Janis M Miller1,2, Kieran M Hawthorne3, Lee Park1, Margaret Tolbert1, Katie Bies1, Caroline Garcia1, Ruta Misiunas1, William Newhouse4, Abigail R Smith3. 1. Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA. 2. Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA. 3. Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA. 4. Center for Health Communications Research, University of Michigan, Ann Arbor, Michigan, USA.
Abstract
Purpose: To test a novel bladder health tutorial on use of the Knack for overcoming bladder control challenges. The Knack-tutorial is a self-administered vignette-based instructional program on preempting bladder challenges in daily life (urgency, stress-leakage, or urge-leakage) through anticipatory, well-timed pelvic floor muscle contraction at the moment of challenge. Materials and Methods: This is a randomized controlled trial pilot test of 108 women with stress or mixed urinary incontinence. The Knack-tutorial group saw a 15-minute slide show with 10 vignettes portraying use of the Knack in daily life. The slide show format used inserted narrated videos, dubbed and animation enhanced pictures and cartoons, and automatic slide advancement. A control group saw a similarly constructed slide show on incorporating good diet/exercise habits. Outcomes were self-perceived improvement (yes/no, and as 0%-100%) 1 month after viewing the tutorial. Results: We enrolled 123 women, randomizing 64 to Knack-tutorial group and 59 to diet/exercise tutorial group. Eleven and one participant, respectively, did not return. Three did not fill out the self-perceived improvement report. Significant improvement was reported by 71% in the Knack-tutorial group compared to 25% in the diet/exercise group (p < 0.001). Self-perceived improvement was 21%-22% higher (Model I Est: 21.01, SE: 4.25, p < 0.001) in the Knack-tutorial group. Conclusions: An electronic tutorial viewed independent of a health care provider with vignettes showing Knack application to manage the everyday bladder challenges women face shows benefit of a magnitude that warrants more widespread use and rigorous testing. A professional remake of the intervention is now available (www.myconfidentbladder.com).
RCT Entities:
Purpose: To test a novel bladder health tutorial on use of the Knack for overcoming bladder control challenges. The Knack-tutorial is a self-administered vignette-based instructional program on preempting bladder challenges in daily life (urgency, stress-leakage, or urge-leakage) through anticipatory, well-timed pelvic floor muscle contraction at the moment of challenge. Materials and Methods: This is a randomized controlled trial pilot test of 108 women with stress or mixed urinary incontinence. The Knack-tutorial group saw a 15-minute slide show with 10 vignettes portraying use of the Knack in daily life. The slide show format used inserted narrated videos, dubbed and animation enhanced pictures and cartoons, and automatic slide advancement. A control group saw a similarly constructed slide show on incorporating good diet/exercise habits. Outcomes were self-perceived improvement (yes/no, and as 0%-100%) 1 month after viewing the tutorial. Results: We enrolled 123 women, randomizing 64 to Knack-tutorial group and 59 to diet/exercise tutorial group. Eleven and one participant, respectively, did not return. Three did not fill out the self-perceived improvement report. Significant improvement was reported by 71% in the Knack-tutorial group compared to 25% in the diet/exercise group (p < 0.001). Self-perceived improvement was 21%-22% higher (Model I Est: 21.01, SE: 4.25, p < 0.001) in the Knack-tutorial group. Conclusions: An electronic tutorial viewed independent of a health care provider with vignettes showing Knack application to manage the everyday bladder challenges women face shows benefit of a magnitude that warrants more widespread use and rigorous testing. A professional remake of the intervention is now available (www.myconfidentbladder.com).
Authors: Carolyn M Sampselle; Diane K Newman; Janis M Miller; Keri Kirk; Mary Ann DiCamillo; Todd H Wagner; Trivellor E Raghunathan; Ananias C Diokno Journal: J Urol Date: 2016-12-31 Impact factor: 7.450
Authors: Adélia Lúcio; Christiane Boaventura Lourenço; Benito Pereira Damasceno; Maria Helena Baena de Moraes Lopes; Carlos Arturo Levi Dʼancona Journal: Am J Phys Med Rehabil Date: 2019-04 Impact factor: 2.159
Authors: Janis M Miller; Carolyn Sampselle; James Ashton-Miller; Gwi-Ryung Son Hong; John O L DeLancey Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2008-06
Authors: Patricia S Goode; Kathryn L Burgio; Julie L Locher; David L Roth; Mary G Umlauf; Holly E Richter; R Edward Varner; L Keith Lloyd Journal: JAMA Date: 2003-07-16 Impact factor: 56.272