Additional Feedback Research Articles

Effective therapeutic components in Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality disorder.

The study aimed to examine the relative contribution to borderline personality disorder (BPD) symptom change of two potential effective therapeutic components in a manualized group psychotherapy (Systems Training for Emotional Predictability and Problem Solving; STEPPS): development of emotional/behavior regulation skills and group alliance. A repeated measures design assessed BPD symptom change over time, use of behavior and emotion regulation skills taught in STEPPS, and perceptions of global alliance within the group. Data were analyzed using hierarchical multiple regression. Additional qualitative feedback was analyzed using quantitative content analysis. Data were collected from 14 STEPPS groups across three NHS Trusts. Forty participants completed the study and were included in the final analysis. Self-reported skill acquisition throughout STEPPS treatment and satisfaction with intragroup relationships at the group midpoint were associated with improvement in BPD symptoms at the end of treatment, once symptoms at the start and mid-point of treatment had been controlled for. These two factors also emerged as the top two factors cited in qualitative feedback to explain subjective improvements observed as a result of STEPPS treatment. This is the first study to investigate and find support for acquisition of emotion and behavior regulation skills in STEPPS and satisfaction with intragroup relationships as potential effective therapeutic components in the treatment. Causal relationships cannot be concluded from this study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Conception And Implementation of an virtual Reality application for the evaluation of different types of commercially available haptic gloves

Abstract Immersion and presence are important aspects of virtual reality (VR). Efforts are therefore being made to enhance these effects in order to increase the impact of VR and its transferability to reality. This is particularly important in research areas such as medical education and psychology. The development of haptic gloves has therefore increased significantly in recent years. These are immersive input devices designed to make virtual objects tangible. However, the research field is still very new and there is insufficient research on their handling and effect. For this reason, an application was developed to compare different haptic data gloves with different haptic technologies. A glove with vibrotactile feedback (Manus Prime X Haptic VR) and a glove with additional force feedback (SenseGlove) were used and compared in multiple tasks. These include finger tracking and gesture recognition, as well as hand tracking and the behaviour of gloves when grasping objects with and without haptics. The aim is to determine how well the haptics could be integrated and which is more accepted by the test subjects. For this purpose, a questionnaire has been designed to evaluate the effect of the haptic gloves on users. It aims to get a first impression of the tactile gloves available on the market and to advance research in the area.

Robust Speed Control of Uncertain Two-Mass System

The main purpose of this work is to present a robust speed control structure for a two-mass system. The tested system consists of a PI controller with two additional feedback. The coefficients of the control system are selected using a pattern-search optimization method in order to obtain robustness to changes in the system parameters. The control system requires information about non-measurable state variables. For this purpose, it is proposed to use a multilayer observer. In order to show the advantages of the MLO system, this article also presents comparative studies with a classical observer. A number of simulation and experimental tests are carried out. The obtained results confirmed a much higher quality of control in the system cooperating with a multilayer observer compared to the system with a classical observer.

Bioinspired preactivation reflex increases robustness of walking on rough terrain

Walking on unknown and rough terrain is challenging for (bipedal) robots, while humans naturally cope with perturbations. Therefore, human strategies serve as an excellent inspiration to improve the robustness of robotic systems. Neuromusculoskeletal (NMS) models provide the necessary interface for the validation and transfer of human control strategies. Reflexes play a crucial part during normal locomotion and especially in the face of perturbations, and provide a simple, transferable, and bio-inspired control scheme. Current reflex-based NMS models are not robust to unexpected perturbations. Therefore, in this work, we propose a bio-inspired improvement of a widely used NMS walking model. In humans, different muscles show an increase in activation in anticipation of the landing at the end of the swing phase. This preactivation is not integrated in the used reflex-based walking model. We integrate this activation by adding an additional feedback loop and show that the landing is adapted and the robustness to unexpected step-down perturbations is markedly improved (from 3 to 10 cm). Scrutinizing the effect, we find that the stabilizing effect is caused by changed knee kinematics. Preactivation, therefore, acts as an accommodation strategy to cope with unexpected step-down perturbations, not requiring any detection of the perturbation. Our results indicate that such preactivation can potentially enable a bipedal system to react adequately to upcoming unexpected perturbations and is hence an effective adaptation of reflexes to cope with rough terrain. Preactivation can be ported to robots by leveraging the reflex-control scheme and improves the robustness to step-down perturbation without the need to detect the perturbation. Alternatively, the stabilizing mechanism can also be added in an anticipatory fashion by applying an additional knee torque to the contralateral knee.

An Enhanced Feedback Adaptive Observer for Nonlinear Systems With Lack of Persistency of Excitation

The design of exponentially convergent adaptive observers is addressed for linear observable systems which are perturbed by linearly parameterized nonlinearities depending on measured signals (inputs and outputs). When there is a lack of persistency of excitation a new robust adaptive observer is presented which performs an additional feedback depending on the kernel of the Gramian of the regressor matrix, which is computed online, and generates state variables estimates whose estimation errors are exponentially convergent to zero, provided that a design parameter is chosen to be sufficiently small. The boundedness of the parameter and observer estimation errors is always guaranteed. Parameter estimates do not converge to their true values unless the regressor matrix is persistently exciting (i.e. the Gramian of the regressor matrix is nonsingular): in this case, a well-known exponentially convergent adaptive observer is reobtained, since the additional feedback is zero.

Textile-based Wearable to Monitor Heart Activity in Paediatric Population: A Pilot Study.

Cardiac monitoring for children with heart disease still employs common clinical techniques that require visits to hospital either in an ambulatory or inpatient setting. Frequent cardiac monitoring, such as heart rate monitoring, can limit children's physical activity and quality of life. The main objective of this study is to evaluate the performance of a textile-based device (SKIIN) in measuring heart rate (HR) in different tasks: lying down, sitting, standing, exercising, and cooling down. Twenty participants including healthy children and children with heart disease were included in this study. The difference between the HRs recorded by the SKIIN was compared with a reference electrocardiogram collection by normalized root mean squared error. Participants completed a questionnaire on their experience wearing the textile device with additional parental feedback on the textile device collected. Participants had the median age of 14 years (range: 10-17 years), with body mass index 23.1 ± 3.8 kg/m2 and body surface area 1.70 ± 0.25 m2. The HR recorded by SKIIN and reference system significantly changes between tasks (P < 0.001), while not significantly different from each other (P > 0.05). The normalized root mean squared error was 3.8% ± 3.0% and 3.6% ± 3.7% for healthy and the heart disease groups, respectively. All participants found the textile device non-irritating and easy to wear. This study provides proof of concept that HR can be robustly and conveniently monitored by smart textiles, with similar accuracy to standard-of-care devices.

Unstable confocal resonator with external flat semi-transparent mirror for additional feedback

Main characteristics (mode structure of power loss, divergence of resonant radiation) of a three-mirror laser cavity with additional feedback are theoretically studied in the Fresnel approximation on the basis of the Fox-Lee integral equation. The resonator consists of two spherical mirrors, which form an unstable confocal resonator, and a flat semi-transparent mirror, which is installed outside the reference unstable resonator perpendicular to its optical axis. The flat coupling mirror returns part of the radiation back inside the resonator. The level of additional feedback is determined by the reflection coefficient of the flat mirror and the position of the mirror along the optical axis of the resonator. Variation of these parameters makes it possible to control the transparency of the three-mirror resonator over a wide range, up to values close to zero. Results of this paper can be used in the development of high-power lasers with wide aperture (Fresnel numbers of ∼100) on the basis of low-gain active media.

Applying RE-AIM to evaluations of Veterans Health Administration Enterprise-Wide Initiatives: lessons learned.

The United States Veterans Health Administration (VHA) Office of Rural Health funds Enterprise-Wide Initiatives (system-wide initiatives) to spread promising practices to rural Veterans. The Office requires that evaluations of Enterprise-Wide Initiatives use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. This presents a unique opportunity to understand the experience of using RE-AIM across a series of evaluations. The authors conducted a study to document the benefits and pitfalls of using RE-AIM, capture the variety of ways that the team captured the elements of RE-AIM, and develop recommendations for the future use of RE-AIM in evaluation. The authors first conducted a document review to capture pre-existing information about how RE-AIM was used. They subsequently facilitated two focus groups to gather more detailed information from team members who had used RE-AIM. Finally, they used member-checking throughout the writing process to ensure accurate data representation and interpretation and to gather additional feedback. Four themes emerged from the document review, focus groups, and member checking. RE-AIM: provides parameters and controls the evaluation scope, "buckets" are logical, plays well with other frameworks, and can foster collaboration or silo within a team. Challenges and attributes for each RE-AIM dimension were also described. Overall, participants reported both strengths and challenges to using RE-AIM as an evaluation framework. The overarching theme around the challenges with RE-AIM dimensions was the importance of context. Many of these benefits and challenges of using RE-AIM may not be unique to RE-AIM and would likely occur when using any prescribed framework. The participants reported on the RE-AIM domains in a variety of ways in their evaluation reports and were not always able capture data as originally planned. Recommendations included: start with an evaluation framework (or frameworks) and revisit it throughout the evaluation, consider applying RE-AIM PRISM (Practical Robust Implementation Framework) to gain a broader perspective, and intentionally integrate quantitative and qualitative team members, regardless of the framework used.

Starting a conversation about estimands with public partners involved in clinical trials: a co-developed tool

BackgroundClinical trials aim to draw conclusions about the effects of treatments, but a trial can address many different potential questions. For example, does the treatment work well for patients who take it as prescribed? Or does it work regardless of whether patients take it exactly as prescribed? Since different questions can lead to different conclusions on treatment benefit, it is important to clearly understand what treatment effect a trial aims to investigate—this is called the ‘estimand’. Using estimands helps to ensure trials are designed and analysed to answer the questions of interest to different stakeholders, including patients and public. However, there is uncertainty about whether patients and public would like to be involved in defining estimands and how to do so. Public partners are patients and/or members of the public who are part of, or advise, the research team. We aimed to (i) co-develop a tool with public partners that helps explain what an estimand is and (ii) explore public partner’s perspectives on the importance of discussing estimands during trial design.MethodsAn online consultation meeting was held with 5 public partners of mixed age, gender and ethnicities, from various regions of the UK. Public partner opinions were collected and a practical tool describing estimands, drafted before the meeting by the research team, was developed. Afterwards, the tool was refined, and additional feedback sought via email.ResultsPublic partners want to be involved in estimand discussions. They found an introductory tool, to be presented and described to them by a researcher, helpful for starting a discussion about estimands in a trial design context. They recommended storytelling, analogies and visual aids within the tool. Four topics related to public partners’ involvement in defining estimands were identified: (i) the importance of addressing questions that are relevant to patients and public in trials, (ii) involving public partners early on, (iii) a need for education and communication for all stakeholders and (iv) public partners and researchers working together.ConclusionsWe co-developed a tool for researchers and public partners to use to facilitate the involvement of public partners in estimand discussions.

Sensor-based augmented visual feedback for coordination training in healthy adults: a scoping review.

Recent advances in sensor technology demonstrate the potential to enhance training regimes with sensor-based augmented visual feedback training systems for complex movement tasks in sports. Sensorimotor learning requires feedback that guides the learning process towards an optimal solution for the task to be learned, while considering relevant aspects of the individual control system-a process that can be summarized as learning or improving coordination. Sensorimotor learning can be fostered significantly by coaches or therapists providing additional external feedback, which can be incorporated very effectively into the sensorimotor learning process when chosen carefully and administered well. Sensor technology can complement existing measures and therefore improve the feedback provided by the coach or therapist. Ultimately, this sensor technology constitutes a means for autonomous training by giving augmented feedback based on physiological, kinetic, or kinematic data, both in real-time and after training. This requires that the key aspects of feedback administration that prevent excessive guidance can also be successfully automated and incorporated into such electronic devices. After setting the stage from a computational perspective on motor control and learning, we provided a scoping review of the findings on sensor-based augmented visual feedback in complex sensorimotor tasks occurring in sports-related settings. To increase homogeneity and comparability of the results, we excluded studies focusing on modalities other than visual feedback and employed strict inclusion criteria regarding movement task complexity and health status of participants. We reviewed 26 studies that investigated visual feedback in training regimes involving healthy adults aged 18-65. We extracted relevant data regarding the chosen feedback and intervention designs, measured outcomes, and summarized recommendations from the literature. Based on these findings and the theoretical background on motor learning, we compiled a set of considerations and recommendations for the development and evaluation of future sensor-based augmented feedback systems in the interim. However, high heterogeneity and high risk of bias prevent a meaningful statistical synthesis for an evidence-based feedback design guidance. Stronger study design and reporting guidelines are necessary for future research in the context of complex skill acquisition.

Arabic Teaching Efficacy Model (ATEM): A Language Teaching Model Design

This study investigates the role of self-efficacy (S-e) in teaching Arabic and proposes a model for teaching that encompasses teaching goals, materials, and strategies. The study draws on Bandura's scientific works and other studies that develop S-e theory. The model is developed based on the characteristics of the materials that promote the growth of S-e in students, using three different methods. The resulting Arabic Teaching Efficacy Model (ATEM) improves objective thinking, critical thinking, responsiveness, and student persistence through active mastery experiences, vicarious experiences, verbal persuasion from others, social recognition, and reinforcement of physiological and affective aspects. ATEM recommends themes such as Science and technology, What do you think?, I can speak arabic, I speak arabic every day, What is your experience?, Other people's experiences, and Respect for others as teaching materials. Additionally, ATEM suggests teaching strategies such as social modeling, social persuasion, additional feedback, and group work.

Analysis, description and assessment of the regional public administration system using a task-specific feedback control model

Subject. This article discusses the problem of people's trust in authorities in the regions of Russia. Objectives. The article aims to analyze regional legal acts regulating the cooperation of authorities and the population. Methods. For the study, we used the methods of mathematical analysis. Results. The article proposes a methodology for evaluating a strategic planning document, which involves the selection of signals of setting, comparing, computing, actuating or measuring devices. It represents the reconstruction of a single control loop of the selected object, as well as additional control objects and feedback loops. Conclusions. The implementation of formalized management models in the process of developing programmes for the strategic development of regions will improve the effectiveness of purposeful activities.

Strategic Combination of Theory, Plain Language, and Trusted Messengers Contribute to COVID-19 Vaccine Uptake: Lessons Learned from Development and Dissemination of a Community Toolkit.

Widely accepted practices for the development of health education materials include the use of theoretically driven content, the execution of plain language writing and design strategies, the solicitation of community input, and a plan for dissemination via trusted messengers. Here, we describe the development of a COVID-19 vaccine education toolkit and share preliminary outcomes from dissemination via community health workers. The toolkit was developed to equip community messengers to educate community members about the COVID-19 vaccine. It includes an easy-to-read workbook for community learners, a Leader Guide with scripting, and additional resources for community health workers and other local messengers. The Health Belief Model was used to select content for the workbook, which was refined with input from community members. A team of trained plain language writers worked with clinicians and subject matter experts to draft content that was deemed readable, understandable, and actionable by formal measures and drafts were further refined with additional community feedback. Survey results from community health workers who used the toolkit to provide local education about COVID-19 vaccines indicate that the toolkit facilitated confidence in their ability to deliver scientific content to their community members. More than two-thirds report that use of the toolkit facilitated community members' decisions to receive COVID-19 vaccines.

Unraveling the Role of (Meta-) Cognitive Functions in Pacing Behavior Development during Adolescence: Planning, Monitoring, and Adaptation.

This study aimed to investigate whether (meta-) cognitive functions underpin the development of the self-regulated distribution of effort during exercise (i.e., pacing) throughout adolescence. Participants included 18 adolescents (9 girls, 15.6 ± 2.5 yr old) and 26 adults (13 women, 26.8 ± 3.1 yr old), all recreationally active but unfamiliar with time trial cycling. The (meta-) cognitive functions involved in preexercise planning were quantified by calculating the difference between estimated and actual finish time during a 4-km cycling time trial. The capability to monitor and adapt one's effort distribution during exercise was measured during a 7-min submaximal trial, in which the participants were tasked with adhering to a set submaximal goal velocity either with (0-5 min) or without (5-7 min) additional feedback provided by the researcher. Analyses included between-group comparisons (ANOVA) and within-group comparisons (correlation) ( P < 0.05). Adolescents were less accurate in their estimation of the task duration. The adolescents' overestimation of task duration of the 4-km time trial was accompanied by pacing behavior characteristics resembling a longer trial (i.e., more even power output distribution, lower RPE, more pronounced end-spurt). Contrary to the adults, the adolescents deviated relatively more from the goal velocity during the 7-min submaximal trial, when no additional feedback was provided by the researcher. Within the adolescent group, estimation of task duration accuracy ( r = 0.48) and adherence to goal velocity ( r = 0.59) correlated with age. The (meta-) cognitive functions involved in the preexercise planning and the monitoring and adaptation of the distribution of effort during exercise underpin the development of pacing behavior during adolescence. Feedback from the (social) environment can be used to aid the monitoring and adaptation of effort expenditure in adolescents.

An Active Inductor Based Transimpedance Amplifier with Two Local Feedbacks as a Fiber Optic Application

An important use of active inductor feedback is reported. It was evident that a frequency dependent impedance of an active inductor is similar to that of an ordinary spiral inductor which is a key advantage in integrated circuit design given the fact that Mosfet-based active inductor circuit occupies less volume on board a chip. In this work, a 42 dBΩ transimpedance (TIA) gain at 1 GHz is obtained with 33 𝑝𝐴⁄√𝐻𝑧 of input referred noise with a very low power consumption of 0.605 mW. The Common-Gate Common-Source input stage with an active inductor feedback is reported in this work for the first-time long side a second stage current mirror with additional local active inductor feedback. The extremely low level of power consumption is considered to be another key advantage for that matter despite the moderate levels of TIA gain, bandwidth and input-referred noise current spectral density with 1V DC supply voltage. The LTspice software was used for simulation.

Endometriosis Symptoms and Their Impacts on the Daily Lives of US Women: Results from an Interview Study.

This interview study sought to capture patients' experiences and perceptions of endometriosis symptoms and their impacts on daily life, as described by women in their own words. Using open-ended questions and a concept-elicitation approach, this study assessed the signs and symptoms of endometriosis and their impacts on different aspects of quality of life, including daily activities, functioning, and well-being. This interview study included US women with moderate-to-severe endometriosis-associated pain who completed one of two Phase 3, randomized, double-blind, placebo-controlled trials (SPIRIT 1 or SPIRIT 2; ClinicalTrials.gov identifiers: NCT03204318, NCT03204331). Interviews were conducted via a web/Internet-based video platform or telephone by trained interviewers, using open-ended questions in a concept-elicitation approach, and probes as needed to obtain additional feedback on the burden of endometriosis. Qualitative data from the interviews were analyzed, and emerging concepts were coded by independent coders. Concept saturation was evaluated to determine if all endometriosis-related symptoms and impacts had been described by the sample of women interviewed. Forty women participated in this study. In total, 18 unique symptoms of endometriosis emerged from the interviews; pelvic pain (92.5%), dyspareunia (80.0%), and heavy bleeding (75.0%) were the most commonly reported endometriosis symptoms. A total of 33 unique impacts of endometriosis symptoms were identified across 11 concepts: physical impacts, impacts on activities of daily living, social impacts, sleep impacts, emotional impacts, appearance impacts, financial impacts, sex-related impacts, work/school-related impacts, fertility impacts, and cognitive impacts. Concept saturation was achieved for both symptoms and impacts of endometriosis. This interview study provides substantive qualitative data on the burden of endometriosis, from the perspective of affected women in the US. The findings demonstrate the debilitating effect of endometriosis symptoms, which limit and adversely impact women's daily lives.

The Development of a Video-based Nutrition Education Curriculum for Patients Undergoing Radical Cystectomy.

The treatment for patients with muscle-invasive bladder cancer includes neoadjuvant chemotherapy followed by radical cystectomy. The American Urological Association guidelines stress the optimization of patient performance status in the perioperative setting. Therefore, implementation of nutrition education is critical for the multi-disciplinary care of this vulnerable patient population and wide distribution of information is critical. The goal of our study was to create a nutrition-based video education series for patients undergoing chemotherapy and radical cystectomy for bladder cancer. Scripts for the videos were developed through an iterative process by experts in nutrition, urology, and communication. Providers and patient advocates were recruited to perform semi-structured interviews and surveys for additional feedback. Performer facial emotion recognition (Noldus™) was used to assess displayed emotion by the presenters. Mangold VisionPlayer software was used for participant eye movement tracking of the video content. A knowledge survey was created, and Item Content Validity Index (I-CVI) was calculated with a nutrition expert advisory board. Participants were recruited for cognitive interviewing to understand the mental processes and interpretations while answering questions. The video series is available to the public on the Bladder Cancer Advocate Network (BCAN) website at the following URL: https://bcan.org/facing-bladder-cancer/nutrition-bladder-cancer/eating-healthy-bladder-cancer/. Cinematic filming methods, (smaller depth of field, lighting, and camera movement) enhanced message delivery along with music and text on screen to anchor important concepts. This study can be a framework for the development of a patient education video library accessible through electronic medical records, health care applications, and patient advocacy websites.

Flexible torque control for wind turbines considering frequency response under wind speed crossing region

The operational range of a wind turbine is typically divided into two regions based on wind speed: below and above the rated wind speed. The turbine switches between these two regions depending on the prevailing wind speed; however, during the transition, the generator may undergo transient shocks in torque, which can negatively impact both the mechanical load of the turbine and the reliability of the power system. This article presents a flexible torque control method for wind turbines, specifically designed to handle the transition between wind speed regions when the turbine is participating in frequency regulation. First, the anomalies in generator torque caused by traditional torque control methods during frequency response scenarios are analyzed. Next, two methods—dynamic deloading and flexible torque control—are developed to address these issues. The developed methods set transition regions based on generator speed, which helps to reduce the impact of transient changes in generator torque. Importantly, the addition of transition regions does not require additional feedback, making the controller easy to implement. The response characteristics of the proposed methods are then analyzed under different deloading factors and wind speeds using model linearization. Simulation studies are presented to verify the effectiveness of the proposed methods. Overall, this study demonstrates the potential value of flexible torque control methods for wind turbines, which can help to mitigate the negative impact of torque shocks and improve the reliability and efficiency of wind power systems.

Focus Group Study of Medical Stakeholders to Inform the Development of Resilient Together for Dementia: Protocol for a Postdiagnosis Live Video Dyadic Resiliency Intervention.

Alzheimer disease and related dementias (ADRD) are increasingly common conditions that disrupt the lives of persons living with dementia and their spousal care partners. At the time of ADRD diagnoses, many couples experience challenges that produce emotional distress and relationship strain. At present, there are no interventions to address these challenges early after diagnoses to promote positive adjustment. The study protocol described here is part of the first phase of a larger program of research that aims to develop, adapt, and establish the feasibility of Resilient Together for Dementia (RT-ADRD), a novel dyadic skills-based intervention to be delivered over live video early after diagnosis, with the goal of preventing chronic emotional distress. This study will elicit and systematically summarize perspectives of ADRD medical stakeholders to inform the procedures (eg, recruitment and screening methods, eligibility, timing of intervention, and intervention delivery) of the first iteration of RT-ADRD prior to pilot-testing. We will recruit interdisciplinary medical stakeholders (eg, neurologists, social workers, neuropsychologists, care coordinators, and speech language pathologists) from academic medical center clinics in the departments treating persons living with dementia such as neurology, psychiatry, and geriatric medicine via flyers and word-of-mouth referrals from clinic directors and members of relevant organizations (eg, dementia care collaboratives and Alzheimer disease research centers). The participants will complete electronic screening and consent procedures. Consenting individuals will then participate in a 30- to 60-minute qualitative virtual focus group, held either via telephone or Zoom, using an interview guide designed to assess provider experiences with postdiagnosis clinical care and to gather feedback on the proposed RT-ADRD protocol. The participants will also have the opportunity to participate in an optional exit interview and web-based survey to gather additional feedback. Qualitative data will be analyzed using a hybrid inductive-deductive approach and the framework method for thematic synthesis. We will conduct approximately 6 focus groups with 4-6 individuals in each group (maximum N=30 individuals; until saturation is reached). Data collection began in November 2022 and will continue through June 2023. We anticipate that the study will be completed by late 2023. The results from this study will inform the procedures of the first live video RT-ADRD dyadic resiliency intervention focused on the prevention of chronic emotional and relational distress in couples shortly after ADRD diagnoses. Our study will allow us to gather comprehensive information from stakeholders on ways to best deliver our early prevention-focused intervention and gain detailed feedback on study procedures prior to further testing. DERR1-10.2196/45533.

Web-Based Knowledge Translation Tool About Pediatric Acute Gastroenteritis for Parents: Pilot Randomized Controlled Trial.

Acute gastroenteritis (AGE) in children is a leading cause of emergency department (ED) visits, resulting in substantial health care costs and stress for families and caregivers. The majority of pediatric AGE cases are caused by viral infections and can be managed at home using strategies to prevent dehydration. To increase knowledge of, and support health decision-making for, pediatric AGE, we developed a knowledge translation (KT) tool (fully automated web-based whiteboard animation video). The aim of this study was to assess the potential effectiveness of the web-based KT tool in terms of knowledge, health care decision-making, use of resources, and perceived benefit and value. A convenience sample of parents was recruited between December 18, 2020, and August 10, 2021. Parents were recruited in the ED of a pediatric tertiary care hospital and followed for up to 14 days after the ED visit. The eligibility criteria included parent or legal guardian of a child aged <16 years presenting to the ED with an acute episode of diarrhea or vomiting, ability to communicate in English, and agreeable to follow-up via email. Parents were randomized to receive the web-based KT tool (intervention) about AGE or a sham video (control) during their ED visit. The primary outcome was knowledge assessed before the intervention (baseline), immediately after the intervention, and at follow-up 4 to 14 days after ED discharge. Other outcomes included decision regret, health care use, and KT tool usability and satisfaction. The intervention group participants were invited to participate in a semistructured interview to gather additional feedback about the KT tool. A total of 103 parents (intervention: n=51, 49.5%, and control: n=52, 50.5%) completed the baseline and postintervention assessments. Of these 103 parents, 78 (75.7%; intervention: n=36, 46%, and control: n=42, 54%) completed the follow-up questionnaire. Knowledge scores after the intervention (mean 8.5, SD 2.6 vs mean 6.3, SD 1.7; P<.001) and at follow-up (mean 9.1, SD 2.7 vs mean 6.8, SD 1.6; P<.001) were significantly higher in the intervention group. After the intervention, parents in the intervention group reported greater confidence in knowledge than those in the control group. No significant difference in decision regret was found at any time point. Parents rated the KT tool higher than the sham video across 5 items assessing usability and satisfaction. The web-based KT tool improved parental knowledge about AGE and confidence in their knowledge, which are important precursors to behavior change. Further research is needed into understanding what information and delivery format as well as other factors influence parents' decision-making regarding their child's health. ClinicalTrials.gov NCT03234777; https://clinicaltrials.gov/ct2/show/NCT03234777. RR2-10.1186/s40814-018-0318-0.