A feasibility randomised controlled trial of patient education videos assessing multimedia design effects on engagement and learning in adolescents with scoliosis

Abstract Multimedia patient education is increasingly used in healthcare, particularly useful in under-resourced settings. While scientific content is well studied, limited research examines how design influences patient engagement. Scoliosis often lacks adequate resources, and integration of multimedia learning principles in this context remains underexplored. Objectives This triple-masked three-armed feasibility parallel randomised controlled trial (RCT) assessed the viability of examining how evidence-informed design principles affect knowledge, engagement, quality of life, anxiety, and physical activity among Irish community-based adolescents with scoliosis. Methods Forty-six participants aged 10–18 were randomised into usual care (UC), standard video education (TRAD), or videos incorporating multimedia learning principles (AUGM). Videos were delivered weekly online over six weeks. Primary outcomes: feasibility of recruitment, intervention adherence, outcome completion, satisfaction and adverse events. Secondary outcomes: knowledge (quizzes), engagement (YouTube analytics), quality of life (EQ-5D-Y-3 L, SRS-22r), anxiety (STAI-Ch), and physical activity (PAQ-Ch)—were evaluated at baseline, post-intervention and week 8. Results Of 112 respondents, 46 participants (mean age 14.8 ± 2.0, 86% female) consented and were randomised (UC: n = 16, AUGM: n = 15, TRAD: n = 15). Baseline completion was 93.5%, weekly adherence ranged from 77 to 97% and follow-up completion was 82.6%. No adverse events occurred. 80% were satisfied with the videos. Knowledge improved by 9% (± 15%) across all groups and improved more when engagement with the videos was higher (p=0.011). Dropouts in the AUGM group were lower (n = 1) vs. the UC or TRAD groups (n = 3 each). Conclusion This feasibility RCT demonstrated successful recruitment, retention, and outcome completion, supporting a fully powered RCT to evaluate multimedia design principles in scoliosis education. Practice implications Delivering an online educational intervention is feasible and expands reach to rural/remote patients with scoliosis and reduce travel burdens. Online education fosters learning, especially for those who engage more on the first viewing. Using evidence-informed design appears to enhance adherence to and reduce dropouts. Graphical Abstract