Engagement Index Research Articles

A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program.

Purpose: Mobile health (mHealth) interventions have great potential to promote health. To increase consumer engagement in mHealth interventions it is necessary to address factors that influence the target demographic. The Growing healthy (GH) program is the first obesity prevention program delivered via a smartphone app and website offering evidence-based information on infant feeding from birth until 9 months of age. This sub-study aimed to explore how the design features, quality of the app and participant characteristics influenced parents' engagement with the GH app.Methods: A sequential mixed methods design was used. The GH app participants (225/301) were considered for this sub-study. Participant app engagement was measured through a purpose-built Engagement Index (EI) using app metrics. Participants were categorized as low, moderately or highly engaged based on their EI score upon completing the 9 months program and were then invited to participate in semi-structured telephone interviews. Participants who used the app program, given an EI score and expressed interest to participate in these interviews were eligible. The interviews explored factors that influenced app engagement including delivery features and quality. Thematic analysis networks was used for analysis.Results: 108/225 expressed interest and 18 interviews were conducted from low (n = 3), moderately (n = 7), or highly (n = 8) engaged participants based on purposeful sampling. Participants defined as highly engaged were likely to be a first-time parent, felt the app content to be trustworthy and the app design facilitated easy navigation and regularly opened the push notifications. Participants defined as having low or moderate engagement were likely to have experience from previous children, felt they had sufficient knowledge on infant feeding and the app did not provide further information, or experienced technological issues including app dysfunction due to system upgrades.Conclusions/Implications: This study demonstrated a novel approach to comprehensively analyse engagement in an mHealth intervention through quantitative (Engagement Index) and qualitative (interviews) methods. It provides an insight on maximizing data collected from these programs for measuring effectiveness and to understand users of various engagement levels interaction with program features. Measuring this can determine efficacy and refine programs to meet user requirements.

Who’s that SMARTgirl? Reaching Cambodian Female Entertainment and Sex Workers with HIV Prevention Services

Engagement in prevention services is crucial to reducing HIV risk among female entertainment and sex workers (FESW), and SMARTgirl is the national social marketing HIV prevention program for Cambodian women engaged in sex and entertainment work. Informed by the Behavioral Model of Vulnerable Populations, three multivariate logistic regression analyses examined correlates of three indices of engagement along the SMARTgirl HIV prevention continuum: (1) receipt of outreach services (past 3months); (2) being registered as a SMARTgirl member; and (3) SMARTgirl club attendance (past year). Among the 1077 FESW enrolled in nine Cambodian provinces, women working in a brothel or freelance (adjusted odds ratio [aOR] 2.48; 95% CI 1.44-4.26) and those exchanging sex for drugs during the past 3months (aOR 0.45; 95% CI 0.25-0.81) had significantly lower odds of contact with a SMARTgirl outreach worker. Women who reported having more than ten sexual partners in the past 3months (aOR 0.54; 95% CI 0.32-0.89) and those who reported binge alcohol use (aOR 0.53; 95% CI 0.29-0.98) had significantly lower odds of being registered as SMARTgirl members. Exchanging sex for drugs was also associated with increased odds of attending a SMARTgirl club (aOR 2.03; 95% CI 1.04-3.98). Novel methods to deliver HIV prevention services are warranted to more effectively reach FESW who exchange sex for drugs, engage in binge alcohol use, report a greater number of sexual partners, and those not working in established work venues.

Detecting Disengagement From HIV Care Before It Is Too Late: Development and Preliminary Validation of a Novel Index of Engagement in HIV Care.

Engagement in care is critical to achieving and sustaining optimal benefits of efficacious antiretroviral therapies for HIV infection. Current metrics of engagement in care, including problematic patterns of retention in care, adherence to treatment, and viral suppression, are often detected late in the disengagement process. We sought to develop and validate a patient-centered screener of engagement in care that can be used to identify deficits in patient perceptions of engagement before the development of poor outcomes, including loss to follow-up, treatment nonadherence, virologic failure, and the resulting increased likelihood of HIV-associated morbidity and mortality and onward transmission of HIV. Using input from patients, providers, and researchers through in-person focus groups and an online Delphi process, we developed a self-report measure of engagement in care that was validated with 3296 patients from 7 clinics across the United States. Results supported a single dimension of engagement in care measured by 10 items. Lower scores on the HIV Index were related to higher depression and anxiety symptoms, greater use of alcohol and stimulants, and increased likelihood of reporting internalized HIV stigma. Higher Index scores were positively associated with self-report measures of antiretroviral therapy adherence, corroborative clinic records documenting appointment attendance, and increased likelihood of recent viral load suppression. The HIV Index offers promise as a patient-centered diagnostic and prognostic screener for engagement in care that can be used to trigger interventions to promote better clinical outcomes for persons living with HIV.

693-P: Baseline Characteristics and Self-Care Behavior Goals of Adolescents with Type 1 Diabetes Enrolled in MyDiaText™

Background: Adolescence is associated with suboptimal diabetes control, with average HbA1C levels of 9.0%. Adolescents are highly engaged in mobile technology; over half report sending text messages at least daily. Text messaging (TM) is most commonly used technology in adolescents with type 1 diabetes (T1D). Pilot studies have demonstrated TM to be a useful tool in diabetes education. MyDiaText™ is a website and TM platform created to support behavior change in adolescents with T1DM. Enrollment in a randomized controlled trial (RCT) using MyDiaText™ began in August 2018. Objective: To report the baseline characteristics, self-care behaviors, and engagement in a TM intervention for T1D education and support in a diverse population. Methods: Subjects were recruited from the CHOP Diabetes Center. Enrollment criteria for the trial included: 12-18 years, >1 year from diagnosis and point-of-care HbA1C > 8%. Adolescents selected an AADE7™ Self-Care Behavior (SCB) goal on which to focus. Those in the intervention group received daily educational and motivational text messages. Self-Care Inventory (SCI), 14 questions scored 1-5, and HbA1C were obtained at baseline. Engagement index, defined as number of responses/total messages received, was calculated by the application. Results: There were 107 subjects (average age = 15.8 years {45.8% M, 52.3% F, 1.9% other; 60 (56.1%) W, 33 (30.8%) B, 10 (9.3%) mixed race and 4 (3.7%) other; 11 (10.2%) identified as Hispanic}) enrolled. “Monitoring” was most common SCB selected, 45 subjects (42.4%). Mean (range) baseline HbA1C was 10.0% (8.0-14.1). Mean baseline SCI score was 3.36 (1.07-5.0). Engagement was 60% or greater for 74% of subjects in treatment arm. Conclusions: A diverse population of adolescents with T1D and suboptimal control preferred text messaging support for blood glucose monitoring and demonstrated high engagement in MyDiaText™. Further analyses will determine the efficacy of MyDiaText™ on diabetes outcomes. Disclosure T. Kaushal: None. L.E. Katz: None. M.E. Marowitz: None. J. Joseph: None. D.P. Ritter: None. T.H. Lipman: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (2T32DK063688-11-12 to L.E.K.)

Training engagement, baseline cognitive functioning, and cognitive gains with computerized cognitive training: A cross-diagnostic study

Computerized cognitive training (CCT) interventions are increasing in their use in outpatient mental health settings. These interventions have demonstrated efficacy for improving functional outcomes when combined with rehabilitation interventions. It has recently been suggested that patients with more cognitive impairment have a greater therapeutic response and that reduced engagement in training can identify cases who manifest low levels of benefit from treatment. Participants were psychiatric rehabilitation clients, with diagnoses of major depression, bipolar disorder and schizophrenia. Newly admitted cases received CCT, delivered via Brain HQ, with cognitive functioning divided into groups on the basis of a BACS t-score of 40 or less vs. more. Training engagement was indexed by the number of training levels achieved per day trained. Forty-nine cases trained on average for 17 days and completed a mean of 150 levels. Overall, patients improved by an average of 4.4 points (0.44 SD) in BACS t-scores (p < .001). Improvements were positively correlated with training engagement (r = 0.30, p < .05), but not with days trained (r = 0.09) or levels earned (r = 0.03) alone. Patients with higher levels of baseline cognitive performance had reduced cognitive gains (p < .003), but did not have less training engagement (p = .97). Diagnoses did not predict cognitive gains (p = .93) or target engagement (p = .74). Poorer performance at baseline and higher levels of training engagement accounted for >10% in independent variance in cognitive gains. The mean level of cognitive improvement far exceeded practice effects. The index of engagement, levels achieved per training day, is easily extracted from the training records of patients, which would allow for early and continuous monitoring of treatment engagement in CCT activities and therapist intervention as needed to improve engagement.

Use of the Pope Engagement Index to Measure the Cognitive Load of Biochemistry Students while Completing a 3D Physical Serine Protease Modeling Activity

Research has shown students have significant difficulty understanding enzyme‐substrate relationships. One way instructors have suggested to support students while learning this content is through the use of 3D physical models of the enzyme and substrate. However, little research has been conducted on how the models impact the learning process and the cognitive load of the students. This study aims to measure the cognitive load of biochemistry students while completing a modeling activity focused on understanding the relationship between the substrates and active site of serine proteases. During a simulated learning environment, biochemistry students completed an activity related to how enzymes and substrates interact based on electronics, stereochemistry and geometric complementary using the serine protease physical models. During the activity electroencephalography was used to capture student cognitive processing in order to assign cognitive load of the tasks in the activity using the Pope Engagement Index. This presentation will specifically focus on how spatial ability of the student impacted the level of engagement and in what region of the brain was engaged when completing various tasks. Additional discussion will focus on how changes to the models impacted the cognitive load of the participants when completing the activity. Suggestions will be provided for faculty to think about when developing modeling activities to decrease extraneous cognitive load for students.Support or Funding InformationThis project is supported by the National Science Foundation under award number IUSE 1711402/1711425 to University of Minnesota, Rochester and Kennesaw State University.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Tracking Students’ Mental Engagement Using EEG Signals during an Interaction with a Virtual Learning Environment

Monitoring students’ level of engagement during learning activities is an important challenge in the development of tutoring interventions. In this paper, we explore the feasibility of using electroencephalographic signals (EEG) as a tool to monitor the mental engagement index of novice medicine students during a reasoning process. More precisely, the objectives were first, to track students’ mental engagement evolution in order to investigate whether there were particular sections within the learning environment that aroused the highest engagement level among the students, and, if so, did these sections have an impact on learners’ performance. Experimental analyses showed the same trends in the different resolution phases as well as across the different regions of the environments. However, we noticed a higher engagement index during the treatment identification phase since it aroused more mental effort. Moreover statistically significant effects were found between mental engagement and students’ performance.

Analysis of the Indicator’s Performance to Predict Indonesian Teacher Engagement Index (ITEI) using Artificial Neural Networks

Research related to the Indonesian Teacher Engagement Index (ITEI) is still being developed to get better predictive accuracy. In this study we conducted an analysis using the Neural Network approach to determine the performance of each dimension obtained from the ITEI database. Root Mean Square Errors values ​​generated when using variables in dimensions related to Nationality Character are quite low, which is 0.151, with a correlation of 0.906 and execution time of 13s. In addition, the Nationality Character Dimension obtained excellent performance predictions when combined with the Positive Education Dimension. The Square Errors Root Mean value can be reduced to 0.102 with 8s execution time. The results of this analysis will be used as the basis for developing ITEI applications in the future so that the resulting Teacher Profiling can be used as a basis for policies and strategies to improve teacher performance and engagement in the school environment.

Building an Artificial Neural Network with Backpropagation Algorithm to Determine Teacher Engagement Based on the Indonesian Teacher Engagement Index and Presenting the Data in a Web-Based GIS

Teacher engagement is a newly-emerged concept in the field of Indonesian teacher education. To support this concept, we designed an artificial neural network (ANN) using backpropagation, stochastic learning, and steepest gradient descent algorithms to determine teacher engagement based on the Indonesian Teacher Engagement Index (ITEI). The resulting ANN may be used in a data-gathering website for teachers to use for self-evaluation and self-intervention. The optimal architecture for the ANN has 44 input nodes, 26 first hidden layer nodes, 20 second hidden layer nodes, and 7 output nodes, with a learning rate of 0.05 and trained over 5000 iterations. The sample data used for training was gathered by ITEI researchers and the Executive Board of Indonesian Teachers Association (Pengurus Besar Persatuan Guru Republik Indonesia, PB-PGRI) and includes data of teachers from all around Indonesia. The maximum accuracy of this ANN was 97.98%. The sample data were then used to create an executive information system presented in the form of a map created using ArcGIS Pro software.

Relationship and Interaction between Person and Work Environment Fit Dimensions

In the context of permanent changes in labour market it is insufficient to assess the correspondence between an employee and job only in terms of an employee’s skills, knowledge and competencies in respect to job requirements. We should search for a greater variety of common aspects between the individual and the working environment s/he acts in. Organizations want to select employees who will best meet the demands of the job, adapt to training and changes in job demands, and remain loyal and committed to the organization. Prospective employees in their turn are looking for the organizations which make use of their particular abilities and meet their specific needs. Today’s high-performing employees are looking for more than compensation packages and benefits, they are interested in the increase of their value in labour market. Congruence between the employee and his/her working environment is examined by the multidimensional theory of person-environment fit. A number of studies proving the impact of different dimensions of person-environment fit on employees’ attitudes and behaviour have been carried out. It is established that different dimensions of fit are related to employees’ behaviour and attitude benevolent for the organization, such as job satisfaction, organizational commitment, better performance quality, lower turnover of employees, organizational citizenship behaviour, job engagement, and lower job stress indexes. Nevertheless, scientific literature review has demonstrated that some forms of person-environment fit have not comprehensively been explored and there is a shortage of integrated studies on individual forms of person-environment fit, as well as their correlation with other variables.The aim of the research was to examine the relations of selected person-environmental fit dimensions and their connections to certain attitudes of employees. The objectives of the research were as follows: to analyze theoretical aspects of person and profession, organization and job fit conceptions and their relation to the attitudes of employees; to analyze the interconnection of employees’ profession, organization and job fit and their relations to job satisfaction and intentions to quit the job in one of the biggest Lithuanian insurance companies. The research is relevant as insurance market of the country is permanently increasing, the number of loyal and competent employees is insufficient and high rates of turnover are notable. Thus, it is important to study the factors relating to the above described context and to analyze how person-job environment fit relates to the factors important to employees’ turnover. The research was implemented during the period of January – February, 2018. The respondents were 91 employees of the insurance enterprise holding professionally and hierarchically different positions in the organization.The data analysis has revealed that positive relationships exist between all explored dimensions of person-environment fit. Further analysis has demonstrated that with the growing person-profession, personorganization and person-job fit, employee job satisfaction is increasing and thus his/her intent to leave a position is diminishing. The only dimension, i.e. demands-abilities fit, did not correlate with the employee intention to leave. The results of the study have also revealed that links between person-environment fit dimensions and the analyzed employee attitudes are more complex than simple direct links.This research revealed the importance of needs – supplies correspondence in forecasting the attitudes of employees important for the organization, i.e. job satisfaction and intentions to quit the job. Skills, knowledge and competencies’ based correspondence to job requirements which is widely analyzed in previous research and practically applied in the employee selection and recruitment procedures, had no forecasting effect on the employees’ attitudes. These results revealed the satisfaction of employees’ needs in the efforts to retain him/her. Moreover, the results indicated that the satisfaction of employees’ needs better forecast employees job satisfaction than employee-organization fit. The research also revealed the indirect impact of person-profession fit on the attitudes of employees. It became clear that employee-profession fit influences needs-suppliers correspondence which forecasts employees’ attitudes. Thus, insufficient person-profession fit preconditions diminishes the satisfaction of employees’ needs, which in its turn directly predicts job satisfaction and intentions to quit the job. This confirms the assumption that employees’ needs as expressed in the organizational environment highly depend on the employees’ embeddedness in their profession.

Acoustic Neurofeedback Increases Beta ERD During Mental Rotation Task

The purpose of the present study was to identify the effect of acoustic neurofeedback on brain activity during consecutive stages of mental rotation of 3D objects. Given the fact that the process of mental rotation of objects is associated with desynchronisation of beta rhythm (beta ERD), it was expected that suppression in this band would be greater in the experimental group than in the controls. Thirty-three participants were randomly allocated to two groups performing the classic Shepard–Metzler mental rotation task (1971). The experimental group received auditory stimuli when the level of concentration fell below the threshold value determined separately for each participant based on the engagement index [β/(α + Θ)]. The level of concentration in the control group was not stimulated. Compared to the controls, the experimental group was found with greater beta-band suppression recorded above the left parietal cortex during the early stage and above the right parietal cortex during the late stage of mental rotation task. At the late stage of mental rotation, only the experimental group was found with differences in beta ERD related to varied degrees of the rotation angle and the control condition (zero angles, no rotation) recorded above the right parietal cortex and the central area of cerebral cortex. The present findings suggest that acoustic feedback might improve the process of mental rotation.

The Association between Social Engagement, Loneliness, and Risk of Dementia: A Systematic Review and Meta-Analysis.

It has been reported that social engagement may be associated with dementia risk. We searched PubMed, EMBASE, PsycINFO, CINAHL, LILACS, Biomed Central, Scopus, and Web of Science from January 2012 - May 2017, supplemented by extraction from previous reviews. We included cohort and case-control studies examining the association between social engagement or loneliness and dementia risk, pooling data using a random-effects model. Registered: PROSPERO (CRD42017067074). We included 31 cohort and 2 case-control studies comprising 2,370,452 participants. Poor social engagement indices were associated with increased dementia risk, including having a poor social network (RR = 1.59, 95% CI 1.31-1.96; I2 = 0.00%) and poor social support (RR = 1.28, 95% CI 1.01-1.62; I2 = 55.51%). In long-term studies (≥10 years), good social engagement was modestly protective (RR = 0.88, 95% CI 0.80-0.96; I2 = 0.00%). Loneliness was non-significantly associated with increased risk (RR = 1.38, 95% CI 0.98-1.94; I2 = 45.32). Our findings encourage interventions targeting social isolation and disengagement for dementia prevention.

Simple Electroencephalographic Treatment-Emergent Marker Can Predict Repetitive Transcranial Magnetic Stimulation Antidepressant Response-A Feasibility Study.

Prefrontal repetitive transcranial magnetic stimulation (rTMS) repeated daily for 4 to 6 weeks is used to treat major depressive disorder, but more than 50% of patients do not achieve significant response. Here we test the validity of a simple electroencephalographic (EEG) marker that predicts nonresponse to rTMS. Such a marker could potentially increase rTMS effectiveness by directing nonresponders to alternative treatments or by guiding early modification of stimulation parameters. We retrospectively analyzed 2-channel EEG data captured in the OPT-TMS National Institute of Mental Health-sponsored, multicenter study. Cumulative Brain Engagement Index (cBEI), a measure derived from template matching that allows scoring EEG dynamics along treatment, was computed. Six hundred sixty-five EEG recordings were analyzed. In the rTMS group, the median cBEI was found to increase in the responder group but remained unchanged in the nonresponder group. The difference between the cBEI of the groups became statistically significant by the third valid EEG sample. Within 5 samples, 91% of the responders presented with a cBEI above a preset threshold. Within 9 samples, 17% of the nonresponders had a cBEI above the threshold. This study demonstrates the feasibility of a simple-to-capture EEG marker as a treatment-emergent marker of response to rTMS treatment of depression. In the OPT-TMS study, discontinuing treatment when the cBEI dropped below the threshold between the fifth to ninth treatment potentially could have avoided administration of 485 (63%) of 765 treatments. Because the marker can be generated online, it would be of interest to evaluate, in future studies, whether it could be used to tune treatment parameters and improve remission rates.

Axial patellar engagement index and patellar tilt after medial patello-femoral ligament reconstruction in children and adolescents

BackgroundThe medial patello-femoral ligament (MPFL) is a major patellar stabiliser whose reconstruction in adults involves graft fixation within a femoral tunnel. In skeletally immature patients, in contrast, the graft is fixed to the soft tissues to allow normal growth.The primary objective of this prospective study was to perform computed tomography (CT) and magnetic resonance imaging (MRI) assessments of medium-term correction of patellar tilt and of the axial patellar engagement index (AEI) after a paediatric variant of MPFL reconstruction in skeletally immature patients. HypothesisMPFL reconstruction, performed alone or combined with other procedures in skeletally immature patients, decreases patellar tilt and improves the AEI. Material and methodsEighteen children and adolescents with a median age of 14.6 years (range, 8–17 years) who underwent MPFL reconstruction on 20 knees were included in this prospective observational study. A double-strand gracilis tendon graft passed through the medial collateral ligament was used. MPFL reconstruction was performed alone in 13 knees and was combined with lateral retinaculum release, tibial tuberosity translation, and/or trochleoplasty in 7 knees. Patellar tilt and AEI values determined on preoperative and post-operative imaging studies with the quadriceps relaxed and contracted were compared. A physical examination was also performed. ResultsFrom baseline to last follow-up after a mean of 43 months (range, 24–63 months), patellar tilt decreased from 20° preoperatively to 9° with the quadriceps relaxed and from 33° to 15.4° with the quadriceps contracted. The AEI increased from 0.78 at baseline to 0.93 at last follow-up. No dislocation or subluxation recurrences were recorded during follow-up. DiscussionThe patellar tilt and AEI improvements seen after paediatric MPFL reconstruction confirm the study hypothesis. This is the first prospective study of patellar position in the axial plane as assessed by CT and MRI after paediatric MPFL reconstruction. In everyday clinical practice, 3D assessments of patellar tilt and the AEI should be performed to evaluate correction of the abnormalities. Level of evidenceII, non-randomised prospective observational study.

Monitoring Migraine Cycle Dynamics with an Easy-to-Use Electrophysiological Marker-A Pilot Study.

Migraine attacks can cause significant discomfort and reduced functioning for days at a time, including the pre-ictal and post-ictal periods. During the inter-ictsal period, however, migraineurs seem to function normally. It is puzzling, therefore, that event-related potentials of migraine patients often differ in the asymptomatic and inter-ictal period. Part of the electrophysiological dynamics demonstrated in the migraine cycle are attention related. In this pilot study we evaluated an easy-to-use new marker, the Brain Engagement Index (BEI), for attention monitoring during the migraine cycle. We sampled 12 migraine patients for 20 days within one calendar month. Each session consisted of subjects’ reports of stress level and migraine-related symptoms, and a 5 min EEG recording, with a 2-electrode EEG device, during an auditory oddball task. The first minute of the EEG sample was analyzed. Repetitive samples were also obtained from 10 healthy controls. The brain engagement index increased significantly during the pre-ictal (p ≈ 0.001) and the ictal (p ≈ 0.020) periods compared with the inter-ictal period. No difference was observed between the pre-ictal and ictal periods. Control subjects demonstrated intermediate Brain Engagement Index values, that is, higher than inter-ictal, yet lower than pre-ictal. Our preliminary results demonstrate the potential advantage of the use of a simple EEG system for improved prediction of migraine attacks. Further study is required to evaluate the efficacy of the Brain Engagement Index in monitoring the migraine cycle and the possible effects of interventions.

The Prevalence of Culture Change Practice in US Nursing Homes: Findings From a 2016/2017 Nationwide Survey.

Given the dynamic nursing home (NH) industry and evolving regulatory environment, depiction of contemporary NH culture-change (person/resident-centered) care practice is of interest. Thus, we aimed to portray the 2016/2017 prevalence of NH culture change-related processes and structures and to identify factors associated with greater practice prevalence. We administered a nationwide survey to 2142 NH Administrators at NHs previously responding to a 2009/2010 survey. Seventy-four percent of administrators (1583) responded (with no detectable nonresponse bias) enabling us to generalize (weighted) findings to US NHs. From responses, we created index scores for practice domains of resident-centered care, staff empowerment, physical environment, leadership, and family and community engagement. Facility-level covariate data came from the survey and the Certification and Survey Provider Enhanced Reporting system. Ordered logistic regression identified the factors associated with higher index scores. Eighty-eight percent of administrators reported some facility-level involvement in NH culture change, with higher reported involvement consistently associated with higher domain index scores. NHs performed the best (82.6/100 weighted points) on the standardized resident-centered care practices index, and had the lowest scores (54.8) on the family and community engagement index. Multivariable results indicate higher index scores in NHs with higher leadership scores and in states having Medicaid pay-for-performance with culture change-related quality measures. The relatively higher resident-centered care scores (compared with other domain scores) suggest an emphasis on person-centered care in many US NHs. Findings also support pay-for-performance as a potential mechanism to incentivize preferred NH practice.

Reading engagement and reading literacy performance: effective policy and practices at home and in school

Based on the data of Program for International Student Assessment 2009, this paper examines how various aspects of home literacy environment, school climate and students' reading engagement related to their reading performance. A profile of Hong Kong students' three indices of reading engagement – namely, reading enjoyment, reading diversity and online reading – relative to other East Asian societies is first presented. The relative contributions of different family‐level and classroom‐level factors on Hong Kong students' reading engagement are then examined by using hierarchical linear modelling. Assessment of the relative impact of the three engagement indices on reading performance shows that reading enjoyment is the strongest predictor. That home‐school cooperation in cultivating a positive reading climate, nurturing a good reading habit for all students and enhancing the classroom and teaching climate appear to be promising avenues for improving students' reading engagement and performance may be of importance for shaping future policy and practice.

Neural correlates of action video game experience in a visuospatial working memory task

Studies have shown improved cognitive performance of action video game players (AVGPs); however, the corresponding neural correlates are still unclear. The present study aims to investigate whether the unsupervised training on action video games contributes to the visuomotor adaptation of working memory or not, considering neural measures. Twenty-seven-Channel electroencephalogram (EEG) signals from 35 participants are recorded while performing Corsi block-tapping task (CBTT), a working memory task incorporating recall of visual and sequential–spatial information, and are analyzed employing wavelet transform-based feature extraction techniques. For removing artifacts, we have used the wavelet denoising method. Different mother wavelet functions, with different thresholding algorithms, are compared. The dmeyer mother wavelet function along with Rigorous SURE soft thresholding emerged as the best combination for denoising. Comparison of wavelet energy features has revealed improved rhythmic activity in AVGPs. Also, two measures of engagement index β/(α + θ) and β/α are computed which has provided good classification accuracies with ANFIS classifier. Higher engagement indexes are found in the frontal, right parietal and occipital cortex of AVGPs. These results evidence the neurocortical modulation among the players that may attribute to the effective cognitive processes in AVGPs related to the task.

Ground-truthing social vulnerability indices of Alaska fishing communities

Community vulnerability is increasingly evaluated through quantitative social indices, typically developed using secondary data sources rather than primary data collection. It is necessary to understand the validity of these indices if they will be used to inform policy and decision making. This paper presents a ground-truthing effort to validate quantitative indices that characterize the well-being of Alaska fishing communities. We utilized ethnographic data collected from 13 representative communities and a capital assets framework to ground-truth the indices, in which qualitative ranks of vulnerability were compared against quantitative indices. The majority (73.8%) of ranks were in complete or moderate agreement and the results indicate that most of the indices are representative of community vulnerability; yet some variables utilized to create the indices could be modified to better reflect realities in Alaska. Indices of commercial fishery engagement and reliance appeared to be more reliable than socio-economic indicators, particularly for smaller fishing communities. We also confirmed that the indices do not capture political, or ecological factors that affect levels of community vulnerability. We conclude that quantitative indices of community vulnerability are useful rapid assessment tools; however, they should be validated, and complemented with ethnographic data prior to their implementation as policy making and management tools.

Development and validation of an instrument to measure patient engagement in Hong Kong Special Administrative Region, China.

ObjectiveThe objective of this study was to develop, pilot test, and psychometrically validate a patient engagement questionnaire, called Patient Engagement Index (PEI), in Hong Kong, China.MethodThe method employed was based on a patient engagement framework and literature review and expert panel discussion. A new measure named PEI with 20 items divided into five factors was developed. A pilot study of 40 patients was used to confirm the clarity of PEI. Explored factor analysis was used to confirm the construct validity. Cronbach’s alpha, intercorrelation coefficients (ICCs), and weighted kappa were used to assess the internal consistency reliability and test–retest reliability separately. Rasch model and differential item functioning were also used to further confirm the fit of the instrument.ResultsIn all, 324 participants successfully completed the survey. Based on the evaluation of exploratory factor analysis and theoretically considerations, a four-factor structure comprising 20 items was identified. Rasch analysis also confirmed that the model has a good fit (ranging from 0.662 to 1.294). All domains were considered internally consistent (alpha >0.7). Test–retest showed both ICC (>0.6) and weighted kappa (>0.4) meeting the minimum recommended standard. No ceiling or floor effect was found. Furthermore, Spearman’s correlation coefficient confirmed that PEI had good internal validity.ConclusionPEI was shown to have good reliability and validity. This is a short, quick, and appropriate tool to assess the extent of patient engagement in both clinical and research settings.