Effects of an Online Education Program on Physical Therapists' Confidence in Weight Management for People With Osteoarthritis: A Randomized Controlled Trial

Abstract

OBJECTIVE: Evaluate effects of an online education program about weight management for osteoarthritis on physiotherapists' self-reported confidence in knowledge and skills in weight management, and attitudes toward obesity.

METHOD: A two-group randomized controlled trial, 80 physiotherapists (58 female) randomized to education or control groups. The theoretically- and evidence-informed online self-directed training program covered biopsychosocial elements of obesity and weight management. The primary outcome was self-reported confidence in knowledge in weight management using a customised validated tool (scale 14-70, higher scores indicating higher confidence) assessed at baseline and six weeks. Secondary measures included confidence in nutrition care, clinical skills in weight management, and weight stigma. Process measures evaluated participant experience. Differences in change between groups were compared using linear regression models adjusted for baseline scores and stratifying variables (clinical setting; confidence in weight management). Moderation analysis was performed using an interaction approach in a linear regression model and multivariable fractional polynomial interaction approach.

RESULTS: 79 (99%) participants completed outcome measures at six weeks. The education group demonstrated greater improvement in confidence in knowledge than control (adjusted mean-difference (95% confidence intervals) 22.6 units (19.6,25.5). Greater improvement in knowledge was associated with lower baseline values (interaction p-value=0.002). Secondary outcomes showed greater improvements in confidence in skills and nutrition care and in weight stigma domains favouring the education group. Over 90% of participants would recommend the program to peers.

CONCLUSION: An online education program improves physiotherapists' short-term confidence in knowledge and skills in weight management for people with osteoarthritis and reduces weight stigmatized attitudes.