Educating caregivers of persons with cerebral palsy in night-time postural care: A randomized trial comparing two online training programs

Objective: Compare effectiveness of two differently formatted training programs in educating night-time postural care implementers. Design: Mixed-methods parallel-group double-blind design with random assignment. Setting: United States academic institution. Participants: Thirty-eight adult caregivers/providers of children with cerebral palsy. Interventions: Both 2-hour online programs included content on night-time postural care evidence, risk-factor monitoring, sleep-system types, positioning methods, and assessments. Group A used interactive videos, Group B summary information with web-links. Main Measures: We measured self-perceived competence via questionnaires (baseline, post-training, post-simulation) containing 4-point rating-scales of knowledge, ability, and confidence and measured positioning ability via a simulation observation instrument comprising 16 positioning-task ratings with space for describing performance. We recorded participant actions/statements using fieldnotes. Results: Thirty-eight completed training (19 per group). Group A (vs B) showed significantly greater self-perceived competence changes post-training (0.46 points (SE 0.17), P = 0.008). Thirty-seven positioned a standardized “client,” with groups not differing significantly on total tasks completed correctly (F(1, 92.32) = 1.91, P = 0.17) averaging 11.85 (SE 0.83) and 12.60 (SE 0.84) of 16 tasks correct. Group A’s post-positioning/simulation self-ratings were significantly associated with actual ability (r = 0.53, P = 0.019). In both groups ⩾47% of caregivers incorrectly completed the tasks of placing head and neck in neutral and snugging up all [positioning] parts. Conclusion: The sleep care positioning training program (interactive video-based format) is effective in building caregivers’ self-perceived competence for night-time postural care. While the lesson was well-received by caregivers and considered a “match [to their] learning style,” the lesson did not lead to greater improvement in actual ability to position the “client” compared to control training.