Designing multimedia patient education materials for adolescent idiopathic scoliosis: A protocol for a feasibility randomized controlled trial of patient education videos

the small amount of design recommendations in MSK healthcare are based mostly on litera- ture arising narrative reviews [28–30], non-randomized studies, cross-sectional surveys, or case series [12]. Regardless, there is potential for educational materials to fill a gap where healthcare services are known to be under strain, which can occur due to a lack of resources or rural/remote locations [31]. Under resourcing is found in public healthcare systems for scoliosis, where waitlists can pre- vail for services [32–34], mirroring the dilemma of many musculoskeletal health services. Such services cannot rely on immediate one-to-one clinical encounters to provide education, whether for financial or geographical reasons [35]. Innovation has been required in healthcare to bring information and guidance to patients in these situations, with digital mediums providing such solutions. Scoliosis patients and their families have well-documented information needs [12,36,37] and multimedia education materials offer the advantage of dispersing healthcare infor- mation in a manner that is cheap, en masse [31,38,39], and without physical proximity [40,41]. Rationale Multimedia education has been examined extensively in the pedagogical literature, resulting in recommendations on how to best design materials in order to maximise engagement and learning [13,42] While this information has informed the design of educational materials in healthcare [14–27] this has been less frequent in the MSK literature with only one RCT exam-

ining osteoarthritis-related pain [43], and other MSK conditions being informed by narrative advice only [28–30]. The use of such principles [42] has not been tested in a randomized con- trolled trial of education for a MSK population such as adolescent idiopathic scoliosis. Given the uncertainty surrounding the recruitment of this age bracket from the community and the unknown ability to engage with patient education materials over a trial period, a feasi- bility study is warranted to provide information on the design and implementation of a poten- tial trial. Aims and objectives The aim of the eventual three-armed parallel randomized controlled trial will be to compare the effectiveness of multimedia educational videos with and without evidence-informed design implementation against usual care for patients with adolescent idiopathic scoliosis. It will have an objective to examine if using videos with evidence-informed design results in superior post-treatment, 8 week, and 26 week outcomes for video engagement, knowledge translation and retention, and patient reported outcomes compared to videos formatted to match existing online resources [44] or treatment as usual for this population with AIS. We hypothesise that such an intervention will result in superior outcomes for video engagement, knowledge trans- lation and retention, and for patient reported outcomes. The more immediate aim of this feasibility RCT will be to assess the feasibility of running this trial with the objective of examining the recruiting, the intervention use, the intervention

adherence, and the outcome assessment at baseline and eight weeks. It will be planned and evaluated using the RE-AIM framework [45] in order to optimise reach, effectiveness, adop- tion, implementation, and maintenance and determine the feasibility of this RCT and any aspects that cannot be pragmatically explored in sufficient depth will be explained to avoid shortcomings in reporting that have been previously observed [46–48]. Materials and methods This triple-masked three-armed feasibility parallel randomized controlled trial will be con- ducted in Ireland and is prospectively registered on ClinicalTrials.gov. It was designed in PLOS ONE Multimedia education materials for adolescent idiopathic scoliosis PLOS ONE | https://doi.org/10.1371/journal.pone.0297394 May 23, 2024 2 / 14 Funding: The author(s) received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist.