Chenxi Liu

All Publications

• Empowering Bladder Health Education for Children: Integrating Situated Learning Theory and the ARCS Model in Online Program Design JOURNAL OF PEDIATRIC HEALTH CARE Liu, C., Chu, J., Hughes, T., Follis, C., Kan, K. M. 2026; 40 (1): 112-127

  Abstract

  Urotherapy, including behavior modification education, improves pediatrics lower urinary tract symptoms, but access remains limited due to a lack of publicly available, evidence-based programs. We developed Bladder Basics, a self-paced online bladder health education program and examined its instructional design and acceptability.Informed by Situated Learning Theory and the ARCS Model, Bladder Basics teaches key bladder health practices to promote behavior changes in an authentic, engaging way. 70 children ages 5-10 years with bladder symptoms and their parents watched Bladder Basics over four weeks, then completed online surveys and open-ended questions.Bladder Basics was well-accepted and demonstrated high motivational appeal. Participants reported positive attitudes, strong engagement, and interest in expanded content. Parents observed increased child engagement and self-efficacy in adopting bladder health-promoting behaviors.Integrating the two theoretical frameworks supports authentic, engaging bladder health education, enhancing motivation and acceptability, and potentially promoting healthy behavior adoption.

  View details for DOI 10.1016/j.pedhc.2025.09.005

  View details for Web of Science ID 001658931600001

  View details for PubMedID 41065601

• Practice patterns, barriers, and attitudes toward urotherapy for pediatric lower urinary tract symptoms: A societies for pediatric urology survey. Journal of pediatric urology Chu, J., Liu, C., Ritchie, C., Kan, K. M. 2025

  Abstract

  Pediatric lower urinary tract symptoms (LUTS) are common in school-age children. Urotherapy (UT), the first-line treatment involving education on behavioral changes, is typically delivered through in-person 1:1 clinic visits, which can limit access and strain clinic resources. Although novel formats such as group classes and self-paced videos show comparable efficacy to standard UT, their adoption remains limited by a lack of understanding provider acceptability and operational feasibility. This study surveyed pediatric urologists to understand clinical practice patterns and perceptions toward adoption of novel UT formats. Two UT programs at our institution, Bladder Bootcamp (virtual group class) and Bladder Basics (self-paced video curriculum) were included. The findings aim to guide the development and implementation of scalable UT programs to improve LUTS care.A 35-item survey was distributed to members of the Societies for Pediatric Urology, assessing clinical practice patterns, beliefs regarding UT, and attitudes and perceived barriers toward adoption of a virtual group education class and self-paced video curriculum. Descriptive analyses and Wilcoxon signed-rank tests to compare attitudes and perceived barriers between the two programs were conducted.The response rate was 12.3 % (46/374). Most respondents were White/European (73.2 %), male (65.1 %), employed at an academic center (57.8 %), and in practice for ≥20 years (35.6 %), and 47.8 % held a leadership position in their practice. Commonly recommended UT resources included physical resources (73.9 %), institution-specific patient education materials (63 %), wearable devices (47.8 %), and online resources (39.1 %), with 52.2 % agreeing these resources allow for optimal care. Additional resources that would improve care included online resources (63 %), healthcare apps (50 %), and wearable devices (37 %). Most respondents (60.9 %) preferred in-person 1:1 visits as the ideal method for first-line LUTS treatment. There was greater interest in offering (p = 0.0204) and feasibility in operating (p = 0.0068) the self-paced video curriculum. No significant difference was found for need (p = 0.856) between the two programs. Primary adoption barriers included adequate funding and institutional support. Staffing (p = 0.00388) and funding (p < 0.001) were greater barriers for operating the virtual group education class.While traditional in-person UT is preferred among pediatric urologists, there is interest and need for novel formats, such as virtual self-paced and group educational programs. Addressing key barriers, such as funding and institutional support, is critical for successful implementation. Engaging implementation partners and positioning these formats as complementary to standard care will be crucial for overcoming practical challenges and optimizing UT delivery.

  View details for DOI 10.1016/j.jpurol.2025.07.020

  View details for PubMedID 40829983

• Effectiveness of an Online Health Education Program for Pediatric Lower Urinary Tract Symptoms. Urology Liu, C., Chu, J., Kan, K. M. 2025

  Abstract

  Urotherapy effectively treats pediatric lower urinary tract symptoms, but its delivery is limited in clinical settings. We examined the feasibility and effectiveness of Bladder Basics, a home-based, self-paced online bladder health education program, in improving symptoms and knowledge.Children aged 5 - 10 years with bladder symptoms and their parents were recruited. All participants completed Bladder Basics over four weeks, with outcomes measured at baseline, 4 weeks, and 12 weeks. Feasibility was evaluated through recruitment, engagement, and post-assessment completion. Secondary outcomes included dysfunctional voiding symptom scores, parents' subjective improvement, care-seeking interest, bladder health knowledge, and self-efficacy. Analyses included paired t-tests, Wilcoxon tests, sign tests, and McNemar's tests.Of 70 families, 72% completed the program, 73% completed the 4-week survey, and 67% completed the 12-week survey. Symptom scores improved significantly: 32% at 4 weeks and 42% at 12 weeks. Of children initially screening positive for bladder symptoms, 39% fell below the cutoff score at 4 weeks and 55% at 12 weeks. 85% and 93% of parents reported child symptom improvements at 4 and 12 weeks. Parents reporting no need for clinic visits increased from 45% to 69% at 4 weeks. Knowledge of key urotherapy concepts was improved, such as peeing every 3 hours and bowel health awareness. Self-efficacy improved significantly, with a median increase of 4.6 points at 4 weeks (p = 0.018).Bladder Basics improved bladder symptoms and knowledge and demonstrated potential for broader scalability with strong participant interest and high engagement.NCT05852353.

  View details for DOI 10.1016/j.urology.2025.05.058

  View details for PubMedID 40456454

• Determining mobile learning acceptance outside the classroom: an integrated acceptance model ETR&D-EDUCATIONAL TECHNOLOGY RESEARCH AND DEVELOPMENT Liu, C., Correia, A., Kim, Y. 2025

  View details for DOI 10.1007/s11423-025-10514-w

  View details for Web of Science ID 001498443200001

• Applying dynamic structural equation modeling (DSEM) to examine the dynamics of students' affect and learning goal achievement CONTEMPORARY EDUCATIONAL PSYCHOLOGY Kim, M., Yang, J., Liu, C., Gezer, T., Wong, J. D. 2024; 78

  View details for DOI 10.1016/j.cedpsych.2024.102297

  View details for Web of Science ID 001283379900001

• Critical antecedents of mobile learning acceptance and moderation effects: A meta-analysis on technology acceptance model EDUCATION AND INFORMATION TECHNOLOGIES Liu, C., Wang, Y., Evans, M., Correia, A. 2024

  View details for DOI 10.1007/s10639-024-12645-8

  View details for Web of Science ID 001204643400005

• Forging Connections in a Digital World: Are Educational Organizations Maximizing Their Position in the Twittersphere? Journal of Educational Technology Development and Exchange Qi, R., Correia, A., Liu, C., Xu, F., Li, T. 2024; 17 (2): 134-153

  View details for DOI 10.18785/jetde.1702.06

• An Innovative Mobile Learning Acceptance Model for Out-of-Classroom Learning Association for Educational Communications and Technology (AECT) Liu, C., Correia, A., Kim, Y. 2022: 210-219
• A Case Study of Learners' Engagement in Mobile Learning Applications ONLINE LEARNING Liu, C., Correia, A. 2021; 25 (4): 25-48

  View details for DOI 10.24059/olj.v25i4.2827

  View details for Web of Science ID 000727381800001

• Evaluating videoconferencing systems for the quality of the educational experience DISTANCE EDUCATION Correia, A., Liu, C., Xu, F. 2020; 41 (4): 429-452

  View details for DOI 10.1080/01587919.2020.1821607

  View details for Web of Science ID 000573156500001