Scaling Digital Health Innovation: Developing a New 'Service Readiness Level' Framework of Evidence.

Digital innovation has scaled exponentially in many sectors including tourism, banking, and retail. It is well cited that the health sector is slower to embrace digital health innovations (DHI) beyond the pilot stage and consequently, many successful DHI pilot projects have failed to scale up. Such failure arises in part from a knowledge gap around what type and level of evidence are needed to convince implementers and decision makers to fund, endorse, or adopt new innovations into care delivery systems and sustainable practice. Much is known about the range of DHI evaluation methods used; however, less is published on the evidence that decision makers need to move innovations to scale. This paper draws on interviews (N = 18) with decision makers/project leads engaged in DHI in Scotland to identify what evidence matters when making DHI adoption/scale decisions. The results are used to present a heuristic service readiness level (SRL) framework that captures the changing nature of the evidence base required over a project lifecycle for progression to scale. We utilise this framework to discuss 'what evidence' is required and 'how data accumulate' over time to assist project teams to build a 'DHI case for scale'.

The Effectiveness of the Foodbot Factory Mobile Serious Game on Increasing Nutrition Knowledge in Children.

The interactive and engaging nature of serious games (i.e., video games designed for educational purposes) enables deeper learning and facilitates behavior change; however, most do not specifically support the dissemination of national dietary guidelines, and there are limited data on their impact on child nutrition knowledge. The Foodbot Factory serious game mobile application was developed to support school children in learning about Canada's Food Guide; however, its impacts on nutrition knowledge have not been evaluated. The objective of this study was to determine if Foodbot Factory effectively improves children's knowledge of Canada's Food Guide, compared to a control group (control app). This study was a single-blinded, parallel, randomized controlled pilot study conducted among children ages 8-10 years attending Ontario Tech University day camps. Compared to the control group (n = 34), children who used Foodbot Factory (n = 39) had significant increases in overall nutrition knowledge (10.3 ± 2.9 to 13.5 ± 3.8 versus 10.2 ± 3.1 to 10.4 ± 3.2, p < 0.001), and in Vegetables and Fruits (p < 0.001), Protein Foods (p < 0.001), and Whole Grain Foods (p = 0.040) sub-scores. No significant difference in knowledge was observed in the Drinks sub-score. Foodbot Factory has the potential to be an effective educational tool to support children in learning about nutrition.

Optimizing Child Nutrition Education With the Foodbot Factory Mobile Health App: Formative Evaluation and Analysis.

BACKGROUND: Early nutrition interventions to improve food knowledge and skills are critical in enhancing the diet quality of children and reducing the lifelong risk of chronic disease. Despite the rise of mobile health (mHealth) apps and their known effectiveness for improving health behaviors, few evidence-based apps exist to help engage children in learning about nutrition and healthy eating. OBJECTIVE: This study aimed to describe the iterative development and user testing of Foodbot Factory, a novel nutrition education gamified app for children to use at home or in the classroom and to present data from user testing experiments conducted to evaluate the app. METHODS: An interdisciplinary team of experts in nutrition, education (pedagogy), and game design led to the creation of Foodbot Factory. First, a literature review and an environmental scan of the app marketplace were conducted, and stakeholders were consulted to define the key objectives and content of Foodbot Factory. Dietitian and teacher stakeholders identified priority age groups and learning objectives. Using a quasi-experimental mixed method design guided by the Iterative Convergent Design for Mobile Health Usability Testing approach, five app user testing sessions were conducted among students (ages 9-12 years). During gameplay, engagement and usability were assessed via direct observations with a semistructured form. After gameplay, qualitative interviews and questionnaires were used to assess user satisfaction, engagement, usability, and knowledge gained. RESULTS: The environmental scan data revealed that few evidence-based nutrition education apps existed for children. A literature search identified key nutrients of concern for Canadian children and techniques that could be incorporated into the app to engage users in learning. Foodbot Factory included characters (2 scientists and Foodbots) who initiate fun and engaging dialogue and challenges (minigames), with storylines incorporating healthy eating messages that align with the established learning objectives. A total of five modules were developed: drinks, vegetables and fruit, grain foods, animal protein foods, and plant protein foods. Seven behavior change techniques and three unique gamified components were integrated into the app. Data from each user testing session were used to inform and optimize the next app iteration. The final user testing session demonstrated that participants agreed that they wanted to play Foodbot Factory again (12/17, 71%), that the app is easy to use (12/17, 71%) and fun (14/17, 88%), and that the app goals were clearly presented (15/17, 94%). CONCLUSIONS: Foodbot Factory is an engaging and educational mHealth intervention for the Canadian public that is grounded in evidence and developed by an interdisciplinary team of experts. The use of an iterative development approach is a demonstrated method to improve engagement, satisfaction, and usability with each iteration. Children find Foodbot Factory to be fun and easy to use, and can engage children in learning about nutrition.

Re-Making Teacher Professional Development.

With the introduction of the new two-year Bachelor of Education program across Ontario, our Faculty of Education has introduced a twenty-hour internship. This internship is meant to provide real-world teaching experience for teacher candidates, who are nearing the end of their formal education. By maker pedagogies, we refer to the inquiry-based, student-directed, constructionist approaches to learning typically used in makerspaces. Makerspaces have gained traction in Ontario classrooms, particularly in the last two years. These spaces and their pedagogies facilitate the development of students' global competencies (Hughes, 2017; Somanath et al., 2016). We welcomed eleven teacher candidates (TCs) into our STEAM 3D Maker Lab as part of their internship course for professional development (PD) to provide them with pedagogical experience in a makerspace environment. Our research focused on exploring how the TCs developed a better understanding of maker pedagogies and the associated tools through this PD. As the internship was created and facilitated by an education graduate student in the lab, we extended the research to also investigate this student's development in identifying and understanding some of the best practices associated with making as learning. Through analysis of the TCs' and graduate student's experiences, we identify some best practices in maker-focused professional development for beginning teachers.

Exploring Maker Cultures and Pedagogies to Bridge the Gaps for Students with Special Needs.

Through this ethnographic study, the researchers investigate the efficacy of using "makerspace" pedagogies with students who are identified as having special needs. These pedagogies include the transferable skills and global competencies as outlined by the Ontario Ministry of education. The research questions address how teachers view changes in his/her special education students' behaviour and learning based on their participation in maker-related activities, including, but not limited to coding, programmable robots, and circuits, in the classroom. Teachers were supported through professional development by our STEAM 3D Maker Team at the Faculty of Education and then subsequent visits made to each of 20 different schools investigated how maker pedagogies were being employed. Qualitative data was collected in the form of digital video and audio recordings, photographs, observational field notes, and individual and focus group interviews. The data suggest that the use of maker pedagogies can facilitate a number of improved outcomes for students with exceptionalities, including confidence and perseverance, engagement and motivation, self-regulation, collaborative skills, and increased academic achievement.