Unpacking the Role of Feedback in Virtual Team Effectiveness

Feedback is a cornerstone of human development. Not surprisingly, it plays a vital role in team development. However, the literature examining the specific role of feedback in virtual team effectiveness remains scattered. To improve our understanding of feedback in virtual teams, we identified 59 studies that examine how different feedback characteristics (content, source, and level) impact virtual team effectiveness. Our findings suggest that virtual teams benefit particularly from feedback that (a) combines performance-related information with information on team processes and/or psychological states, (b) stems from an objective source, and (c) targets the team as a whole. By integrating the existing knowledge, we point researchers in the direction of the most pressing research needs, as well as the practices that are most likely to pay off when designing feedback interventions in virtual teams.

The Value of Mechanistic Experiments to Target the Shared Neural Circuitry of Parenting and Addiction: The Potential for Video Feedback Interventions

Certain neural processes that underlie addiction are also central to parenting, notably stress and reward. Parenting interventions that incorporate the unique context of caregivers with addiction have demonstrated some success: However, real-world implementation of evidence-based interventions can be difficult with this population. Video feedback interventions are an especially promising approach to reach parents who experience barriers to participation, particularly caregivers with addiction. A translational neuroscientific approach to elucidating the mechanisms of change in these interventions will aid the delivery and success of this method and advance theory surrounding parenting in the context of addiction. Along these lines, we provide an example of one video feedback intervention, Filming Interactions to Nurture Development, that will serve as such a mechanistic experiment.

Two-Age-Structured COVID-19 Epidemic Model: Estimation of Virulence Parameters to Interpret Effects of National and Regional Feedback Interventions and Vaccination

The COVID-19 epidemic has recently led in Italy to the implementation of different external strategies in order to limit the spread of the disease in response to its transmission rate: strict national lockdown rules, followed first by a weakening of the social distancing and contact reduction feedback interventions and finally the implementation of coordinated intermittent regional actions, up to the application, in this last context, of an age-stratified vaccine prioritization strategy. This paper originally aims at identifying, starting from the available age-structured real data at the national level during the specific aforementioned scenarios, external-scenario-dependent sets of virulence parameters for a two-age-structured COVID-19 epidemic compartmental model, in order to provide an interpretation of how each external scenario modifies the age-dependent patterns of social contacts and the spread of COVID-19.

How well do critical care audit and feedback interventions adhere to best practice? Development and application of the REFLECT-52 evaluation tool

Background Healthcare Audit and Feedback (A&F) interventions have been shown to be an effective means of changing healthcare professional behavior, but work is required to optimize them, as evidence suggests that A&F interventions are not improving over time. Recent published guidance has suggested an initial set of best practices that may help to increase intervention effectiveness, which focus on the “Nature of the desired action,” “Nature of the data available for feedback,” “Feedback display,” and “Delivering the feedback intervention.” We aimed to develop a generalizable evaluation tool that can be used to assess whether A&F interventions conform to these suggestions for best practice and conducted initial testing of the tool through application to a sample of critical care A&F interventions. Methods We used a consensus-based approach to develop an evaluation tool from published guidance and subsequently applied the tool to conduct a secondary analysis of A&F interventions. To start, the 15 suggestions for improved feedback interventions published by Brehaut et al. were deconstructed into rateable items. Items were developed through iterative consensus meetings among researchers. These items were then piloted on 12 A&F studies (two reviewers met for consensus each time after independently applying the tool to four A&F intervention studies). After each consensus meeting, items were modified to improve clarity and specificity, and to help increase the reliability between coders. We then assessed the conformity to best practices of 17 critical care A&F interventions, sourced from a systematic review of A&F interventions on provider ordering of laboratory tests and transfusions in the critical care setting. Data for each criteria item was extracted by one coder and confirmed by a second; results were then aggregated and presented graphically or in a table and described narratively. Results In total, 52 criteria items were developed (38 ratable items and 14 descriptive items). Eight studies targeted lab test ordering behaviors, and 10 studies targeted blood transfusion ordering. Items focused on specifying the “Nature of the Desired Action” were adhered to most commonly—feedback was often presented in the context of an external priority (13/17), showed or described a discrepancy in performance (14/17), and in all cases it was reasonable for the recipients to be responsible for the change in behavior (17/17). Items focused on the “Nature of the Data Available for Feedback” were adhered to less often—only some interventions provided individual (5/17) or patient-level data (5/17), and few included aspirational comparators (2/17), or justifications for specificity of feedback (4/17), choice of comparator (0/9) or the interval between reports (3/13). Items focused on the “Nature of the Feedback Display” were reported poorly—just under half of interventions reported providing feedback in more than one way (8/17) and interventions rarely included pilot-testing of the feedback (1/17 unclear) or presentation of a visual display and summary message in close proximity of each other (1/13). Items focused on “Delivering the Feedback Intervention” were also poorly reported—feedback rarely reported use of barrier/enabler assessments (0/17), involved target members in the development of the feedback (0/17), or involved explicit design to be received and discussed in a social context (3/17); however, most interventions clearly indicated who was providing the feedback (11/17), involved a facilitator (8/12) or involved engaging in self-assessment around the target behavior prior to receipt of feedback (12/17). Conclusions Many of the theory-informed best practice items were not consistently applied in critical care and can suggest clear ways to improve interventions. Standardized reporting of detailed intervention descriptions and feedback templates may also help to further advance research in this field. The 52-item tool can serve as a basis for reliably assessing concordance with best practice guidance in existing A&F interventions trialed in other healthcare settings, and could be used to inform future A&F intervention development. Trial registration Not applicable.

69 Continuous and Regular Live Feedback is Required to Maintain An Improvement in the Quality of Discharge Summaries. Shop 75 +

Background This quality improvement project aims to improve communication between secondary and primary care at the time of hospital discharge of older patients. Introduction Discharge summaries (DS) are a key component of communication between secondary and primary care. Poor quality DS are associated with poorer outcomes in terms of adverse events [1], readmissions [2] and medication errors [3]. There is NICE and AMRC guidance on what constitutes a good DS [4, 5]. Method Prospective review of DS from a range of wards was completed in August 2017 against a detailed data tool. A random selection of DS from the same wards was audited monthly from November 2017 onwards. A novel live-feedback system was introduced to the same wards in February 2018 so that the teams completing DS received feedback on how well their summaries complied with the recommendations and what areas needed improvement. A change in staffing lead to a break in the delivery of monthly feedback to the ward teams from April to September 2019 when it was re-commenced. Results In the majority of areas there has been an increase in the quality of the DS from the beginning of the project until March 2019 when the regular feedback interventions were suspended. There was a decrease in the quality of summaries in July and August 2019, followed by an increase as regular feedback interventions recommenced in September 2019. The aggregate results of the four main components of DS (follow-up actions, medicines, clinical summary, and functional assessment), scored “good” in 13% of DS at baseline, 40% in March 2019, 20% in July 2019 and 31% in October 2019. Conclusions The suspension of regular direct interventions resulted in a significant deterioration in the quality of discharge summaries, and this improved quickly after reintroduction of PDSA cycles in key areas. Continuous quality improvement requires uninterrupted focus on regular live feedback. References 1. Clegg et al. Lancet 2013; 381: 752–62. 2. Samra et al. Age Ageing 2017; 46: 911–9. 3. Romero-Ortuno et al. Age Ageing 2012; 41: 684–9.

Managing Stress Effectively: A Longitudinal Transtheoretical Comparison of Successful Changers, Relapsers, and Non-Changers

Background. Stress levels among Americans are considerable. This research examined Transtheoretical Model of Behavior Change (TTM) constructs for stress management in groups organized by longitudinal progress (dynatypes): Maintainers, Relapsers, and Stable Non-Changers. Methods. Secondary data analysis of a computer-tailored intervention group examined construct use over time across the three groups. Adults (n=427) meeting criteria for not engaging in stress management behaviors at baseline comprised the analytic sample. Participants received three TTM-tailored feedback interventions to help facilitate change at baseline, 3 and 6 months. Demographics, Stage of Change, 10 Processes of Change, Decisional Balance (Pros and Cons), and Self-Efficacy were assessed at baseline, 6, 12, and 18 months. Repeated measures MANOVA followed by ANOVAs, with Tukey follow-up tests assessed differences in use of TTM constructs longitudinally across dynatype groups. Results. Ten of the 13 TTM constructs differentiated between Successful Changers and Stable Non-Changers at baseline and over time. Relapsers were more similar to Successful Changers than to Stable Non-Changers in their use of all constructs, except Self-Efficacy. Conclusion. Findings suggest that baseline cognitive and behavioral constructs can improve prediction of different intervention outcomes 18 months later.

Who Opts in to Alcohol Feedback and How Does that Impact Behavior? A Pilot Trial

Personalized feedback interventions (PFIs) are effective in reducing alcohol consumption and related problems across populations. However, most PFI research is based on individuals who self-select into research and, thus, little is known about the role of choice in outcomes. The current study sought to (a) characterize individuals who opt in versus out of a brief alcohol-related PFI, (b) assess participants’ consistency in that choice over two time points, and (c) evaluate changes in peak alcohol consumption among those who did and did not receive the PFI. Participants reporting past-year alcohol consumption were recruited through Prolific. At the outset of the survey, participants were asked to opt in or out of receiving feedback on their drinking at the end of the survey. Participants at Time 1 (N = 732) were 41% female, 91% White, and 8% Hispanic (Mage = 36, SD = 12.25, range = 18-80). A subset of participants were invited back for a 30-day retest (Time 2; N = 234); these were 38% female, 89% White, and 6% Hispanic, (Mage = 38, SD = 12.13, range = 18-78). Those reporting higher maximum drinks and more drug use were more likely to opt into feedback than those with lower use. Further, 85% of participants were consistent in their choice of whether to receive feedback across Time 1 and Time 2. Among participants with Time 1 and Time 2 data (N = 234), there was no effect of feedback on intensity of consumption at Time 2. Results indicate that individuals who engage in high-risk substance use are more likely to opt-in to personalized alcohol feedback, and the majority of them do so consistently. For other drinkers, additional interventions, such as motivational interviewing, may be needed to increase openness to intervention. Feedback beyond what was provided in this study is also needed to impact actual drinking behavior.

Informing the research agenda for optimizing audit and feedback interventions: results of a prioritization exercise

Background Audit and feedback (A&F) interventions are one of the most common approaches for implementing evidence-based practices. A key barrier to more effective A&F interventions is the lack of a theory-guided approach to the accumulation of evidence. Recent interviews with theory experts identified 313 theory-informed hypotheses, spread across 30 themes, about how to create more effective A&F interventions. In the current survey, we sought to elicit from stakeholders which hypotheses were most likely to advance the field if studied further. Methods From the list of 313, three members of the research team identified 216 that were clear and distinguishable enough for prioritization. A web-based survey was then sent to 211 A&F intervention stakeholders asking them to choose up to 50 ‘priority’ hypotheses following the header “A&F interventions will be more effective if…”. Analyses included frequencies of endorsement of the individual hypotheses and themes into which they were grouped. Results 68 of the 211 invited participants responded to the survey. Seven hypotheses were chosen by > 50% of respondents, including A&F interventions will be more effective… “if feedback is provided by a trusted source”; “if recipients are involved in the design/development of the feedback intervention”; “if recommendations related to the feedback are based on good quality evidence”; “if the behaviour is under the control of the recipient”; “if it addresses barriers and facilitators (drivers) to behaviour change”; “if it suggests clear action plans”; and “if target/goal/optimal rates are clear and explicit”. The most endorsed theme was Recipient Priorities (four hypotheses were chosen 92 times as a ‘priority’ hypotheses). Conclusions This work determined a set of hypotheses thought by respondents to be to be most likely to advance the field through future A&F intervention research. This work can inform a coordinated research agenda that may more efficiently lead to more effective A&F interventions.