Digital Health Project
During the time of distance learning, both lectures followed an online flipped classroom concept with live input sessions and complementary coaching sessions via Zoom, as well as additional online learning materials for self-study activities via Moodle, tutorial video clips via Vimeo, and finally, dedicated discussion and user forums in Moodle and Discourse.
Implementation of the course during the time of distance learning
In the first part of both lectures live weekly input sessions were offered via Zoom. Here, students were able to ask questions and discuss the topics with their classmates and the lecturer in a synchronous way, also with moderated chat interactions in Zoom and the Slido tool. Additional asynchronous online lessons offered students complementary learning materials in Moodle including multiple-choice questions, scientific articles, and discussion forums to learn additional relevant content and to deepen their understanding of and reflect on the learning material delivered during the live input sessions.
With a focus on “learning-by-doing”, individual programming exercises were offered in the Digital Health Project lecture to prepare the students for the group work of the second part of that lecture. For the programming exercises MobileCoach was used, an open source software tool for the delivery of digital health interventions, initiated already in 2015 by Dr. Kowatsch and collaboratively developed by ETH Zurich, University of Zurich, and the University of St.Gallen (mobile-coach.eu). Video tutorials on how to use MobileCoach for intervention development were pre-recorded by Dr. Kowatsch to support the students with the programming exercises (vimeo.com/channels/1623373, see also Figure 2a). Furthermore, a dedicated user forum allowed students not only to ask questions regarding MobileCoach (discourse-mobilecoach.ch, see also Figure 2b) but also to support their classmates in an asynchronous way, i.e. students learnt from each other. In the second part of both lectures, students formed interdisciplinary teams with the overall goal to conduct either (1) a market analysis of existing digital health interventions for the prevention of noncommunicable diseases (e.g. diabetes or depression; a topic especially of high relevance in the context of the ongoing pandemic), to identify shortcomings of these interventions and to pitch a superior intervention based on these shortcomings (in “Digital Health”) or (2) to design, implement and to evaluate a smartphone-based and chatbot-delivered health literacy intervention with MobileCoach which was then critically evaluated by classmates (in “Digital Health Project”). Especially the group efforts carried out in the Digital Health Project lecture led to mobile applications for iOS and Android which were made available for assessment purposes to all students of the lecture. Students were asked to use the apps of the other groups for one week with the goal to assess their utility and to provide feedback on how to improve them.
A health literacy quiz implemented by each group was used to measure to which degree health literacy was improved. The goal in both lectures was not only to offer a learning experience about the design and evaluation of digital health interventions in general but also to better cope with the ongoing pandemic by specifically learning more about those interventions that are highly relevant in times of social isolation and mental strain, i.e. stress management, diet, exercise, and sleep quality.
In the final and third part of both lectures, students presented their group work in a synchronous way either via pre-recorded video clips of their presentations (in case Internet bandwidth was limited for specific students) or live via the screen sharing feature of Zoom. After each presentation, students were able to ask follow-up questions and to discuss the outcomes of the group presentations. In addition, and asynchronously, students were asked to quantitatively and qualitatively peer-review the group presentations via Moodle.
As a side effect of both lectures and with the start of the pandemic, Elena+ Care for COVID-19 – A Pandemic Lifestyle Care Intervention (elena.plus) was developed as students were intrinsically motivated to apply their lessons learnt to a highly relevant real-world problem (see also figures 3a/b/c). Initiated by students under the lead of Joseph Ollier (PhD student D-MTEC) and Dr. Kowatsch, Elena+ gained such a momentum that also renowned researchers with expertise in behavioral medicine, clinical psychology, public health, and technology marketing from around the globe joined the Elena+ project. The resulting smartphone-based and chatbot-delivered intervention is available in English and Spanish, and Tamil is currently being implemented. The scientific paper describing the intervention was recently accepted by Frontiers in Public Health (10.3389/fpubh.2021.625640).
Course description
Overall concept of the course before the pandemic - during - after
Before the pandemic, the Digital Health and Digital Health Project courses were structured in two parts consisting of on-site sessions and complementary online lessons. In the first part, students learnt and discussed the course topics in weekly on-site sessions. Complementary learning material, multiple‐choice questions, and exercises were provided via Moodle to strengthen the knowledge. In the second part, students worked in teams and used their knowledge from the first part of the courses (1) to either conduct a market analysis on existing digital health interventions (Digital Health) or (2) to develop a smartphone-based health intervention with the open-source platform external page MobileCoach (Digital Health Project). In the Digital Health Project course, additional software tutorial external page video clips and a external page MobileCoach user forum were made available to support the students with their assignments. Each team did finally present and discuss their results to their fellow students who provided peer reviews via Moodle. Additional on-site coaching sessions were offered to support the teams with their group work.
During the pandemic, on-site sessions of the Digital Health and Digital Health Project courses were replaced with online Zoom sessions and interactions with students were primarily conducted with the chat feature of Zoom and Slido. Specifically, the online coaching sessions of the Digital Health Project course resulted in a more efficient knowledge transfer because lecturer and teaching assistants were not only able to use the screen sharing and “take control of a remote computer” features of Zoom to support students in a hands-on manner but also other students were able to observe these interactions and apply the lessons’ learnt to their assignments.
After the pandemic, coaching sessions of both lectures will still be delivered online due to the increased efficiency in knowledge transfer during the pandemic. Also, Slido will be used during the input sessions to foster interactions in both lectures.