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Dementia prevention through the reduction of modifiable risk factors is gaining attention as a public health strategy. However, public knowledge of dementia risk and protective factors remains low. Web-based education offers a potential solution to raise awareness and promote risk-reduction behaviors. This randomized controlled trial evaluated the effectiveness of DementiaRisk.ca, an internet-based multimedia educational intervention, in increasing knowledge of dementia risk factors, intentions to engage in risk reduction behaviors, and changes in health behaviors. A 2-arm randomized controlled trial was conducted with 510 participants (265 in the intervention group and 245 in the control group). Participants were randomized to receive either the e-learning about dementia risk and promoting brain health, which included a multimedia lesson and microlearning emails, or a control intervention focused on mild cognitive impairment. Outcomes included knowledge of dementia risk factors, intentions to engage in risk reduction, and health behaviors, measured at baseline (T1), 4 weeks (T2), and 2 months postintervention (T3). Outcomes were analyzed using linear mixed effects models with fixed effects for group, time, and their interaction, and a random intercept for participants. Of the 510 randomized participants, 405 (79.4%) completed all intervention components. Participants were predominantly female (n=309, 60.6%) and aged 55 years or older (n=284, 55.7%). Baseline mean dementia knowledge scores were 17.0 (SD 5.5) in the intervention group and 17.4 (SD 6.0) in the control group. At T2, scores increased to 25.8 (SD 4.5) and 23.6 (SD 5.1), respectively, yielding a between-group difference of 2.2 points (95% CI 1.2-3.2; P<.001), which was sustained at T3. Both groups showed significant improvements in knowledge, intentions, and health behaviors over time, with larger knowledge gains in the intervention group and particularly among participants with lower educational attainment. Intentions to engage in dementia risk reduction improved in both groups at T2 (intervention: +1.0, 95% CI 0.2-1.8; control: +1.4, 95% CI 0.5-2.3), with no significant between-group difference. Self-reported physical activity increased from 31.7 (SD 25.0) to 38.6 (SD 27.5) in the intervention group and from 29.9 (SD 23.5) to 32.5 (SD 26.6) in the control group, with a between-group difference of 5.4 points at T2 (95% CI 0.3-10.5; P=.04). No significant between-group differences were observed for diet, alcohol use, or other health behaviors. Qualitative findings indicated that participants valued the intervention for improving awareness of dementia risk factors, motivating proactive lifestyle changes, and enhancing confidence in applying prevention information. This internet-based dementia risk reduction e-learning program improved dementia-related knowledge and increased self-reported physical activity, particularly among participants with lower educational attainment. Effects on other health behaviors were limited. These findings support the use of well-designed e-learning as a scalable public health strategy to strengthen dementia risk reduction literacy and encourage selected healthy behaviors.

Background Providing training to school personnel on how to prevent, recognize, and manage anaphylaxis is critical. Asynchronous e-learning (where instructional material is available on-demand) may be well-suited to help with the implementation, scale, and dissemination of this training. In this paper, we report on the design, pilot testing, widespread implementation, and evaluation of an online course for school personnel. Methods Best practices in evidence-based instructional design for e-learning were incorporated into the course. Content was based on consensus guidelines and reviewed by experts. Initial pilot testing demonstrated large gains in post-course knowledge and self-confidence, as well as several suggestions for improvement. A website was developed to facilitate self-enrolment and delivery of the course modules in 2015 and has since been freely available. Results From 2015 to 2022 there have been over 170,000 course completions, with over one quarter of users completing the course more than once. Most completions occur at the start of the school year in the month of September. The median time to completion was about 25–30 min. Post-course participant self-reported confidence with epinephrine auto-injectors (EAIs) and emergency management of anaphylaxis was very high, and over 95% of participants would recommend the course to others. The average score on the 10-item post-course quiz was 9.05, with a pass rate of over 95%. Conclusions The AllergyAware e-learning course for school personnel is highly satisfactory to users, with high post-course quiz performance and self-reported confidence in anaphylaxis management. It provides a scalable and accessible approach to training school personnel on this critical topic. Future research is needed to assess participants’ application of knowledge in real-world settings. Trial registry The Hamilton Integrated Research Ethics Board reviewed the study protocol and granted exemption from full review per their review process, as this was considered a quality improvement initiative.

Objective The objective of this study was to evaluate the online component of a blended curriculum for psychiatry residents on the use of electroconvulsive therapy (ECT) to treat depression in older adults. Methods Second- and third-year general psychiatry residents completed a blended learning curriculum during their core geriatric psychiatry rotation. The curriculum consisted of didactic seminars, hands-on clinical management, and two online clinical cases focused on the management of late-life depression with ECT. Knowledge acquisition following module completion was measured using a nine-question multiple-choice test. The authors adapted the Medical E-Learning Evaluation Survey (MEES) to measure resident satisfaction, clinical relevance, and instructional design. Results A total of 37 residents completed both online modules. Of these, 35 residents completed the knowledge test and 23 completed the adapted MEES. Almost all participants (96%) agreed or strongly agreed that the modules were relevant to their clinical work, evidence-based, able to be completed in a reasonable amount of time, and a valuable learning experience. The average score on the knowledge test, after removing one outlier, was 83%. Conclusion Psychiatry residents are very satisfied with the content and delivery of the online component of a blended curriculum for understanding the use of ECT for late-life depression. Future work should examine satisfaction with the remainder of the curricula as well as the impact on longer-term knowledge acquisition and patient care.

Background/Objectives: Delirium, an acute cognitive disturbance, is often unrecognized by family or friend care partners, contributing to delayed interventions and negative health outcomes. UnderstandingDelirium.ca is an e-learning lesson developed to address this gap by improving delirium knowledge among the public, patients, and family/friend care partners. Our objective was to evaluate the acceptability, intention to use, and perceived impact of Understanding Delirium e-learning among public users. Methods: A convergent mixed-methods observational evaluation combining survey-based quantitative data and thematic analysis was conducted. The survey included the Net Promoter Score (NPS), the short-form Information Assessment Method for patients and consumers (IAM4all-SF), and an open-text feedback item. Descriptive statistics were used to summarize IAM4all-SF responses, assessing perceived relevance, understandability, intended use, and anticipated benefit. Open-text comments were analyzed thematically by two independent reviewers who reached consensus through discussion. Subgroup analysis of qualitative themes was performed by age, gender, and NPS category. Results: Among 629 survey respondents, over 90% of respondents agreed that the lesson was relevant, understandable, likely to be used, and beneficial. The NPS was rated ‘excellent’ (score of 71), and lesson uptake included over 7000 unique users with a 35% completion rate. Qualitative analysis revealed themes of high educational value, emotional resonance, and perceived gaps in prior healthcare communication. Respondents emphasized the lesson’s clarity, intent to share, and potential for wider dissemination. Conclusions: UnderstandingDelirium.ca is a promising, guideline-aligned digital intervention that has potential to enhance delirium literacy and reduce care partner distress. Findings suggest that the Understanding Delirium e-learning can effectively improve public delirium literacy and should be integrated into care partner and clinical workflows.

Background: Generative artificial intelligence (AI) tools including ChatGPT have the potential to augment the process of designing examinations and assessments for medical learners, leading to time and resource savings, and the ability to produce large volumes of practice problems tailored to learner-specific strengths and weaknesses. Methods: This study compares the quality of free-text assessment problems and answer keys generated by ChatGPT to those produced by faculty educators for a renal and hematology curriculum subunit. Five expert reviewers reviewed a collection of 21 free-text assessment problems, 9 from a collection of historical assessment problems used in an undergraduate medical program and 12 produced with ChatGPT. Reviewers assigned a score from 1 to 5, reflecting the overall quality. Results: The average quality of problems generated by ChatGPT was greater than that of human-generated problems (4.00 vs. 2.71, p < 0.001). Using ordinal mixed-effect modeling, human-generated problems had significantly lower odds of receiving higher ratings than ChatGPT-generated problems (β = −2.43, 95% confidence interval −3.34 to −1.51, p < 0.001). Conclusions: It is suggested that ChatGPT can assist expert faculty educators in producing assessment tools, with direct benefits to medical learners, although it cannot entirely replace this role in its current state.

Personal support workers (PSWs) are often expected to provide ongoing support for complex conditions and have identified an increased need for training in several areas, including dementia and mental health. Web-based interventions may be helpful complements to traditional in-person continuing education and training, but their effectiveness must be explored further. This study's objective was to evaluate the usability, usefulness, satisfaction with, and effectiveness of the web-based Dementia Foundations Program among unregulated care providers who provide care to persons living with dementia or are in training. A cohort of 50 PSWs, PSW trainees, and paid care companions from 3 recruitment sites were invited to access the Dementia Foundations Program, a 4-hour self-paced web-based program composed of 4 courses, for up to 6 weeks. Usability, usefulness, and satisfaction were assessed using surveys after each course and following the program. Dementia knowledge and attitudes were measured using the Dementia Knowledge Assessment Scale and the Dementia Attitudes Scale, with differences between baseline and postprogram scores analyzed using repeated measures ANOVA. Participants reported high levels of satisfaction with the program. Of the 50 participants, 46 (92%) agreed that the web-based training met their expectations, 47 (94%) agreed that the training covered a broad range of topics and was not missing any important content, and 49 (98%) agreed that the web-based training would benefit them. There was a significant postprogram improvement in dementia knowledge as measured by the Dementia Knowledge Assessment Scale, with an average 30% improvement across all cohorts. Dementia Attitudes Scale scores were also significantly improved postprogram across all cohorts. This pilot study in PSWs, PSW trainees, and unregulated care companions demonstrated high satisfaction levels with the web-based Dementia Foundations Program. There were substantial improvements in knowledge and small improvements in attitudes for participants, and it was perceived as a useful tool that complemented their existing education and training. The Dementia Foundations Program is a user-friendly and effective e-learning program, which can be conveniently scaled and spread to enhance unregulated care provider dementia education.

OBJECTIVES ChatGPT is an artificial intelligence model that can interpret free-text prompts and return detailed, human-like responses across a wide domain of subjects. This study evaluated the extent of the threat posed by ChatGPT to the validity of short-answer assessment problems used to examine pre-clerkship medical students in our undergraduate medical education program. METHODS Forty problems used in prior student assessments were retrieved and stratified by levels of Bloom's Taxonomy. Thirty of these problems were submitted to ChatGPT-3.5. For the remaining 10 problems, we retrieved past minimally passing student responses. Six tutors graded each of the 40 responses. Comparison of performance between student-generated and ChatGPT-generated answers aggregated as a whole and grouped by Bloom's levels of cognitive reasoning, was done using t-tests, ANOVA, Cronbach's alpha, and Cohen's d. Scores for ChatGPT-generated responses were also compared to historical class average performance. RESULTS ChatGPT-generated responses received a mean score of 3.29 out of 5 (n = 30, 95% CI 2.93-3.65) compared to 2.38 for a group of students meeting minimum passing marks (n = 10, 95% CI 1.94-2.82), representing higher performance (P = .008, η2 = 0.169), but was outperformed by historical class average scores on the same 30 problems (mean 3.67, P = .018) when including all past responses regardless of student performance level. There was no statistically significant trend in performance across domains of Bloom's Taxonomy. CONCLUSION While ChatGPT was able to pass short answer assessment problems spanning the pre-clerkship curriculum, it outperformed only underperforming students. We remark that tutors in several cases were convinced that ChatGPT-produced responses were produced by students. Risks to assessment validity include uncertainty in identifying struggling students and inability to intervene in a timely manner. The performance of ChatGPT on problems requiring increasing demands of cognitive reasoning warrants further research.

Background Many cancers are preventable through lifestyle modification; however, few adults engage in behaviors that are in line with cancer prevention guidelines. This may be partly due to the mixed messages on effective cancer prevention strategies in popular media. The goal of the McMaster Optimal Aging Portal (the Portal) is to increase access to trustworthy health information. The purpose of this study was to explore if and how knowledge translation strategies to disseminate cancer prevention evidence using the Portal influence participants’ knowledge, intentions and health behaviors related to cancer risk. Methods Adults ≥40 years old, with no cancer history were randomized to a 12-week intervention (weekly emails and social media posts) or control group. Quantitative data on knowledge, intentions and behaviors (physical activity, diet, alcohol consumption and use of tobacco products) were collected at baseline, end of study and 3 months later. Participant engagement was assessed using Google Analytics, and participant satisfaction through open-ended survey questions and semi-structured interviews. Results Participants ( n  = 557, mean age 64.9) were predominantly retired (72%) females (81%). Knowledge of cancer prevention guidelines was higher in the intervention group at end of study only (+ 0.3, p  = 0.01). Intentions to follow cancer prevention guidelines increased in both groups, with no between-group differences. Intervention participants reported greater light-intensity physical activity at end of study (+ 0.7 vs. 0.1, p  = 0.03), and reduced alcohol intake at follow u (− 0.2 vs. + 0.3, p  < 0.05), but no other between-group differences were found. Overall satisfaction with the Portal and intervention materials was high. Conclusions Dissemination of evidence-based cancer prevention information through the Portal results in small increases in knowledge of risk-reduction strategies and with little to no impact on self-reported health behaviours, except in particular groups. Further tailoring of knowledge translation strategies may be needed to see more meaningful change in knowledge and health behaviours. Trial registration ClinicalTrials.gov NCT03186703 , June 14, 2017.

The prevalence of dementia is increasing in Canada and in many countries internationally. People living with dementia are highly dependent on family and friend care partners, who may have little knowledge of the disorder. Web-based interventions in dementia have been shown to improve care partner mental health and reduce burden, but few have been widely implemented or rigorously studied. We developed a web- and email-based dementia education platform for care partners, iGeriCare, which includes 12 asynchronous, multimedia, e-learning lessons and email-based content to reinforce the learning. The primary objective of this pilot study is to evaluate the feasibility and care partner acceptance of the intervention, including study methods. Secondary objectives will examine the effectiveness of the educational resources on family care partners' knowledge, self-efficacy, and sense of burden. This study is a 2-arm, pilot, feasibility, randomized controlled trial. A total of 125 family or friend care partners for a person living with dementia-who are residing in Canada, aged 16+ years, and comfortable using the internet and email-will be recruited using coinvestigator networks and Facebook digital marketing advertisements. Participants will be randomly assigned to either the intervention group (receiving the dementia web- and email-based educational intervention) or the control group (receiving an alternate topic e-learning lesson and emails) and will have 8 weeks to complete baseline surveys and the assigned e-learning. After 8 weeks, participants will have 2 weeks to complete poststudy surveys. This protocol will be repeated with a second cohort of 100 care partners recruited from a paid panel service based on learnings from initial feasibility results. Initial recruitment began on September 6, 2022, and concluded on October 2, 2022. A total of 125 participants were randomly assigned to the intervention (n=61) or control (n=64) group. Data collection concluded in January 2023. Preliminary feasibility results showed a substantial number of participants who did not engage with the protocol as intended. A decision was made to recruit a second cohort of participants to address these protocol deviations. Secondary recruitment began on June 12, 2023, and concluded on June 27, 2023. A total of 100 participants were randomly assigned to the intervention (n=53) or control (n=47) group. Data collection concluded in September 2023. Further results will be published in peer-reviewed journals and presented at conferences. This study is investigating the feasibility, acceptability, and effectiveness of a web- and email-based dementia care partner educational intervention. The results of this study will contribute to the planning of a larger randomized controlled trial in the future, as well as the evaluation of innovative, cost-effective, and efficient dementia care partner resources that can complement traditional approaches. ClinicalTrials.gov NCT05114187; https://clinicaltrials.gov/study/NCT05114187. DERR1-10.2196/67048.

Research has shown that engaging in a range of healthy lifestyles or behavioral factors can help reduce the risk of developing dementia. Improved knowledge of modifiable risk factors for dementia may help engage people to reduce their risk, with beneficial impacts on individual and public health. Moreover, many guidelines emphasize the importance of providing education and web-based resources for dementia prevention. Internet-based interventions may be effective, but few have been studied rigorously or widely disseminated. We created DementiaRisk, an award-winning, web- and email-based education platform for the public focused on modifiable risk factors, featuring multimedia e-learning and email \"microlearning\" content, to help raise awareness and improve knowledge of actions to reduce dementia risk. This protocol describes a randomized controlled trial to (1) evaluate whether exposure to DementiaRisk changes knowledge of dementia risk factors, intention to engage in risk reduction activities, and health behaviors related to dementia risk reduction and to (2) explore qualitative aspects including participants' engagement and satisfaction with the intervention and barriers and facilitators to use. Using a sequential explanatory mixed methods design, this study conducts a quantitative analysis followed by a qualitative inquiry to evaluate outcomes and feasibility. In total, 485 participants will be recruited on the web and randomly assigned to 2 groups: one accessing DementiaRisk and the other receiving alternative e-learning on mild cognitive impairment. Assessments will be delivered on the web at baseline (T1), at 4 weeks (T2), and at 2 months after the intervention (T3). Knowledge will be assessed using items from the Dementia Knowledge Assessment Scale, intentions to engage in risk reduction activities will be assessed using items in line with current evidence, and health behaviors related to dementia risk reduction will be assessed using items from the Godin-Shephard Leisure Time Physical Activity Questionnaire along with additional questions related to a range of health status domains. Outcomes and feasibility will be assessed using the Information Assessment Method for patients and consumers. A linear mixed effects model will be used to examine the relationship between each outcome score by group and time point. This study was approved by the Hamilton Integrated Research Ethics Board on August 24, 2022 (project ID 14886) and received funding in February 2023. Recruitment took place from March 28, 2023, to April 28, 2023, with the final participants completing the intervention by August 18, 2023. Analyses and interpretation of data are ongoing. DementiaRisk is a readily scalable, technology-enhanced solution for dementia prevention education. It has been designed using evidence-based principles of multimedia learning. It has the potential to scale and spread widely using the open internet, so it may be able to reach a wider audience than traditional in-person educational interventions. ClinicalTrials.gov NCT05383118; https://clinicaltrials.gov/study/NCT05383118. DERR1-10.2196/64718.