JMIR Publications

ABSTRACT

Background:

Background:

Brief counseling can motivate patients to initiate health behavior change. However, increasing the provision of brief counseling by nurses is difficult due to contextual and practitioner-level factors impeding nurses’ motivation and intentions to provide brief counseling (e.g., unfavorable attitude toward brief counseling, lack of perceived control linked to barriers). Theory-based implementation interventions could address these practitioner-level factors and support evidence-based practice in relation to brief counseling. Web-based, adaptive e-learning programs are a novel type of implementation intervention that could address the limitations of current brief counseling training programs, such as accessibility and personalization.

Objective:

This paper presents a study protocol for evaluating the effectiveness of the E_MOTIVA implementation intervention—a theory-based, web-based, adaptive e-learning program—to increase nurses’ and nursing students’ intentions to provide brief counseling for smoking, an unbalanced diet and medication nonadherence.

Methods:

A two group, single-blind, randomized controlled trial will be conducted with nurses and nursing students enrolled in a Bachelor of Science in Nursing program (N=50). Participants in the experimental group (EG) will be allocated to the E_MOTIVA intervention—a theory-based, web-based, adaptive e-learning program—while participants in the active control group (CG) will be allocated to the E_MOTIVB intervention, a knowledge-based, web-based, standardized e-learning program. The E_MOTIVA intervention was designed to influence the constructs of the Theory of Planned Behavior (e.g., attitude, subjective norms and perceived behavioral control) in relation to brief counseling. The Cognitive Load Index and User Engagement Scale will be used to assess participants’ cognitive load and engagement related to e-learning. Participants will complete the Brief Counseling Nursing Practices Questionnaire—Abridged Version at baseline and at the follow-up. All study measures will be completed online.

Results:

The study is ongoing (ISRCTN32603572). Results of the study will provide answers to the primary hypothesis, i.e., that EG participants will demonstrate a greater change in the score of intentions to provide brief counseling between baseline (–T1) and follow-up (T4) (H1). Secondary hypotheses include greater improvements in attitudes (H2), subjective norms (H3), perceived control (H4), behavioral beliefs (H5), normative beliefs (H6), and control beliefs (H7) regarding brief counseling in the EG between baseline and follow-up. We also anticipate lower intrinsic and extrinsic cognitive loads (H8, H9), higher germane cognitive load (H10), and higher engagement (H11, H12) in the EG.

Conclusions:

This study will be among the first in evaluating a novel type of implementation intervention, a theory-based, web-based, adaptive e-learning program, in nurses and nursing students. This type of intervention has the potential to support evidence-based practice through accessible, personalized training in wide-ranging domains in nursing. Clinical Trial: This protocol is registered at isrctn.com on October 14, 2019. The registration number is ISRCTN32603572. This is the link to the information on the trial register: https://doi.org/10.1186/ISRCTN32603572.