The effect of a web-based training for improving primary health care providers’ knowledge about diabetes mellitus management in rural China: A pre-post intervention study

English version

Autoři: Mu-Hong Wei ^aff001; Xian-Zhen Chen ^aff001; Xing-Xin Zhan ^aff001; Zhi-Xia Zhang ^aff001; Shao-Jing Yu ^aff001; Wei-Rong Yan ^aff001
Působiště autorů: Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China ^aff001; School of Nursing and Rehabilitation, Xinyu University, Xinyu, China ^aff002; Wuchang University of Technology, Wuhan, China ^aff003
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222930

Souhrn

Background

The performance of primary health care providers regarding DM management is poor in rural China, and effective training methods for providers are urgently needed. This study aimed to evaluate the effect of web-based training for improving knowledge about DM management among primary health care providers in rural China and to further compare the effects of the training effect between primary health care providers with different backgrounds.

Methods

A pre-post intervention study was conducted from April to August 2014. In this study, a total of 901 primary health care workers were recruited from six counties in Hubei province. To evaluate the effect of the web-based training, the knowledge achievement of participants was measured with multiple choice questions (MCQ) at baseline, at the end of two weeks of training and at three months after training. A mixed linear model (MLM) was used to measure group differences in the mean scores at baseline and follow-up.

Results

After the web-based training, the knowledge scores of the village doctors increased from 73.58 at baseline to 89.98 at posttest and to 84.57 three months after the training. For township health workers, we observed an upward trend in scores from 78.87 at the pre-test to 91.72 at the second test, and at the three months after the training, the scores increased to 94.91. For village doctors, greater knowledge achievement was observed between the scores at baseline and after two weeks of training(adjusted difference: 3.55, P = 0.03) compared to that observed for the township health workers, while decreased their knowledge achievement between baseline and the third-test compared with that of township health workers (adjusted difference: 5.05, P = 0.01).

Conclusions

This study suggested that web-based training was an effective method for improving the knowledge of primary health care providers about management of DM in remote areas. Compared with the effect of the training on village doctors, the training had a poor short-term effect on township health workers but a better long-term effect.

Klíčová slova:

Health care providers – Medical doctors – Schools – Internet – Educational attainment – Pilot studies – Trainees

Zdroje

1. Yang L, Shao J, Bian Y, Wu H, Shi L, Zeng L, et al. Prevalence of type 2 diabetes mellitus among inland residents in China (2000–2014): A meta‐analysis. Journal of Diabetes Investigation 2016, 7(6):845–852.

2. Hu FB. Globalization of Diabetes: The role of diet, lifestyle, and genes. Diabetes Care 2011, 34(6):1249–1257. doi: 10.2337/dc11-0442 21617109

3. Li M, Su L, Liang B, Tan J, Chen Q, Long J et al. Trends in Prevalence, Awareness, Treatment, and Control of Diabetes Mellitus in Mainland China from 1979 to 2012. International Journal of Endocrinology 2013, 2013(4):753150.

4. Tian M, Feng D, Chen X, Chen Y, Sun X, Xiang Y et al. China's rural public health system performance: a cross-sectional study. Plos One 2013, 8(12):e83822. doi: 10.1371/journal.pone.0083822 24386284

5. Hung LM, Shi L, Wang H, Nie X, Meng Q. Chinese primary care providers and motivating factors on performance. Family Practice 2013, 30(5):576–586. doi: 10.1093/fampra/cmt026 23788201

6. Liu X, Li Y, Li L, Zhang L, Ren Y, Hao Z. Prevalence, awareness, treatment, control of type 2 diabetes mellitus and risk factors in Chinese rural population: the RuralDiab study. Scientific Reports 2016, 6:31426. doi: 10.1038/srep31426 27510966

7. Li T, Lei T, Xie Z, Zhang T. Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example. Bmc Health Services Research 2015, 16(1):42.

8. Zhao Y, Chen R, Wang B, Wu T, Huang Y, Guo A. General Practice On-the-Job Training in Chinese Urban Community: A Qualitative Study on Needs and Challenges. Plos One 2014, 9(4):e94301. doi: 10.1371/journal.pone.0094301 24728399

9. Sun H, Huang AJ, Cao ZM. Standing and Role of the Large-Scale Comprehensive Public Hospital in General Medical Education in China. Chinese General Practice 2011, 14:1752–1754.

10. Li X, Liu J, Huang J, Qian Y, Che L. An analysis of the current educational status and future training needs of China's rural doctors in 2011. Postgraduate Medical Journal 2013, 89(1050):202–208.

11. Khatony A, Nayery ND, Ahmadi F, Haghani H, Vehvilainenjulkunen K. The effectiveness of web-based and face-to-face continuing education methods on nurses' knowledge about AIDS: a comparative study. Bmc Medical Education 2009, 9(1):1–7.

12. Zhang Z, Zhan X, Li Y, Hu R, Yan W. Web-Based Training for Primary Healthcare Workers in Rural China: A Qualitative Exploration of Stakeholders’ Perceptions. Plos One 2015, 10(5):e0125975. doi: 10.1371/journal.pone.0125975 25961727

13. Paliadelis PS, Stupans L, Parker V, Piper D, Gillan P, Lea J et al.: The development and evaluation of online stories to enhance clinical learning experiences across health professions in rural Australia. Collegian 2015, 22(4):397–403. 26775526

14. Ballew P, Castro S, Claus J, Kittur N, Brennan L, Brownson RC. Developing web-based training for public health practitioners: what can we learn from a review of five disciplines? Health Education Research 2013, 28(2):276–287. doi: 10.1093/her/cys098 22987862

15. Seble F, Yianna V, Zohray T, Nadia M, Heather R, Hannah W. E-learning in medical education in resource constrained low- and middle-income countries. Human Resources for Health 2013, 11(1):1–15.

16. Nartker AJ, Stevens L, Shumays A, Kalowela M, Kisimbo D, Potter K. Increasing health worker capacity through distance learning: a comprehensive review of programmes in Tanzania. Human Resources for Health 2010, 8(1):1–10.

17. Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Internet-Based Learning in the Health Professions: A Meta-analysis. Jama the Journal of the American Medical Association 2008, 300(10):1181. doi: 10.1001/jama.300.10.1181 18780847

18. Khoja S, Scott RE. Creating e-learning resources in preventive medicine for developing countries. Journal of Telemedicine and Telecare 2007, 13(2):105–106. doi: 10.1258/135763307780096131 17359576

19. Blankstein U, Dakurah T, Bagan M, Hodaie M. Structured online neurosurgical education as a novel method of education delivery in the developing world. World Neurosurgery 2011, 76(3–4):224–230. doi: 10.1016/j.wneu.2011.02.041 21986410

20. Tang S, Tian L, Cao WW, Zhang K, Detels R, Li VC. Improving reproductive health knowledge in rural China—a web-based strategy. Journal of Health Communication 2009, 14(7):690. doi: 10.1080/10810730903204270 19851919

21. Gannon M, Qaseem A, Snow V. Community-based primary care: improving and assessing diabetes management. American Journal of Medical Quality 2010, 25(1):6–12. doi: 10.1177/1062860609345665 19786594

22. Zhang S, Zhang W, Zhou H, Xu H, Qu Z, Guo M. How China's new health reform influences village doctors' income structure: evidence from a qualitative study in six counties in China. Human Resources for Health 2015, 13(1):26.

23. Hipgrave D, Guo S, Mu Y, Guo Y, Yan F, Scherpbier R. Chinese-style decentralization and health system reform. Plos Medicine 2012, 9(11):e1001337. doi: 10.1371/journal.pmed.1001337 23139644

24. Wei L, Yu BO. "Sophomore Phenomenon" and "Plateau Phenomenon" in College English Learning: Analysis of Causes of "Plateau Phenomenon" in English Learning among Students of Yunyang Medical College and Countermeasures. Northwest Medical Education 2008. doi: 10.1186/1472-6920-8-15

25. Xue Z.Influence of "Plateau Phenomenon" on Chemistry Learning. Teaching of Forestry Region 2017.

26. Hart C. Factors Associated with Student Persistence in an Online Program of Study: A Review of the Literature. Journal of Interactive Online Learning 2012, 11(1):19–42.

27. Ding Y, Smith HJ, Fei Y, Xu B, Nie S, Yan W. Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China. Bulletin of the World Health Organization 2013, 91(1):64–69. doi: 10.2471/BLT.12.109447 23397352

28. Li X, Cochran C, Lu J, Shen J, Hao C, Wang Y. Understanding the shortage of village doctors in China and solutions under the policy of basic public health service equalization: evidence from Changzhou. International Journal of Health Planning & Management 2015, 30(1):42–55.