Audiovisual aids in primary healthcare settings’ waiting rooms. A systematic review

Figures & data

Figure 1. Flow chart of manuscripts selection.

Table 1. Principal characteristics of the peer-reviewed articles included in the current review.

Study ID	Practice speciality	Audiovisual aid(s) used in the studies	Topic or general purpose of the study	Aid display	Design, data source	Number of patients	GRADE assessment	Outcome(s) studied	Main results
1-Ashe [13]	Paediatrics	Poster	Antibiotic prescriptions for children with respiratory illnesses	1 month	Historical comparison in doctors’ prescriptions	720	Very low	PP	PP: not SS
2-Assathiany [14]	Paediatrics	None, poster, pamphlet, (TV, videos)	Every educational issue regarding children	Unknown	Survey parents + physicians	1830	Very low	K, U, D, PP	K, U, and D: theme dependant, no significance calculation
3-Stephens [15]	PHC	Poster	Occurrence of patient–physician weight loss conversations	5 days	Quasi-experimental	668	Low	D	D: not SS
4-Eubelen [16]	GP	Videotape recording	Tetanus booster vaccination prescription by the GP	6 months	Quasi-experimental. Local pharmacists	20,109	Moderate/low	HB	HB: increase vaccination prescriptions (0.79% vs 0.39%, P < 0.0001)
5-Frosch [17]	PHC	Videotape recording vs pamphlet	Cancer screening: to enhance autonomous decision-making	Once	Quasi-experimental, separate room, recruited by staff	207	Moderate/low	D, HB, K	D and HB: not SS; K: increase with video vs pamphlet (no significance calculation)
6-Goodman [18]	PCC	Videotape recording	Influenza vaccination of pregnant women	3 months	RCT, separate rooms, interview by phone	105	Moderate	HB, K	HB: not SS (P = 0.70); K increased protection by vaccination (mother difference = 0.49, P = 0.003; baby difference = 0.59, P = 0.001)
7-Myint-U [19]	STD	Videotape recording, poster	Reduce the acquisition of new infections	4 weeks	Survey + staff observation	1096	Low	U	U: interest of the video: 49–85% watched
8-Warner [20]	STD	Videotape recording, poster	Reduce the acquisition of new infections	11 × 4 weeks	RCT; 3 centres, clinical records + local registries	38,635	Moderate	HB, U, K	HB: decrease of encounters for new infection: (HR = 0.91; 95%CI: 0.84–0.99) K, U: increased perception of STD risk
9-Birukila [21]	PHC	Video clip shareable on smartphones via Bluetooth®	Polio vaccination uptake in low literacy communities	Unknown	Staff observation	Unknown	Very low	HB	HB: doubled polio vaccine uptake (no significance calculation)
10-Carlfjord [22]	PHC	Computer	Prevention of alcohol use disorders and sedentariness	1 year	Survey, lifestyle test questionnaire	3027	Low	U	U: interest for 5.7% respondents amongst patients
11-Gerber [23]	GP	Computer	diabetes education targeting individuals with low health literacy levels	1 year	RCT, 5 centres, lifestyle test questionnaire	183	Moderate	HB, K	HB: HbA1c: not SS (–0.2 ± 2.0); K: not SS (0.32 ± 2); U: increase of perceived self-efficacy (1.51 ± 1.5)
12-Gilliam [24]	FPC	Tablet	Promotion of long-acting reversible contraceptive methods in deprived women	Unknown	RCT, tablet vs usual care, questionnaire, review of chart	52 (per-protocol)	Moderate	D, K, U,	D: more discussion with physician (7.1 vs 32.1%, P = 0.02), K: increase for LARCM and U: interest of the message
13-Larsson [25]	PHC	Computer (digital signage technology)	Social marketing message for increasing radon program participation	3 years	Quasi-experimental, 3 centres, crossover: intervention vs usual	99	Low	HB	HB: increase of radon test kit purchase (t = 2.69; 95%CI: 1.20–8.47; P = 0.01) and nutrition programme (χ² = 3.13; P = 0.077).
14-Pawar [26]	OPC	Pamphlets, vdeotape recording, ‘special events’	Educational information on healthy eating, exercising, and smoking cessation	1 year	Survey, staff assisted	79	Very low	HB, K	HB: 13% quit smoking (no significance calculation); K: not SS

GP: general practice; FPC: family planning clinic; LARCM: long-acting reversible contraceptive methods; OPC: outpatients psychiatric clinic; PCC: prenatal care centre; PHC: other primary healthcare service; STD: sexually transmitted disease; SS: statistically significant; RCT: randomized controlled trial; D: discussion with the physician; HB: health behaviour change; K: knowledge improvement; PP: physician prescription change; U: usefulness or interest of the message; HbA1c: glycated haemoglobin.

Ashe D, Patrick PA, Stempel MM, et al. Educational posters to reduce antibiotic use. J Pediatr Health Care. 2006;20:192–197.

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Assathiany R, Kemeny J, Sznajder M, et al. The pediatrician's waiting room: A place for health education? Arch Pediatr. 2005;12:10–15.

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Stephens GS, Blanken SE, Greiner KA, et al. Visual prompt poster for promoting patient-physician conversations on weight loss. Ann Fam Med. 2008;6:(Suppl)S33–S36.

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Eubelen C, Brendel F, Belche J-L, et al. Effect of an audiovisual message for tetanus booster vaccination broadcast in the waiting room. BMC Fam Pract. 2011;12:104.

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Frosch DL, Légaré F, Mangione CM. Using decision aids in community-based primary care: A theory-driven evaluation with ethnically diverse patients. Patient Educ Couns. 2008;73:490–496.

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Goodman K, Mossad SB, Taksler GB, et al. Impact of video education on influenza vaccination in pregnancy. J Reprod Med. 2015;60:471–479.

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Myint UA, Bull S, Greenwood GL, et al. Safe in the city: Developing an effective video-based intervention for STD clinic waiting rooms. Health Promot Pract. 2010;11:408–417.

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Warner L, Klausner JD, Rietmeijer CA, et al. Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics. PLoS Med. 2008;5:e135.

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Birukila G, Babale SM, Epstein H, et al. Reducing resistance to polio immunisation with free health camps and Bluetooth messaging: An update from Kaduna, Northern, Nigeria. Glob. Public Health. 2017;12:19–30.

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Carlfjord S, Nilsen P, Leijon M, et al. Computerized lifestyle intervention in routine primary health care: Evaluation of usage on provider and responder levels. Patient Educ. Couns. 2009;75:238–243.

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Gerber BS, Brodsky IG, Lawless KA, et al. Implementation and evaluation of a low-literacy diabetes education computer multimedia application. Diabetes Care. 2005;28:1574–1580.

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Gilliam ML, Martins SL, Bartlett E, et al. Development and testing of an iOS waiting room ‘app’ for contraceptive counseling in a Title X family planning clinic. Am J Obstet Gynecol. 2014;211:481.e1–488.

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Larsson LS. The Montana Radon Study: Social marketing via digital signage technology for reaching families in the waiting room. Am J Public Health. 2015;105:779–785.

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Pawar D, Mojtabai R, Goldman A, et al. Assessment of response to providing health-related information in a community psychiatry outpatient setting. J Psychiatr Pract. 2016;22:344–347.

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