Participation in organized sports and other forms of active living have important health benefits in adolescence and adulthood. Unfortunately, the transition to secondary school has been shown to be a barrier to participation. Social networks can play important roles in activating adolescents, and information and communication technology (ICT) interventions can augment this role. To date, there are few insights into what adolescents themselves think and feel about barriers to and motivators for active living, the role of their social networks in active living, and the potential of ICT for physical activity (PA).This study aimed to gather insights into the perspectives of adolescents aged 12 to 14 years on active living and sports participation, motivators and demotivators for active living, and the potential roles of their social network and of ICT.A total of 26 adolescents aged 12 to 14 years from different levels of Dutch secondary schools participated in 1 of 5 semistructured focus group interviews, in which they talked about sports and PA, their social networks, their ICT use, and the role of social networks and ICT in PA. All interviews were transcribed and analyzed using a thematic qualitative approach.The study showed that all participants were physically active, although the transition to secondary school made this difficult, mostly because of time constraints. Participants saw positive physical and mental health effects as important benefits of active living. They regarded social benefits as strong motivators for active living: being together, making friends, and having fun together. However, the social network could also demotivate through negative peer judgment and negative feedback. Participants were willing to share their own positive experiences and hear about those from close peers and friends but would not share their own (and were not interested in others’) negative experiences or personal information. Participants were mainly interested in descriptive norms set by others and obtained inspiration from others for PA. With respect to using ICT for active living, participants stated a preference for social challenges among friends, personalized feedback, goals, activities, and rewards. Competition was seen as less important or even unattractive. If mentioned, participants felt that this should be with friends, or peers of a similar level, with fun being more important than the competition itself.This study shows that adolescents feel that their social network is and can be a strong driver of active living. They are willing to use ICT-based solutions that make use of social networks for PA as long as these solutions involve their current (close) network and use an approach based on being together and having fun together. Physical inactivity is one of the most important threats to individual health worldwide and is the number one factor for all-cause mortality -5, contrThe benefits of PA are especially pronounced in children and adolescents, because adequate PA not only affects their immediate health status, such as positive changes in adiposity, skeletal health, psychological health, and cardiorespiratory fitness ,15, but Given the strong evidence for the benefits of PA, and the role it could play in preventing debilitating health conditions and the promotion of healthy lifestyles, it is vital to understand the facilitators of and barriers to an active lifestyle in childhood and adolescence . This unOne specific, well-researched factor that affects PA is the impact of life transitions. Generally speaking, life transitions are all known moments in which people are most at risk of adopting a less physically active lifestyle -26. SeveTo support adolescents to be active, a broad range of interventions exist ,35. An iInformation and communication technologies (ICTs) offer previously unseen opportunities to tap into adolescents’ social networks. In recent years, 90% to 95% of teens in Western countries have reported having access to and regularly using a smartphone ,55, withGiven the available theory and evidence supporting the importance of active living for adolescents and the potential for (ICT-based) social network interventions to support them in obtaining and sustaining an active lifestyle, it is surprising to find that there is little attention in the current literature regarding what adolescents themselves think and feel about the barriers to and facilitators of active living, the role of their social network, and the potential for ICT-based interventions therein. Therefore, this study aimed to address this gap in the literature. This was done by presenting the results of a qualitative focus group study, in which we asked Dutch adolescents aged between 12 and 14 years who had just entered secondary school, about (changes in) their PA, the role of their peer groups and other social networks in PA, sharing information about active living with their peer groups and others, social media use regarding PA, and their wishes and preferences regarding potential ICT-based interventions.This study used a qualitative design using focus group interviews. Focus groups provide a way to collect qualitative data by engaging a small number of people in an informal group discussion, characterized by a focus on prechosen subjects and an interaction between participants . They prA total of 14 secondary schools in the Dutch provinces of Overijssel and Gelderland were approached; 2 schools agreed to participate . In each school, 2 classes were selected. In 1 school, the head teacher informed the pupils of the opportunity to participate, stating that the focus group interview would be on PA and how others influence PA. If interested, they could sign up and receive information material and consent forms via email. In the other school, research assistants visited the classes and introduced the research. Pupils were given the information material and informed of the theme of the focus group, and they received a link to the consent forms. Before taking part, all participants and their parents had read the information, had the opportunity to ask further questions, and had given their full consent.All focus group sessions took place at the pupils’ schools in one of their classrooms. All data were gathered by 4 research assistants as partial fulfillment of their master’s thesis. Each focus group session was led by 3 research assistants, with 1 assuming the role of discussion leader or moderator, whereas the other 2 acted as observers. All the focus group sessions were recorded using a voice recorder. The focus group moderator led the interview by asking 4 main starter questions on sports and PA, web-based and offline social networks and PA, technology and PA, and social media and PA. The moderator asked follow-up questions, if needed. All starter questions and potential follow-up questions are included in A priori sample size calculations in qualitative research are subject to conceptual debates and practical uncertainty. Saturation, that is, the condition when adding more data does not lead to new insights, is often seen as a criterion for the inclusion of more participants once the analysis has started. As a rule of thumb, 20 to 40 participants are usually considered sufficient to achieve saturation in individual interview–based qualitative research . In focuThis research was approved by the Ethical Committee of the Faculty of Social Sciences of the Radboud University Nijmegen, The Netherlands (case number ECSW-2021-141), and performed in accordance with the 2013 Declaration of Helsinki.All interviewees and their parents had ample time to consider their participation, asked questions, and signed informed consent forms. The interview data were stored securely and pseudonymized. The participants received no compensation to participate.Data collection was performed by 4 research assistants, all pedagogical science MSc students, as part of their graduation research. The research questions, interview guide, data collection, and initial thematic analysis rounds were supervised by all the authors. A further round of thematic analysis and refinement of the codebase was performed by all authors.SH is the principal behavioral scientist at the OnePlanet Research Centre; his work focuses on the acceptability, usability, and efficacy of technological innovations to support people in healthy living. FvA is a postdoctoral researcher and BS is a full-time professor and principal investigator of the active living program at the Radboud University Nijmegen; their work focuses on studying the determinants and opportunities for active living and supporting people in achieving a more active lifestyle.All focus-group recordings were transcribed and checked by the research assistants who led the interview. They anonymized the transcript by removing personal information. All transcripts were then read into the qualitative analysis software, ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) for Windows . These dA total of 26 adolescents  participated in 5 focus groups of 4 to 7 participants. All participants were aged between 12 and 14 years. The educational backgrounds of the 26 participants differed, with 9 (35%) adolescents attending prevocational secondary education, 5 (19%) participants attending senior general secondary education, and 12 (46%) participants attending preuniversity education. An overview of the descriptive statistics for each focus group session is presented in All (N=26) participants mentioned participating in sports and other forms of PA  at least once a week. Of the 26 participants, only 2 (8%) participants were active only once a week , and 1 (4%) participant said they were active on every day of the week. Football was by far the most popular sport, with 19 mentions of it. Of the 26 participants, workouts, fitness and gymnastics were mentioned by 4 (15%) participants: free running, golf, scouting, and volleyball by 3 (12%) participants; dancing, cycling, running, hockey, tennis, and swimming by 2 (8%) participants; and athletics, badminton, basketball, boot camp, kickboxing, “klootschieten” , korfball, motor cross, horse riding, ice skating, and road skating were mentioned once.Staying physically active, PA and the social network, and PA and digital technology. These themes had five, three, and five subthemes, respectively. Staying physically active had the following subthemes: (1) Changes in PA because of secondary school, (2) Changes in PA because of other reasons, (3) Perceived capabilities needed for PA, (4) Motivators for PA, and (5) Demotivators for PA. The PA and the social network theme had the following subthemes: (1) Who would I share with? What would I share? What do I want to know from others? (2) The social network as driver of PA, and (3) The social network as barrier to PA. PA and digital technology had the following subthemes: (1) Goal setting and action planning, (2) Social and interactive aspects, (3) Other BCTs, (4) Negative sides to digital technologies, and (5) User experience aspects. An overview of all themes, subthemes, codes belonging to subthemes, and the frequency of these codes are shown in Thematic analysis allowed the construction of 3 themes: The transition to secondary school brought with it changes in PA for many participants. Many participants explicitly mentioned quitting (one of their) sports activities, and only a few said that they became more active. The increased burden of secondary school was mentioned as the main reason, especially with regard to longer school hours and increased homework (Dutch primary school children have relatively little to no homework and shorter school days); some participants mentioned that they reduce sports activities to be able to spend time with friends:In primary school, I went out to play every day, after school and in the evening, with friends. And yeah, I cannot do that anymore because of school and homework.Participant in group 1I don’t see changes, only that I sometimes have to cancel football or another sport because, well, because school takes up a lot of time.Participant in group 2The COVID-19 pandemic has led to an (at least) temporary reduction in PA for all participants due to regulations or quarantines. Interestingly, the COVID-19–related regulations also led to more creative ways of being physically active when organized activities were restricted. Participants also mentioned resuming their activities as soon as possible. Another non–transition-related reason for limited PA was the seasonal influence, with less activity in winter:During the pandemic, we could not have training sessions, or matches. I did a lot less sport then.Participant in group 3My coach created an online group and offered activities: who has time on this day at that time? And we had to see for ourselves if we could make it, and if there were only four of us, it was fun, and if there weren’t even four, it could not take place. Like that, we could continue practice once or twice a week, but sometimes we could not.Participant in group 4With regard to motivators for PA, participants mentioned being together and having fun together as the most important aspect. Participants mentioned making friends and being motivated by others as the drivers of motivation:You need a bond with your team if you do football or another team sport. If you have bad team spirit... We had a period where our team was no fun to be in...Participant in group 3If you join a sport club, it gives you a lot of social contacts as wellParticipant in group 2Other important motivators for PA were the positive mental health effects associated with being active as well as positive physical health effects and adoption of healthy habits. Psychosocial aspects such as achieving mastery and competence or having a purpose in life were also mentioned. Competing with others was not considered an important motivational driver of PA:You know, when I’m stressed, to clear my headParticipant in group 2When I’m doing homework and I am getting tired, I take a walk or move around for a bit; they say it helps you concentrateParticipant in group 3When I’m in a bad mood and I do sport, I am happy again and then my parents are happy as well [laughs]Participant in group 4I just like the adrenalineParticipant in group 1Many participants mentioned psychosocial skills such as confidence, perseverance, self-efficacy, and successful experiences as drivers of PA:I like it when I can do something and my brother wants to do it as well, it gives me confidenceParticipant in group 5When we are 7-0 behind in a match, it is hard to keep faith; sometimes kids leave the field crying and that does you no goodParticipant in group 5But if I believe in myself, I can perform a lot betterParticipant in group 4Participants also mentioned demotivators to engage in PA. Again, social aspects were the most prominent: unlikeable coaches, teammates, and audiences as important demotivators for (organized) PA. Being judged on performance and a lack of confidence were also mentioned as demotivators:If you have a bad coach, you feel like going less and if that goes on, you just quitParticipant in group 1I’m in a mixed football team with boys and girls, but lately all the girls have been ill and then I won’t go either, that influences me. The boys aren’t always nice, are theyParticipant in group 5Participants mentioned a range of ways to interact with their social networks regarding PA. First, there were some types of information they would share with others or want to know from others and some information they would not share or want to know. Second, the information shared with, or received from, others had different perceived effects on the participants. In the eyes of the participants, others could not only motivate but also demotivate. BCTs involved were feedback on behavior and performance; social comparison; and providing a descriptive norm, practical support, emotional support, and inspiration.Participants said they wanted to share their information with people they already knew: friends, parents, and siblings. Classmates and peers who they did not know but were on similar performance levels in terms of PA and sport were hardly ever mentioned. No mention was made about wanting to share information with people more distant than direct contacts or people who are not peers:Some of my classmates are in my team, I share a lot with them about sport, but not with other classmatesParticipant from group 5I talk to my mother about it, and she would ask me about what happened and what I did, so I share with her what I doParticipant in group 2When talking about what information participants would want to share, they mostly mentioned wanting to share the kind of activity, its intensity, and the amount of time or duration of the activity; however, some participants also mentioned not wanting to share this information. Sharing performance levels, successes, and failures was less popular. Some participants would want to share successes, and few participants would share failures, if they felt the failures were socially acceptable and not too detrimental to their self-image. More participants would not share failures:I share [information about how often I do sport], but I can imagine that people who move less would enjoy sharing that lessParticipant from group 1But, you know, I would sooner tell someone that I won, or I succeeded, or I am happy or proud about thisParticipant from group 4I would not share how often I do sport, or what I eat, or that kind of thingParticipant from group 2With respect to wanting to hear from others, similar patterns arose: wanting to know the activity itself, the amount of PA, and the intensity of others’ PA were mentioned often, but participants did not want to hear about others’ failures and overall were not very interested in others’ successes or performance levels:How much sport people do and what kind. We used to do that, when we were stuck in quarantine, we would ask each other what we were doing now. Just because we could not do any other sportParticipant in group 1For instance, when they do something successful, that’s nice, but not when they did not succeedParticipant in group 5Why people sit on the sofa all day and not just enjoy doing a sport, or why some others exercise so much, if there’s a reason for that or if they just enjoy itParticipant in group 2Participants felt that people in their social network can act both as drivers and barriers to motivation for PA, depending on the sign of the feedback; positive feedback was seen to be a strong motivator, especially from coaches and friends. However, the detrimental effects of negative feedback were mentioned even more often, with negative feedback from coaches and spectators at sports matches seen as the most harmful. Negative peer judgment and negative gender norms in sports activities played strong roles in negative social effects on PA. Overall, coaches, teammates, parents and siblings, and friends played the biggest role, and teachers, web-based role models, and spectators at sports matches played a lesser role:That happens with friends too, if you’re doing a sport that they find weird and they give their opinion, it can make you quitParticipant in group 2And when I tell [them] I enjoy kickboxing, I get reactions like “why do you like that, you are a girl?” and I just don’t care at all about thatParticipant in group 3If the coach says you’re doing great, you tend to believe that because they know what they are talking about. And that makes me try even harderParticipant in group 1Participants felt that the social network could support PA by providing practical support, almost always in the form of inviting the participant to take part in activities or pushing the participant toward being active. Providing emotional support was seen as another strong facilitator of PA. Furthermore, people from the social network could provide a descriptive norm  and provide inspiration (showing what activities are possible). Finally, participants thought that social comparison could be both a driver and a barrier for PA:I guess I started football because of [other participant]; she said we are looking for more cool girls on the team, and yes, that convinced me to joinParticipant in group 2When people are yelling “come on, you can do it, keep it up!” that helps. It gives you a bit of support. “This time you might not hit the ball right, but next time you’ll do fine.”Participant in group 1Participants mentioned a broad range of social media platforms that they regularly used. Snapchat (n=8), WhatsApp (n=7), Instagram (n=7), TikTok (n=7), and YouTube (n=5) were often mentioned. Participants were aware of apps (6 mentions) and gadgets (7 mentions) for PA, and most participants had used at least one of those at some point to track PA or perform workouts. Participants also mentioned YouTube (6 times) as a provider of inspirational videos. Social media, as well as gaming and Netflix, were recognized as distractors (16 mentions) and stimulators (21 mentions) of PA:If you follow more people on YouTube who post about sport and stuff, it makes you feel like doing it yourself more. You can push yourself to do it like that.Participant in group 3I notice I go outside to do sport less because I get side-tracked by other stuff, like when I just did my homework and I’m like now is the time to watch some TV or play a game, and when I’m sitting on the sofa, I find it really hard to get up again and go outside and get active.Participant in group 4When considering what BCTs would encourage them to engage with digital technology for PA, the participants mentioned goal setting, social and interactive techniques, notifications and reminders, feedback on behavior, and rewards for use and goal attainment. Competition was generally considered uninteresting; if any competition at all was taking place, participants found it important that they competed with peers of a similar level.Most participants saw goal setting and support in action planning as effective BCTs to encourage PA. Setting your own goals, tailored to one’s own needs and attainment level, and personalized action plans were seen as important for uptake and sustained engagement. Participants especially found setting their own challenges and being able to choose from different activities to be important. Keeping steps small and feasible, support in keeping up streaks and other ways to form habits, and being able to adjust goals also emerged:I would not use preset groups, but if I can create my own group and set my own goals, I would like to do this much next month or next week, like that.Participant in group 1Or the app could tell you “you should do this and that, and this is for the leg muscles, and this is for the stomach, and if you do this so often, you will go this direction” or something like that.Participant in group 3I guess it is important to set your own goals, or else if it says you need to do 5000 steps, you will keep on receiving notifications that you still need to walk, and then you will want to remove it.Participant in group 4The second group of BCTs mentioned often by the participants was social and interactive techniques. Autonomy, that is, creating one’s own groups; inviting friends; and being able to give each other challenges; and fairness, that is, competition only against peers of similar level, were seen as important:Adding your own groups, and then play who gets the most points. You can do that with your own friend group—“let’s use this app and we’ll do this much this month.” Who gets most points wins?Participant from group 1Last year, my group eight (last year of primary school) used the [Popular Dutch app for suggesting walks], and everybody started taking walks and comparing who went furthest.Participant in group 5Like, I would challenge [other participant], saying here, I managed to do this, will you beat that? That sort of thing. You keep encouraging each other like that.Participant from group 2Participants mentioned rewards for the use of the app and for goal attainment as potential drivers of engagement: the ability to unlock premium content; receive points, badges, and web-based stickers; or receive products and gadgets as a reward were mentioned as different reward possibilities, with monetary incentives seen as less motivating. Feedback on performance, especially personalized feedback, and the use of notifications and reminders to keep up engagement were also seen as potential drivers of engagement:It could give you an overview of where you have been last month. “You have been using this app for a month now, would you want to see where you ran?” Red and dark yellow can be where you went a lot, and light yellow where you went less.Participant in group 4It can give you points, and you can use them to buy an avatar that runs your route with you, like the car in Google Maps.Participant in group 1We used that [popular Dutch app for suggesting walks] and you kept on getting, what was it again, some kind of medal or something—“you achieved this, you will get this next time.” You do want to collect them all, you know?Participant in group 2Participants also saw downsides to digital solutions for PA. The potential dangers of addiction and overuse were seen as important downsides, as were having to deal with negative comments and responses, privacy issues, potential discord and friction, and demotivation when missing goals:I know that some people can get very insecure when they see stuff on social media, like some people can do great things and they cannotParticipant in group 5And you should not get 800 messages, because it’ll make you remove the app very quicklyParticipant in group 2For example, when you do a lot of steps and end up higher on the leader board, that works, but if you don’t get higher or don’t get on the leader board and it feels like you lose, it will make you stop playing at onceParticipant in group 4I would not make it super-competitive; it has to remain fun, and you’ll end up doing only this thingParticipant from group 5Finally, the participants mentioned the importance of a good user experience and the design of PA technology. Ease of use, attractive design, and not having in-app commercials all play a role in uptake and sustained use:Well, I think it’s a definite plus if the app isn’t too complicated. Because when you install an app where everything is difficult at first, you’ll soon think “never mind, I’m not doing all this”Participant in group 2Yes, when you’re doing great, and then there’s an ad for sweets or chocolate...Participant in group 3Physical activity, The social network in physical activity, and Digital technology for physical activity) and 26 subthemes. Including the next run of 2 group sessions added only 3 new codes (2.97%), which was below the predefined cutoff point of 5%; no new themes and subthemes occurred. This means that thematic and code saturation can be assumed to have been achieved.The analysis of the base set of 3 group sessions revealed 112 codes in 3 main themes , but would not share negative experiences or personal information. Some participants would share information such as sports frequency, while others would not. With respect to receiving information from others, participants would mostly want to know what others do as inspiration for their own activities, that is, what others do as a descriptive norm for PA or to know what activities they can do together . They were not interested in the negative experiences of others. These insights have no direct counterpart in the current literature. Few studies on sharing PA experiences among adolescents exist, and those studies have a smaller sample size and do not justify their conclusions because they concern the usability of a specific digital application . HoweverParticipants mentioned a range of BCTs through which their social networks helped them in active living. Emotional support is important, and it is mostly the coach and friends or teammates who provide it, as well as the family members. Coaches, teammates, and physical education teachers can also have demotivating influences. Practical support can come from a wider social network; this includes triggers to “get you off the sofa” or facilitate locations and activities. Thus, feedback from the social network is a two-sided sword. Participants stated that negative feedback and judgment, which often relate to gender norms, can be detrimental to motivation, whereas positive feedback boosts confidence and motivation. Social comparison also plays a role; participants wanted to compare themselves to people who had similar interests and capabilities and disliked “perfect” images on Instagram. The role of the social network in active living described by the participants of this study is similar to that reported in recent literature, where inspiration, the impact of positive feedback , positivWith respect to ICT-based solutions to promote active living, the participants mentioned many well-known BCTs from the literature. The most prominent were personalized feedback, personalization of goals and challenges, and notification that strikes a careful balance between providing positive stimulation and avoiding becoming bothersome, and rewards. If competition was included, participants felt that it should be with friends, their own groups, or people at a similar level. Competition was mostly mentioned in a social context, with fun being more important than the competition itself. Finally, attractiveness, ease of use, and personalization were mentioned as important design features. These insights into which BCT participants believed to affect their engagement in PA reflect recent overviews from the literature on what works for engagement . The parAlthough the results of this study provide an overview of what participants thought and felt about social networks, digital media, and PA, they are by no means exhaustive, given the study design that had focus group discussions rather than questionnaires or other quantitative approaches. An example is the mention of social media use: WhatsApp received 7 mentions, whereas it is likely that all participants used this platform. Participants often added to others’ answers, that is, if one participant already mentioned something , others did not feel the need to mention it as well. Therefore, this study is not an overview of which social media and how frequently adolescents use it, but it does provide information on which channels are useful when working with adolescents. Another limitation is the setting of the study: the experiences that the participants mentioned may be typical only for Dutch adolescents aged 12 to 14 years and may lack validity in other societal settings. However, we expect the themes mentioned by the participants in this study to hold true for children and adolescents across many populations. Further research in other settings can test this expectation.Every scientific study is subject to bias, and this study is no exception. A likely bias is attributed to the self-selection of participants; only those who expressed interest were invited to participate. This may have led to a skewed distribution of PA in the sample. In fact, all participants were physically active, which may have been unrealistic. This potential skewness may also explain why attitudes toward PA were not a topic of discussion. However, as PA also included obligatory physical education, it is not unreasonable to assume that the participants’ PA reflects that of the general adolescent population. Recent figures show that 75.8% of adolescents aged 12 to 18 years in the Netherlands participate in sports at least weekly , and theLiterature shows that there is a need for more specific research into the effect of socioeconomic status and sex differences on active living in adolescents . HoweverThis paper shows that adolescents felt that their social network was and can be a strong driver of PA and active living. They were willing to use ICT-based solutions that make use of social networks for PA, as long as they involve their peers, close friends, and teammates. They felt it was fine to share some information such as their successes, and sometimes their general activity. They would not share their failures and would not be interested in competition unless it was mostly about having fun together while competing with peers of similar performance levels. ICT-based solutions should have personalized goals and feedback, provide the ability to create their own groups and set their own challenges, and facilitate having fun and meeting each other.The results of this study could be of interest to anyone , and social workers) currently undertaking or planning interventions to support PA in adolescents. The results show that there are opportunities to develop ICT-based, social network–including interventions for active living. These should be open solutions that help adolescents in goal setting, reaching out to friends, setting each other challenges, being together, and enjoying themselves together, all through the lens of PA. The results show not only that it may be fruitful to move away from the individual approach, which is still too common in digital technology for PA, but also that these technologies should aim for more cooperation than competition. Such ICT-based solutions could support adolescents in having a more active lifestyle and overcome the potential negative effects of the transition to secondary school, setting the stage for sustained activity in later life.


Current orthodoxy states that feedback should be timely and face-to-face, yet the optimal timing and mode of delivery for feedback is unclear. We explored what “optimal timing” means from residents’ points of view as feedback providers and receivers, to ultimately inform strategies to optimize feedback in training.As near-peers who have dual roles in both providing and receiving feedback, 16 subspecialty (PGY4 and 5) internal medicine residents were interviewed about their perceptions of the optimal timing and format of feedback. Using constructivist grounded theory, interviews were conducted and analyzed iteratively.Drawing on their experiences as providers and recipients, residents described simultaneously considering and weighing multiple factors when deciding on when and how to provide feedback. These included their own readiness to engage in providing meaningful feedback, the perceived receptiveness of the learner and the apparent urgency of feedback delivery . Face-to-face verbal feedback was valued for encouraging dialogue but could be uncomfortable and limited by time constraints. Written feedback could be more honest and concise, and the possibility of asynchronous delivery had potential to overcome issues with timing and discomfort.Participants’ perceptions of the optimal timing of feedback challenge current assumptions about the benefits of “immediate” versus “delayed”. The concept of “optimal timing” for feedback was found to be complex and context-dependent, defying a formulaic approach. There may be a role for asynchronous and/or written feedback, which has potential to address unique issues identified issues in near-peer relationships. With the implementation of competency-based medical education (CBME) in North American residency training over the last several years, there has been a paradigm shift to embrace a culture of feedback and formative assessment. The current orthodoxy is that feedback should be timely and delivered in a safe environment, formatted to be balanced, specific and actionable, and focused on well-informed content; the common understanding or implication is that it should be provided face-to-face 234. But 23Face-to-face, verbal feedback affords opportunities for real-time interaction and an interpersonal connection, and is associated with improvements in workplace performance . However5781011Timeliness of feedback is centered on the concept that “delayed” feedback, provided far from the time of performance, is thought to hold less value than “immediate” feedback . However13215The current orthodoxy, prioritizing “timeliness” and “face to face” delivery, may not adequately take into consideration the individual recipient or provider’s preferences, and may not be best suited for every context. Despite multiple research studies that explore features of effective feedback, the potential affordances of written feedback as a modality as it relates to timing is not well explored 17. GivenWe used constructivist grounded theory (CGT) to explore senior subspecialty medical residents’ perceptions on the optimal timing and delivery of feedback. Grounded theory is exploratory, with the aim of understanding the core processes underlying our perspectives on feedback. The constructivist approach actively engages the researchers’ background knowledge and experiences into the research, interpretive and analytic processes. 1920 As a19We recruited residents from 8 subspecialty medicine programs at the University of Toronto (postgraduate years 4 and 5 (PGY 4/5)) by asking their program directors (or administrative assistants) to forward an email invitation. There were approximately 90 residents in the included programs, which were selected based on similarity of core training and similar roles as near-peers: cardiology, endocrinology, gastroenterology, geriatrics, general internal medicine, hematology and oncology, nephrology and respirology. We also encouraged participating residents to share our study information with their peers. A small monetary incentive was provided to facilitate recruitment. Subspecialty medical residents are senior residents who have completed 3 years of IM training, and who uniquely have a dual role in providing and receiving feedback. With the introduction of CBME, the role of senior residents providing feedback is now more formalized . This poWe conducted one-on-one, 60-minute virtual interviews with each participant. A semi-structured interview guide with open-ended questions was used to explore residents’ current understanding of feedback, and their thoughts, feelings and reflections around receiving and delivering feedback (Appendix 1). All interviews were conducted by AL, with the intention that the use of a near-peer to facilitate the interview would minimize power differentials. Interviews were audio-recorded, transcribed verbatim by a third party and anonymized. Data analysis occurred concurrently with data collection, allowing for insights that would shape and refine subsequent data collection in accordance with the iterative nature of CGT .Interviews were analyzed independently by AL and SG using line-by-line coding in NVivo software . Researc20We conducted sixteen interviews between February and November 2021. See We found that near peers displayed a keen awareness of the needs of learners, even in their roles as feedback providers. This awareness heavily influenced decisions on timing of feedback delivery, and several potential affordances of delayed feedback were identified. However, participants demonstrated an ambivalence to the mode of feedback delivery, citing several risks and benefits of both verbal and written feedback.When deciding on the right time for feedback, participants described many co-existing considerations that they weighed during each encounter. We characterized these considerations as provider, contextual and receiver-related.Feedback provider considerations included self-awareness and emotional regulation. In the moment, participants determined their own readiness to engage meaningfully in a feedback conversation.It’s the recognition of trying to be self-aware, and that’s actually taking your own pulse and are you in a place where you can actually give feedback right now, and if you can’t, then delay it. (P12)Another resident noted that if they felt “emotionally charged” themselves then the timing wasn’t right to provide feedback, and a delay would allow them “to come up with better insight and reflection” to provide to the learner. (P5)The potential risks involved to existing interpersonal relationships also factored into feedback provider considerations. Participants noted that a relationship “changes both the way you interpret and give [feedback]” (P14), and that it’s harder to give honest feedback to someone you are close to. Others described a sense that there is a “social expectation that you’re colleagues and that you just don’t know if something you’re saying about them may offend them or not be taken the right way.” (P11) Even if the recipient wasn’t very close, even a “friend of a friend”, it could be difficult to give “very honest feedback” because personal relationships could be “impaired or jeopardized”. (P12)Contextual considerations included the type and content of the feedback, and the setting and environment.If it was something that is a bit more emotionally heavy, I think those conversations can be saved for kind of a later setting, and I have myself have done that where I flagged a certain incident, noted that it was a high emotional moment and not exactly a time for me to sit with the learner and really dissect it. (P5)Among receiver considerations, participants emphasized learners’ apparent readiness for feedback. One participant noted that they have learned to “gauge whether or not the learner is looking for feedback”, because it is possible to want to provide feedback only to find that the learner is “not in the right mindset at that moment to receive it”. (P1) Readiness was affected by the recipient’s mental and emotional state, the setting for feedback, and the expectation of feedback. Participants also identified that alignment with self-perception carried significant influence in acceptability of feedback in the view of near-peers.It has to do with the person’s self-awareness and conception of themselves as a physician, and whether or not the feedback sort of creates a huge emotional disturbance where it’s totally not aligned with what they think of themselves in that case. (P4)Therefore, in specific contexts, enabling time for self-reflection became an important receiver consideration.And sometimes people need a little bit of time for their own reflection before coming back to a debrief…The disadvantage of immediate feedback is maybe you do need a bit of time for personal reflection. (P16)A key finding was that these considerations coexisted simultaneously and were often in tension. Participant 12 weighs the situational considerations at play, noting that “if it’s more of a communication, conflict resolution issue, I think you don’t have to rush to it” but “if it was a major safety incident that requires to be addressed immediately, that’s a different situation”. At the same time, they identified some risks associated with immediate feedback, including that “real-time feedback always risks creating an awkward or weird dynamic in the team”.Overall, our participants’ dual roles as providers and recipients of feedback gave them a heightened awareness to the situational and receiver considerations, displaying the unique perspectives of near peers. The only constant seemed to be a general sense that feedback should not be provided when the recipient is post-call, as people are “exhausted”, “shut down” (P5), “dysregulated” (P2) or their “frontal lobe doesn’t function” (P4).In further exploring issues of timing of feedback, we asked participants about verbal feedback, which occurs face-to-face, and written feedback, which typically does not involve a face-to-face conversation. Rather than expressing a preference for one or the other, participants instead offered a nuanced view, identifying both affordances and drawbacks of each approach to feedback. Compared to written feedback, Participant 13 reported that “verbal feedback is much more flexible. It’s much more malleable” and as the learner “it offers the opportunity to ask questions and get clarification if it’s delivered properly.” Some participants also felt that giving feedback verbally engaged the learner more, by having them “participate actively in the feedback session.” (P12). They prefer it to feel more of an “exchange, in a more conversational, bidirectional way”. The opportunity to have a conversation left less room for misinterpretation, and was thought to be helped by non-verbal communication:You can assess body language, you can see the person’s facial expressions, how they react. They can also get what you’re saying by tone of voice, they can interpret something that you’re saying completely differently, depending on all of those things that you can’t get over written word. (P14)However, participants also acknowledged that verbal feedback could lead to more uncomfortable situations, leading to a tendency to give more positive feedback. For this reason, some felt it was easier to be more honest in writing.I think that as a sort of person giving feedback, it’s definitely harder to give negative feedback in person than it is to, say, write it down… you might misconstrue things in a certain way that makes things a bit lighter than they really are. Particularly if it’s really negative feedback. Like you have this person who’s problematic or has done very poorly, I think it’s really hard to give them the frank truth in-person. (P6)As the provider, written feedback allowed for the construction of more intentional feedback.In writing, I think you do get to spend a little bit more time to compose what you’re saying and to frame it exactly in the way that you want… you could build in more learning objectives if you yourself had the time to reflect on what actually does that feedback mean and what do you want the person to take away from it. (P4)Written feedback also tended to be more concise and direct, which were both qualities identified by our participants as important aspects of good feedback.With writing, there’s an opportunity to kind of edit what you’re saying. So if I write a big flowery phrase about… That only has one point of useful feedback in it, I can edit it down so that it’s just really clear. (P7)Furthermore, it offers the opportunity for asynchronous delivery which had potential benefits in the roles of both provider and recipient. As a feedback provider, one participant felt it would be particularly useful “when you’re so busy on service that you might not get time to actually talk to someone face to face”, or if someone was post-call and too tired; in these cases having a different “avenue to provide them the feedback is definitely important” (P4). Another participant, considering their role as a recipient, felt that written feedback had advantages.I think that written feedback, you can sort of… If you don’t like what you read, you can sort of choose not to read at that time, and then go back to look at it later and, “Oh yes. Okay, that’s a good point.” And you just can work on the process. (P9)Interestingly, permanence could be viewed in both negative and positive ways. For example, participants commonly noted concerns that “when you put something in writing, [it] could have consequences. (P2) On the other hand, the same permanence was often identified as a potential advantage in that it creates a lasting record for the learner that can be referred to at a time with more readiness to accept feedback.It depends on the context, but sometimes it might just be that [the learner is] not absorbing it in the moment because they’re overwhelmed by other things, whereas if you went back to it later, they might. Sometimes it just might be a personality thing where they just might not agree with you. So I think in that sense, writing it down is helpful (P3)Two key concepts were identified by our participants as potential opportunities to increase the role of written communication in feedback. In the experience of participant 9, written feedback could seem a lot less like coaching… and more like “either an evaluation or a complaint”. This was reflected in the cultural manner by which written feedback was usually approached.We have all these EPAs [entrustable professional activities], and the stuff that’s written in the EPA is literally just like a summary of what we’ve just talked about in person. So then, it’s just repetitive, it’s not new information (P4)Reframing the current role of written feedback may better balance the weight and allow for a larger role in feedback delivery.When it’s lower stakes, when it’s frequent, not necessarily about a big bad situation that happened and everyone complained about you, when it has pointed next steps… I think in that situation, it’s very much coaching. (P9)Secondly, participants perceived written feedback as a skill that can be developed and rewarded, which heralds an opportunity for improvement.I’ve seen that people tend to just do coaching quite naturally, verbally, whereas I think it takes quite a bit of effort to make your written feedback sound like coaching. (P9)We explored the concept of timeliness when giving and receiving feedback, by interviewing near-peers who are in a unique position of acting in both roles. Our participants were highly attuned to the needs of the recipient in the moment and illustrated the complexity of considering when and how to give effective feedback. At any one moment, provider, contextual and recipient considerations could be in direct tension, and there were circumstances where delayed feedback was preferred. Provider emotions, feedback on communication or interpersonal conflict, and receiver fatigue were reasons to delay feedback. Concerns about patient safety and the potential for greater specificity were reasons for near peers to offer immediate feedback. But these factors defied a formulaic approach. For example, a senior resident might struggle to balance the simultaneous need to provide immediate feedback regarding a patient safety incident, a desire to protect their own emotional state as someone involved in the event, and the lack of apparent readiness for feedback in the recipient. Our study sheds light on these nuances of feedback timing. In their roles as both providers and receivers, participants could not identify a single “optimal timing” of feedback. These findings suggest a need to frame the timing of feedback as a continuum, a push-and-pull, instead of as a traditional binary model of “immediate” or “delayed”. Asynchronous delivery of feedback in writing can increase flexibility for both the provider and receiver, although it is not widely used in near-peer relationships. Our study provides an important insider perspective, adding to the literature suggesting we should more carefully consider the perspective of the person receiving feedback 2426272829.262728Teaching on effective feedback generally focuses on optimal structure, content, and timing . FurtherOur study offers several additional considerations that affect perceptions of the optimal timing of feedback. Providers of feedback require the skills to navigate multiple judgements, be willing to practice self-reflection and regulation, understand the relationship between feedback and individuals, and appreciate the role of the learner as an equal participant of the feedback process 33. Our f34Participants often indicated a preference for verbal feedback, as it allowed for conversation and dialogue. The risk of miscommunication was felt to be lower and the encounter could be enhanced through non-verbal elements of communication such as body language or tone. In their role as feedback recipient, participants valued the opportunity to engage, ask questions, and get clarification. Yet these benefits were not always realized, as face-to-face conversations could be time consuming, uncomfortable and sometimes confrontational. Feedback in written form is therefore attractive, as it can be delivered asynchronously. When prompted, participants readily identified several affordances of written feedback such as the ability to be more organized, direct and concise. Furthermore, participants were highly sensitive to tone and language in written comments, suggesting the ability to control non-verbal elements of communication in the written word. Dialogue is fundamental to learning and should be adaptive, discursive, interactive, and reflective.  While naThe permanence of written feedback was perceived as potentially detrimental when thought of as assessment, but could be helpful if used carefully in providing feedback. Our participants perceived the role of written feedback as being perhaps more beneficial for the provider than the recipient, as it was often viewed as being used more for “evaluation” or to document a “complaint”. If we intend written feedback to truly be perceived as “feedback”, our findings suggest that we need to clarify its role and uses.  For examBecause this study was conducted at a single institution, local practices and education culture may have influenced our participants’ perspectives and experiences. This was somewhat mitigated by the fact that more than half of the participants had previous learning experiences at different institutions. Our participants were predominantly women, which may need to be considered when transferring our findings to other groups. Gender inequality in both feedback and assessment has been well described, but was beyond the scope of our study. 42 We focOur study adds important insights to the feedback literature from the perspectives of near peers, who hold dual roles as providers and recipients of feedback. The concept of “optimal timing” for feedback was found to be complex and context-dependent, defying a formulaic approach. The near-peer relationship may offer unique affordances and challenges to feedback, and what works in the context of teacher-learner relationships may not transfer in a predictable way to the near-peer setting. Educators should embrace more flexibility when teaching about timing and modality of feedback. More focus on the development of written communication skills may enable us to incorporate conversation and dialogue in writing, and capitalize on some of the potential advantages of written feedback, such as its role in asynchronous delivery.The additional file for this article can be found as follows:10.5334/pme.1052.s1Appendix 1.Interview Guide.


The Peruvian environmental action plan seeks headwaters protection as one of its integrated watershed management objectives. However, heterogeneous social and environmental conditions shape this freshwater management challenge at subnational scales. We have noticed different interpretations of this challenge. To map the debate, understand the diverse interpretations, and frame political choices, we conducted semi-structured interviews with institutional and non-institutional stakeholders for performing discourse analysis in an Andean watershed where mountaintop gold mining, midstream farmers, and the downstream Cajamarca city coexist. One discourse dominates the debate on protecting the freshwater supply and argues the importance of river impoundment, municipal storage capacity, and institutional leadership. The other two discourses revolve around protecting the mountain aquifer. The second discourse does so with a fatalistic view of headwaters protection and rural support. The third discourse partially shifts the debate towards the need for improving rural capacity building and (ground)water inventories. To understand evolutions in society, it is crucial to understand these three discourses, including the types of knowledge that actors present as legitimate, the attributed roles to all stakeholders, and the kinds of worldviews informing each discourse. The interaction among discourses could hinder integrated watershed management at worst or, at best, help inspire multi-stakeholder collaboration. Freshwater management for inland mining is expected to contribute to sustainable development . HoweverIn Peru, the Ministry for Environment has formulated a National Environmental Action Plan (PLANAA). The water sector’s goals include (i) integrated watershed management with a focus on headwaters protection, ecosystems, and sustainable management; (ii) guaranteeing the control of discharges in waterbodies; (iii) improving the water use and availability for the agricultural sector; and (iv) guaranteeing the full coverage of wastewater treatment and reuse in urban areas and increasing it in rural areas . In addiIn the northern Peruvian Andes, the Yanacocha mine (MYSRL) exploits gold and silver ores at the headwaters of four watersheds, wherein two (Mashcon and Chonta) are sub-basins of the Amazon and the other two (Rejo and Honda) drain into the Pacific Slope . AssessmA discourse can be defined as “a specific ensemble of ideas, concepts, and categorisations that are produced, reproduced, and transformed in a particular set of practices and through which meaning is given to physical and social realities” . A discoRather than opposing economic or engineering analyses, discourse analysis is an asset for addressing complex environmental problems  because Discourse analysis has been used to map and scrutinise freshwater management debates. For instance, the transition to a bio-based economy in the Netherlands encounters two interpretations for addressing water quality monitoring, either focusing on norm-compliant physicochemical quality or norm-flexible ecological functionality . LikewisThe Mashcon watershed , northerA total of 28 watershed stakeholders were interviewed for this study, including mining, institutional, rural, and urban respondents. These consisted of six inhabitants of Cajamarca city and sixteen inhabitants of the rural homesteads of Llushcapampa Baja, Llushcapampa Alta, Llanomayo, Purhuay Bajo, Quishuar Corral, Tual, Aliso Colorado, and Cince las Vizcachas. The remaining six interviewees consisted of one representative each for the following institutions: Cajamarca’s water company (SEDACAJ), MYSRL, National Meteorology and Hydrology Service (SENAMHI), Cajamarca’s Regional Government (GORE), Municipality’s Management of Basic Sanitation, Natural Resources and Climate Change  and the board of water users of the Mashcon (JUM). The interviews were conducted in 2018, except for a videoconference with the municipality in 2020 and MYSRL, which was interviewed in 2019.Semi-structured interviews were conducted following ethical  and technical  considerations see . The intFor performing discourse analysis, we adapted the approach from Hajer  and DryzThe discourse elements  were intBefore the gold mining boom in Cajamarca, the creation of a milk condensation plant in 1974 motivated lower-valley landowners to invest in irrigation and dairy cattle. Eventually, slope farmers shifted their economic activities as well, from sheep to cattle farming and from food crops to forage. With the 1990s expansion of cattle farming to neighbouring provinces, forage crops were being deemed advantageous for being drought and freeze resistant, in addition to guaranteeing a rural income thanks to the industrial milk demand. The latter was helped by the establishment of a second dairy factory in 1999 . The FAOIn 1992, the headwaters of the Mashcon watershed were given in concession to MYSRL. By 2002, the mining personnel grew to 7561 from the initial 517 workers , and witRural water sanitation (RWS) evolved after evaluating two management models: the supply and the demand approaches, wherein the latter was validated. The supply model of the 1990s departed from the central government’s technological preference under cost-benefit reasoning. Once installed, water systems were left in charge of local actors, often yielding the infrastructures defective. Conversely, the 2000s demand approach worked upon request of the demand. The local government and communities participated in the technology decision-making process. The communities’ investment, capacity building, and workforce for rural water projects aimed to a gradual modification in habits and systems ownership. The local authorities and water users became responsible for keeping the RWS services in a sustainable state. Sustainability in this context was understood as the integration of infrastructure, operation and maintenance, primary health care, and sanitary education . Since 2Contrary to the rural case, the urban water management capabilities were surpassed by the population dynamics. Since 1980, no additional water plant has been built to date (Interview 24). Between 1993 and 2007, Cajamarca city experienced a faster population growth (3.4 percent per year) than the national average of 2 percent per year .Water sanitation deficiencies in Cajamarca, such as having “running water only for a few hours a day”, are worse in impoverished areas of the city due to infrastructural deficiencies. Rural immigrants also struggle to access sanitary and health services . A 2016 The precedent historical overview highlights the complexity of freshwater management, marked by mining impacts mitigation measures in upstream rural areas as well as social evolutions in both rural and urban areas. Our analysis of the semi-structured interviews identified three freshwater management discourses. While there were overlapping arguments in the debate, the ideal–typical representation follows particular roots that inform each discourse. The identified discourse elements are summarized in The first discourse highlights the need for increasing the freshwater withdrawal and municipal storage capacity. River impoundment, water users’ education, and institutional leadership are prominent arguments in the debate. The storyline is “casted in concrete” in the form of reservoirs, dams, and irrigation canals built by MYSRL, as well as in the municipal water infrastructure of SEDACAJ. These two institutions, and the municipality, narrate the storyline.−1 and states that “the recharges maintain in equilibrium with the groundwater reserves, substituting the water volumes withdrawn from the exploitation pits sufficiently” [The mine’s water treatment, storage, and downstream allocation constitute a compensation measure “validated by the Local Water Authority and the Ministry of Agriculture” (Interview 26). The National Water Authority (ANA) authorises MYSRL to withdraw groundwater at a rate of 601.8 L.sciently” . The SEDciently” . Namely,−1 in 2012, but only 60% is supplied by SEDACAJ in the dry season. From the 214 L.s−1 of freshwater withdrawn by SEDACAJ in the dry season, only 150 L.s−1 are billed to clients. Around 30% of the treated flow is lost by clandestine connections and leaks  [The freshwater management challenges revolve around three core problems. First, water shortages in Cajamarca city are worsened by increasing droughts and population growth. A press release of SEDACAJ states that “the absence of rain is causing the service to be restricted to only hours” . The citifespan) . The min−1 in 2030 [The Cajamarca city water demand will mount to 390 L.s in 2030 . To face−1 of tap water, in addition to benefiting agriculture with 74% of its dammed volume. Incremental amendments to the existing municipal infrastructure  are short-term measures [A river impoundment technology has been proposed by MYSRL and the Association Los Andes de Cajamarca (ALAC) to solve the urban supply–demand mismatch. The Chonta River dam project (Interviews 24 and 26) would enable the production of 370 L.smeasures . The MYSRegarding institutional roles, the MYSRL representative explains that a “mining company like Yanacocha, likewise others in the north or south, is an important factor for there to be water, but it is not the actor. The actor is the state through its institutions” (Interview 26). An inter-institutional platform (GIR) organised by the municipality, and with ALAC in the secretariat, is addressing the protection of peri-urban riverbanks and the rehabilitation of the collapsed waste stabilisation ponds for bird watching (Interview 27). The GIR, one says, “is a program that has several projects with the aim of providing more water for the city” (Interview 26). Regarding institutional arrangements, the SEDACAJ representative argues that “the legislative decree 1280 has been published. It indicates that the city should be integrated with the rural area. This means that water companies should be in charge of the JASS administration” (Interview 24). The mining representative adds that “if the law would say that Yanacocha, or any other mining company, must discharge drinking water, we would have to comply” (Interview 26).Regarding water user roles, the municipality representative believes that “the biggest challenge is environmental education. People know …, but it is not yet applied. So, as long as there is no such a culture of water care, it is not only the responsibility of the provider company, but the responsibility of the user” (Interview 27). The mining representative explains that “it is a matter of culture of the neighbours who pollute” because as the water “goes down it becomes contaminated. Not by mining activities, but by the action of the same neighbours who pollute it”. Moreover, the representative adds that MYSRL coordinates with “canal users, agricultural producers and grassroots organizations” for implementing programs of water care and hygiene (Interview 26).In practice, MYSRL shall comply with environmental norms, as well as social and economic viabilities of their mining operations (Interview 26). SEDACAJ shall cover the demand of their urban clientele (Interview 24). Moreover, the municipality’s management of basic sanitation, natural resources, and climate change authorises the JASS organization and provides them with technical support (Interview 27). In addition, ALAC administers the MYSRL donations as well as specific agreements for improving the public water service, with the aim to “facilitate processes linked to project execution under the terms of reference and products approved by the responsible institutions: the provincial municipality of Cajamarca and SEDACAJ” .The second discourse argues the plausibility of a worst-case scenario, where freshwater becomes scarcer and conflicts intensify. Hence, stricter freshwater surveillance and increased awareness among all stakeholders are needed. Protecting the headwaters, rural support, and religious beliefs are cornerstones of this discourse. The storyline is narrated by non-institutional stakeholders who reproduce their experiences with mining, authorities, or neighbours added to the debate.Apocalyptic interpretations have been reported in rural communities of Cajamarca, related to the central government’s Programa Juntos. The proposed economic transfers to pregnant women and mothers of minors were seen as a “diabolical making” or an intention of “dangerous appropriation” . RegardiThe freshwater management challenges depart from three core problems at least. First, rural inhabitants feel excluded by authorities  or overpowered by MYSRL . An urban interviewee agrees by saying that “the authorities fail to support the farmer, even though farming is the basis for the nourishing of humanity” (Interview 17). A farmer explains that “when we the communities make protests for water, we receive little support to our claims” … “when there is money, they say everything is alright” (Interview 6). A deputy mayor adds that “often the authorities, in times of political campaign, they arrive here and offer this and that to us. And in the end, as if the peasants were whatever, the peasants are not considered. I mean, it has happened several times and it continues!” (Interview 1). Another one refers to participatory monitoring practices by saying that “Yanacocha does it with COMOCA, but it is only known by them” (Interview 5). A second problem is the impact of mining on the functioning of freshwater. For interviewee 6, mining explosions produce earthquakes that deviate the water springs’ flow to other locations. Moreover, the interviewees reported having lost the recreational uses, quantity, and quality of freshwater . One explains, “Before in this river, that now looks more like a brook, there used to be trouts for feeding my family. But nowadays, there are no trouts due to mining” (Interview 9). Another says that “before, our water was pure, of translucent colour. But nowadays the water comes turbid, which is noticeable when collecting water in a container and observing the settling down of sediments at the bottom, and a bad smell due to the water treatment by Yanacocha” (Interview 2). Another one who believes that replacing the headwaters artificially “will never have the same natural value”, explains that “the cuncul, which is a frog-like animal but with its little big head and its tail, before there were many. Now not. You see them minimally nearby to the water springs” (Interview 21). The third problem is that “the population pollutes as well” (Interview 16). One remembers playing in the Mashcon river as a child, when ”it was fun to go into the river, the contamination was not that much. But now there is plenty of garbage” (Interview 20). A deputy mayor says that in Cajamarca city, “people drink a soda and throw it into the river. That is why the photos of the river full of garbage come out. And then they say that the mine is polluting, but it still gives a care” (Interview 16). Moreover, some rural users “steal” the water according to interviewees 1, 14, and 28, as one summarises saying: “What we saw when we were kids was a lot of water coming, because it rained more. And now the flow has diminished, and we are not conscious about it. People have stolen water from the canal and caused pipe breaks. This water is stolen for their irrigation and animals, due to the scarcity in the dry season” (Interview 14).A deputy mayor believes that “the future will be more complicated … and for this we think that if there is that support, we would have prevention” (Interview 16). Another one says that “mining activities will expand and kill all the water springs that remain. The ones who will suffer the most will be the children of the future” (Interview 21). Several respondents share the view that water scarcity is a biblical premonition and a fate, “not only for our population, but worldwide. It’s written in God’s words” (Interview 1). In addition to converging into religious arguments , another one states that “the water quantity and quality future will be a mortal war. That will be the end of humanity because there is no solution” (Interview 17).No fundamental technological changes are needed, but support to “install modern equipment for chlorination” (Interview 2) as well as “technification of irrigation for the crops” (Interview 8). Freshwater source separation prevents the risk of contamination in rural areas . The latter thanks to having piped water, or agua entubada, captured from water springs. Such a source, one says, “is the only one left. Nowadays we drink spring water, which we think has not yet been contaminated” (Interview 2). In urban areas, one interviewee consumes water that “comes from wells like underground terraces” (Interview 19). Another urban interviewee, who believes that “several people have died of liver fluke due to the water” in the countryside, prefers bottled water over the agua entubada because “they say that water is treated, but no analyses have been done” (Interview 17). One interviewee explains that the freshwater provision for non-mining users depends on the continuity of MYSRL’s operations (Interview 5). Regarding institutional roles, interviewee 13 says that ”there should be surveillance, and protection of the water springs” (Interview 13). The other two explain that, in addition to performing the chlorination, the JASS imposes fines on those who use the piped water for agricultural purposes (Interviews 1 and 21). One believes that authorities should “care for our health and the children of future generations. They should do the analyses, flow measurements in our water systems to have assurance in our waters” (Interview 5). In addition to economic support to rural water projects (Interviews 2 and 17), interviewee 4 explains that the training given by the medical post has prevented health problems related to water consumption. Interviewee 5 adds that MYSRL “also helps us with our household water”.Regarding the role of rural water users, they rely on a learn-by-listening approach. As one explains: “We participate in capacity building and we are told that the river water is not for domestic use, but only for animals” (Interview 5). Another one adds that part-time jobs at MYSRL enabled him to learn about waste sorting and sharing this with the community because “we learn by listening from the speeches and apply it in our households” (Interview 16). Moreover, peasants “have septic tanks”, and “each family knows what to do with their wastes. Some garbage is buried” (Interview 8). Moreover, the importance of traditional ecological knowledge manifests among the rural arguments for protecting the headwaters. Andean grasslands or pajonales alto-andinos, as well as the aliso tree (Interviews 10 and 13), are known to attract and store water naturally  since the grandparents’ times (Interview 1). Lastly, neighbours recommend that each other use the water carefully  and, according to one, to “pray to God, because God created waters and seas, the earth and the mountains” (Interview 12).The third discourse emerges from interviewees concerned over the disordered urban growth and lack of local studies . The storyline is narrated by representatives of the GORE, JUM, SENAMHI, and a rural respondent who, in summary, argues the need for improving the capacity building, informed decisions, and (ground)water inventories.The 2002 decentralisation process transferred the function of land use planning from the national to the regional governments. In Cajamarca, the GORE identified areas of water potential within the MYSRL concession, resulting in “a power struggle or a controversy, which was both a technical and a political process” . In the Three problems raise awareness on knowledge generation for understanding the freshwater management challenges. First, “the accentuation of climatic variability, which are very rainy periods greater than normal and very dry ones well below normal. That variability is becoming more intense and frequent”, in turn causing problems on freshwater distribution and soils (Interview 22). Second, uninformed decisions lead to resource squandering. One says that groundwater abstraction is being presented by certain municipalities as promising, although the urban groundwater reserve is uncharacterised (Interview 25). Another example is given by interviewee 7, who refers to a recent landslide caused by a collapsing reservoir, and highlights that the Ministry of Construction, Housing and Sanitation is expending a lot in fuel, machinery, and workforce to fix this problem; “why? because a previous study was not done” (Interview 7). Third, a flawed model of rural support. For instance, after participatory water monitoring practices, the water samples are sent to Lima, and “the results are communicated after almost three months. Everything that is there is explained to the people, but it is hardly understood” (Interview 23). Regarding agricultural support, one says that “the government provides potato seeds. Professionals make the function only to inform the number of people, hectares, seeds, potatoes, but they do not come to revise”. Likewise, MYSRL gave cows, sheep or guinea pigs to the peasants “but never gave training … Yanacocha gave guinea pigs to around 400 people. What are they now? around 10 or 20 people who maybe have a lot of guinea pigs. They give cows for letting it die later” (Interview 7). Another one adds that “young people do not have the vocation to be farmers; they do not seize water properly” (Interview 23).Covering the water demand will be more difficult with an increasing population  and unstoppable climate change (Interview 22). One says it is necessary to “change much of our habits” and “search for alternatives that enable us to live with this phenomenon that is coming” (Interview 22). The increasing pressure on freshwater resources means “the city will be hit hardest” (Interview 22) since “the water we consume here in the city of Cajamarca is regulated in the watersheds” (Interview 25). Another says that “effective order is needed at all levels … In Cajamarca, and throughout Peru, the challenge is to leave informality and move to formality … This happens mostly in the urban area”(Interview 25).Regarding the role of technology, an interviewee believes that freshwater protection is related to “making visible the problems that exist. Have a good knowledge of how our water sources are” (Interview 25). The JUM presentative explains that MYSRL “has a project”, which is “an agreement with ALAC and students of the last cycles of civil engineering of the Private University of the North. We seek to update the inventories to be able to give a good service and see the problems of the canals. There are surveillance systems as of 2017, where different public and private institutions participate in controlling the amount of water” (Interview 23). The SENAMHI representative explains that they “work at the watershed level as well. These issues of monitoring, climate analysis, at the level of districts, and watersheds” (Interview 22). Regarding the presence of excess chlorine or lime in the water, interviewee 23 believes that “perhaps our water does not need that measure, but another treatment”.Regarding institutional roles, the SENAMHI and GORE representatives explain that their roles in water resources management are indirect by providing technical documents to the water authorities for them to make informed decisions. Such information is important “for risk management issues in water management” (Interview 22), as well as the determination of water potential areas. The latter was in collaboration with a Regional Technical Commission of 36 representatives, including the GORE (Interview 25). Regarding institutional arrangements, the GORE representative identified a loophole in the groundwater abstraction legislation because “this drainage is being treated equally as the drainage of wastewater” (Interview 25). For one interviewee, it is also important that MYSRL “complies with the standards of quality and quantity of water. Plant native plants, so that there is water” (Interview 22). Another recommends that “there should be a dialogue between countryside and city, authorities and population. Especially, making it comprehensible from authorities to the peasant and the investments that they make” (Interview 7). Rural water users should avoid clientelism. As interviewee 7 says, “that is badly taught, and the people keep on asking, and make protests for demanding more aid”. The same person adds that it is important to “share among both professionals and farmers and grow as one people”, in addition to recommending MYSRL invest in forming rural leaders by sending the best of the young generation to agriculture-leading countries such as The Netherlands or Israel (Interview 7).The interviewees’ interests, arguments, and practices on freshwater management were explored and classified into three discourses with their respective roots and convergent groups of actors. Therefore, the previous sections provided the answer to our first research question: the Mashcon watershed stakeholders have three interpretations of how to address the freshwater management challenges. Rather than focusing on the contrasts among discourses , the aimThe level of influence of discourse can be analysed in two steps. On the one hand, the more concrete conceptualisations provided by the actors, the more structuration a discourse has and, thus, more chances of influencing the debate among storylines. On the other hand, institutional influence is reached if the definitions/arguments of discourse are translated into institutional practices or arrangements . The domThe first discourse reiterates the need for increasing freshwater sources and educating water users with strong institutional leadership. Such a view influences the debate throughout the watershed since water harvesting, storage, and moderate usage, in addition to freshwater surveillance by institutions, are important to the other two discourses as well. The strategies of water users’ education and incremental water infrastructure developments are reproduced by ALAC, which has collaborated since 2013 with the municipality to organise the GIR  (Interview 27). The technological solution for the Cajamarca city water shortage  is institutionalised in the central government’s interest in “large hydraulic projects for the benefit of Agriculture” . The rolThe second discourse, narrated by non-institutional stakeholders, is based on a widespread fatalistic view of the future of water scarcity and the overpowering of rural freshwater users. These actors reproduce their negative experiences with mining or authorities into the debate, stressing that water-related social conflicts will increase. The consistency of such an argumentation throughout the watershed reflects a certain level of structuration, although medium rather than high. The latter because fatalistic arguments are discouraged by the first discourse, as the MYSRL explains: “I see that a future like the war for water is mostly projected. And all of that is a pessimistic sense. I believe that the human being is an extremely adaptable being” (Interview 26). The suboptimal conditions of Peruvian peasants’ agriculture have recently been appointed at the governmental level by approving the Agricultural Emergency Plan. The latter is in the framework of the Declaration of Emergency of the Agricultural and Irrigation Sector (D.S. N° 003-2022-MIDAGRI). This has led, for example, to a supreme decree obliging the milk industry to use fresh milk as raw material instead of imported powder ingredients (D.S. N° 004-2022-MIDAGRI), as well as a call for the restructuration of the AgroPerú budget (D.S. N° 007-2022-MIDAGRI). Despite these measures, the second discourse has no institutionalisation in the scope of the interviewees’ arguments. Thus, by using definitions disregarded by institutional actors, in addition to struggling to define the changes to be made in the current model, the second discourse hardly influences the debate or the large-scale freshwater management projects.The third discourse’s storyline is narrated by a wood entrepreneur, the JUM, GORE, and SENAMHI representatives. These are indirect actors who highlight the importance of environmental knowledge generation  for making the freshwater management challenges visible. Although the third discourse lacks a strategy for integrating environmental knowledge generation with freshwater management measures, it is informed by weaknesses in making MYSRL’s freshwater management norm compliant while overlooking the urban vulnerability. The PLANAA seeks the integration of the GORE with the National System for Environmental Information (SINIA), but no concrete strategy for protecting the groundwater reserves has been given by the Peruvian government. Recently, guidelines for making inventories of groundwater sources have been published . MoreoveThe three discourses are primarily not contradicting each other, as shown by the recognition that freshwater protection is a challenge beyond mining impacts. Nonetheless, it is necessary to explore the barriers to interaction among groups of actors . The firAnother study in Cuzco identified a fatalistic view on future climate change impacts on livelihoods in socioeconomically vulnerable groups of stakeholders . BrüggerOne step forward in environmental policy was the updating of the 2004 legislation for environmental liabilities of mining investments (Law 28271), namely amending a loophole that enabled certain mining companies to avoid responsibility by resigning their mining rights. From 7104 unassigned environmental mining liabilities, the Peruvian government has remediated 1180 . UnfortuA window of opportunity for critical reforms in mining’s freshwater management norms, and probably for making the arguments of the second and third discourses relevant to decision-makers, is found in two of the five strategic guidelines of the National Action Plan on Business and Human Rights (PNA) 2021–2025 . These gOverall, freshwater management developments would benefit from increasing the emphasis on analysing how coalitions are formed and informed. What is being put forward as legitimate regarding the dynamics of meaning and knowledge is needed within policy networks, despite the unpredictability of the policy implementation outcomes . The socMoreover, freshwater management challenges arising from different interests, interpretations, and practices among all the concerned stakeholders also take place at much larger scales than that of our study area and in other parts of the world. This is the case of Central Asia, which is conditioned by its historical background  and different socio-economic conditions at present, which in turn increase the social, normative, institutional, and infrastructural complexities for managing freshwater systems ,55. LikeWe found three ways of interpreting freshwater management: the incremental, fatalistic, and informative discourses, which are based on, respectively, institutional power concentration, rural overpowering, and the potential power of environmental knowledge generation. In order to understand evolutions in society, it is crucial to understand these three discourses, including the kinds of knowledge that actors put forward as legitimate, what roles they attribute to all stakeholders, and by what kinds of worldviews their discourses are informed. The need for honest dialogue among rural and urban, institutional and non-institutional stakeholders, as well as between professional and non-professional water managers, represents a multi-level challenge. Our findings also suggest that despite the high diversity of Andean societies, certain patterns emerge that require careful attention from authorities. A phenomenological understanding of the barriers to stakeholders’ interaction is relevant to broad freshwater management objectives, given the urgent need to accommodate the profound social–ecological changes induced by large-scale mining concessions, global change, and remnants of intellectual colonisation.