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yidanedencao edited this page Jun 11, 2024 · 9 revisions

Precision Feedback Causal Pathways

Goal Approach Causal Pathway

This pathway describes the influence of feedback interventions that show the message recipient that their performance is improving, and is approaching an explicit performance goal. This goal is institutional, and invariate with changes to peer performance.

Preconditions

Preconditions for Goal approach are factors that are necessary for the success of the feedback intervention using this pathway. The Goal approach pathway has the following preconditions:

Information content preconditions:

  1. Goal comparator content (BP)
  2. Negative performance gap content (BP)
  3. Positive performance trend content (BP)

Message preconditions:

  1. Goal comparator element (BP)
  2. Negative performance gap set (BP)
  3. Positive performance trend set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The Goal approach causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - To what extent is this message aligned with characteristics of the behavior/task, context, and recipient personality, with regard to motivation to avoid negative outcomes / problem (prevention focus), or motivation to achieve positive outcomes / develop and learn (promotion focus)?
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?
  5. Slope of trend

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. Adapted from Carey et. al. 2019. The goal approach pathway has the following mechanisms:

  1. Awareness (knowledge): The message may change the recipient's awareness of their own performance and of institutional performance goals.
  2. Goals: The message may create or reinforce mental representations of outcomes or end states that an individual wants to achieve relative to their clinical performance.
  3. Motivation: The message may give the recipient purpose or direction towards changing their own performance.
  4. Optimism: The message may increase the recipient's confidence that things will happen for the best or that desired performance goals will be attained.

Outcomes

The expected outcome of a successful goal approach pathway precision feedback intervention is clinical process performance improvement.

Goal Gain Causal Pathway

The goal gain causal pathway describes the influence of feedback interventions that show the recipient that their performance is better than that of an explicit goal, such as the performance threshold set by MPOG.

Preconditions

Preconditions for goal gain are factors that are necessary for the success of the feedback intervention that uses the goal gain pathway. The goal gain pathway has the following preconditions:

Information content preconditions:

  1. Goal comparator content (BP)
  2. Positive performance gap content (BP)
  3. Positive performance trend content (BP)
  4. Achievement content (BP)

Message preconditions:

  1. Goal comparator element (BP)
  2. Positive performance gap set (BP)
  3. Positive performance trend set (BP)
  4. Achievement set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The goal gain causal pathway has the following moderators:

  1. Message recency - The number of months since the message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - To what extent is the message aligned to the behavior/task's characteristics, context, and recipient personality (motivated by bad outcome prevention vs. good outcome promotion).
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?
  5. Slope of trend - Derivative of the performance measure in the time domain
  6. Time since last loss

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. Adapted from Carey et. al. 2019. The goal gain pathway has the following mechanisms:

  1. Awareness (knowledge): The message may change the recipient's awareness of their own performance and of institutional performance goals.
  2. Goals: The message may create or reinforce mental representations of outcomes or end states that an individual wants to achieve, relative to their clinical performance.
  3. Motivation: The message may give the recipient purpose or direction towards changing their own performance.

Outcomes

The expected outcome of the successful influence of an email that uses the goal gain pathway is clinical process performance improvement or sustainment.

Goal Loss Causal Pathway

This pathway describes the influence of feedback interventions that show the message recipient that their performance has fallen below an explicit performance goal, assigned independently of institutional peer performance.

Preconditions

Preconditions for Goal Loss are factors that are necessary for the success of the feedback intervention using this pathway. The Goal Loss pathway has the following preconditions:

Information content preconditions:

  1. Goal comparator content (BP)
  2. Negative performance gap content (BP)
  3. Negative performance trend content (BP)
  4. Loss content (BP)

Message preconditions:

  1. Goal comparator element (BP)
  2. Negative performance gap set (BP)
  3. Negative performance trend set (BP)
  4. Loss set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The Goal Loss causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - To what extent is this message aligned with characteristics of the behavior/task, context, and recipient personality, with regard to motivation to avoid negative outcomes / problem (prevention focus), or motivation to achieve positive outcomes / develop and learn (promotion focus)?
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?
  5. Slope of trend
  6. Time since last achievement

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. Adapted from Carey et. al. 2019. The goal loss pathway has the following mechanisms:

  1. Awareness (knowledge): The message may change the recipient's awareness of their own performance and of institutional performance goals.
  2. Goals: The message may create or reinforce mental representations of outcomes or end states that an individual wants to achieve, relative to their clinical performance.
  3. Motivation: The message may give the recipient purpose or direction towards changing their own performance.

Outcomes

The expected outcome of a successful goal loss pathway precision feedback intervention is clinical process performance improvement.

Improving Causal Pathway

This pathway describes the influence of feedback interventions that show the message recipient that their performance has improved. Feedback messages about improving performance motivate providers by enhancing providers' knowledge about their performance trends and fostering a sense of optimism. Example feedback messages that are part of the Improving Causal Pathway include "Your performance is improving" and "Congratulations on your improved performance."

Preconditions

Preconditions for improving are factors that are necessary for the success of the feedback intervention using this pathway. The improving pathway has the following preconditions:

Information content preconditions:

  1. Positive performance trend content(BP)

Message preconditions:

  1. Positive performance trend set(BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The improving causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - To what extent is this message aligned with characteristics of the behavior/task, context, and recipient personality, with regard to motivation to avoid negative outcomes / problem (prevention focus), or motivation to achieve positive outcomes / develop and learn (promotion focus)?
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. The social loss pathway has the following mechanisms:

  1. Awareness (knowledge): The message may change the recipient's awareness of their high performance, relative to peers.
  2. Optimism - The message may influence the recipient's confidence that things will happen for the best and they will continue to increase their performance, gaining social status.

Outcomes

The expected outcome of the successful influence of an email that uses the improving pathway is clinical process performance improvement.

Social Approach Causal Pathway

This pathway describes the influence of feedback interventions informing the recipient that their performance is approaching that of a social comparator, such as a top performer benchmark or peer average.

Preconditions

Preconditions are factors necessary for the success of a social approach precision feedback intervention. The social approach causal pathway has the following preconditions:

Information content preconditions:

  1. Social comparator content (BP)
  2. Negative performance gap content (BP)
  3. Positive performance trend content (BP)

Message preconditions:

  1. Social comparator element (BP)
  2. Negative performance gap set (BP)
  3. Positive performance trend set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The social approach causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - To what extent is the message aligned to the behavior/task's characteristics, context, and recipient personality (motivated by bad outcome prevention vs. good outcome promotion).
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?
  5. Slope of trend - Derivative of the performance measure in the time domain

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. Adapted from Carey et. al. 2019. The social approach pathway has the following mechanisms:

  1. Awareness (knowledge) - The message may change the recipient's awareness of their performance level, its change over time, and of their peers' performance via institutional benchmarks.
  2. Subjective norms - The message may influence the recipient by creating or reinforcing knowledge of their peers' performance and their relative status within their peer group.
  3. Motivation - The message may give the recipient purpose or direction towards changing their performance for a given measure.
  4. Optimism - The message may influence the recipient's confidence that things will happen for the best and they will continue to increase their performance, gaining social status.

Outcomes

A successful precision feedback intervention leveraging the social approach pathway should increase clinical process performance improvement.

Social Better Causal Pathway

The causal pathway "social better" describes the influence of feedback interventions that show the recipient that their performance is better than that of a social comparator, such as a top performer benchmark or peer average.

Preconditions

Preconditions for social better are factors that are necessary for the success of feedback intervention using this pathway. The social better pathway has the following preconditions:

Information content preconditions:

  1. Social comparator content (BP)
  2. Positive performance gap content (BP)

Message preconditions:

  1. Social comparator element (BP)
  2. Positive performance gap set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The social better causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - To what extent is this message aligned with characteristics of the behavior/task, context, and recipient personality, with regard to motivation to avoid negative outcomes / problem (prevention focus), or motivation to achieve positive outcomes / develop and learn (promotion focus)?
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. Adapted from Carey et. al. 2019. The social better pathway has the following mechanisms:

  1. Awareness (knowledge) - The message may change the recipient's awareness of their high performance, relative to peers.
  2. Subjective norms - The message may influence the recipient by creating or reinforcing their perception of their own high-performer status within their peer group.
  3. Motivation - The message may influence the recipient to maintain their status as a top performer for a given measure.

Outcomes

The expected outcome of the successful influence of an email that uses the social better pathway is clinical process performance improvement or sustainment.

Social Gain Causal Pathway

This pathway describes the influence of feedback interventions informing the recipient that their performance has become better than that of a social comparator, such as a top performer benchmark or peer average.

Preconditions

Preconditions for social gain are factors necessary for the success of the precision feedback intervention using this pathway. The social gain pathway has the following preconditions: Information content preconditions:

  1. Social comparator content (BP)
  2. Positive performance gap content (BP)
  3. Positive performance trend content (BP)
  4. Achievement content (BP)

Message preconditions:

  1. Social comparator element (BP)
  2. Positive performance gap set (BP)
  3. Positive performance trend set (BP)
  4. Achievement set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The social gain causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - To what extent is the message aligned to the behavior/task's characteristics, context, and recipient personality (motivated by bad outcome prevention vs. good outcome promotion).
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?
  5. Slope of trend - Derivative of the performance measure in the time domain
  6. Time since last loss - Time in months since the last 'loss' event occurance for a recipient

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. The social gain pathway has the following mechanisms:

  1. Awareness (knowledge) - The message may change the recipient's awareness of their newfound or increased high performance relative to their peers.
  2. Subjective norms - The message may influence the recipient by creating or reinforcing their perception of their newfound top-performer status within their peer group.
  3. Motivation - The message may motivate the recipient to work to maintain their new status as a top performer.

Outcomes

A successful precision feedback intervention leveraging the social gain pathway should increase clinical process performance improvement.

Social Loss Causal Pathway

This pathway describes the influence of feedback interventions that show the message recipient that their performance has become worse than that of a social comparator, such as a top performer benchmark or peer average.

Preconditions

Preconditions for social loss are factors that are necessary for the success of the feedback intervention using this pathway. The social loss pathway has the following preconditions:

Information content preconditions:

  1. Social comparator content (BP)
  2. Negative performance gap content (BP)
  3. Negative performance trend content (BP)
  4. Loss content (BP)

Message preconditions:

  1. Social comparator element (BP)
  2. Negative performance gap set (BP)
  3. Negative performance trend set (BP)
  4. Loss set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The social loss causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - To what extent is this message aligned with characteristics of the behavior/task, context, and recipient personality, with regard to motivation to avoid negative outcomes / problem (prevention focus), or motivation to achieve positive outcomes / develop and learn (promotion focus)?
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?
  5. Slope of trend
  6. Time since last loss

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. The social loss pathway has the following mechanisms:

  1. Awareness (knowledge): The message may change the recipient's awareness of their high performance, relative to peers.
  2. Subjective norms: The message may influence the precipient by creating or reinforcing their perception of their own top-performer status within their peer group.
  3. Motivation: The message may motivate the recipient to work to maintain their status as a top performer.

Outcomes

The expected outcome of a successful social loss pathway precision feedback intervention is clinical process performance improvement.

Social Worse Causal Pathway

This pathway describes the influence of feedback interventions informing the recipient that their performance is worse than that of a social comparator, such as a top performer benchmark or peer average.

Preconditions

There are several preconditions that are necessary for the success of feedback intervention using the social worse causal pathway. They are subdivided into informational and message preconditions, and are as follows:

Information content preconditions:

  1. Social comparator content (BP)
  2. Negative performance gap content (BP)

Message preconditions:

  1. Social comparator element (BP)
  2. Negative performance gap set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The social gain causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - How aligned is the message with characteristics of the behavior/task, context, and recipient personality (motivated by prevention vs. promotion mindset with regard to future outcomes)?
  4. Gap size - How large is the gap between the recipient's performance level and that of the social comparator?

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. Adapted from Carey et. al. 2019. The social gain pathway has the following mechanisms:

  1. Awareness (knowledge) - The message may change the provider's awareness of their own lagging performance relative to their peers.
  2. Subjective Norms - Messages may influence the recipient's perception of their performance status within their peer group, and that it is below a peer benchmark.
  3. Motivation - The message may give the recipient new purpose to reach a peer benchmark by increasing their performance for a given measure.

Outcomes

The expected outcome of a successful social worse pathway intervention is clinical performance improvement.

Worsening Causal Pathway

This pathway describes the influence of feedback interventions informing the recipient that their performance is worse than that of the prior month.

Preconditions

There are two necessary preconditions for the success of feedback intervention using the worsening causal pathway. They are subdivided into informational and message preconditions, and are as follows:

Information content preconditions:

  1. Negative performance trend content (BP)

Message preconditions:

  1. Negative performance trend set (BP)

Moderators

Moderators are factors that inhibit or promote the influence of the feedback intervention on the recipient. The social gain causal pathway has the following moderators:

  1. Message recency - The number of months since this message was delivered previously.
  2. Message delivery count - How many times has the recipient previously received this message in the last year?
  3. Regulatory fit - How aligned is the message with characteristics of the behavior/task, context, and recipient personality (motivated by prevention vs. promotion mindset with regard to future outcomes)?
  4. Gap size - How large is the gap between the recipient's performance level and that of their last month's performance?

Mechanisms

Mechanisms are factors that the intervention operates through to influence the feedback recipient. The social gain pathway has the following mechanisms:

  1. Awareness (knowledge) - The message may change the provider's awareness of their own lagging performance relative to last month's performance data.
  2. Motivation - The message may motivate the provider to work to increase their performance, eliminating the downward performance trend.

Outcomes

The expected outcome of a successful worsening pathway intervention is clinical performance improvement.

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