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

Jennifer Ann Hutson, James S. Hodges, Le Ann Snow

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
JournalClinical Rehabilitation
Early online dateApr 15 2021
StateE-pub ahead of print - Apr 15 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Principal Investigator received funding toward participant reimbursement and hiring of research study personnel from a University Academic Professional Development Committee (APDC) Grant.

Publisher Copyright:
© The Author(s) 2021.


  • Night-time postural care training
  • cerebral palsy
  • online caregiver education
  • postural care
  • sleep positioning

PubMed: MeSH publication types

  • Journal Article


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