Evaluating the impact of the Understanding Multiple Sclerosis online course on participant MS knowledge, health literacy, resilience, self-efficacy, quality of life, and MS symptom severity

Background: Little is known about the impact of online health education on multiple sclerosis (MS)-related knowledge and other health outcomes in the MS community. Objectives: To estimate the impact of participating in a massive open online course (MOOC) about MS on course completer MS-related knowledge, health literacy (HL), self-efficacy, resilience, quality of life, and MS symptom severity. Methods: In this cohort study, using a single group pre-test/post-test design (n=560), we examined the effects of MOOC participation on MS-related knowledge and other outcomes using a paired t-test. We used regression and structural equation modelling to examine the association between participant characteristics, changes in other outcomes, and changes in MS-related knowledge. Results: We found significant increases in MS-related knowledge for people living with MS (PwMS) (+2.13 points, p<0.001) and those without MS (+5.16 points, p<0.001), with larger effect sizes for those with higher educational levels. Among PwMS, there were also significant increases in seven HL subscales and self-efficacy, but no increase in resilience, MS symptoms severity or quality of life. Among people without MS, there were increases in two HL subscales and quality of life, but no increase in resilience or self-efficacy. Changes in MS-related knowledge were not associated with sex or changes in other study outcomes. Conclusions: There was a significant increase in MS-related knowledge, which was unrelated to the changes in the other study outcomes, both for PwMS and for those not living with MS. Outcome-specific health educational interventions may be needed to effect change in other health outcomes.