Super Users Research Articles

How do scholars and non-scholars participate in dataset dissemination on Twitter

Focusing on the dataset dissemination structure on Twitter, this study aims to investigate how users of two different identities, scholars and the public, participate in the dissemination process. We collected 2464 datasets from Altmetric.com and used social network analysis to plot the graphs. From a macroscopic viewpoint, most datasets were diffused by viral dissemination (structure II) and mixed dissemination (structure III), and the diffusion level was fundamentally one or two levels. Based on the topics clustering results of the datasets, the majority were about open access, research data, and Altmetrics, as well as astronomy, biology, medicine, and environmental engineering. The dataset dissemination structure shared a little relationship with the research topic. From the microscopic viewpoint of parent nodes and child nodes, during the dataset dissemination, there were only marginally more Twitter users with scholar status than non-scholar ones, suggesting that compared with traditional academic accomplishments such as journal papers. However, the dataset seems to be more professional and targeted; significant audience beyond academics are also involved. During disseminating datasets on Twitter, most tended to be diffused among users of the same identity. However, a few non-scholars played crucial roles, such as super users and intermediaries. Overall, a considerable part of tweets and tweets of parent nodes with the ability to spread is primarily the tweets commented simultaneously forwarded (type II) are posted at the same time commented. Hence, this study underlines the significance of research data-sharing and social media's role in public participation in science.

Super-High-Utilizer Patients in an Urban Academic Emergency Department: Characteristics, Early Identification, and Impact of Strategic Care Management Interventions.

Patients who visit the emergency department (ED) with high frequency are typically categorized as super users, high utilizers, or super-high utilizers (SHUs) based on the relative frequency of hospital care they require, compared with other ED patients (Chambers et al., 2013; Rinehart et al., 2018). Common characteristics of patients with frequent utilization of emergency services are well described in the literature, including high chronic disease burden, substance abuse, and psychiatric disorders (LaCalle & Rabin, 2010; Sandoval et al., 2008; Szekendi et al., 2015). There has been relatively less focus on the characteristics of high utilizers who are frequently admitted to inpatient services following their ED encounters (Boonyasai et al., 2012; Raven et al., 2011). Healthcare spending attributed to the highest utilizers of the ED, categorized as SHUs, is disproportionately high (Bergenstal et al., 2020; Jiang et al., 2006...

Abstract 6907: Implementing Quality Improvement With Fellow-in-Training Super Users: Preventing Preventable Strokes Initiative

Introduction: Quality improvement (QI) is an integral requirement of post graduate training. To reduce stroke by addressing lack of anticoagulation (AC) for patients with atrial fibrillation (AF), the Heart Rhythm Society (HRS) led QI initiatives at metropolitan area “safety-net” hospitals, health systems that deliver a significant level of service to medically and socially vulnerable populations. We incorporated a fellow-in-training “Superuser” team in the design of a QI initiative at University of Florida Health Jacksonville. Hypothesis: Our hypothesis was that the use of a team of fellows in training to conduct academic detailing can enhance the impact of QI intervention Methods: This initiative was designed to integrate guideline-based treatment algorithms and alerts into the Electronic Health Record (EHR) and to disseminate education for the provider and patient, with emphasis on shared-decision making. An interdisciplinary team was organized among divisions of cardiology, internal medicine, family medicine, information technology and pharmacy. The first stage was to collect benchmark data to identify gaps in guideline-directed AC. EHR records from July through December 2020 were reviewed. To assist with PDSA (Plan, Do, Study, Act) interventions, a Superuser team was formed by fellows-in-training in cardiology and electrophysiology, as well as residents in internal medicine. The information technology department generated bi-weekly data reports to monitor progress. Bi-weekly Superuser meetings were held to analyze data, identify improvement strategies, and form a plan of action. A total of five PDSA cycles were planned and conducted over a 6-month period. Results: At benchmark, 43.67% of AF patients with a CHA 2 DS 2 -VASc score of 2 or more were untreated with AC. This percentage was reduced to 42.16% after five PDSA cycles. There were 1.5% more patients treated with AC after six months, compared to the benchmark data. This improvement in AC percentage could have resulted in the prevention of 1.5 strokes. Conclusion: Appropriate and sustained interventions can improve quality measurement in guideline-based AF management. Fellows-in-training can be mobilized to support these efforts. The QI initiative achieved some success and built a foundation for future outcomes-based improvement, as well as an enthusiasm for QI by fellows-in-training.

Crowdsourcing Fungal Biodiversity: Approaches and standards used by an all-volunteer community science project

Fungal Diversity Survey (FunDiS) is an all-volunteer community science organization that documents the diversity and distribution of macrofungi (visible with the naked eye) across North America. FunDiS addresses a key gap in biodiversity conservation: fungi, one of life’s major kingdoms, have been largely neglected in conservation efforts. Fungi are hyperdiverse: it is estimated that only 5% of fungal species have been described (Willis 2018), while support for professional taxonomists has been declining for decades. Therefore, FunDiS engages legions of amateur mycologists to document fungal diversity. Our participation model has four levels for crowdsourcing fungal biodiversity. It consists of a pyramid of participants and skills, continually drawing more people in at the base (simplest tasks), and encouraging them to move up to the next level. Level 1. Field observations: Community scientists document fungi in the field with georeferenced color photos and post observations on public, databased platforms; FunDiS uses iNaturalist and Mushroom Observer. FunDiS established a curated iNaturalist project called the FunDiS Diversity Database, inspired by FungiMap in Australia. Mushroom enthusiasts add observations, with the incentive that they will be reviewed by a team of expert identifiers. Another team of triagers goes through new observations, rejects those that do not follow FunDiS quality standards, and writes encouraging notes to posters on how to make observations more scientifically valuable. As of August 2021, there were almost 50,000 verifiable observations, of which 30,465 (including 3,204 species) were research grade and uploaded by iNaturalist onto the website of the Global Biodiversity Information Facility (GBIF). Another FunDiS initiative, Rare Fungi Challenges, enlists amateurs to search for rare or threatened fungi. Level 2. Sequence: FunDiS built a program for amateurs to submit tissue for DNA sequencing and provided help interpreting results. Barcoding is especially needed to identify fungi because mopho-characteristics and images are often insufficient. Participants register projects, post observations to iNaturalist or Mushroom Observer, and apply to FunDiS for sequencing grants or pay out-of-pocket for sequencing. More than 200 local projects have been registered from Alaska to Puerto Rico, and Iceland to Hawaii. Some 7,000 specimens were sequenced by June 2021. Data are deposited in GenBank. Level 3. Voucher: FunDiS supports preserving well-documented, dried specimens in curated fungaria. To date, this participation level has developed slowly because of limitations of personnel and capacity of those institutions. Level 4. Super User: These are advanced observers with extensive field knowledge who have learned DNA technology; can teach others how to analyze DNA results and create phylogenies; and even describe new species. There are perhaps several dozen super users in the North American fungal science community. Challenges and lessons Feedback - Feedback to and from participants is critical to the success of community science projects. We have learned that it takes time and personnel to inspire rich interaction with participants in real time and that relying on volunteers with insufficient capacity for coordination, consistency and continuity often disappoints participants. Similarly DNA sequencing is intimidating to most amateurs. We found that guidance was needed for many participants just to correctly document, dry and submit tissue samples for sequencing. An even bigger challenge is making sense of the data that is generated, e.g., knowing if the sequence is of a described species or should be identified as a new species. Deep knowledge is needed for this kind of decision-making. In the past year we were fortunate to have the volunteer services of two professional mycologists and a doctoral student to analyze sequence data. Linking data - Linking data between field observations, genetic sequences and specimens is a major challenge. Our initial goal was to automate both external and internal data flows, but success has been limited with volunteer programmers. They managed to automate uploading iNaturalist and Mushroom Observer observations to our sequencing facility (Barcode of Life), but most other linkages have been tracked by volunteers on static spreadsheets. Paid staff - In retrospect, it was optimistic to attempt a project of such ambitious scope using only volunteer management and labor. The vast majority of community science projects are institution-based, with paid staff to manage and funds for outreach (Pocock et al. 2017). To continue at the present scale, we believe a core of paid staff is essential to leverage the large community we have been building.

Proactive integrated virtual healthcare resource use in primary care

BackgroundProactive integrated virtual healthcare resource (VHR) use can improve efficiency, maximize resource capacity for delivering optimal coordinated care and improve patient outcomes. Proactive integrated VHR use is vital for delivering high quality care. Our objectives were to identify proactive integrated VHR use among primary care teams, best practices and targeted implementation strategies to promote proactive integrated VHR use.MethodsThis is a mixed-method descriptive study. We employed a community-based participatory approach to collect data and the Consolidated Framework for Implementation Research to analyze and contextualize findings. A cross-sectional sample of primary care team members (n = 65) from a Department of Veterans Affairs medical center participated in focus groups, follow-up interviews (n = 16), and respond to self-report surveys. Operational subject matter experts (n = 15) participated in informant interviews.ResultsSurvey data described current use and factors that influenced singular VHR use and were convergent with qualitative findings. Focus group and interview data described no evidence of proactive integrated VHR use. Differences and similarities were identified between both utilization groups, such as facilitators and barriers, recommendations, patient education and preferred implementation strategies. All groups reported issues around VHR availability knowledge and access and functionality. Participants identified the need for best practices that are specific to care tasks and performance measures. Expert informant interviews identified a list of VHR tools that could be proactively integrated across the healthcare continuum.ConclusionsHealth systems are leveraging technologies to proactively integrate VHR to maximize information exchange, clinical decision support and patient engagement. VHR is critical during global pandemics, such as COVID-19, to maintain access to care coordination and delivery while abiding by public health recommendations. Though recent requirements for reducing contact create an intrinsic motivation, cultural change through education and best practices of proactive integrated use across the healthcare continuum is needed to create a culture of VHR super users.

THE IMPACT OF SOCIAL MEDIA USE ON SLEEP QUALITY AND PERFORMANCE AMONG COLLEGIATE ATHLETES

Background:Social media (SM) use among young adults has increased significantly in recent years and has been linked to poor sleep quality. College athletes pose a unique risk for poor sleep given their many demands. Currently, limited research is available on the impact of SM use on sleep quality, or the competition performance of college athletes.Hypothesis:College athletes who use more SM will have worse sleep quality and worse competition performance.Methods:A cross-sectional study design was employed among local NCAA Division III athletes. Data was collected via a SM use form, lifestyle survey, and PROMIS sleep disturbance questionnaire. SM volume (hours of SM use per day over 7 days) was recorded using the iPhone screen time function. The main outcome measures were sleep quality, using the PROMIS T-score, and performance, collected through publicly available competition results. Participants were divided into 3 groups based on their SM volume; 1) moderate SM users (SM time ≤ 2hours/day), 2) active SM users (SM time < 2 - ≤5hours/day), and 3) super active SM users (SM time > 5hours/day). For sleep quality, an ANCOVA was used to identify differences in the 3 groups while controlling for covariates (i.e. injury status, caffeine use, number of roommates, academic load, catastrophic life event, life balance and sleep medication use) that might impact sleep and performance. For performance, a binary logistic regression model was used to determine the independent association between each variable and competition performance after adjusting for confounders.Results:87 athletes (age:19.5±1.2 years, 40 males, 47 females) completed the survey. All males participated in track and field, while the females consisted of 37 track athletes and 10 swimmers. Controlling for the effect of lifestyle variables, a difference in sleep quality was identified among the three groups (p=0.025), (Table 1. A pairwise comparison indicated that the sleep quality of super active SM users was worse than moderate SM users (p=0.033) (Figure 1). For competition performance, an independent association was found between increased Facebook time and poor performance after adjusting confounders (aOR: 0.989, 95%CI: 0.978-0.999, p=0.038), (Table 2,3).Conclusion:High SM use appears to have a negative impact on sleep quality. Also, greater SM use may hinder competition performance among college athletes. These findings may have implications for developing SM use guidelines for college athletes to improve their sleep quality and performance.Tables/Figures:Figure 1.Pairwise Comparison of Sleep Quality and Social Media use

The Raystation conversation: Multidisciplinary perceptions about training, leadership, and communication during implementation of new technology

PurposeThere is very little information guiding cancer centres as they plan for costly and time consuming implementation programs for new technology. The purpose of this research was to explore the perspectives of multiple professional groups directly involved in the implementation of a next generation treatment planning system at a large academic cancer centre . MethodsThis research was a single centre, prospective study using a qualitative design and three-phased approach (interviews, questionnaire, and focus groups). The target population included radiation therapists, oncologists, and physicists that received Raystation training during initial clinical implementation. ResultsTraining was received positively by most respondents, but the lengthy lead-up time between training and clinical use led to decreased confidence with the software across all professional groups. Multidisciplinary training was not considered useful when learning tool function, but would have been helpful when practicing on clinically relevant cases. Respondents appreciated the proactive communication, as well as the multidisciplinary leadership implementation strategy. Therapist ‘Super Users’ emerged as a pivotal leadership and communication role in the successful implementation of Raystation. ConclusionsThis research provided valuable multidisciplinary insight into the implementation of Raystation. The multidisciplinary leadership team and proactive communication strategy were considered vital to the success of the implementation. Learner suggestions - such as increasing the number of Therapist ‘Super Users’, minimizing training-to-clinical lead time, and the creation of practice cases that are more relevant to daily clinical duties - should be incorporated into future training programs for similar new technology.

Online Learning Transition Based on Internet and E-Commerce Classroom Learning Management System (LMS)

In the era of digital information, especially in the field of education, online learning methods are currently developing rapidly in the learning and teaching process. The aim of this project is to provide a uniform and consistent user interface in the new learning management system (LMS) for students and faculties and to promote super users who will assist the faculty in a smooth transition from. The curriculum template is provided in the LMS for online learning processes or called e-Learning and has various training opportunities with super users that are interactive so that online learning will be effective and quality. (57%) report results from faculty feeling competent or very competent (36%) in their ability to use. Canvas ™ LMS after project implementation; There are several survey comments reflecting a positive response to the transition to Canvas ™. This project produces quality, student-centered online learning. Where is in accordance with the standardized template framework.

Mobile Health Use Predicts Self-Efficacy and Self-Management in Adolescents with Sickle Cell Disease

Background: Sickle cell disease (SCD) is associated with medical challenges that often worsen for adolescents and young adults (AYA) when caregivers begin to transfer responsibility for care. Living with SCD requires self-management and self-efficacy and is a critical concern for AYA as they navigate complex medical systems. However, previous research indicates that AYA with SCD often lack the ability, confidence, and skills to manage their disease effectively. As most AYA with SCD are now "technology natives," mobile health (mHealth) holds considerable promise for assessing and changing behaviors to improve health outcomes. In a previous feasibility and acceptability study, AYA with SCD provided qualitative feedback that they would use mHealth (a co-designed mobile app) and that it was beneficial for tracking health behaviors. Thus, we integrated the mHealth app into a group intervention (SCThrive) and hypothesized that more engagement with the mHealth app would result in increased self-management and self-efficacy for AYA with SCD. Methods: Our analysis from a single-site, randomized control trial (NCT02851615) assessed data from only AYA in the treatment arm (N = 26) who received the SCThrive intervention and used the mHealth app. The sample included AYA with SCD aged 13 to 21 years (Mage = 16.7 years; 54% female; 46% HbSS genotype; all African American/Black) who received six-weekly group sessions (3 in-person, 3 online). All SCThrive participants were provided with the mobile app (iManage) on an iPad. The Transition Readiness Assessment Questionnaire (TRAQ-5) assessed self-management skills and the Patient Activation Measure (PAM-13) assessed self-efficacy at baseline and posttreatment. We also assessed engagement (logins), confidence and completion of self-management goals (e.g., exercising, take medications), pain diary entries, and mood symptoms recorded on the iManage app (see Figure 1). Results: Preliminary analyses indicated that most AYA with SCD logged on to the iManage app (Mlogins = 7.8, SD = 9.1, range = 1 - 45) and viewed their pain diary (Mviews = 5.7, SD = 9.1, range = 1 - 45) at least once a week. Eighty-eight percent of AYA saved a pain diary entry and the most commonly used strategies for managing pain episodes were resting (22%), drinking water (19%), and using distraction (8%). AYA viewed their self-management goals about once every 11 days (Mdays = 11.24, SD = 13, range = 0 - 57). All AYA created (Mgoals = 5.7, SD = .72, range = 4 - 7), but only 54% of AYA completed at least one self-management goal. Of the 149 self-management goals created by the entire sample, only 37 (25%) were recorded as completed. AYA with a confidence level of 7 or lower were least likely to complete their self-management goals (14%) (see Figure 2). Correlation analyses demonstrated that logging on to the iManage app more frequently was associated with completing more self-management goals (r = .38), documenting pain symptoms more frequently (r = .54), and lower mood ratings (r = .54). Primary analyses demonstrated that after controlling for scores at baseline, the number of logins to the iManage app (p = .08, η2 = .13) predicted self-efficacy (PAM-13) and (p = .05, η2 = .17) self-management skills (TRAQ-5). Completing more self-management goals on the iManage app did not predict scores on the PAM-13, but, surprisingly, predicted lower scores (less self-management) on the TRAQ-5 (p = .08, η2 = .14). Conclusion: Lessons learned from our study indicate that it can be challenging to maintain engagement in mHealth for AYA with SCD, but for those who do engage there are significant benefits related to self-management goals, documenting pain symptoms, and mood. Supporting hypotheses, engaging more with the iManage app was related to higher-reported self-efficacy and self-management skills. Some AYA engaged with the app infrequently and did not create or complete self-management goals; others were "super users" and logged into the app daily. Increasing the frequency of reminder messages, encouraging more interactions with peers, and tailoring the opportunity to earn incentives are potential modifications for future interventions. However, our findings indicate that a mHealth app can be effectively integrated into a clinical trial and is related to positive outcomes. Although there are challenges to address, mHealth has the potential to bring about changes in behavior and improve health in the SCD population. Disclosures No relevant conflicts of interest to declare.

On track to the stomach! ! Cortrak® for the insertion of nasogastric tubes amongst neuroscience patients – how effective is it?

Abstract Nasogastric tube feeding is common amongst neuroscience patients and they are typically placed blindly at the bedside. However, the procedure for inserting feeding tubes has remained time consuming with misplacement into the lungs still occurring. Methods for checking nasogastric tube placement have evolved over time but complications remain. The Cortrak® 2 enteral access system (EAS) uses a computer screen for real-time placement viewing using an electromagnetic stylet to avoid the complications of blind tube insertion. A trial was commenced to determine whether the Cortrak® 2 is accurate for nasogastric tube placement and whether this eliminates the use of x-ray. The trial also examined whether the Corgrip® NG/NJ feeding tube retention system would prevent the need for reinsertion of nasogastric tubes and reduce the need for a one on one health care assistant watch to prevent removal. Super users were trained to insert the Cortrak® nasogastric tubes and the Corgrip® feeding tube retention system. The trial demonstrated favourable results and these will be presented.

Methamphetamine, Amphetamine, and MDMA Use and Emergency Department Recidivism.

Emergency department (ED) recidivism and the use of amphetamine and associated derivatives such as methamphetamine and MDMA (MAE), are intersecting public health concerns. This study aims to determine the frequency of ED recidivism of patients who use MAE and associated factors. The study was a retrospective 6-year electronic medical record review of patients with MAE-positive toxicology screens and single and multiple ED visits in the span of 12months. There were 7844 ED visits by 5568 MAE-positive patients. Average age was 42±13years. The majority were male (65%), white (46%), tobacco smokers (55%), and in the psychiatric discharge diagnostic-related group (41%), followed by blunt trauma (20%). Admission rate was 35%, with another 17% transferred to inpatient psychiatric treatment facilities. Occasional (2-5 visits/year), heavy (6-11 visits/year), and super users (≥12 visits/year) altogether accounted for 20% of patients and 43% of visits. Heavy and super users combined represented 2% of patients and 10% of visits, with significant differences for race/ethnicity, health insurance, tobacco smoking, and psychiatric/cardiovascular/trauma discharge diagnostic-related groups. Heavy and super users were less likely to be admitted and more likely to be discharged to an inpatient psychiatric treatment facility. Regression analysis revealed racial/ethnic differences, female gender, and tobacco smoking to be associated with super and heavy use. Heavy users were more likely to have cardiovascular-related discharge diagnoses. The prevalence of ED recidivism in patients who use MAE is similar to published ranges for general ED users. Significant differences in demographics, discharge diagnoses, insurance, smoking, and disposition exist between nonfrequent and frequent ED users.

Community science participants gain environmental awareness and contribute high quality data but improvements are needed: insights from Bumble Bee Watch

Bumble Bee Watch is a community science program where participants submit photos of bumble bees from across Canada and the United States for expert verification. The data can be used to help better understand bumble bee biology and aid in their conservation. Yet for community science programs like this to be successful and sustainable, it is important to understand the participant demographics, what motivates them, and the outcomes of their participation, as well as areas that are working well or could be improved. It is also important to understand who verifies the submissions, who uses the data and their views on the program. Of the surveyed users, most participate to contribute to scientific data collection (88%), because of a worry about bees and a desire to help save them (80%), to learn more about species in their property (63%) or region (56%), and because of a personal interest (59%). About 77% report increased awareness of species diversity, while 84% report improvement in their identification skills. We found that 81% had at least one college or university degree. There were more respondents from suburban and rural areas than urban areas, but area did not affect numbers of submissions. While half were between 45 and 64 years of age, age did not influence motivation or number of submissions. Respondents were happy with the program, particularly the website resources, the contribution to knowledge and conservation efforts, the educational values, and the ability to get identifications. Areas for improvement included app and website functionality, faster and more detailed feedback, localized resources, and more communication. Most respondents participate rarely and have submitted fewer than ten records, although about five percent are super users who participate often and submit more than fifty records. Suggested improvements to the program may increase this participation rate. Indeed, increased recruitment and retention of users in general is important, and advertising should promote the outcomes of participation. Fifteen experts responded to a separate survey and were favorable of the program although there were suggestions on how to improve the verification process and the quality of the submitted data. Suggested research questions that could be asked or answered from the data included filling knowledge gaps (species diversity, ranges, habitat, phenology, floral associations, etc.), supporting species status assessments, effecting policy and legislation, encouraging habitat restoration and management efforts, and guiding further research. However, only about half have used data from the project to date. Further promotion of Bumble Bee Watch and community science programs in general should occur amongst academia, conservationists, policy makers, and the general public. This would help to increase the number and scope of submissions, knowledge of these species, interest in conserving them, and the overall program impact.

Abstracts of the 29th Annual Pediatric Pharmacy Association (PPA) Meeting April 29 to May 3, 2020

Abstracts of the 29th Annual Pediatric Pharmacy Association (PPA) Meeting April 29 to May 3, 2020

The temporal evolution of a far-right forum

The increased threat of right-wing extremist violence necessitates a better understanding of online extremism. Radical message boards, small-scale social media platforms, and other internet fringes have been reported to fuel hatred. The current paper examines data from the right-wing forum Stormfront between 2001 and 2015. We specifically aim to understand the development of user activity and the use of extremist language. Various time-series models depict posting frequency and the prevalence and intensity of extremist language. Individual user analyses examine whether some super users dominate the forum. The results suggest that structural break models capture the forum evolution better than stationary or linear change models. We observed an increase of forum engagement followed by a decrease towards the end of the time range. However, the proportion of extremist language on the forum increased in a step-wise matter until the early summer of 2011, followed by a decrease. This temporal development suggests that forum rhetoric did not necessarily become more extreme over time. Individual user analysis revealed that super forum users accounted for the vast majority of posts and of extremist language. These users differed from normal users in their evolution of forum engagement.

E-Money Challenge in Disruption Era: Uncovering the Dilemma Issues from Consumers’ Perspective

Purpose: The purpose of this paper is to determine factors that drive e-money provider system named Link Aja (produced by Telkomsel, a telecommunication company in Indonesia) users to become less active in using Link Aja, especially users located in Bandung, by remembering some potential commerce and trading conducted in the city that have great potential benefits if all transaction are supported by e-money Link Aja.&#x0D; Methodology: This study uses quantitative methods with descriptive and exploration research types. The technique of collecting data has spread the questionnaire to users in Bandung who have an account but less active in using Link Aja. Factoring Analysis as statistical tools were used to analyze the data and test the hypotheses.&#x0D; Results: There are six factors which determine the decreasing of Link Aja users activity in transaction, consist of (1) Security and limited discount, (2) Explicit fees, (3) Machine and update system unpredictable, (4) Networks, (5) Confuse term and condition, and (6) Disadvantage of time and popularity. &#x0D; Research Implication: This research presents update factors in terms of activity in using e-money from the opposite perspective (less active side), in completing factors of e-money motivation. The main limitation is the narrow scope, emphasizing only users located in Bandung city. This paper may involve more users further to present strong factors about e-money activity.&#x0D; Practical Implication: This research presents determinant factors about less active in using e-money among users that may help Telecommunication Company by recovering these elements. This paper gives valuable references to e-money providers to consider factors founded in offering better service for users and improve the amount of super active Ling Aja users in daily transactions.&#x0D; Originality/value: This study provides the determination of dominant factors that cased the less active activity and transaction among users of Link Aja and contributes to a better understanding of how to provide better service of e-money based on these factors for improvement further.

Using Cluster Analysis to Explore Engagement and e-Attainment as Emergent Behavior in Electronic Mental Health.

BackgroundIn most e-mental health (eMH) research to date, adherence is defined according to a trial protocol. However, adherence to a study protocol may not completely capture a key aspect of why participants engage with eMH tools, namely, to achieve personal mental health goals. As a consequence, trial attrition reported as non-adherence or dropout may reflect e-attainment, the discontinuation of eMH engagement after personal goals have been met. Clarifying engagement patterns, such as e-attainment, and how these align with mental health trajectories, may help optimize eMH design and implementation science.ObjectiveThis study aimed to use clustering techniques to identify real-world engagement profiles in a community of eMH users and examine if such engagement profiles are associated with different mental health outcomes. The novelty of this approach was our attempt to identify actual user engagement behaviors, as opposed to employing engagement benchmarks derived from a trial protocol. The potential of this approach is to link naturalistic behaviors to beneficial mental health outcomes, which would be especially informative when designing eMH programs for the general public.MethodsBetween May 2013 and June 2018, Australian adults (N=43,631) signed up to myCompass, a self-guided eMH program designed to help alleviate mild to moderate symptoms of depression, anxiety, and stress. Recorded usage data included number of logins, frequency of mood tracking, number of started and completed learning activities, and number of tracking reminders set. A subset of users (n=168) completed optional self-assessment mental health questionnaires (Patient Health Questionnaire-9 item, PHQ-9; Generalized Anxiety Disorder Questionnaire-7 item, GAD-7) at registration and at 28 and 56 days after sign-up. Another subset of users (n=861) completed the PHQ-9 and GAD-7 at registration and at 28 days.ResultsTwo-step cluster analyses revealed 3 distinct usage patterns across both subsamples: moderates, trackers, and super users, signifying differences both in the frequency of use as well as differences in preferences for program functionalities. For both subsamples, repeated measures analysis of variances showed significant decreases over time in PHQ-9 and GAD-7 scores. Time-by-cluster interactions, however, did not yield statistical significance in both subsamples, indicating that clusters did not predict symptom reduction over time. Interestingly, users who completed the self-assessment questionnaires twice had slightly but significantly lower depression and anxiety levels at sign-up compared with users who completed the questionnaires a third time at 56 days.ConclusionsFindings suggested that although users engaged with myCompass in different but measurable ways, those different usage patterns evoked equivalent mental health benefits. Furthermore, the randomized controlled trial paradigm may unintentionally limit the scope of eMH engagement research by mislabeling early mental health goal achievers as dropouts. More detailed and naturalistic approaches to study engagement with eMH technologies may improve program design and, ultimately, program effectiveness.

User Engagement and Attrition in an App-Based Physical Activity Intervention: Secondary Analysis of a Randomized Controlled Trial.

BackgroundThe success of a mobile phone app in changing health behavior is thought to be contingent on engagement, commonly operationalized as frequency of use.ObjectiveThis subgroup analysis of the 2 intervention arms from a 3-group randomized controlled trial aimed to examine user engagement with a 100-day physical activity intervention delivered via an app. Rates of engagement, associations between user characteristics and engagement, and whether engagement was related to intervention efficacy were examined.MethodsEngagement was captured in a real-time log of interactions by users randomized to either a gamified (n=141) or nongamified version of the same app (n=160). Physical activity was assessed via accelerometry and self-report at baseline and 3-month follow-up. Survival analysis was used to assess time to nonuse attrition. Mixed models examined associations between user characteristics and engagement (total app use). Characteristics of super users (top quartile of users) and regular users (lowest 3 quartiles) were compared using t tests and a chi-square analysis. Linear mixed models were used to assess whether being a super user was related to change in physical activity over time.ResultsEngagement was high. Attrition (30 days of nonuse) occurred in 32% and 39% of the gamified and basic groups, respectively, with no significant between-group differences in time to attrition (P=.17). Users with a body mass index (BMI) in the healthy range had higher total app use (mean 230.5, 95% CI 190.6-270.5; F2=8.67; P<.001), compared with users whose BMI was overweight or obese (mean 170.6, 95% CI 139.5-201.6; mean 132.9, 95% CI 104.8-161.0). Older users had higher total app use (mean 200.4, 95% CI 171.9-228.9; F1=6.385; P=.01) than younger users (mean 155.6, 95% CI 128.5-182.6). Super users were 4.6 years older (t297=3.6; P<.001) and less likely to have a BMI in the obese range (χ22=15.1; P<.001). At the 3-month follow-up, super users were completing 28.2 (95% CI 9.4-46.9) more minutes of objectively measured physical activity than regular users (F1,272=4.76; P=.03).ConclusionsTotal app use was high across the 100-day intervention period, and the inclusion of gamified features enhanced engagement. Participants who engaged the most saw significantly greater increases to their objectively measured physical activity over time, supporting the theory that intervention exposure is linked to efficacy. Further research is needed to determine whether these findings are replicated in other app-based interventions, including those experimentally evaluating engagement and those conducted in real-world settings.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12617000113358; https://www.anzctr.org.au/ACTRN12617000113358.aspx

UPDATE OF THE CRAWL, WALK, RUN METHODOLOGY FRAMEWORK

This study updated the Crawl, Walk, Run methodology framework (CWRM) for the current digital marketing circumstances, observed in the context of the artistic community in virtual space. Four main premises of CRWM have been considered in order to address the effectiveness of online campaigns based on the laddering support through tiers of engagement (personal, social, advocating); empowering super users; providing source materials for user-generated content; and using tools people are familiar with. The analysis was performed on the data collected from the online community which has operated for 43 days. Data on the number of registered users, their interactions with web site content and showcased artworks were gathered. The specific online platform was created for the purpose of this research and the campaign for its promotion was conducted both in Serbia and globally. The materials for direct communications (email, instant messaging), social media promotion (social networks, blogs) and public relations (articles in online and traditional media) were created. CRWM was proved to be efficient framework for the establishment of online presence of the artistic community. However, we propose that social networks should be introduced in the stage three instead of in the stage four, due to the increase of their applications compared to the time when the CRWM was formulated. All activities once they start should be maintained and performed throughout the campaign lifetime. This study represents one of the first efforts aimed at updating of the CRWM theoretical framework and provides business community with hands-on solutions in modern digital marketing.

Students’ perceptions of the educational value of Twitter: a mixed-methods investigation

It has been suggested that Twitter can be used in healthcare education to enhance active engagement and access to information. However, there is limited information regarding students’ perceptions of this platform as a pedagogical tool. This study explored the perceptions of final-year undergraduate physiotherapy students in relation to a dedicated Twitter feed that was used to support learning throughout the academic year. A mixed-methods design was utilised. A total of 33 students participating in pre- and post-surveys and two focus groups (super users and novice users) provided rich data regarding value perceptions. The results indicate that the Twitter feed was a positive addition to teaching/education and provided insights in three themes: digital literacy, educational experience and professional identity. Twitter appeared to add value to the students’ educational experience via peer-assisted learning, collaboration and connectivity. Professional identity awareness can impact students’ Twitter activity; therefore, consideration regarding the enhancement of self-confidence and active engagement within this platform is recommended.

Building Informatics-Savvy Health Departments: The Systems Development Life Cycle.

Building Informatics-Savvy Health Departments: The Systems Development Life Cycle.