Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement.

BACKGROUND: Low engagement rates with digital mental health interventions are a major challenge in the field. Multicomponent digital interventions aim to improve engagement by adding components such as social networks. Although social networks may be engaging, they may not be sufficient to improve clinical outcomes or lead users to engage with key therapeutic components. Therefore, we need to understand what components drive engagement with digital mental health interventions overall and what drives engagement with key therapeutic components. OBJECTIVE: Horyzons was an 18-month digital mental health intervention for young people recovering from first-episode psychosis, incorporating therapeutic content and a private social network. However, it is unclear whether use of the social network leads to subsequent use of therapeutic content or vice versa. This study aimed to determine the causal relationship between the social networking and therapeutic components of Horyzons. METHODS: Participants comprised 82 young people (16-27 years) recovering from first-episode psychosis. Multiple convergent cross mapping was used to test causality, as a secondary analysis of the Horyzons intervention. Multiple convergent cross mapping tested the direction of the relationship between each pair of social and therapeutic system usage variables on Horyzons, using longitudinal usage data. RESULTS: Results indicated that the social networking aspects of Horyzons were most engaging. Posting on the social network drove engagement with all therapeutic components (r=0.06-0.36). Reacting to social network posts drove engagement with all therapeutic components (r=0.39-0.65). Commenting on social network posts drove engagement with most therapeutic components (r=0.11-0.18). Liking social network posts drove engagement with most therapeutic components (r=0.09-0.17). However, starting a therapy pathway led to commenting on social network posts (r=0.05) and liking social network posts (r=0.06), and completing a therapy action led to commenting on social network posts (r=0.14) and liking social network posts (r=0.15). CONCLUSIONS: The online social network was a key driver of long-term engagement with the Horyzons intervention and fostered engagement with key therapeutic components and ingredients of the intervention. Online social networks can be further leveraged to engage young people with therapeutic content to ensure treatment effects are maintained and to create virtuous cycles between all intervention components to maintain engagement. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12614000009617; https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12614000009617.

Supporting mental health self-care discovery through a chatbot.

Good mental health is imperative for one's wellbeing. While clinical mental disorder treatments exist, self-care is an essential aspect of mental health. This paper explores the use and perceived trust of conversational agents, chatbots, in the context of crowdsourced self-care through a between-subjects study (N = 80). One group used a standalone system with a conventional web interface to discover self-care methods. The other group used the same system wrapped in a chatbot interface, facilitating utterances and turn-taking between the user and a chatbot. We identify the security and integrity of the systems as critical factors that affect users' trust. The chatbot interface scored lower on both these factors, and we contemplate the potential underlying reasons for this. We complement the quantitative data with qualitative analysis and synthesize our findings to identify suggestions for using chatbots in mental health contexts.

Satisfaction and performance of software developers during enforced work from home in the COVID-19 pandemic.

Following the onset of the COVID-19 pandemic and subsequent lockdowns, the daily lives of software engineers were heavily disrupted as they were abruptly forced to work remotely from home. To better understand and contrast typical working days in this new reality with work in pre-pandemic times, we conducted one exploratory (N = 192) and one confirmatory study (N = 290) with software engineers recruited remotely. Specifically, we build on self-determination theory to evaluate whether and how specific activities are associated with software engineers' satisfaction and productivity. To explore the subject domain, we first ran a two-wave longitudinal study. We found that the time software engineers spent on specific activities (e.g., coding, bugfixing, helping others) while working from home was similar to pre-pandemic times. Also, the amount of time developers spent on each activity was unrelated to their general well-being, perceived productivity, and other variables such as basic needs. Our confirmatory study found that activity-specific variables (e.g., how much autonomy software engineers had during coding) do predict activity satisfaction and productivity but not by activity-independent variables such as general resilience or a good work-life balance. Interestingly, we found that satisfaction and autonomy were significantly higher when software engineers were helping others and lower when they were bugfixing. Finally, we discuss implications for software engineers, management, and researchers. In particular, active company policies to support developers' need for autonomy, relatedness, and competence appear particularly effective in a WFH context.

Evaluation of a calibration rig for stereo laparoscopes.

BACKGROUND: Accurate camera and hand-eye calibration are essential to ensure high-quality results in image-guided surgery applications. The process must also be able to be undertaken by a nonexpert user in a surgical setting. PURPOSE: This work seeks to identify a suitable method for tracked stereo laparoscope calibration within theater. METHODS: A custom calibration rig, to enable rapid calibration in a surgical setting, was designed. The rig was compared against freehand calibration. Stereo reprojection, stereo reconstruction, tracked stereo reprojection, and tracked stereo reconstruction error metrics were used to evaluate calibration quality. RESULTS: Use of the calibration rig reduced mean errors: reprojection (1.47 mm [SD 0.13] vs. 3.14 mm [SD 2.11], p-value 1e-8), reconstruction (1.37 px [SD 0.10] vs. 10.10 px [SD 4.54], p-value 6e-7), and tracked reconstruction (1.38 mm [SD 0.10] vs. 12.64 mm [SD 4.34], p-value 1e-6) compared with freehand calibration. The use of a ChArUco pattern yielded slightly lower reprojection errors, while a dot grid produced lower reconstruction errors and was more robust under strong global illumination. CONCLUSION: The use of the calibration rig results in a statistically significant decrease in calibration error metrics, versus freehand calibration, and represents the preferred approach for use in the operating theater.

Predictors of well-being and productivity among software professionals during the COVID-19 pandemic - a longitudinal study.

The COVID-19 pandemic has forced governments worldwide to impose movement restrictions on their citizens. Although critical to reducing the virus' reproduction rate, these restrictions come with far-reaching social and economic consequences. In this paper, we investigate the impact of these restrictions on an individual level among software engineers who were working from home. Although software professionals are accustomed to working with digital tools, but not all of them remotely, in their day-to-day work, the abrupt and enforced work-from-home context has resulted in an unprecedented scenario for the software engineering community. In a two-wave longitudinal study (N = 192), we covered over 50 psychological, social, situational, and physiological factors that have previously been associated with well-being or productivity. Examples include anxiety, distractions, coping strategies, psychological and physical needs, office set-up, stress, and work motivation. This design allowed us to identify the variables that explained unique variance in well-being and productivity. Results include (1) the quality of social contacts predicted positively, and stress predicted an individual's well-being negatively when controlling for other variables consistently across both waves; (2) boredom and distractions predicted productivity negatively; (3) productivity was less strongly associated with all predictor variables at time two compared to time one, suggesting that software engineers adapted to the lockdown situation over time; and (4) longitudinal analyses did not provide evidence that any predictor variable causal explained variance in well-being and productivity. Overall, we conclude that working from home was per se not a significant challenge for software engineers. Finally, our study can assess the effectiveness of current work-from-home and general well-being and productivity support guidelines and provides tailored insights for software professionals.

Dimensions of ecological validity for usability evaluations in clinical settings.

The development, evaluation, and eventual deployment of novel medical devices is a complex process involving various areas of expertise. Although the need for a User Centred Design approach to the development of both hardware and software has long been established, both current regulatory guidelines and widespread evaluation approaches fail to reflect the challenges encountered during day-to-day clinical practice. As such, the results from these evaluations may not provide a realistic account of the problems encountered by users when introduced to clinical practice. In this paper, we present a case study on designing the evaluation of a novel device to support laparoscopic liver surgery. Through a reflective account of the design of our usability evaluation, we identify and describe seven primary dimensions of ecological validity encountered in clinical usability evaluations. These dimensions are: 'user roles', 'environment', 'training', 'scenario', 'patient involvement', 'software', and 'hardware'. We analyse three recently published clinical usability evaluation articles to assess (and illustrate) the applicability and completeness of these dimensions. Finally, we discuss the compromises encountered during clinical usability evaluations and how to best report on these considerations. The framework presented here aims to further the agenda of ecologically valid evaluation practice, reflecting the constraints of medical practice.