Research AppraisalRandomised Controlled Trial

Enhancing parental health knowledge through digital knowledge mobilisation tools: a randomised controlled trial and qualitative study

BMJ paediatrics openElliott, Sarah A, Cyrkot, Samantha, Scott, Shannon D et al.22 May 2026DOI

Clinical Snapshot

70CEBM
Evidence: ModerateRandomised Controlled Trial

PICO Framework

P — PopulationParents or legal guardians of children under 5 years across Canada
I — InterventionDigital knowledge mobilisation tools (blogshots) delivering Choosing Wisely Canada recommendations on childhood conditions
C — ComparatorDifferent sets of blogshots on alternative childhood conditions (cross-over design)
O — OutcomesPrimary: change in parental knowledge. Secondary: change in expectations, intentions, actions, and usability of blogshots

Bottom Line

This Canadian RCT demonstrates that digital 'blogshots' can effectively improve parental knowledge about common childhood conditions in the short term, though benefits diminish over time. While the intervention showed statistical significance with a small effect size (d=0.30), the clinical significance remains unclear as actual healthcare behaviours and outcomes were not measured. The study's strength lies in its pragmatic design and scalability potential. However, limitations include lack of participant blinding, short-lived knowledge gains, and absence of clinical outcome data. For Australian practitioners, this suggests digital health education tools may be useful adjuncts to traditional patient education, particularly for addressing common paediatric concerns aligned with Choosing Wisely recommendations. The intervention's low cost and broad applicability make it potentially valuable for health services seeking to improve parental health literacy, though expectations should be tempered by the modest and temporary nature of knowledge improvements observed.

Evidence: Moderate

Key Findings

  • P Value: p < 0.001

  • Effect Size: Cohen's d = 0.30 (small effect size)

  • Primary Outcome: Significant improvement in knowledge scores for topics covered by blogshots at 5-week follow-up

  • Nnt Or Sensitivity: Not calculable from available data

  • Confidence Interval: Not reported in abstract

Clinical Application

Highly feasible given digital delivery method and low resource requirements Relevant to Australian primary care and paediatric practice; could complement existing health education initiatives and align with RACGP patient education guidelines Parents and caregivers of young children seeking reliable health information

Abstract

OBJECTIVE: To assess the effectiveness of blogshots (ie, image-based digital knowledge mobilisation tools) to increase knowledge and manage expectations with respect to six Choosing Wisely Canada (CWC) recommendations about common childhood conditions. DESIGN: Multimethod study including a non-pharmacological randomised controlled trial and qualitative interviews. SETTING: Online questionnaires and semistructured interviews across Canada. PARTICIPANTS: Parents or legal guardians of children under 5 years. INTERVENTION: Participants were randomly allocated to receive one of two sets of blogshots whereby a blogshot on a new CWC topic was delivered weekly over 3 weeks (Group A: pharyngitis (diagnosis), common cold, asthma; Group B: pharyngitis (treatment), bronchiolitis, otitis media). Study investigators were blinded to participant allocation. Baseline and follow-up (week 5, month 3, month 6) questionnaires were administered. Qualitative interviews contextualised intervention data. MAIN OUTCOME MEASURES: The primary outcome was change in knowledge. Secondary outcomes were change in expectations, intentions, actions over time and usability of the blogshots. RESULTS: 167 participants (n=133 (80%) mothers) were included in the final analysis (group A, n=85; group B, n=82). Baseline knowledge scores did not differ between groups. At follow-up 1, those who received the blogshot for a given topic scored significantly higher (p<0.001, d=0.30) on knowledge questionnaires, compared with those that did not. No differences were observed in knowledge scores between groups at follow-up 2 and 3. Participants expressed intentions to use the blogshots (eg, share with friends, physicians), as well as actions (eg, wait/watch approach vs seek healthcare) to manage their child's condition. Qualitative data (n=13 interviews) showed that blogshots are aesthetically pleasing and contain easy to read and understandable information. CONCLUSIONS: Blogshots can be an effective tool to disseminate child health information to parents. Due to the online dissemination, this approach could be scaled to a broader international level and applied to different health topics that are relevant across the world. TRIAL REGISTRATION NUMBER: NCT06005337.

References

  1. 1.Elliott, S. A., Cyrkot, S., Scott, S. D., & Hartling, L. (2026). Enhancing parental health knowledge through digital knowledge mobilisation tools: a randomised controlled trial and qualitative study. BMJ Paediatrics Open. https://doi.org/10.1136/bmjpo-2025-004197
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