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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  
  [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  
  1. 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.
  2. 1instruments or scales were developed by the authors, unless referenced.
  3. 2reliability of outcome measure/scale tested using Cronbach’s alpha.
  4. 3p ≤ 0.05.
  5. 4several questions could equally be categorised as ‘communication’, ‘satisfaction’ or ‘self-efficacy’. The most appropriate question(s) have been included in this Table.
  6. 5Homer, et al.[66] lacked comparison group satisfaction data, and have therefore not been included.
  7. 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.
  8. 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.
  9. 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.
  10. 9significant only for those children with milder asthma symptoms.
  11. 10measured together, as emergency room/GP visits and hospitalisation.