Efficacy of a training program to support the application of the Guideline Evidence-based Health Information: a randomized controlled trial and process evaluation

BACKGROUND: The Guideline Evidence-based Health Information addresses health information providers and aims to improve the quality of health information. This study aimed to evaluate the efficacy of a training program for health information providers to support the application of the guideline. We expected the intervention to improve the quality of health information compared with providing the guideline alone. METHODS: In this superiority randomized controlled trial, providers responsible for producing and publishing health information were allocated 1:1 to the intervention (guideline and training program) and control (publicly available guideline) groups using computer-generated block randomization. The e-learning program (31 h, offered over 6-7 weeks) comprised modules on evidence-based medicine and the application of the guideline. Each provider committed to producing a single piece of health information informing a health-related decision on the topic of their choice. The primary outcome was the quality of health information, operationalized as adherence to the guideline recommendations, as measured using the Mapping Health Information Quality (MAPPinfo) checklist. Means were compared between groups using a t-test. The assessment and analyses were blinded to the group allocation. An accompanying process evaluation was conducted. RESULTS: We included 18 health information providers (nine in each group), with a total of 54 individual participants. Eight health information items were assessed in each group. The primary analysis estimated the mean MAPPinfo checklist values at 30.2% (95% CI, 24.6 to 35.9) for the intervention and at 22.7% (95% CI, 17.4 to 27.9) for the control group. The difference between groups was estimated at 7.6% (95% CI, - 0.2 to 15.3; p = 0.055). Individual and structural implementation barriers of the guideline recommendations were identified. CONCLUSIONS: We did not achieve the targeted sample size of 26 providers. A lack of resources was one of the main barriers to recruitment. Although our study did not provide conclusive evidence regarding the primary outcome, the participants rated the training program as relevant. Therefore, the training program will be made available to health information providers upon request. TRIAL REGISTRATION: ISRCTN registry, ID: ISRCTN96941060. Registered on March 7, 2019. STUDY PROTOCOL: https://doi.org/10.1186/s13063-020-04287-1 (Trials 2020).