Engagement Scores Research Articles

A Mixed-Methods Comparison of Interventions to Increase Advance Care Planning.

Although interventions can increase advance care planning (ACP) engagement, it remains unclear which interventions to choose in primary care settings. This study compares a passive intervention (mailed materials) to an interactive intervention (group visits) on participant ACP engagement and experiences. We used mixed methods to examine ACP engagement at baseline and six months following two ACP interventions. Eligible patients were randomized to receive mailed materials or participate in two ACP group visits. We administered the 4-item ACP Engagement survey (n = 110) and conducted interviews (n = 23). We compared mean scores and percent change in ACP engagement, analyzed interviews with directed content analysis to understand participants' ACP experiences, and integrated the findings based on mailed materials or group visits intervention. All participants demonstrated increased ACP engagement scores. At six months, group visit participants reported higher percent change in mean overall score compared with mailed materials participants (+8% vs +3%, P < .0001). Group visits participants reported that being prompted to think about end-of-life preferences, gaining knowledge about ACP, and understanding the value of completing ACP documentation influenced their ACP readiness. While both interventions encouraged patients to start considering and refining their end-of-life preferences, group visits made patients feel more knowledgeable about ACP, highlighted the importance of completing ACP documentation early, and sparked further ACP discussions with others. While primary care patients may benefit from mailed ACP materials, patients reported increased readiness after ACP group visits. Group visits emphasized the value of upstream preparation, ongoing conversations, and increased knowledge about ACP.

Factors in the Perioperative Nurses' Work Environment That Predict Work Engagement.

Perioperative nurse engagement and certification are associated with a culture of safety, which is crucial in perioperative environments. Therefore, examining relationships between engagement, the practice environment, and certification is warranted. The purposes of this study were to examine the relationships between the perioperative practice environment and reported nurse engagement, determine differences in engagement based on certification, and identify facilitators and barriers to attaining and sustaining certification. In this multiphase mixed-methods study, we used a convenience sample of perioperative nurses (N=379) to examine relationships between engagement, the practice environment, and certification. Qualitative interviews were conducted (n=15) to supplement the quantitative findings. Leadership support (β=0.23, P=.001) and nursing foundations for quality care (β=0.21, P=.01) were significant predictors of engagement. Certified nurses did not have significantly higher mean engagement scores when compared with noncertified peers. Qualitative interviews corroborated the findings.

Sensory processing and engagement of autistic children in childhood routines

ABSTRACT: Background: Occupations constitute a foundation of human existence, however, the impairment of skills in processing sensory information can impact the engagement of children diagnosed with Autism Spectrum Disorder (ASD). Objective: to investigate the relationship between sensory processing and the engagement of autistic children with 2 to 5 years old in their routines. Method: a quantitative correlational study was carried out. Caregivers responses were collected through an online survey, employing a chain-referral sampling method with two questionnaires, the SPM-P (Sensory Processing Measure - Preschool - Home Form) and the CEQ (Children's Engagement Questionnaire). Results: a total of 56 respondent families [30 families with ASD children and 26 with typically developing (TD) children] were obtained. A correlation and multiple regression analysis identified that the final scores for sensory processing and engagement correlated inversely in ASD and TD children, and that ASD diagnosis and impaired Motor Planning and Ideas significantly reduced engagement, while higher age and schooling incresead it. Conclusion: we observed that the use of strategies that increase the child's engagement in their routines is essential to promote the acquisition of new skills for participation in daily life.

Examining a Healthy Lifestyle as a Moderator of the Relationship between Psychological Distress and Cognitive Decline among Older Adults in the NuAge Study

Introduction: The objective of this study was to examine whether a healthy lifestyle composite score of social engagement, physical activity, and Mediterranean diet adherence moderates the association between psychological distress and global cognitive decline among cognitively healthy older adults (67+ years of age at baseline). Methods: A total of 1,272 cognitively intact older adults (M_age = 74.1 ± 4.1 years, 51.9% female) in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) completed a series of self-reported questionnaires to measure psychological distress and lifestyle behaviors, and the Modified Mini-Mental Examination (3MS) to assess cognitive performance at baseline and annually over 3 years. Results: Controlling for sociodemographic and health-related characteristics, greater psychological distress was associated with steeper cognitive decline over time among males (B = −0.07, 95% CI: [−0.12, −0.02]), but not females (B = 0.008, 95% CI: [0.03, 0.04]). Although a healthy lifestyle composite score did not statistically significantly moderate the distress-cognition relationship (B = −0.005, 95% CI: [−0.02, 0.01]), there was an association between higher psychological distress and greater cognitive decline at low levels of social engagement (B = −0.05, 95% CI: [−0.09, −0.006]), but not at high levels of social engagement (B = 0.02, 95% CI: [−0.03, 0.07]). Conclusion: This study suggests that the potentially harmful impact of stress on cognitive function may be malleable through specific healthy lifestyle behaviors and emphasizes the importance of taking a sex-based approach to cognitive aging research.

Let's Walk: A Quasi-Experimental Multi-Component Intervention to Improve Physical Activity and Social Engagement for Older Chinese American Adults.

Physical activity (PA) is critical for healthy aging, yet < 16% of U.S. older adults meet federal recommendations for moderate to vigorous PA. Asian Americans are a rapidly growing segment of the older adult population, who are less likely to meet these guidelines, and are frequently under-represented in clinical trials. This quasi-experimental pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of a culturally tailored walking program to improve PA and social engagement for older Chinese Americans in Boston, MA. Participants at two community organizations were assigned to an enhanced walking or walking only condition for 12 weeks. Mixed effect repeated measures analysis addressed the study aims. The enhanced walking group (intervention) had fewer steps at baseline and less of a reduction in steps by 12 weeks as compared with the walking only (control) condition. Mean social engagement scores were significantly higher at 12 weeks (p = .03) for the intervention group. A culturally tailored walking intervention was feasible and acceptable for older Chinese Americans, improving social engagement and PA scores.

Engagement With a Remote Symptom-Tracking Platform Among Participants With Major Depressive Disorder: Randomized Controlled Trial.

Multiparametric remote measurement technologies (RMTs), which comprise smartphones and wearable devices, have the potential to revolutionize understanding of the etiology and trajectory of major depressive disorder (MDD). Engagement with RMTs in MDD research is of the utmost importance for the validity of predictive analytical methods and long-term use and can be conceptualized as both objective engagement (data availability) and subjective engagement (system usability and experiential factors). Positioning the design of user interfaces within the theoretical framework of the Behavior Change Wheel can help maximize effectiveness. In-app components containing information from credible sources, visual feedback, and access to support provide an opportunity to promote engagement with RMTs while minimizing team resources. Randomized controlled trials are the gold standard in quantifying the effects of in-app components on engagement with RMTs in patients with MDD. This study aims to evaluate whether a multiparametric RMT system with theoretically informed notifications, visual progress tracking, and access to research team contact details could promote engagement with remote symptom tracking over and above the system as usual. We hypothesized that participants using the adapted app (intervention group) would have higher engagement in symptom monitoring, as measured by objective and subjective engagement. A 2-arm, parallel-group randomized controlled trial (participant-blinded) with 1:1 randomization was conducted with 100 participants with MDD over 12 weeks. Participants in both arms used the RADAR-base system, comprising a smartphone app for weekly symptom assessments and a wearable Fitbit device for continuous passive tracking. Participants in the intervention arm (n=50, 50%) also had access to additional in-app components. The primary outcome was objective engagement, measured as the percentage of weekly questionnaires completed during follow-up. The secondary outcomes measured subjective engagement (system engagement, system usability, and emotional self-awareness). The levels of completion of the Patient Health Questionnaire-8 (PHQ-8) were similar between the control (67/97, 69%) and intervention (66/97, 68%) arms (P value for the difference between the arms=.83, 95% CI -9.32 to 11.65). The intervention group participants reported slightly higher user engagement (1.93, 95% CI -1.91 to 5.78), emotional self-awareness (1.13, 95% CI -2.93 to 5.19), and system usability (2.29, 95% CI -5.93 to 10.52) scores than the control group participants at follow-up; however, all CIs were wide and included 0. Process evaluation suggested that participants saw the in-app components as helpful in increasing task completion. The adapted system did not increase objective or subjective engagement in remote symptom tracking in our research cohort. This study provides an important foundation for understanding engagement with RMTs for research and the methodologies by which this work can be replicated in both community and clinical settings. ClinicalTrials.gov NCT04972474; https://clinicaltrials.gov/ct2/show/NCT04972474. RR2-10.2196/32653.

Nutrition Management Miniprograms in WeChat: Evaluation of Functionality and Quality.

With the rise in people's living standards and aging populations, a heightened emphasis has been placed in the field of medical and health care. In recent years, there has been a drastic increase in nutrition management in domestic research circles. The mobile nutritional health management platform based on WeChat miniprograms has been widely used to promote health and self-management and to monitor individual nutritional health status in China. Nevertheless, there has been a lack of comprehensive scientific evaluation regarding the functionality and quality of the diverse range of nutritional miniprograms that have surfaced in the market. This study aimed to evaluate the functionality and quality of China's WeChat nutrition management miniprogram by using the User Version of the Mobile Application Rating Scale (uMARS). This observational study involves quantitative methods. A keyword search for "nutrition," "diet," "food," and "meal" in Chinese or English was conducted on WeChat, and all miniprograms pertaining to these keywords were thoroughly analyzed. Then, basic information including name, registration date, update date, service type, user scores, and functional scores was extracted from January 2017 to November 2023. Rating scores were provided by users based on their experience and satisfaction with the use of the WeChat miniprogram, and functional scores were integrated and summarized for the primary functions of each miniprogram. Moreover, the quality of nutrition management applets was evaluated by 3 researchers independently using the uMARS. Initially, 27 of 891 miniprograms identified were relevant to nutrition management. Among them, 85.2% (23/27) of them offered features for diet management, facilitating recording of daily dietary intake to evaluate nutritional status; 70.4% (19/27) provided resources for nutrition education and classroom instruction; 59.3% (16/27) included functionalities for exercise management, allowing users to record daily physical activity; and only 44.4% (12/27) featured components for weight management. The total quality score on the uMARS ranged 2.85-3.88 (median 3.38, IQR 3.14-3.57). Engagement scores on the uMARS varied from 2.00 to 4.33 (median 3.00, IQR 2.67-3.67). Functional dimension scores ranged from 3.00 to 4.00 (median 3.33, IQR 3.33-3.67), with a lower score of 2.67 and a higher score of 4.33 outside the reference range. Aesthetic dimension scores ranged from 2.33 to 4.67 (median 3.67, IQR 3.33-4.00). Informational dimension scores ranged from 2.33 to 4.67 (median 3.33, IQR 2.67-3.67). Our findings from the uMARS highlight a predominant emphasis on health aspects over nutritional specifications in the app supporting WeChat miniprograms related to nutrition management. The quality of these miniprograms is currently at an average level, with considerable room for functional improvements in the future.

Exploring the Factors Influencing the College Students’ Engagement in Mobile Learning in Palestine

This study aims to explore the factors influencing students’ engagement in mobile learning at Palestine Technical University Kadoorie. It utilizes a mixed research approach that combines both quantitative and qualitative designs. The study sample consists of 37 college students from two different faculties: Arts and Educational Sciences, and Applied Sciences. Data were collected using a pre-existing scale for engagement and its factors. Semi-structured interviews were conducted with 12 students who completed the scales. The findings showed a statistically significant difference in the total engagement scores, specifically in the emotional engagement dimension. However, there was no statistical significance found in the social, cognitive, or behavioral domains. Factors related to instructors are influential factors in student engagement and have been found to be statistically significant. Qualitative findings supported the quantitative results for this question, which showed subthemes of instructor-related factors such as instructor presence, motivation, teaching strategies, and technical environment. Researchers recommend that policymakers and educators prioritize the engagement factors of students in mobile learning. One of the limitations is the generalizability of this study. The participants who were surveyed were exclusively sourced from two departments within one university. To broaden the scope, we suggest that future research include individuals from various disciplines, universities, academic institutions, and students.

Surrogate decision-makers from historically marginalized populations have lower levels of preparedness for care planning.

Surrogate preparedness for medical decision-making is an important part of care planning. This study examined preparedness and engagement among historically marginalized surrogates. Surrogates were included if they were named medical decision-makers by patients ≥55 years at a San Francisco safety-net and Veterans Affairs hospital. We assessed preparedness for medical decision-making by asking if surrogates had been formally asked to be the medical decision-maker, if patients had discussed medical wishes with surrogates, and if the surrogate role and these medical wishes had been documented. We assessed surrogate confidence and readiness using a modified Surrogate ACP Engagement Survey. We used Wilcoxon rank-sum tests to measure the association of engagement scores with surrogate characteristics. Of 422 surrogates, their mean age was 53 years (SD ±14.5), 73% were from minoritized groups, 38% were Spanish-speaking, and 15% had limited health literacy. For preparedness outcomes, 13% of surrogates were not formally asked to play this role, 46% reported the patient had not discussed end-of-life medical wishes, and 51% reported there had been no formal documentation of the surrogate role. Surrogates reported higher confidence 4.43/5 (SD ± 0.64) than readiness 3.70 (1.22) for decision-making (p < 0.001). Confidence and readiness scores were lower among historically marginalized participants. More resources are needed to prepare surrogate decision-makers from historically marginalized communities for discussing patient's goals of care and treatment preferences.

Income in Relation to Psychosocial Factors Among Stroke Survivors using Smartwatches for Atrial Fibrillation Monitoring.

Timely detection of atrial fibrillation (AF) is critical for stroke prevention. Smartwatches are FDA-approved devices that can now aide in this detection. Investigate how socioeconomic status is associated with self-reported psychosocial outcomes, including anxiety, patient activation, and health-related quality of life in stroke survivors using smartwatch for AF detection. We analyzed data from the Pulsewatch study, a randomized controlled trial (NCT03761394). Participants in the intervention group wore a cardiac patch monitor in addition to a smartwatch for AF detection, whereas the control group wore only the cardiac patch monitor. Generalized anxiety disorder-7 scale, Consumer Health Activation Index and short-form health survey were completed to assess anxiety, patient activation, physical and mental health status at baseline, 14, and 44 days. We used a longitudinal linear regression model to examine changes in psychosocial outcomes in low (<$50K) vs. high (>$50K) income groups. A total of 95 participants (average age 64.9± 9.1 years; 57.9% male; 89.5% non-Hispanic white) were included. History of renal disease (p-value 0.029), statin use (p-value 0.034), depression (p-value 0.004), and anxiety (p-value <0.001), were different between the income groups. In the adjusted model, the low-income group was associated with increased anxiety (β 2.75, p-value 0.0003), and decreased physical health status (β -5.07, p-value 0.02). There was no change identified in self-reported patient engagement and mental health status score. Our findings demonstrate that low SES is associated with worse self-reporting of physical health status, and this may influence psychosocial outcomes in smartwatch users.

Social Goal Orientation, Academic Engagement and Creativity as Predictors of Secondary School Students’ Academic Achievement in Mathematics in Anambra State, Nigeria

Social goal orientation, academic engagement and creativity are strong indicators and facilitators for effective learning. The association among these variables to jointly predict academic achievement has been vague and nebulous in the field of educational psychology. The study aimed to explore the students’ social goal orientation, academic engagement, and creativity as predictors of academic achievement in mathematics in Anambra State. Four research questions and three null hypotheses were formulated for the study. The study adopted a predictive correlational design. The population comprised of 21,204 SS II students from which a sample of 1560 was drawn using probability sampling procedure. Standardized research instruments such as; Social Goal Orientation Questionnaire (SGOQ), Students’ Academic Engagement Questionnaire (SAEQ) and Epstein Creativity Competencies Inventory (ECCI) developed by Epstein were used for data collection. Students’ mathematics achievement scores from the state wide promotion examination were used to represent mathematics achievement. Cronbach’s alpha was used to determine the reliability of the items in the instruments. A reliability indices were found to be .88, .82, and .92 for SGOQ, SAEQ and ECCI respectively. These scores made the instruments fit for the study. The standard multiple regression was used to analyze the collected data. The standard multiple regression was used to analyze the collected data. The research question 1 was answered using multiple regression. The research question 2 was answered using unstandardized β. The research question 3 was answered using adjusted R2. The research question 4 was answered using standardized β. The null hypothesis 1 was tested using F-test for regression model. The null hypothesis 2 was tested using t-test for adjusted R2. The null hypothesis 3 was tested using t-test for β at .05 level of significance. Findings showed that students social orientation, academic engagement and creativity scores yielded an adjusted R square of .007. This implies that predictors accounted for about 0.7% of the variance scores in academic achievement. Also, the analysis of variance indicated that the regression equation was significant in predicting academic achievement in mathematics. This implies that at least one of the independent variables significantly predicted academic achievement in mathematics. Based on these findings, it was recommended that students should consider social goal orientation, academic engagement and creativity as adaptive motivational variables that have jointly predict academic achievement.

Effects of intervention by trained care managers on advance care planning engagement among long-term care service users in Japan: a pre- and post-pilot comparative study across multiple institutions.

A majority of Japanese care managers lack medical qualifications, feel uncomfortable discussing future medical choices and believe that it is not their responsibility. As there is a paucity of care manager intervention studies, this study aimed to measure changes in advance care planning engagement among long-term care service users before and after intervention by care managers with communication training. A multi-institutional pre- and post-pilot comparative study. A multi-institutional pre- and post-trial study was performed from August 2022 to January 2023 (trial ID: 000048573). Nine trained care managers communicated with 30 long-term care service users regarding advance care planning, and the pre- and post-trial advance care planning engagement scores were compared. Additionally, the post-trial impact of events score was investigated. All 30 long-term care service users completed the trial. The advance care planning engagement score increased after the trial. The sample size was considered adequate for future trials. Years of experience as a care manager, impact of events score, and having a clinical frailty scale of ⩾5 were significant explanatory variables that affected the objective variable of the difference between pre- and post-trial advance care planning engagement score. This study on the impact of advance care planning communication interventions by trained care managers offers insights into determining appropriate sample sizes and identifying factors influencing future research outcomes. Advance care planning engagement of long-term care service users might change before and after intervention by care managers through advance care planning communication. University Hospital Medical Information (UMIN) Network Trial ID: 000048573.

Research on Online Education Teaching Mode of Colleges and Universities Based on Internet Technology

Abstract The steady growth of online education in Chinese higher education, despite its drawbacks, underscores an increasing interest in digital learning platforms. This study proposes enhancements to the Paragraph Vector, Stacking classifiers, and ZEN semantic coders to construct accurate learner profiles, facilitating personalized online education. By applying these improved models, universities can adapt their online courses more effectively, as demonstrated by case study analyses. Performance data for a sample of college students shows a concentration of scores between 80 and 90, with an average of 84.01, suggesting moderate academic achievement. Engagement metrics, particularly in educational experience richness, scored highest at 3.7854, with all engagement scores averaging above 3, indicating a strong engagement in the learning process.

Knowledge, attitude, and practices of adolescents and peer educators in relation to the components of the National Adolescent Health Program in India: findings from a cross-sectional survey.

Adolescence is a critical period of growth and development. Many adverse health outcomes in adulthood begin during adolescence, often due to insufficient knowledge and attitudes resulting from a lack of education. Therefore, appropriate knowledge, attitudes, and practices (KAP) regarding various aspects of health are essential for holistic adolescent and lifelong health. In India, the Rashtriya Kishore Swasthya Karyakram (RKSK or National Adolescent Health Strategy) has utilized an innovative peer-education approach to engage with adolescents and improve their KAPs. Amid limited evidence, we aimed to assess the KAP of adolescents regarding the six themes of the RKSK, with a particular focus on the status of peer educators (PEs). Our objective was to evaluate these aspects disaggregated by sex and to examine how engagement with the RKSK peer-education program influenced their KAP. A cross-sectional survey of 238 peer educators and 2885 adolescents enrolled under peer educators was conducted in two localities; Madhya Pradesh and Maharashtra states. KAPs were estimated using descriptive statistics then disaggregated by gender. Practice scores of nutrition and non-communicable disease (NCD) were modelled upon engagement with RKSK (graded as 0, 1, 2, 3). Knowledge was highest regarding substance misuse and lowest in the domains of sexual and reproductive health, and violence and injury. PEs possessed greater knowledge in most domains as compared to adolescents enrolled under them. Attitudes toward abstention from substance misuse were positive, whereas attitudes toward injury and violence, and sexual health, were suboptimal. Boys exhibited better practices related to NCDs, while their nutritional practices were comparatively worse than girls. The RKSK engagement was associated with better nutritional practices: adjusted relative risks (RRs) being 1.04 (95% confidence interval [CI]: 0.94-1.15), 1.12 (1.04-1.21), and 1.21 (1.13-1.31), respectively, for engagement scores 1, 2, and 3 with reference to score 0. The relationship between RKSK engagement and NCD-related practices was restricted to the top engagement group. The knowledge regarding sexual health, and injury and violence, was grossly deficient in adolescents. These components must be prioritized in the program because they are critical for health not only across the life course of individuals but also across generations. However, the RKSK engagement was associated with better practices in a variety of domains, which should be leveraged in the future.

Investigating the relationship between university students' classroom engagement and metacognitive awareness

Metacognitive awareness is an important condition that affects many important skills such as academic success, critical thinking, creative thinking, and classroom engagement in classes. Classroom engagement is a situation that increases the success of students, who actively participates in the lessons, contributes to the lessons, and contributes to active listening cognitively, emotionally and behaviorally. This research is designed in correlational research model and aims to reveal the relationship between metacognitive awareness and classroom engagement. The research was carried out by cluster sampling method in Gaziantep University Education Faculties and BESYO colleges. 289 university students participated in the study. As a result of the research, it was revealed that there is a moderate to high relationship between university students' participation in classes and their metacognitive awareness. Regression analysis revealed that metacognitive awareness explained 44% of the variance in classroom engagement scores. Monitoring skill, one of the sub-dimensions of metacognitive awareness, was one of the factors that best explained students' engagement in the classroom.

Social media addiction relationship with academic engagement in university students: The mediator role of self-esteem, depression, and anxiety

This research analyzed how addiction to social media relates to academic engagement in university students, considering the mediating role of self-esteem, symptoms of depression, and anxiety. A quantitative methodology was used with a non-experimental-relational design. A set of questionnaires was applied to a non-probabilistic sample of 412 students enrolled at the National Autonomous University of Honduras. On average, participants use 4.83 different social media platforms at least once a week. Instagram and TikTok users report significantly higher levels of social media addiction, symptoms of depression, and anxiety compared to non-users. Directly, social media addiction does not significantly influence academic engagement scores. However, there are significant indirect inverse effects on academic engagement. Symptoms of depression and self-esteem mediate these effects. Social media addiction increases symptoms of depression, which in turn decreases academic engagement scores. Social media addiction decreases self-esteem, which serves as a variable that significantly increases academic engagement. Overall, findings suggest that social media addiction has a total inverse effect on academic engagement; symptoms of depression and self-esteem mediate this relationship. The implications of these findings are discussed.

Student Engagement Increases Caring Behaviour of Nursing Students

Background: Even though caring behavior is introduced since nursing students enter the institution, caring behavior is still low, this may be due to a lack of student involvement.Purpose: The study provides insight into the relationship between student engagement and caring behaviour in nursing students.Methods: A descriptive correlational study was conducted. Data were collected from 250 nursing students in the second to fourth years who had clinical practice experience. A cross-sectional study design was conducted. Data were collected using a modified Caring Behaviour Inventory (CBI) and a Student Course Engagement Questionnaire (SCEQ). Pearson product-moment correlation analysis techniques were used.Results: The overall student engagement score was 73.7 ± 6.8 on average while the caring behaviour score was 74.6 ± 6.5. Student engagement was significantly associated with caring behaviour r = .905 (p 0.001).Conclusion: Based on the finding that student engagement is strongly linked to the display of caring behavior in nursing students, it is clear that active engagement in the learning process is critical for fostering an understanding of caring behaviour. This study provides valuable insights for nursing lecturers seeking to increase student engagement and improve the development of caring behaviour among nursing students. By incorporating strategies that encourage active student participation and engagement, nursing departments can help to facilitate the development of caring behavior among their students.

Frequency of laughter and work engagement among Japanese employees: a cross-sectional study during COVID-19.

Laughter is associated with better health and occurs most frequently during casual conversations. However, the COVID-19 pandemic has impaired social interactions, which may have reduced the frequency of laughter and led to poor well-being among workers. This study investigated the relationship between laughter frequency and work engagement among Japanese employees during the pandemic. We conducted a web-based survey among Japanese employees (20-59 yr) via an internet survey company in December 2021; 1,058 valid data were analysed. Of the respondents, 65.1% laughed at least once a week, but the frequency was much lower than that reported in previous studies conducted before the pandemic. Additionally, those who laughed at least once a week had significantly higher work engagement scores than those who laughed less than once a month. Although employees reduced their frequency of laughter during the pandemic, a certain frequency of laughter may be important for maintaining their work engagement.

Stakeholder engagement in urban water management: A SWOT analysis of the Banger polder system in Semarang

Semarang is a coastal city of more than 1.6 million people and is considered a global hotspot for land subsidence due to groundwater extraction. Large parts of the city are below sea level already. The Banger polder Project, Launched in 2016, aimed to reduce flood risk in the area by developing a technically well-functioning polder system, creating a sustainable water management organization and improving stakeholder participation. Stakeholder engagement is critical for the financial and operational support of the polder system. However, the results show that Semarang's stakeholder engagement scores the lowest on the OECD ladder of stakeholder engagement. This paper assesses the engagement of various stakeholder representatives in the water management organization and identifies key strengths, weaknesses, opportunities, and threats to the polder system through a SWOT analysis. The main threats are the lack of awareness among residents, that leads to solid waste being disposed of in waterways, the lack of adequate management and funding, and uncertainty about the future maintenance system.

Youth-Therapist and Parent-Therapist Match and Mismatch on Internalizing and Externalizing Treatment Goals as Predictors of Treatment Engagement.

Therapist-client cognitive match upon key constructs such as treatment goals is purported to be an important component of culturally competent care. For adolescent clients, treatment may involve both youths and their parents, suggesting the need to consider both youth-therapist and parent-therapist perspectives. This longitudinal study examined broadband youth-therapist and parent-therapist treatment goal matching and mismatching in relationship to treatment engagement in a culturally diverse sample of 245 outpatient mental health service-using youth. Although goal matching/mismatching did not uniformly predict treatment engagement as measured by a total score, youth-therapist internalizing goal matching predicted better youth engagement, and parent-therapist externalizing goal mismatch marginally predicted worse parent engagement. When selected post hoc analyses examined relationships to four individual engagement dimensions, youth-therapist internalizing goal matches positively predicted youth Client-therapist interaction, Communication/Openness, Client's perceived usefulness of therapy, and Collaboration with treatment, while parent-therapist externalizing goal mismatch negatively predicted parent Collaboration with treatment. Findings support the importance of cognitive match on treatment goals as well as the consideration of both parent and youth perspectives, matched and mismatched goals, internalizing and externalizing goals, and examining individual dimensions in addition to total scores of engagement.