632-2.

  PMID: 28962637 BACKGROUND

• Gerolamo AM, Jutel A, Kovalsky D, Gentsch A, Doty AMB, Rising KL. Patient-Identified Needs Related to Seeking a Diagnosis in the Emergency Department. Ann Emerg Med. 2018 Sep;72(3):282-288. doi: 10.1016/j.annemergmed.2018.02.021.

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• Lateef F. Patient expectations and the paradigm shift of care in emergency medicine. J Emerg Trauma Shock. 2011 Apr;4(2):163-7. doi: 10.4103/0974-2700.82199.

  PMID: 21769199 BACKGROUND

• Sharot T, Sunstein CR. How people decide what they want to know. Nat Hum Behav. 2020 Jan;4(1):14-19. doi: 10.1038/s41562-019-0793-1. Epub 2020 Jan 13.

  PMID: 31932690 BACKGROUND

• Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health Aff (Millwood). 2013 Feb;32(2):207-14. doi: 10.1377/hlthaff.2012.1061.

  PMID: 23381511 BACKGROUND

• McHale P, Wood S, Hughes K, Bellis MA, Demnitz U, Wyke S. Who uses emergency departments inappropriately and when - a national cross-sectional study using a monitoring data system. BMC Med. 2013 Dec 13;11:258. doi: 10.1186/1741-7015-11-258.

  PMID: 24330758 BACKGROUND

• Nicholson E, McDonnell T, De Brun A, Barrett M, Bury G, Collins C, Hensey C, McAuliffe E. Factors that influence family and parental preferences and decision making for unscheduled paediatric healthcare - systematic review. BMC Health Serv Res. 2020 Jul 17;20(1):663. doi: 10.1186/s12913-020-05527-5.

  PMID: 32680518 BACKGROUND

• Nyquist AC, Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis. JAMA. 1998 Mar 18;279(11):875-7. doi: 10.1001/jama.279.11.875.

  PMID: 9516004 BACKGROUND

• Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, Burroughs H, Jinks C. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52(4):1893-1907. doi: 10.1007/s11135-017-0574-8. Epub 2017 Sep 14.

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• Ltd, Q.S.R.I.P., NVivo qualitative data analysis software. Version 10, 2012.

  BACKGROUND

• Ashcraft LE, Asato M, Houtrow AJ, Kavalieratos D, Miller E, Ray KN. Parent Empowerment in Pediatric Healthcare Settings: A Systematic Review of Observational Studies. Patient. 2019 Apr;12(2):199-212. doi: 10.1007/s40271-018-0336-2.

  PMID: 30328069 BACKGROUND

• Hartling L, Elliott SA, Buckreus K, Leung J, Scott SD. Development and evaluation of a parent advisory group to inform a research program for knowledge translation in child health. Res Involv Engagem. 2021 Jun 7;7(1):38. doi: 10.1186/s40900-021-00280-3.

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Related Links

• Morville P. User Experience Design.

MeSH Terms

Conditions

Common Cold; Pharyngitis; Otitis Media; Bronchiolitis; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Picornaviridae Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Pharyngeal Diseases; Stomatognathic Diseases; Otorhinolaryngologic Diseases; Otitis; Ear Diseases; Bronchitis; Bronchial Diseases; Lung Diseases, Obstructive; Lung Diseases; Leukemia, Lymphoid; Leukemia; Neoplasms by Histologic Type; Neoplasms; Hematologic Diseases; Hemic and Lymphatic Diseases; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Immune System Diseases

Study Officials

• Lisa Hartling, PhD

  University of Alberta

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will be randomly assigned to Group A or Group B in this study. Group A will receive three of six blogshots over a 4-week period (a different blogshot will be sent by email to them each week for three weeks, then in the final week they will receive the same three blogshots in one summary email to review). Group B will receive the other three of six blogshots, following the same email sequence and timing. The reason for assigning them into a group is to help us evenly share the blogshots between all participants. Each group will act as their own control. All participants from both groups will be asked to complete one baseline questionnaire at the start of the study and a follow-up questionnaire at week 5, month 3 and month 6 about different common acute childhood conditions, the blogshots and their content. All participants can also participate in an optional semi-structured interview to give their thoughts on the blogshots and their experience in the study.

Study Record Dates

• First Submitted: July 25, 2023
• First Posted: August 22, 2023
• Study Start: June 5, 2023
• Primary Completion: April 23, 2024
• Study Completion: April 23, 2024
• Last Updated: May 22, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)