Generalizing findings from a randomized controlled trial to a real-world study of the iLookOut, an online education program to improve early childhood care and education providers’ knowledge and attitudes about reporting child maltreatment

Autoři: Chengwu Yang aff001;  Carlo Panlilio aff002;  Nicole Verdiglione aff003;  Erik B. Lehman aff004;  Robert M. Hamm aff005;  Richard Fiene aff006;  Sarah Dore aff003;  David E. Bard aff008;  Breanna Grable aff006;  Benjamin Levi aff009
Působiště autorů: Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York City, New York, United States of America aff001;  Department of Educational Psychology, Counseling and Special Education, Pennsylvania State University, University Park, Hershey, Pennsylvania, United States of America aff002;  Departments of Humanities, Penn State College of Medicine, Hershey, Pennsylvania, United States of America aff003;  Departments of Population Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, United States of America aff004;  Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America aff005;  Departments of Psychology & Human Development Research Center, Pennsylvania State University, Middletown, Pennsylvania, United States of America aff006;  Research Institute for Key Indicators, Middletown, Pennsylvania, United States of America aff007;  Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America aff008;  Departments of Humanities & Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, United States of America aff009
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article


In recent years, real-world studies (RWS) are gaining increasing interests, because they can generate more realistic and generalizable results than randomized controlled clinical trials (RCT). In 2017, we published a RCT in 741 early childhood care and education providers (CCPs). It is the Phase I of our iLookOut for Child Abuse project (iLookOut), an online, interactive learning module about reporting suspected child maltreatment. That study demonstrated that in a RCT setting, the iLookOut is efficient at improving CCPs’ knowledge of and attitudes towards child maltreatment reporting. However, the generalizability of that RCT’s results in a RWS setting remains unknown. To address this question, we design and conduct this large RWS in 11,065 CCPs, which is the Phase II of the iLookOut. We hypothesize replication of the earlier RCT findings, i.e., the iLookOut can improve CCPs’ knowledge of and attitudes toward child maltreatment reporting in a real world setting. In addition, this RWS also explores whether demographic factors affect CCPs’ performance. Results of this RWS confirmed the generalizability of the previous RCT’s results in a real world setting. It yielded similar effect sizes for knowledge and attitudes as were found in the earlier RCT. Cohen’s d for knowledge improvement was 0.95 in that RCT, 0.96 in this RWS; Cohen’s d for attitude improvement was 0.98 in that RCT, 0.80 in this RWS. Also, we found several significant differences in knowledge and attitude improvement with regard to age, race, education, and employment status. In conclusion, iLookOut improves knowledge and attitudes of CCPs about child maltreatment prevention and reporting in a real-world setting. The generalizability of the initial RCT findings to this RWS provides strong evidence that the iLookout will be effective in other real world settings. It can be a useful model for other interventions aimed at preventing child maltreatment.

Clinical trial registration for the original RCT: NCT02225301 ( Identifier)

Klíčová slova:

Teachers – Employment – Jobs – Internet – Religion – Randomized controlled trials – Child abuse – Pennsylvania


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