Child Abuse
Conditions
Keywords
child and adolescent abuse and neglect (CAAN), chatbots, attitude toward reporting, intention to report
Brief summary
The study aims to evaluate the effectiveness of chatbot-facilitated education (CFE) in assisting nursing personnel to prevent child and adolescent abuse and neglect (CAN). The main questions it aims to answer are: 1. Does applying CFE enhance nurses' intention to report CAN? 2. Does applying CFE improve nurses' attitudes toward reporting CAN? 3. Does applying CFE increase nurses' knowledge of CAN? Researchers will compare CFE to lecture-based teaching to verify if CFE can improve the nurses' competency of CAN. Participants will: 1. Attend a CAN course for about 1.5 hours. The experimental group will use CFE, and the control group will only receive lecture-based teaching. 2. Have the CAN course, comprised of two main subjects: CAN and Nurses' Roles and Functions in CAN. 3. Receive the learning effect assessment at three different time points: before the course, one week after, and four weeks after.
Detailed description
Based on the rigor of the study and the anticipated benefits to the participants, we will: 1. Commence participant enrollment only after the protocol has been reviewed and approved by the Research Ethics Committee of Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation. 2. Conduct a minimum of four courses until the participant group reaches full capacity. 3. Ensure that participants are not informed about the specific interventions of the course at the time of their enrollment.
Interventions
OTHERchatbot facilitated teaching
The experimental group will use chatbot to facilitate teaching.
OTHERlecture-based teaching
The control group only receives lecture-based teaching.
Sponsors
Tzu Chi University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Nurses who 1. work in Hualien Tzu Chi Hospital 2. finish the probationary period, directly do the practical care 3. want to participate and sign the consent
Exclusion criteria
The nurses will be excluded if they are in an administrative position or withdraw the protocol for any reason.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intention to Report Child and Adolescent Abuse and Neglect | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment. It comprises eight simulated child abuse scenarios, with participants rating their intention to report each case on an 11-point scale ranging from 0 (no intention to report) to 10 (definite intention to report). The total possible score is 80, with higher scores indicating a stronger and more consistent intention to report suspected CAN cases. |
| Attitude Toward Reporting Child and Adolescent Abuse and Neglect | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment and consists of three sections: five items on attitudes toward child discipline, six items on perceptions of abusive parents, and seven items on professional responsibility in reporting child abuse, totaling 18 items. Participants rate each item on a 7-point Likert scale ranging from 0 (strongly disagree) to 6 (strongly agree). The maximum possible score is 108. Higher scores reflect more negative attitudes toward physical discipline, lower tolerance for abusive behavior by parents, and stronger endorsement of professional responsibility in reporting suspected child abuse. |
| Knowledge About Child and Adolescent Abuse and Neglect | Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after). | This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment and includes 13 true-false items. Participants are instructed to respond with true, false, or don't know for each statement. Correct responses receive one point, while incorrect or don't know responses receive zero. The total possible score is 13, with higher scores indicating greater knowledge of CAN and its relevant legal framework. |
Countries
Taiwan
Participant flow
Recruitment details
We enrolled the participants for a year from July 2023 at a tertiary hospital in eastern Taiwan.
Pre-assignment details
Course promotion commenced in July 2023. The first participant was not enrolled until the inaugural course launched on January 10, 2024. During the six-month preparatory period, we engaged in iterative planning, instructional design, and repeated testing of both the course delivery system and the integrated chatbot functionality.
Participants by arm
| Arm | Count |
|---|---|
| Chatbot-facilitated Education Group Chatbot facilitated teaching: The experimental group will use chatbot to facilitate teaching. | 44 |
| Lecture-based Teaching Group Lecture-based teaching: The control group only receives lecture-based teaching. | 48 |
| Total | 92 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 5 | 1 |
Baseline characteristics
| Characteristic | Chatbot-facilitated Education Group | Lecture-based Teaching Group | Total |
|---|---|---|---|
| Age, Continuous | 27.6 years STANDARD_DEVIATION 5.4 | 29.2 years STANDARD_DEVIATION 7 | 28.5 years STANDARD_DEVIATION 6.3 |
| Education Associate Degree | 3 Participants | 7 Participants | 10 Participants |
| Education Bachelor's Degree | 41 Participants | 41 Participants | 82 Participants |
| Education Doctorate (Ph.D.) | 0 Participants | 0 Participants | 0 Participants |
| Education Master's Degree | 0 Participants | 0 Participants | 0 Participants |
| Job tenure | 5.2 years STANDARD_DEVIATION 5.1 | 6.0 years STANDARD_DEVIATION 6.2 | 5.6 years STANDARD_DEVIATION 5.7 |
| Level of nursing N | 9 Participants | 18 Participants | 27 Participants |
| Level of nursing N1 | 8 Participants | 5 Participants | 13 Participants |
| Level of nursing N2 | 18 Participants | 16 Participants | 34 Participants |
| Level of nursing N3 | 9 Participants | 9 Participants | 18 Participants |
| Level of nursing N4 | 0 Participants | 0 Participants | 0 Participants |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Sex: Female, Male Female | 40 Participants | 39 Participants | 79 Participants |
| Sex: Female, Male Male | 4 Participants | 9 Participants | 13 Participants |
| The experience of dealing with child and adolescent abuse and neglect No | 18 Participants | 26 Participants | 44 Participants |
| The experience of dealing with child and adolescent abuse and neglect Yes | 26 Participants | 22 Participants | 48 Participants |
| The experience of receiving education by using a chatbot No | 43 Participants | 48 Participants | 91 Participants |
| The experience of receiving education by using a chatbot Yes | 1 Participants | 0 Participants | 1 Participants |
| The experience of receiving training in child and adolescent abuse and neglect No | 30 Participants | 31 Participants | 61 Participants |
| The experience of receiving training in child and adolescent abuse and neglect Yes | 14 Participants | 17 Participants | 31 Participants |
| The motives for participating Assignment of workplace | 1 Participants | 1 Participants | 2 Participants |
| The motives for participating Interest | 19 Participants | 20 Participants | 39 Participants |
| The motives for participating Required competency in the workplace | 11 Participants | 14 Participants | 25 Participants |
| The motives for participating Requirement of nursing credits | 13 Participants | 13 Participants | 26 Participants |
| Units Adult intensive care units | 5 Participants | 5 Participants | 10 Participants |
| Units Emergency depaertment | 15 Participants | 17 Participants | 32 Participants |
| Units Medical Surgical Unit | 14 Participants | 24 Participants | 38 Participants |
| Units Pediatric | 10 Participants | 2 Participants | 12 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 49 | 0 / 49 |
| other Total, other adverse events | 0 / 49 | 0 / 49 |
| serious Total, serious adverse events | 0 / 49 | 0 / 49 |
Outcome results
Primary
Attitude Toward Reporting Child and Adolescent Abuse and Neglect
This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment and consists of three sections: five items on attitudes toward child discipline, six items on perceptions of abusive parents, and seven items on professional responsibility in reporting child abuse, totaling 18 items. Participants rate each item on a 7-point Likert scale ranging from 0 (strongly disagree) to 6 (strongly agree). The maximum possible score is 108. Higher scores reflect more negative attitudes toward physical discipline, lower tolerance for abusive behavior by parents, and stronger endorsement of professional responsibility in reporting suspected child abuse.
Time frame: Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chatbot-facilitated Education Group | Attitude Toward Reporting Child and Adolescent Abuse and Neglect | Pre-test | 83.52 score on a scale | Standard Deviation 8.72 |
| Chatbot-facilitated Education Group | Attitude Toward Reporting Child and Adolescent Abuse and Neglect | Post-test 1 | 84.70 score on a scale | Standard Deviation 9.5 |
| Chatbot-facilitated Education Group | Attitude Toward Reporting Child and Adolescent Abuse and Neglect | Post-test 2 | 85.14 score on a scale | Standard Deviation 9.08 |
| Lecture-based Teaching Group | Attitude Toward Reporting Child and Adolescent Abuse and Neglect | Pre-test | 82.40 score on a scale | Standard Deviation 8.69 |
| Lecture-based Teaching Group | Attitude Toward Reporting Child and Adolescent Abuse and Neglect | Post-test 1 | 82.19 score on a scale | Standard Deviation 8.53 |
| Lecture-based Teaching Group | Attitude Toward Reporting Child and Adolescent Abuse and Neglect | Post-test 2 | 80.73 score on a scale | Standard Deviation 11 |
Primary
Intention to Report Child and Adolescent Abuse and Neglect
This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment. It comprises eight simulated child abuse scenarios, with participants rating their intention to report each case on an 11-point scale ranging from 0 (no intention to report) to 10 (definite intention to report). The total possible score is 80, with higher scores indicating a stronger and more consistent intention to report suspected CAN cases.
Time frame: Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chatbot-facilitated Education Group | Intention to Report Child and Adolescent Abuse and Neglect | Pre-test | 60.77 score on a scale | Standard Deviation 10.11 |
| Chatbot-facilitated Education Group | Intention to Report Child and Adolescent Abuse and Neglect | Post-test 1 | 71.07 score on a scale | Standard Deviation 6.51 |
| Chatbot-facilitated Education Group | Intention to Report Child and Adolescent Abuse and Neglect | Post-test 2 | 69.34 score on a scale | Standard Deviation 11.77 |
| Lecture-based Teaching Group | Intention to Report Child and Adolescent Abuse and Neglect | Pre-test | 61.56 score on a scale | Standard Deviation 10.41 |
| Lecture-based Teaching Group | Intention to Report Child and Adolescent Abuse and Neglect | Post-test 1 | 68.29 score on a scale | Standard Deviation 8.91 |
| Lecture-based Teaching Group | Intention to Report Child and Adolescent Abuse and Neglect | Post-test 2 | 68.73 score on a scale | Standard Deviation 8.81 |
Primary
Knowledge About Child and Adolescent Abuse and Neglect
This subscale is part of the Child and Adolescent Abuse and Neglect (CAN) Competency Assessment and includes 13 true-false items. Participants are instructed to respond with true, false, or don't know for each statement. Correct responses receive one point, while incorrect or don't know responses receive zero. The total possible score is 13, with higher scores indicating greater knowledge of CAN and its relevant legal framework.
Time frame: Pre-test (before the course), Post-test 1 (one week after), Post-test 2(four weeks after).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Chatbot-facilitated Education Group | Knowledge About Child and Adolescent Abuse and Neglect | Pre-test | 7.95 score on a scale | Standard Deviation 2.12 |
| Chatbot-facilitated Education Group | Knowledge About Child and Adolescent Abuse and Neglect | Post-test 1 | 9.66 score on a scale | Standard Deviation 1.7 |
| Chatbot-facilitated Education Group | Knowledge About Child and Adolescent Abuse and Neglect | Post-test 2 | 9.32 score on a scale | Standard Deviation 1.89 |
| Lecture-based Teaching Group | Knowledge About Child and Adolescent Abuse and Neglect | Pre-test | 8.75 score on a scale | Standard Deviation 1.79 |
| Lecture-based Teaching Group | Knowledge About Child and Adolescent Abuse and Neglect | Post-test 1 | 9.52 score on a scale | Standard Deviation 1.86 |
| Lecture-based Teaching Group | Knowledge About Child and Adolescent Abuse and Neglect | Post-test 2 | 9.29 score on a scale | Standard Deviation 2.06 |