Feedback Messages Research Articles

Beneficial Features of a mHealth Asthma App for Children and Caregivers: Qualitative Study.

BackgroundmHealth and uHealth apps are available for children with asthma and their caregivers. However, previous studies on mHealth apps for children older than 7 years old with asthma are limited, and most studies on asthma apps do not consider interactions involving communication between children and caregivers. Therefore, a prototype mHealth child asthma app was developed for children and their caregivers, with features of tailored feedback messages in continuing self-management and interactions between children and caregivers.ObjectiveThe aim of this study was to identify the beneficial features of a prototype mHealth app developed for children with asthma and their caregivers.MethodsChildren diagnosed with persistent asthma by allergy specialists at the National Center for Child Health and Development were recruited. The features of a prototype mHealth app for children with asthma and their caregivers were investigated using semistructured interviews after they tried the app. Data were analyzed using thematic analysis. Content-characteristic words were named and grouped together as categories to explore themes.ResultsWe recruited 27 children with asthma aged 2 to 12 years and 26 their caregivers. Findings on the good aspects of the app for children older than 7 years old and caregivers suggested 4 themes (confirmation of asthma knowledge, child-caregiver interaction, design of the app, and child’s interest), and 6 categories were identified. Findings on the good aspects of app for children 7 to 12 years old and caregivers suggested 5 themes (new knowledge, manga as a Japanese-style comic, child’s interest, trigger of self-management, and design and operability), and 11 categories were identified. Findings on the beneficial features of app suggested 6 themes (asthma knowledge, elements for continuous, universal design, notification, monitoring, and functions), and 12 categories were identified.ConclusionsChildren with asthma and their caregivers perceived that the good aspects of the app were learning asthma knowledge with fun, including manga; interaction between child and caregiver; and easy-to-read design, such as colors. They wanted not only the asthma knowledge but also the universal design and enhanced elements, monitoring, and notification functions of the app.

The use of wearable devices in chronic disease management to enhance adherence and improve telehealth outcomes: A systematic review and meta-analysis

Introduction Wearable device (WD) interventions are rapidly growing in chronic disease management; nevertheless, the effectiveness of these technologies to monitor telehealth outcomes has not been adequately discussed. This study aims to evaluate the effects of WDs in adherence and other health outcomes for people with chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), and cardiac disease (CD). Methods CINAHL, PsycINFO, CENTRAL, and EMBASE were searched for randomized controlled trials (RCTs) and non-RCTs from 1937 to February 2020. Studies comparing interventions with the use of WD were assessed for quality in RCTs and a meta-analysis was performed. Results Eleven studies were included in this review. All of the interventions involved WD use with educational support such as goal setting, virtual social support, e-health program, real-time feedback, written information, maintain diary, and text messaging. The meta-analysis showed no difference in adherence (p = .38). The DM group showed effects of more than a 2% reduction in weight when WDs were implemented for three months (risk ratio = 2.20; 95% confidence interval (CI) 1.38 to 3.50; p = .0009), as well as blood glucose (mean difference (MD) = –32.39; 95% CI = –48.07 to –16.72; p < .0001), haemoglobin A1c (MD = –0.69; 95% CI = –1.28 to –0.10; p = .02), and physical exercise time in the CD group (MD = 9.53; 95% CI = 0.59 to 18.47; p = .04). Discussion WD with educational support may be particularly useful for people with DM and CD to enhance support beyond usual care. The results of this review showed insufficient evidence to support the use of WD for COPD to enhance telehealth outcomes for disease management.

An exploratory investigation into the reception of verbal and video feedback provided to players in an Australian Football League club

Coach observation studies commonly examine training and competition environments, with little attention paid to the ways in which coaches provide video feedback in a performance analysis setting. In addition, few studies have considered the reception of feedback by an athlete, or the characteristics of the athlete that may support or hinder feedback reception. The purposes of this study were threefold. First, to examine the characteristics of feedback provided by a coach during a typical video feedback meeting. Second, to measure the impact of this feedback on athlete learning. Third, to consider a range of learner characteristics that may impact feedback reception. Six coaches and six players affiliated with an Australian Football League (AFL) club were recruited. Coach-player dyads were observed in one-to-one video feedback meetings following a game played in the 2017 season. Players were interviewed to test feedback recall. Players also completed a series of tests designed to measure learner characteristics, with the intention of discovering moderating factors of the relationship between feedback and learning outcomes. Rates of feedback generally mirrored those found in previous studies. Coaches provided nearly 30 feedback messages during each meeting. Players recalled 50% of summarised feedback messages but just 6% of all feedback a week later. A ceiling effect on learner characteristics was observed. The paper presents a novel design for examining feedback effectiveness while considering learner characteristics. Given the findings on feedback quantity and recall, coaches are encouraged to adopt a ‘less is more’ approach to providing feedback.

Neither More nor Less: Responsiveness to Performance Feedback and Subsequent Performance

Despite some contradictory findings and missing details on the process of performance feedback itself, the literature on the topic can largely explain why and when the firm strategy changes. While understanding the firm behavior has an enormous value, we are still unsure of the performance consequences of responses to performance feedback. This research aims to contribute to answering the question of the relationship between responsiveness to performance feedback (intensity with which the firm reacts to a given performance feedback message) and subsequent performance. Since the responsiveness has both positive and negative consequences, the relationship is theoretically assumed to be of an inverted U shape. That means that responding either too little or too much is detrimental for subsequent firm performance. Using data from U.S. manufacturing firms, the findings support the inverted U shape relationship between responsiveness and subsequent performance. Furthermore, the research shows the moderating effects of the firm’s proximity to bankruptcy and the industry’s R&D intensity on the relationship. The research contributes to the performance feedback literature and points out potential avenues for prescriptive advice to firms.

Feasibility and Acceptability of Mobile Phone Self-monitoring and Automated Feedback to Enhance Telephone Coaching for People With Risky Substance Use: The QUIT-Mobile Pilot Study.

This study evaluates the feasibility, acceptability, and perceived benefits of mobile-phone delivered self-monitoring queries and feedback integrated into the evidence-based Quit Using Drugs Intervention Trial (QUIT) screening and brief telephone health coaching intervention to prevent progression from risky drug use to addiction as the QUIT-Mobile intervention. Participants (n = 20) were primarily Black/African American and Latino men in Los Angeles with risky substance use. Self-monitoring surveys were sent by text-message twice-weekly for 6 weeks and once-weekly from 6 to 12-weeks. Surveys consisted of 10 questions regarding drug and alcohol use (ie, # days of use) and cravings, quality of life, and medication adherence. Feedback messages praised or encouraged drug use reductions. Coaches monitored patient responses and discussed them in QUIT's telephone coaching sessions. Participants' experiences were assessed qualitatively at 3-month follow-up. Nineteen out of 20 participants that completed the qualitative evaluation from the 12-week follow-up reported: (1) self-monitoring surveys helped them adhere to drug use reduction goals and reflect on associations between self-monitoring domains; (2) preference for higher frequency (twice-weekly) self-monitoring during the 6-week coaching period, and then weekly surveys thereafter but not monthly; and (3) self-monitoring and coaching were mutually reinforcing for their drug use reduction goals. Results are consistent with prior similar research suggesting that mobile phone self-monitoring of drug use and related factors is feasible and acceptable among diverse adults with risky drug use. Findings also suggest the potential benefits of integrating electronic self-monitoring and feedback into substance use reduction interventions such as QUIT to enhance patient self-management and coaching or counseling intervention components.

Non-Invasive Behavioral Reference Group Categorization Considering Temporal Granularity and Aggregation Level of Energy Use Data

Within residences, normative messaging interventions have been gaining interest as a cost-effective way to promote energy-saving behaviors. Behavioral reference groups are one important factor in determining the effectiveness of normative messages. More personally relevant and meaningful groups are likely to promote behavior change. Using readily available energy-use profiles in a non-invasive manner permits the creation of highly personalized reference groups. Unfortunately, how data granularity (e.g., minute and hour) and aggregation (e.g., one week and one month) affect the performance of energy profile-based reference group categorization is not well understood. This research evaluates reference group categorization performance across different levels of data granularity and aggregation. We conduct a clustering analysis using one-year of energy use data from 2248 households in Holland, Michigan USA. The clustering analysis reveals that using six-hour intervals results in more personalized energy profile-based reference groups compared to using more granular data (e.g., 15 min). This also minimizes computational burdens. Further, aggregating energy-use data over all days of twelve weeks increases the group similarity compared to less aggregated data (e.g., weekdays of twelve weeks). The proposed categorization framework enables interveners to create personalized and scalable normative feedback messages.

A Wearable Technology Delivering a Web-Based Diabetes Prevention Program to People at High Risk of Type 2 Diabetes: Randomized Controlled Trial.

BackgroundIntensive lifestyle interventions are effective in reducing the risk of type 2 diabetes, but the implementation of learnings from landmark studies is expensive and time consuming. The availability of digital lifestyle interventions is increasing, but evidence of their effectiveness is limited.ObjectiveThis randomized controlled trial (RCT) aimed to test the feasibility of a web-based diabetes prevention program (DPP) with step-dependent feedback messages versus a standard web-based DPP in people with prediabetes.MethodsWe employed a two-arm, parallel, single-blind RCT for people at high risk of developing diabetes. Patients with a hemoglobin A1c (HbA1c) level of 39-47 mmol/mol were recruited from 21 general practices in London. The intervention integrated a smartphone app delivering a web-based DPP course with SMS texts incorporating motivational interviewing techniques and step-dependent feedback messages delivered via a wearable device over 12 months. The control group received the wearable technology and access to the web-based DDP but not the SMS texts. As this was a feasibility study, the primary aim was to estimate potential sample size at different stages of the study, including the size of the target study population and the proportion of participants who consented, were randomized, and completed follow-up. We also measured the main outcomes for a full-scale RCT, namely, change in weight and physical activity at 6- and 12-month follow-ups, and secondary outcomes, including changes in the HbA1c level, blood pressure, waist circumference, waist-to-hip ratio, and lipid levels.ResultsWe enrolled 200 participants: 98 were randomized to the intervention and 102 were randomized to the control group. The follow-up rate was higher in the control group (87/102, 85.3%) than in the intervention group (69/98, 70%) at 12 months. There was no treatment effect on weight at 6 months (mean difference 0.15; 95% CI −0.93 to 1.23) or 12 months (mean difference 0.07 kg; 95% CI −1.29 to 1.44) or for physical activity levels at 6 months (mean difference −382.90 steps; 95% CI −860.65 to 94.85) or 12 months (mean difference 92.64 steps; 95% CI −380.92 to 566.20). We did not observe a treatment effect on the secondary outcomes measured at the 6-month or 12-month follow-up. For the intervention group, the mean weight was 92.33 (SD 15.67) kg at baseline, 91.34 (SD 16.04) kg at 6 months, and 89.41 (SD 14.93) kg at 12 months. For the control group, the mean weight was 92.59 (SD 17.43) kg at baseline, 91.71 (SD 16.48) kg at 6 months, and 91.10 (SD 15.82) kg at 12 months. In the intervention group, the mean physical activity was 7308.40 (SD 4911.93) steps at baseline, 5008.76 (SD 2733.22) steps at 6 months, and 4814.66 (SD 3419.65) steps at 12 months. In the control group, the mean physical activity was 7599.28 (SD 3881.04) steps at baseline, 6148.83 (SD 3433.77) steps at 6 months, and 5006.30 (SD 3681.1) steps at 12 months.ConclusionsThis study demonstrates that it is feasible to successfully recruit and retain patients in an RCT of a web-based DPP.Trial RegistrationClinicalTrials.gov NCT02919397; http://clinicaltrials.gov/ct2/show/NCT02919397

Student Opinions About Personalized Recommendation and Feedback Based on Learning Analytics

There is a growing interest in the use of learning analytics in higher education institutions. Learning analytics also appear to have the potential to be used to provide personalized feedback and support in online learning. However, when the literature is examined, the use of learning analytics for this purpose appears as a gap to be investigated. This research aims to examine the opinions of pre-service teachers about the personalized recommendation and guidance feedback based on learning analytics. The research was carried out on 40 pre-service teachers in the Computer I course, which was conducted according to the flipped learning model for 12 weeks. Throughout the research process, personalized feedback based on learning analytics was provided by researcher (the researcher is also the teacher of the Computer I course) to pre-service teachers at the end of each week. Accordingly, the students’ weekly learning management system (LMS) obtained learning analytics results from the log data related to their usage behavior. Then, the researcher prepared personalized recommendation and guidance messages based on learning analytics results. Learning analytics results and related recommendations and guidance messages were sent via LMS (from the messaging tool) as feedback. This process was done for each pre-service teacher by the researcher every week during the research process. The data of the research were obtained with a semi-structured opinion form and content analysis was made in the analysis of the data. As a result of the research, beneficial aspects and limitations of personalized recommendation and guidance feedback based on learning analytics from the perspective of pre-service teachers were revealed. In line with the results obtained from the research, various suggestions were made for the design and use of feedback messages based on learning analytics.

Exploring the emotions of international students about their feedback experiences

ABSTRACT Feedback is an essential aspect of enhancing learning. Most studies have used traditional research methods to capture students’ perceptions of effective feedback. Little attention has been paid to what emotions are triggered by feedback and when these emotions are elicited. This paper explored feedback using an electronic log (e-log) to capture multiple feedback events experienced by international students. These events were then explored in a semi-structured interview. An account of the development and implementation of the e-log is included in this paper. Using an interpretivist approach, we analysed students’ emotional responses to feedback. The role of emotions in feedback and learning is studied from a socio-cultural perspective. Findings revealed students had a range of complex and dynamic emotional responses to feedback. Three case studies are presented to further explore this complexity. Students’ emotions were associated with the self, information on feedback messages, or lack of familiarity with feedback practices. Emotions triggered by feedback influenced students’ practices and construction of their new identity in the new academic environment.

Are Students Reading their Teachers’ Comments? The Impact of Digital Feedback in Adult Learning Secondary Education

This paper shows the results of an ongoing research which explores the impact of digital feedback in adult learning at the Institut Obert de Catalunya (IOC), an online public school (Department of Education of Catalonia, Spain). The students are adults who did not obtain a degree in compulsory secondary education at the time. The objective of these studies is twofold: to teach students basic life skills they should know to survive and thrive in nowadays society and to manage lifelong learning. Within this context, feedback plays an important role as it has a huge influence on students’ learning gain. However, are students taking advantage of the teachers’ feedback to improve their tasks? The research is based on the assessments made by students of their teachers’ feedback comments and the improvement those meant in the students’ task completions. Our intention was to prove from the statements made by the students two facts: if the students received feedback effectively and if that resulted in an improvement in their task completions. Seven closed-ended multiple choice questions together with an open-ended one were used to carry out this survey. The first set of questions were used to gather insight about the students’ opinions on the effectivity of the feedback regarding content value, extension and clarity of message. With the open question, we tested how much information the students had retained form their teachers’ feedback messages, and what aspects of it they considered more relevant. These first findings provide new insight into the relation between digital feedback and its impact on academic results.

635-P: Message in an App: A Survey of Feedback Messages about Healthy Coping in Diabetes

Healthy Coping (HC) is a key component of self-management for people with DM. HC includes physical exercise/activity and mood. Mobile apps are a promising tool to promote DSME/S for people with DM. Feedback messages can motivate people to change self-management behaviors. This study reports a survey of HC-related feedback messages in DM apps. We searched “diabetes,” “blood sugar,” “glucose,” and “mood” in iTunes and Google Play to capture apps in English from August-October 2019. We identified 89 out of 1749 DM apps. We tested the apps by entering a range of normal and abnormal values to generate 326 feedback messages. We analyzed the messages regarding DM control, physical exercise, and mood, as well as feedback purpose and timing (Table 1). All apps provided messages acknowledging input in real time. Many apps allowed self-monitoring of blood glucose (65%), however, out of these 174 feedback messages, none suggested behavioral modification (0%) and few advised goal setting (11%). Only some apps allowed input regarding exercise (12%) and mood (35%). Similarly, few messages suggested behavioral modification (11% and 6% respectively) or goal setting (11% and 6% respectively). These findings indicate a lack of focus on HC especially regarding physical activity and mood with goal setting and behavioral modifications. Future DM apps should incorporate purposeful messages to engage people with DM in self-management. Disclosure Q. Ye: None. S.A. Boren: None. U.Z. Khan: None. E.J. Simoes: None. M. Kim: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092950); University of Missouri Research Council (URC-19-153)

Signaling Protocols for Local Area Networks of Drones

Unmanned Aerial Vehicles (UAVs) or drones have become extremely popular and are used in various commercial applications. When multiple UAVs communicate and work together, they form a UAV network. A private UAV network or Local Area Network of Drones (LoDs) is a special type of UAV network which has the minimum number of UAVs to carry out a certain task. All UAVs in a LoD use the wireless medium to send and receive the data as well as the control signals. An organization or a single owner will be more interested in this type of network, where they want multiple UAVs to scan an area, communicate with each other, and send all the images and live video streams to a single ground station. The currently available commercial UAVs Can send the video signals to and receive control signals only from their own ground station controllers. However, in an LoD network where UAVs are connected in tandem, the UAVs that are in the middle of the network have to carry the control and video signals of other UAVs. Given the limited processing power and dynamic memory capacity of UAVs, this would increase the queuing delays and performance.In this paper, we study the frame formats of existing control, feedback, and data messages of commercial AR UAVs and propose a new approach to construct the payloads of control and feedback frames that are suitable for an LoDs. We compare the performance of our approach of single control and feedback frame for all UAVs in a LoD branch with that of separate control and feedback frames for each UAV. We calculate and compare the UAV node processing delay in both types of signaling mechanisms and show that the single control and feedback frame signaling has less delay on the average.

Integrating People, Context, and Technology in the Implementation of a Web-Based Intervention in Forensic Mental Health Care: Mixed-Methods Study.

BackgroundWhile eMental health interventions can have many potential benefits for mental health care, implementation outcomes are often disappointing. In order to improve these outcomes, there is a need for a better understanding of complex, dynamic interactions between a broad range of implementation-related factors. These interactions and processes should be studied holistically, paying attention to factors related to context, technology, and people.ObjectiveThe main objective of this mixed-method study was to holistically evaluate the implementation strategies and outcomes of an eMental health intervention in an organization for forensic mental health care.MethodsFirst, desk research was performed on 18 documents on the implementation process. Second, the intervention’s use by 721 patients and 172 therapists was analyzed via log data. Third, semistructured interviews were conducted with all 18 therapists of one outpatient clinic to identify broad factors that influence implementation outcomes. The interviews were analyzed via a combination of deductive analysis using the nonadoption, abandonment, scale-up, spread, and sustainability framework and inductive, open coding.ResultsThe timeline generated via desk research showed that implementation strategies focused on technical skills training of therapists. Log data analyses demonstrated that 1019 modules were started, and 18.65% (721/3865) of patients of the forensic hospital started at least one module. Of these patients, 18.0% (130/721) completed at least one module. Of the therapists using the module, 54.1% (93/172 sent at least one feedback message to a patient. The median number of feedback messages sent per therapist was 1, with a minimum of 0 and a maximum of 460. Interviews showed that therapists did not always introduce the intervention to patients and using the intervention was not part of their daily routine. Also, therapists indicated patients often did not have the required conscientiousness and literacy levels. Furthermore, they had mixed opinions about the design of the intervention. Important organization-related factors were the need for more support and better integration in organizational structures. Finally, therapists stated that despite its current low use, the intervention had the potential to improve the quality of treatment.ConclusionsSynthesis of different types of data showed that implementation outcomes were mostly disappointing. Implementation strategies focused on technical training of therapists, while little attention was paid to changes in the organization, design of the technology, and patient awareness. A more holistic approach toward implementation strategies—with more attention to the organization, patients, technology, and training therapists—might have resulted in better implementation outcomes. Overall, adaptivity appears to be an important concept in eHealth implementation: a technology should be easily adaptable to an individual patient, therapists should be trained to deal flexibly with an eMental health intervention in their treatment, and organizations should adapt their implementation strategies and structures to embed a new eHealth intervention.

Steps Ahead: optimising physical activity and health in people with cystic fibrosis: Study Protocol for a pilot randomised trial

Background: Physical activity (PA) and exercise are widely documented as key components in the management of cystic fibrosis (CF). In recent years there have been significant improvements in telehealth, in particular; fitness tracking, smartphone use and remote monitoring, all of which may have potential to impact on positive health outcomes in people with CF. The objective of this pilot randomised trial is to explore the potential efficacy of a fitness tracker, which is remotely monitored, combined with personalised text message feedback and goal setting, on lung function, aerobic capacity and PA in adults with CF. Secondary endpoints include quality of life, body composition and wellbeing. Methods: This is a pilot randomised trial which will be conducted at the University Hospital Limerick, Ireland. Participants will be randomised to the intervention or active comparator after their baseline assessment. The 12-week intervention will consist of a fitness tracker (Fitbit Charge 2) which is linked to an online monitoring system (Fitabase) for data collection purposes that enables the physiotherapist to remotely monitor participant data. The CF physiotherapist will set short- and long-term goals with participants and will send one-way text message feedback on Fitbit data and weekly progress. This message will consist of positive reinforcement and re-assess participant goals. The active comparator group will receive a fitness tracker which is also linked to Fitabase; however, no feedback will be provided to participants in this group. Both groups will be re-assessed at 12 weeks. After this point, both groups will continue with the Fitbit alone for a further 12 weeks. Both groups will be re-assessed at 24 weeks. Discussion: This is a novel concept which utilises modern technology, remote monitoring and personalised feedback to investigate the effect on health outcomes in people with CF. Trial registration: ClinicalTrials.gov NCT03672058 (14/09/2018)

Towards effective feedback: an investigation of teachers’ and students’ perceptions of oral feedback in classroom practice

ABSTRACT Few studies have examined how teachers’ oral feedback in whole-class interactions is received, perceived and used by students to enhance learning. This paper details an in-depth study of secondary teachers’ and students’ reflective comments on classroom oral feedback. The study examined perceptions of teachers and students in English and mathematics classroom interactions. Key findings showed that much teacher feedback was not recognised by students, and that when feedback was recognised it was often not perceived as the teacher had intended. Further, feedback in mathematics was more often recognised and perceived as intended compared to English. If feedback is not received by students, or not perceived as intended by the provider, it is unlikely that the feedback message will achieve its intended effect of supporting student learning. The study provides evidence that feedback perceptions – and thus feedback effectiveness – are context-dependent, subject-dependent, and individual-dependent.

Surprise, Hurt, and Anger as Emotional Responses to Expectancy Violations Following Feedback Messages

ABSTRACTUsing expectancy violations theory, this study examined how the communication of unexpected feedback messages evoke emotional responses. A convenience sample (N = 309) reported instances of unexpected feedback within the last month. Results showed that receipt of the feedback message types were considered moderate-to-high violations. Violation expectedness and valence were negatively associated with the emotional responses, but violation importance was positively associated with the emotional responses. Finally, hurt and anger (but not surprise) were positively linked to perceptions of relational damage between the message sender and receiver. Taken together, our study demonstrates that expectancy violations are connected to emotions and relational outcomes.

Unguided Chatbot-Delivered Cognitive Behavioural Intervention for Problem Gamblers Through Messaging App: A Randomised Controlled Trial.

Internet-delivered intervention may be an acceptable alternative for the more than 90% of problem gamblers who are reluctant to seek face-to-face support. Thus, we aimed to (1) develop a low-dropout unguided intervention named GAMBOT integrated with a messaging app; and (2) investigate its effect. The present study was a randomised, quadruple-blind, controlled trial. We set pre-to-post change in the Problem Gambling Severity Index (PGSI) as the primary outcome and pre-to-post change in the Gambling Symptom Assessment Scale (G-SAS) as a secondary outcome. Daily monitoring, personalised feedback, and private messages based on cognitive behavioural theory were offered to participants in the intervention group through a messaging app for 28days (GAMBOT). Participants in the control group received biweekly messages only for assessments for 28days (assessments only). A total of 197 problem gamblers were included in the primary analysis. We failed to demonstrate a significant between-group difference in the primary outcome (PGSI -1.14, 95% CI -2.75 to 0.47, p = 0.162) but in the secondary outcome (G-SAS -3.14, 95% CI -0.24 to -6.04, p = 0.03). Only 6.7% of the participants dropped out during follow-up and 77% of the GAMBOT group participants (74/96) continued to participate in the intervention throughout the 28-day period. Integrating intervention into a chatbot feature on a frequently used messaging app shows promise in helping to overcome the high dropout rate of unguided internet-delivered interventions. More effective and sophisticated contents delivered by a chatbot should be sought to engage over 90% of problem gamblers who are reluctant to seek face-to-face support.

How does the medium affect the message? Architecture students’ perceptions of the relative utility of different feedback methods

Pedagogic discourse on feedback has shifted away from teachers’ actions towards how it is used by students to improve their work and learning strategies. In architecture programmes feedback occurs through a combination of methods; this paper presents the outcomes of a questionnaire study researching undergraduate and postgraduate students’ perceptions of which they considered most and least useful, and how they could be enhanced. With increased attention on dialogic approaches to feedback, the study provides insight into students’ views of the relative utility of several dialogic feedback methods. Key themes that emerged which affect feedback utility are the environment in which feedback takes place, feedback discourse and message content. Although the signature pedagogy is centred on verbal dialogue, the perceived value of that dialogue varied significantly; some methods were considered much more useful, others left students uncertain and seeking greater clarification within the feedback message. The study suggests contact time be considered qualitatively as well as quantitatively. Another significant finding is students’ desire for more visual feedback, which may be salient to disciplines across the art and design subject area. Other implications for practice are discussed.

THRIVE intervention development: using participatory action research principles to guide a mHealth app-based intervention to improve oncology care.

Background:Women with hormone receptor-positive, early-stage breast cancer who adhere to adjuvant endocrine therapy (AET) reduce the risk of cancer recurrence and mortality. AET, however, is associated with adverse symptoms that often result in poor adherence. We applied participatory action research (PAR) principles to conduct focus groups and interviews to refine and enhance a web-enabled app intervention that facilitates patient-provider communication about AET-related symptoms and other barriers to adherence.Methods:We conducted four focus groups with women with early-stage breast cancer on AET (N=28), stratified by race (Black and White) and length of time on AET (<6 months and >6 months), to determine preferences and refine the app-based intervention. A fifth mixed-race focus group was convened (N=6) to refine THRIVE app content using high-fidelity mock-ups and to develop new, tailored feedback messages. We also conducted interviews with oncology nurses (N=5) who participated in the THRIVE randomized controlled trial.Results:Participants reported preferences for weekly reminder messages to use the THRIVE app, a free-text option to write in AET-related symptoms, and app aesthetics. Other requested app features included: a body map for identifying pain, sleep and dental problems on the symptom list, a dashboard, tailored feedback messages, and information about social support resources. Participants also developed new intervention messages, decided which messages to keep, and edited language for appropriateness and sensitivity. They also discussed the type of electronic pill monitor and incentive plan to be used in the intervention. Nurses reported THRIVE alerts integrated seamlessly into their clinical workflow and increased patient-provider communication, facilitating quicker response to patients’ reported symptoms. Nurses reported no negative feedback or usability concerns with the app.Conclusions:THRIVE app content reflects researchers’ partnership with a racially diverse sample of breast cancer survivors and healthcare providers and adherence to participatory design by incorporating patient-requested app features, app aesthetics, and message content. The app has the potential to improve AET adherence and quality of life among breast cancer survivors and reduce disparities in mortality rates for Black women by facilitating communication with healthcare providers.

Effect of a Mobile Phone-Based Glucose-Monitoring and Feedback System for Type 2 Diabetes Management in Multiple Primary Care Clinic Settings: Cluster Randomized Controlled Trial.

BackgroundRecent evidence of the effectiveness of mobile phone–based diabetes management systems is generally based on studies conducted in tertiary hospitals or professional diabetes clinics.ObjectiveThis study aimed to evaluate the clinical efficacy and applicability of a mobile phone–based glucose-monitoring and feedback system for the management of type 2 diabetes mellitus (T2DM) in multiple primary care clinic settings.MethodsIn this multicenter, cluster-randomized controlled, open trial, 13 primary care clinics in Seoul and other large cities in South Korea were voluntarily recruited. Overall, 150 (9 clinics) and 97 (4 clinics) participants with T2DM were assigned to the intervention and control groups, respectively (2:1 allocation). Every month, participants in both groups attended face-to-face physicians’ consultation for the management of diabetes in the clinic. For the intervention group, participants were required to upload their daily self-monitoring of blood glucose (SMBG) results using the mobile phone app in addition to outpatient care for 3 months. The results were automatically transmitted to the main server. Physicians had to check their patients’ SMBG results through an administrator’s website and send a short feedback message at least once a week. At baseline and 3 months, both groups had anthropometry and blood tests, including hemoglobin A1c (HbA1c), and responded to questionnaires about treatment satisfaction and compliance.ResultsAt 3 months, participants in the intervention group showed significantly more improvement in HbA1c (adjusted mean difference to control −0.30%, 95% CI −0.50 to −0.11; P=.003) and fasting plasma glucose (−17.29 mg/dL, 95% CI −29.33 to −5.26; P=.005) than those in the control group. In addition, there was significantly more reduction in blood pressure, and the score regarding treatment satisfaction and motivation for medication adherence increased more in the intervention group than in the control group. In the subgroup analyses, the effect on glycemic control was more significant among younger patients and higher baseline HbA1c levels.ConclusionsThe mobile phone–based glucose-monitoring and feedback system was effective in glycemic control when applied in primary care clinic settings. This system could be utilized effectively with diverse institutions and patients.Trial RegistrationClinical Research Information Service (CRIS) https://tinyurl.com/tgqawbz