A systematic review of interactive multimedia interventions to promote children’s communication with health professionals: implications for communicating with overweight children

Raaff, Carol; Glazebrook, Cris; Wharrad, Heather

doi:10.1186/1472-6947-14-8

BMC Medical Informatics and Decision Making

Table 6 Multimedia intervention outcome measures and intervention effects

From: A systematic review of interactive multimedia interventions to promote children’s communication with health professionals: implications for communicating with overweight children

Study outcome	No. of studies	Study	Outcome measures/scale¹	Reliability tested²	p-value³	ES (d)
Communication	2	[70]	No. child-initiated diabetes discussions: Parent recall (one month)	No	0.0025
		[9]	Child Satisfaction Survey:	No
			Felt involved in the consultation		<0.05
			Orthodontist understands me		ns
Satisfaction	3⁵	[70]	User satisfaction: Instrument not described	No	ns
		[9]	Liked the explanation: Satisfaction Survey⁴	No	ns
		[69]	Satisfaction and Use Questionnaire:	No
			Used assigned intervention ≥ once		0.001
			Used intervention ‘for a long time’		0.0006
			Found intervention ‘easy to use’		ns
DNA rate	3	[6]	DNA at least 1 appt	N/A	ns
			DNA two consecutive appts	N/A	N/K⁶
		[67]	Appts kept out of total planned appointments	N/A	0.04
		[66]	Appts kept out of total planned appointments	N/A	ns
Knowledge acquisition	12	[70]	Interview questions, blood glucose logbook, food exchange chart	No	ns
		[9]	Child Short Answer Knowledge Questionnaire⁴:	No
			Three major orthodontic problems		<0.05
			Two orthodontic appliances/devices used		ns
			Three risks		ns
			Two instructions followed		ns
			Total recall and retention of information presented		<0.05
		[69]	Leukemia Event Knowledge Interview [78]	Yes	0.039
		[74]	Cystic Fibrosis Knowledge Questionnaire (adapted Quittner & Drotar (1997))⁷	Yes	<0.001
		[67]	Child Knowledge of Asthma Management Questionnaire	Yes		0.17
		[66]	Child Knowledge of Asthma Questionnaire	No	<0.001
		[7]	Pediatric Asthma Care Knowledge Survey	No	ns
		[68]	Child Knowledge of Asthma Management Questionnaire [67]	Yes	<0.0001
		[8]	Asthma Knowledge Assessment	Yes	0.001
		[65]⁸	Asthma Knowledge Scale (modified [79])	Yes	ns
			How Much Do I Know About Sickle Cell Disease? Questionnaire (shortened [80])	Yes	ns
		[71]	Encopresis Knowledge Questionnaire	No	ns
			Virginia Encopresis/Constipation Apperception Test [81]	Yes	ns
Changes in self-efficacy	10	[70]	Interview questions	No	0.025
		[9]	Child Satisfaction Survey⁴:	No
			‘Satisfied that I know the causes’		ns
			‘Satisfied that I know the treatment’		ns
			‘Satisfied that I know the expected outcome’		ns
			‘Satisfied that I know the risks’		ns
			‘Satisfied with the explanation of the problems’		<0.05
			‘Confidence in the Orthodontist’		ns
			‘Not afraid of the treatment’		ns
		[69]	Leukemia Children's Health Locus of Control [82]	Yes	0.005
		[74]	Role Play Inventory of Situations and Copy Skills [83]	Yes	<0.001
		[6]	Self-esteem Scale (shortened [84])	No	0.02
		[67]	Child Self-efficacy Expectations Questionnaire	Yes		0.06
		[68]	Child Self-efficacy Expectations Questionnaire [67]	Yes	<0.0001
		[66]	Parent recall: Child attitude toward asthma care	No	ns
			Parent recall: Behaviours related to asthma care	No	ns
		[8]	Children's Asthma Locus of Control ([85], derived from [82])	Yes	0.007	0.5
		[65]⁸	Kidcope [86]	Yes	ns
			Kidcope [86]	Yes	ns
Health outcomes/symptoms	10	[70]	Long-term blood glucose control: HbA1c measurements	No	ns
		[6]	Time to dry (Length of time to achieve 14 consecutive dry nights): Not described	Not stated	ns
			Dry on discharge: Not described	Not stated	ns
			Dry 6 months post-discharge: Questionnaire not described	Not stated	ns
		[72]	Headache activity: Headache Index Composite calculated from Headache Diary [87]	Yes	0.04
			Headache frequency, duration and severity: Pediatric Migraine Disability Assessment [88]	Yes	ns
		[67]	Asthma symptoms: Usherwood Symptom Questionnaire [89]	Yes	0.02⁹
		[66]	Asthma severity: Parent recall	No	ns
		[7]	Lung function (FEV ₁ ): Instrument not described	Not stated	ns
			Days of asthma symptoms since last visit:	No	<0.01
			Parent recall
		[68]	Asthma symptoms: Usherwood Symptom Questionnaire [89]	Yes	ns
		[8]	Lung function (FEV ₁ ): Micromedical Super-Spiro spirometer	Not stated	ns
			Lung function (PEF): Mini-Wright Peak Flow Meter	Not stated	ns
		[73]	Lung function (FEV ₁ ): Instrument not described	Not stated	ns
			Lung function (PEF): Instrument not described	Not stated	ns
		[71]	Child Information Form:	No
			Trips to toilet without parental prompt		0.109
			Bowel movements in the toilet		0.001
			Overall encopresis symptom improvement		0.018
Emergency medical visits	6	[70]	Emergency room/GP visits over past 3 months ¹⁰ : Parent recall	No	ns
		[67]	Number of visits over past year: Parent recall	No		0.03
		[66]	Emergency room visits: Parent recall	No	ns
			Acute GP visits: Parent recall	No	ns
		[7]	Asthma Summary Since Last Visit Questionnaire:	No
			Urgent medical visits		<0.0001
			Emergency room visits		0.0219
		[8]	Unscheduled visits to the GP over past month: Parent recall	No	ns
		[73]	Emergency room visits over past 6 months: Parent questionnaire and GP electronic record	Not stated	ns
Hospitalisation	6	[70]	Hospitalisation over past 3 months ¹⁰ : Parent recall	No	ns
Hospitalisation		[67]	Hospitalisation over past year: Parent recall	No		-0.14
		[7]	Asthma Summary Since Last Visit Questionnaire:	No
			Hospitalisation		0.0313
			Days of stay in hospital		ns
		[68]	Hospitalisation over past year: Parent recall	No	ns
		[8]	Hospitalisation over past month: Parent recall	No	ns
		[73]	Days of stay in hospital over past 6 months: Parent questionnaire and GP electronic record	Not stated	ns

ES–effect size ns–not significant DNA–Did not attend Appt–appointment N/A–not applicable No.–number of FEV₁–Forced expiratory volume PEV–Peak expiratory volume GP–General practitioner HbA1c–glycated haemoglobin N/K–not known.
¹instruments or scales were developed by the authors, unless referenced.
²reliability of outcome measure/scale tested using Cronbach’s alpha.
³p ≤ 0.05.
⁴several questions could equally be categorised as ‘communication’, ‘satisfaction’ or ‘self-efficacy’. The most appropriate question(s) have been included in this Table.
⁵Homer, et al.[66] lacked comparison group satisfaction data, and have therefore not been included.
⁶not known–a chi-square test revealed no statistical significance between the 3 groups (which included a wait-list group) but no sub-analysis of the intervention and comparison group was provided.
⁷ unable to find reference: Quittner, A.L. & Drotar, D. Controlled trial of family interventions for cystic fibrosis. [Research grant] National Institute of Health–October 1997-August 2003.
⁸Hazzard, et al.[65] utilised the STARBRIGHT World MI to explore it’s effect on children with asthma and sickle cell disease. The data is dealt with separately.
⁹significant only for those children with milder asthma symptoms.
¹⁰measured together, as emergency room/GP visits and hospitalisation.

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