An International Study in Competency Education: Postcards from Abroad

Acknowledging that national borders need not constrain our thinking, we have examined a selection of alternative academic cultures and, in some cases, specific schools, in search of solutions to common challenges we face when we consider reorganizing American schools. A wide range of interviews and e-mail exchanges with international researchers, government officials and school principals has informed this research, which was supplemented with a literature review scanning international reports and journal articles. Providing a comprehensive global inventory of competency-based education is not within the scope of this study, but we are confident that this is a representative sampling. The report that follows first reviews the definition of competency-based learning. A brief lesson in the international vocabulary of competency education is followed by a review of global trends that complement our own efforts to improve performance and increase equitable outcomes. Next, we share an overview of competency education against a backdrop of global education trends (as seen in the international PISA exams), before embarking on an abbreviated world tour. We pause in Finland, British Columbia (Canada), New Zealand and Scotland, with interludes in Sweden, England, Singapore and Shanghai, all of which have embraced practices that can inform the further development of competency education in the United States

Data, Data Everywhere, and Still Too Hard to Link: Insights from User Interactions with Diabetes Apps

For those with chronic conditions, such as Type 1 diabetes, smartphone apps offer the promise of an affordable, convenient, and personalized disease management tool. How- ever, despite significant academic research and commercial development in this area, diabetes apps still show low adoption rates and underwhelming clinical outcomes. Through user-interaction sessions with 16 people with Type 1 diabetes, we provide evidence that commonly used interfaces for diabetes self-management apps, while providing certain benefits, can fail to explicitly address the cognitive and emotional requirements of users. From analysis of these sessions with eight such user interface designs, we report on user requirements, as well as interface benefits, limitations, and then discuss the implications of these findings. Finally, with the goal of improving these apps, we identify 3 questions for designers, and review for each in turn: current shortcomings, relevant approaches, exposed challenges, and potential solutions

Trusting in Change

Describes the background to a series of changes that led the foundation, beginning in 2000, to implement a new grantmaking approach

Selected Barriers and Incentives for Participation in a University Wellness Program

Evidence supporting the benefits of worksite health promotion (WHP) programs is extensive. Research shows these programs can improve the health of participants, lower health care costs, and improve the bottom line of employers. Although the evidence of these benefits is vast, reported participation in WHP is not optimal. Little published data exists on employees\u27 perceived incentives and barriers for participation in WHP. The purpose of this study was to determine perceived barriers and incentives for participation in an existing WHP program at a large land-grant university. Opinions of eligible WHP participants were collected using a web-based questionnaire (n = 321). The questionnaire was adapted from questions used in the 2004 HealthStyles survey. Overall percentages and odds ratios of responses were calculated and stratified by demographics. Respondents were 68.5% female, 76.6% were college graduates, 47% were active, and 32.7% had a BMI ≥ 30. The most common reported barrier to using employee wellness services was no time during work day (60.2%). Women were more likely than men to report lack of energy (OR, 4.5; 95% CI, 1.7-11.9) and no time during work day (OR, 2.6; 95% CI, 1.4-4.8) as barriers to participation. Respondents who were underweight and overweight were less likely to report lack of energy than respondents who were obese (OR, 0.2; 95% CI, 0.1-0.6; OR, 0.4; 95% CI, 0.2-0.9). The most common reported incentive was having programs at a convenient time (66.6%). Younger respondents were much more likely to report paid time off work to attend as incentive to participate than respondents 60 or more years (18-29 years OR, 10.8; 95% CI, 2.9-40.1; 30-34 years OR, 4.2; 95% CI, 1.5-11.7; 35-44 years OR, 3.1; 95% CI, 1.3-7.4). Most preferred wellness service or policies were available fitness center (75.9%), health screening tests (75.6%), and paid time to exercise at work (69.6%). The results of this study, combined with an employer\u27s own employee needs assessment, may help universities, and other employers with similar characteristics, design more attractive employee wellness programs. Making employee wellness programs attractive to their potential participants may improve program participation

The datafication of health

Over the past decade, data-intensive logics and practices have come to affect domains of contemporary life ranging from marketing and policy making to entertainment and education; at every turn, there is evidence of “datafication” or the conversion of qualitative aspects of life into quantified data. The datafication of health unfolds on a number of different scales and registers, including data-driven medical research and public health infrastructures, clinical health care, and self-care practices. For the purposes of this review, we focus mainly on the latter two domains, examining how scholars in anthropology, sociology, science and technology studies, and media and communication studies have begun to explore the datafication of clinical and self-care practices. We identify the dominant themes and questions, methodological approaches, and analytical resources of this emerging literature, parsing these under three headings: datafied power, living with data, and data–human mediations. We conclude by urging scholars to pay closer attention to how datafication is unfolding on the “other side” of various digital divides (e.g., financial, technological, geographic), to experiment with applied forms of research and data activism, and to probe links to areas of datafication that are not explicitly related to health.Peer reviewe

Phenomenological Assessment of Integrative Medicine Decision-making and the Utility of Predictive and Prescriptive Analytics Tools

The U.S. Healthcare system is struggling to manage the burden of chronic disease, racial and socio-economic disparities, and the debilitating impact of the current global pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). More patients need alternatives to allopathic or “Western” medicine focused on fighting disease with mechanism, pharmaceuticals, and invasive measures. They are seeking Integrative Medicine which focuses on health and healing, emphasizing the centrality of the patient-physician relationship. In addition to providing the best conventional care, IM focuses on preventive maintenance, wellness, improved behaviors, and a holistic care plan. This qualitative research assessed whether predictive and prescriptive analytics (artificial intelligence tools that predict patient outcomes and recommend treatments, interventions, and medications) supports the decision-making processes of IM practitioners who treat patients suffering from chronic pain. PPA was used in a few U.S. hospitals but was not widely available for IM practitioners at the time of this research. Phenomenological interviews showed doctors benefit from technology that aggregates data, providing a clear patient snapshot. PPA exposed historical information that doctors often miss. However, current systems lacked the design to manage individualized, holistic care focused on the mind, body, and spirit. Using the Future-Focused Task-Technology Fit theory, the research suggested PPA could actually do more harm than good in its current state. Future technology must be patient-focused and designed with a better understanding of the IM task and group characteristics (e.g., the unique way providers practice medicine) to reduce algorithm aversion and increase adoption. In the ideal future state, PPA will surface healthcare Big Data from multiple sources, support communication and collaboration across the patient’s support system and community of care, and track the various objective and subjective factors contributing to the path to wellness

Transforming School-Based Mental Health to Heal the Collective Soul Wound

Pervasive well-being concerns of youth in Alberta are steadily contributing to society’s collective soul wound. In response to this growing need, K-12 systems are faced with increased demands for school-based mental health services. Public Prairie School Division (PPSD) provides student mental health intervention needs through onsite access to school-based teacher counsellors and referrals to centralized psychologists. However, decisions regarding mental health practitioner allocations or practice standards are often left to individuals and generally follow historical practice. This Organizational Improvement Plan (OIP) problematizes PPSD’s lack of system-wide approaches to mental health interventions that can provide assurance of improved efficacy and equity in meeting student mental health needs. Transformative leadership applied within a utilitarian consequentialist lens has the potential to improve individual and collective student well-being. The decolonizing lens of scarring the collective soul wound will elevate system leadership to counter pervasive neoliberalism and allow for change and healing within ethical spaces. Actioning psychosocial change using transformative learning theory positions practitioners as co-creators of new counselling practice standards in response to student and parent feedback. Allocation changes stemming from systemic analysis of demographic and referral data should increase equity of access to teacher counsellors. Evidence of improved access and efficacy in mental health interventions will be sought through interconnected plan-do-study-act cycles and more broadly confirmed through a RE-AIM framework. Verifying PPSD’s collective soul wound scar also requires the application of an Indigenous wellness perspective