Theory-driven educational media development: Improving pressure ulcer prevention practices

PURPOSE

Despite significant achievements in pressure ulcer care and prevention, incidence rates remain high in specific populations and environments, and some advocates maintain that occurrence of pressure ulcers is tantamount to patient abuse. This research used a theory-driven approach to develop and evaluate educational materials to improve quality of care.

METHOD

The development followed a participant-driven, 6 stage, iterative process that drew upon psychosocial behavioral and constructivist educational theories. Previously reported psychosocial models and beliefs data informed the educational objectives, including reinforcement of positive beliefs, redress of negative ones, provision of tools to overcome barriers, and identification of individuals to be “cast.” The resulting DVD and guide were evaluated in a pre/post, controlled field trial (n=63). Differences in knowledge, a psychosocial multivariate composite (attitude, perceived norm, perceived control, and intentions), and satisfaction variables were examined using appropriate uni- and multivariate analyses, including RM-ANCOVA/MANCOVA.

RESULTS

The experimental group demonstrated significantly greater growth in knowledge, the psychosocial composite, and the perceived control component of the composite. Effect sizes were large. Participants rated the materials highly on a 5-point, 10-item usability scale (M=4.77, SD=.347). Strengths, weaknesses, and suggestions for improvement were identified.

The overarching development model and results from each stage will be presented with specific emphasis on the outcomes of the evaluation along with implications for further research and practice with respect to pressure ulcer prevention specifically and to structured, theory-driven professional development more generally. Copies of the program will be provided.

Supported in part by Grants R43AR05031-03&R44AR05031-03 from NIAMS/NIH.