JMIR Research Protocols最新文献

{"title":"Mapping the Literature on Self-Efficacy Levels Among Medical Students in Higher Education: Protocol for a Scoping Review to Guide Educational Strategies.","authors":"Alex Bertolazzo Quitério, Emerson Roberto Dos Santos, João Daniel de Souza Menezes, Matheus Querino da Silva, Clarissa Albuquerque Vaz Nunes, Denise Iglesias Lima Silvestrini, Alana Clara Santos Rocha, Pedro Belchior da Silveira Junior, Andressa Karina Stefani, Thiago Sivieri, Gustavo Gouveia Macedo, Camila Bortoluci de Lima, Janaína Aparecida de Sales Floriano, Marina Ottoboni Rossi, Giovana Viecili Rossi, Ana Paula Bernardes da Rosa, Luís Cesar Fava Spessoto, Gerardo Maria de Araújo Filho, Antônio Hélio Oliani, Denise Cristina Móz Vaz, Izaura Dos Santos Ramos, Fabiana de Souza Orlandi, Samila Bernardi do Vale Lopes, Julio César André","doi":"10.2196/95032","DOIUrl":"https://doi.org/10.2196/95032","url":null,"abstract":"<p><strong>Background: </strong>Self-efficacy significantly influences medical students' academic performance. Rooted in Albert Bandura's social cognitive theory, self-efficacy is defined as an individual's subjective judgment of their capability to organize and execute courses of action required to attain designated types of performances. Unlike general self-esteem, self-efficacy is task- and context-specific. In undergraduate medical education, self-efficacy operates across three interdependent subdomains: (1) academic self-efficacy, encompassing cognitive confidence to master biomedical curricula; (2) clinical skills self-efficacy, reflecting perceived competence in procedural tasks and clinical reasoning; and (3) interpersonal and communication self-efficacy, denoting confidence in empathetic history taking and interprofessional collaboration. These subdomains are presented as a provisional analytical heuristic informed by Bandura's social cognitive theory and prior reviews of self-efficacy in medical education.</p><p><strong>Objective: </strong>This scoping review aims to map and analyze the literature on self-efficacy among medical students, identifying factors in its construction and influence on academic performance. The review also aims to catalog the instruments used to measure self-efficacy and examine changes in self-efficacy over time and across stages of medical training.</p><p><strong>Methods: </strong>Following the frameworks of Arksey and O'Malley, Levac et al, and the Joanna Briggs Institute, this review addresses the question, \"What has been published about self-efficacy levels in higher education among medical students?\" Comprehensive searches across major electronic databases and gray literature will include studies from January 2019 to September 2026, in English, Portuguese, or Spanish, focusing on undergraduate medical students. Searches will be conducted in the Embase, Cochrane Library, PubMed, Scopus, Virtual Health Library, Web of Science databases and in the education- and psychology-focused databases ERIC and PsycInfo using an expanded search strategy incorporating controlled vocabulary (MeSH [Medical Subject Headings], Emtree, and DeCS [Descritores em Ciências da Saúde]) and free-text synonyms. Screening will be performed using Covidence software (Veritas Health Innovation), with discrepancies resolved by a third senior reviewer. Data will be narratively synthesized through descriptive qualitative mapping and structured tabular summaries, without quantitative statistical pooling.</p><p><strong>Results: </strong>This protocol was registered prospectively on the Open Science Framework before manuscript submission. This research has not received specific funding from any agency in the public, commercial, or not-for-profit sectors. No data have been collected as of September 2026. Each of the 4 review phases is estimated to take 2 months. Results are expected to be published approximately 9 to 12 months following the init","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e95032"},"PeriodicalIF":1.6,"publicationDate":"2026-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Algorithmic Noise Adjacency in Cantonese-Language Dementia Education on YouTube: Protocol for a Sociotechnical Audit of Recommendation Environments.","authors":"Benjamin K P Woo","doi":"10.2196/101949","DOIUrl":"https://doi.org/10.2196/101949","url":null,"abstract":"<p><strong>Background: </strong>Older Chinese American adults with limited English proficiency frequently rely on culturally and linguistically tailored online media platforms for dementia education and health literacy. Existing digital health evaluation frameworks primarily assess the internal quality and accuracy of educational materials while overlooking the recommendation environments through which users encounter health information. Commercial recommendation systems may expose users to medically unverified or commercially motivated health content adjacent to evidence-based dementia education resources.</p><p><strong>Objective: </strong>This protocol establishes a reproducible computational framework for auditing recommendation environments surrounding Cantonese-language dementia education videos on YouTube. The study introduces the concept of algorithmic noise adjacency, defined operationally as the concentration of recommendation nodes whose informational utility diverges from evidence-based dementia education objectives within local recommendation neighborhoods.</p><p><strong>Methods: </strong>The protocol uses an automated sociotechnical audit framework centered on 2 Cantonese-language dementia education videos previously examined in longitudinal digital outreach research. A Selenium WebDriver pipeline with a headless Chromium browser architecture and fingerprinting mitigations will simulate 1200 independent browsing sessions distributed uniformly across a 100-day window. Sessions will be routed through a rotating residential proxy infrastructure localized to Southern California Chinese American communities. During each session, the top 10 sidebar recommendation videos adjacent to the source clinical asset (the anchor video) will be extracted. Recommendation metadata will undergo structured semantic classification into 5 mutually exclusive categories: category A, verified public health and clinical infrastructure, category B, diaspora culture and entertainment, category C, commercially motivated health content lacking established clinical validation, category D, unverified alternative medicine, and category E, ambiguous or unclassified baseline noise. Double-coding and consensus adjudication of a random 10% sample will be used to establish interrater reliability. Generalized linear mixed-effects models with logit link functions, session-level random intercepts, and reciprocal rank slot position weighting will evaluate recommendation characteristics while accounting for clustering within browsing sessions. Primary outcome measures include the noise adjacency ratio, slot-weighted noise adjacency ratio, recommendation recurrence density, and neighborhood entropy. Secondary analyses will evaluate temporal recommendation drift and cross-session recommendation variability.</p><p><strong>Results: </strong>Protocol development and pilot automation testing were finalized in September 2026. Automation stress testing, semantic calibration, and proxy","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e101949"},"PeriodicalIF":1.6,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149267699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Acceptability of Videoconference-Based Family Psychoeducation for Young Adult Caregivers of Family Members With Major Depressive Disorder: Protocol for a Pilot Randomized Controlled Trial.","authors":"Hideki Nakamura, Sho Okawa, Hiroki Tanoue, Yoshihiro Goto, Akari Matsuzawa, Keiko Ito","doi":"10.2196/105182","DOIUrl":"10.2196/105182","url":null,"abstract":"<p><strong>Background: </strong>Young adult caregivers of a family member with major depressive disorder (MDD) constitute a vulnerable population. They have substantial support needs because they often experience psychological distress and daily burdens during a developmental period in which education, partnership formation, and parenting frequently overlap with caregiving responsibilities. Consequently, the burden associated with caring for a family member with MDD may adversely affect young adult caregivers' mental health and life stability. Despite these needs, support programs and intervention studies specifically targeting young adult caregivers remain scarce. Videoconference-based family psychoeducation (vFPE) may help address this gap, improving access for individuals facing time and geographic barriers. However, the feasibility of conducting a randomized controlled trial (RCT) of vFPE in this population has not yet been established.</p><p><strong>Objective: </strong>The objective of this study is to examine the feasibility of conducting a waitlist-controlled pilot RCT of vFPE and the acceptability of the vFPE intervention among young adult caregivers of a family member with MDD.</p><p><strong>Methods: </strong>This study is a waitlist-controlled pilot RCT. Young adult caregivers (aged 18-39 y) will be randomly assigned in a 1:1 ratio to either the intervention group or a waitlist control group. Participants in the intervention group will receive 4 weekly 40-minute vFPE sessions. The primary outcomes are feasibility and acceptability. Feasibility will be assessed by recruitment, randomization, intervention completion, dropout rates, and safety. Acceptability will be assessed using the Client Satisfaction Questionnaire-8 Japanese version. Exploratory outcomes, including anxiety and depressive symptoms, mental well-being, psychological distress, caregiver burden, self-efficacy, and health-related quality of life, will be assessed at baseline, postintervention, and 1-month follow-up via online self-administered questionnaires. Exploratory outcomes will be used to inform the design of a future definitive RCT rather than to draw conclusions about intervention effectiveness.</p><p><strong>Results: </strong>This paper describes the study protocol. Ethical approval was obtained from the Research Ethics Committee, Faculty of Nursing, Toho University, on December 18, 2025. Recruitment commenced on January 10, 2026, with the first participant enrolled on February 20, 2026. As of May 2026, 8 participants had been enrolled. Intervention delivery and data collection are expected to continue until March 2028. Study findings will be disseminated through presentations at academic conferences and publication in peer-reviewed journals.</p><p><strong>Conclusions: </strong>This study will clarify the feasibility of conducting an RCT of vFPE among young adult caregivers of a family member with MDD, providing foundational data to inform the design of a future de","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e105182"},"PeriodicalIF":1.6,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Simulation-Based Training Program on Cup Detachment During Vacuum-Assisted Vaginal Birth: Protocol for a Multicenter Quasi-Experimental Before-and-After Study.","authors":"Maria Rosa Vila Hernandez, Sara Tameish, Ivan Hurtado, Maria Del Mar Goya Canino, Alicia Carrera I Boix, Oscar Martinez Perez","doi":"10.2196/100242","DOIUrl":"10.2196/100242","url":null,"abstract":"<p><strong>Background: </strong>Safe vacuum-assisted vaginal birth depends on appropriate case selection, accurate cup placement, controlled traction, recognition of technical difficulty, and timely abandonment of an unsuccessful attempt. Simulation-based education can improve procedural performance, but evidence that vacuum-specific simulation changes patient-level clinical practice remains limited.</p><p><strong>Objective: </strong>This study aims to estimate the change in the occurrence of cup detachment (known as \"pop off\") following implementation of a standardized simulation-based training program for vacuum-assisted vaginal birth. Cup detachment was designated as the single primary outcome after evaluation of the preintervention cohort but before any postintervention versus preintervention comparative analysis.</p><p><strong>Methods: </strong>This multicenter quasi-experimental before-and-after study is being conducted in 19 Spanish maternity hospitals participating in the Registro Español de Morbimortalidad Materna y Perinatal. The implemented preintervention observation period ran from November 28, 2024, through February 28, 2026. The training and washout phase was conducted during March and April 2026, followed by postintervention data collection from May through October 2026. Preintervention clinical variables are ascertained retrospectively from medical records, whereas postintervention data collection is prospective. The intervention combines preparatory theoretical material, a 1-hour face-to-face simulation workshop using a PROMPT FLEX obstetric simulator and vacuum devices, checklist-based assessment, supervised practice, feedback, and debriefing. The primary outcome will be analyzed using modified Poisson regression to estimate risk ratios and 95% CIs, accounting for hospital and protocol-defined calendar time trends. Sequential instrumentation and conversion to cesarean birth will be analyzed separately as key secondary clinical outcomes. Ethical approval was granted by the Clinical Research Ethics Committee of Girona (code 2024.070) on August 5, 2024.</p><p><strong>Results: </strong>This study was funded in November 2024. During the preintervention phase, 1155 cases were recorded in 19 hospitals; 12 were excluded according to the selection criteria, leaving 1143 eligible cases. At the verified July 2026 project update, 144 postintervention cases had been collected. Postintervention data collection is scheduled to close in October 2026; the protocol-defined comparative analysis will be performed after database lock, with publication of the main results planned for summer 2027.</p><p><strong>Conclusions: </strong>The current analysis plan was fixed before database lock and before any formal comparative postintervention versus preintervention effectiveness analysis. The protocol also defines assessment of contamination, intervention fidelity, secular trends, and the limitations inherent to a nonrandomized before-and-after evaluatio","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e100242"},"PeriodicalIF":1.6,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auditory Biofeedback Gait Training in Individuals With Chronic Ankle Instability: Protocol for a Randomized Controlled Trial.","authors":"Danielle Marie Torp, Ji Yeon Choi, Alexandra Edison, Matthew Hoch, Kyle Kosik, Amelia Bruce Leicht, Ilana Patlan, Stacey Slone, Abbey Thomas, Jennifer Xu, Luke Donovan","doi":"10.2196/107775","DOIUrl":"10.2196/107775","url":null,"abstract":"<p><strong>Background: </strong>Chronic ankle instability (CAI) develops in a large majority of patients with lateral ankle sprain (LAS), who often experience recurring injuries, residual feelings of instability, and abnormal neuromuscular patterns. Specifically, gait alterations are common in those with CAI and considered a contributing factor to poor long-term ankle joint health. Yet, there are no evidence-based gait-training protocols targeted to improve biomechanics, which may improve long-term outcomes related to ankle joint health and patient satisfaction.</p><p><strong>Objective: </strong>This study protocol introduces a progressive auditory biofeedback (ABF) gait-training program aimed to improve short- and long-term lower extremity biomechanics and talar cartilage outcomes and reduce the frequency of ankle-giving-way episodes and recurring injuries.</p><p><strong>Methods: </strong>This study is a multisite randomized controlled trial (RCT) with a target enrollment of 100 patients with CAI into a control group (n=50, 50%) or an ABF gait-training program (n=50, 50%). Both groups will complete a progressive 6-week (12-session) protocol comprising walking, ruck marching, and running on a treadmill. Lower extremity kinematics and kinetics, talar cartilage characteristics (via ultrasonography), self-perceived dysfunction and instability, and number of recurring sprains will be assessed prior to intervention, immediately after intervention, and 6 and 12 months postintervention. Finally, the frequency of ankle-giving-way episodes in the 6 months prior to intervention will be compared to the frequency of episodes at the 6- and 12-month time points to determine a longitudinal difference in ankle-giving-way episodes.</p><p><strong>Results: </strong>The study was funded in September 2024 and prospectively registered through ClinicalTrials.gov on March 10, 2025. The first participant was enrolled in May 2025. As of August 2026, 118 individuals had been recruited and 19 participants enrolled. Recruitment will remain open until September 2027, and study completion is expected in September 2028. Data processing is projected to continue through September 2028, with the final report published in June 2029.</p><p><strong>Conclusions: </strong>This study will be the first RCT of ABF gait training to assess the immediate and long-term effects on lower extremity biomechanics, ankle joint health, and patient-reported outcomes in patients with CAI. Results from this study will advance the knowledge of long-term joint health that may be associated with poor outcomes post-LAS.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06868316; https://clinicaltrials.gov/study/NCT06868316.</p><p><strong>International registered report identifier (irrid): </strong>DERR1-10.2196/107775.</p>","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e107775"},"PeriodicalIF":1.6,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Screening Model for Latent Tuberculosis Infection Among Household Contacts of Patients With Tuberculosis Based on the CyTB Test and an Android App: Protocol for a Development and Implementation Study.","authors":"Ramesh Kumar Huda, Deepika Yadav, Pooja Chaudhary, Jayvardhan Singh, Laxmikant Mandhana, Manoj Prajapati, Sumit Kalra, Mukti Khetan, Ramesh Kumar Sangwan, Pankaj Bhardwaj","doi":"10.2196/95534","DOIUrl":"https://doi.org/10.2196/95534","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Latent tuberculosis infection (LTBI) remains a major barrier to tuberculosis elimination, particularly in community settings where household contacts (HHCs) of patients with active tuberculosis are at increased risk of infection and progression to disease. Current tests for LTBI have practical limitations that restrict their use in field and primary care settings. Antigen-based skin testing, combined with digital tools for induration measurement, may improve the accuracy and delivery of HHC screening under routine program conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to develop and evaluate a screening model based on CyTB testing and the TBConnect Android app for LTBI among HHCs of patients with confirmed tuberculosis in Rajasthan, India. We will assess its feasibility and operational performance, the prevalence of LTBI among high-risk groups, and implementation outcomes in a routine program setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This protocol describes a community-based interventional implementation study with a mixed-methods design guided by a logic model and the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework, to be conducted over 24 months in the Balesar block, Jodhpur district, Rajasthan. All eligible HHCs of patients with confirmed tuberculosis identified during the study period will be included, with an estimated screening population of 2400 participants. The intervention combines CyTB-based screening with the TBConnect Android app for participant registration, workflow support, induration recording, follow-up, and reporting. Screening will be implemented through health facility-based, home-based, and camp-based pathways. App-assisted induration measurement will be compared with manual assessment in a subset of participants to evaluate agreement between the 2 methods. Primary outcomes will include screening coverage, LTBI positivity, concordance between app-assisted and manual readings, and feasibility of the 3 screening pathways. Secondary outcomes will include health care worker proficiency, app usability, data completeness, operational efficiency, participant acceptability, and documentation of referral advice among participants with positive CyTB screening results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ethical approval was obtained from the institutional ethics committee of ICMR-NIIRNCD (Indian Council of Medical Research-National Institute for Implementation Research on Non-Communicable Diseases), Jodhpur, Rajasthan, India, on August 7, 2025. Recruitment and CyTB screening began in December 2025 and are scheduled to continue until December 2026. Data cleaning and analysis are planned for after field data collection, and the main findings are expected to be submitted for publication in May 2027.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This protocol describes the implementation and evaluation of a digitally supported CyTB-based LTBI screening model for HHCs of co","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e95534"},"PeriodicalIF":1.6,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Guidelines for Hospital Adoption of Wearable Telemonitoring Systems in Chronic Disease Management: Protocol for a Multiphase Mixed Methods Study.","authors":"Janatarum Srihandono, Winny Setyonugroho, Adi Utarini","doi":"10.2196/89603","DOIUrl":"https://doi.org/10.2196/89603","url":null,"abstract":"<p><strong>Background: </strong>The integration of wearable device-based telemonitoring into hospital systems presents a transformative opportunity for chronic disease management, particularly in settings such as Indonesia facing a high burden of noncommunicable diseases. However, widespread adoption is hindered by multifaceted operational barriers, including workflow integration, data management, and unclear adoption pathways, highlighting a critical need for structured, evidence-based guidance.</p><p><strong>Objective: </strong>This study protocol aims to develop a role-specific adoption guideline for integrating wearable telemonitoring systems into routine workflow in Indonesian hospitals for chronic disease management.</p><p><strong>Methods: </strong>An exploratory sequential mixed methods design is employed across 3 phases. Phase 1 involves a critical interpretive synthesis of the literature to synthesize evidence on wearable technology adoption to populate the Domain-by-Actor matrix. Phase 2 comprises qualitative semistructured interviews with 32 to 44 key stakeholders (administrators, IT staff, and clinicians) from 4 purposively selected hospitals in Yogyakarta, Indonesia, to explore contextual barriers and facilitators. Phase 3 uses a modified nominal group technique with a panel of 12 experts to build consensus and finalize the guideline.</p><p><strong>Results: </strong>As of December 13, 2025, this study is in progress. Ethical approval has been obtained. The critical interpretive synthesis (phase 1) is completed, yielding preliminary thematic data on adoption factors. Data collection for the qualitative interviews (phase 2) has commenced, with interviews conducted at 1 hospital and administrative permissions secured for 2 sites. Recruitment and data collection are ongoing.</p><p><strong>Conclusions: </strong>This protocol offers a systematic methodology to bridge the gap between digital health pilot studies and routine use in clinical operations. By mapping complex adoption factors onto an anticipated Domain-by-Actor matrix, the proposed study has the potential to guide sustainable, role-specific wearable telemonitoring integration across diverse hospital structures.</p>","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e89603"},"PeriodicalIF":1.6,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situational Analysis of Cancer Care Services in India: Protocol for a Nationwide Cross-Sectional Health Systems Study.","authors":"Anita Nath, Abhishek David George, Sudarshan K L, Krishnan Sathishkumar, Thilagavathi Ramamoorthy, Bency Joseph, Gokul Sarveswaran, Prashant Mathur","doi":"10.2196/99765","DOIUrl":"10.2196/99765","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cancer is a significant public health challenge in India, contributing to 8.3% of deaths and 5.0% of disability-adjusted life years in 2016-nearly twice its contribution in 1990. Fragmented service delivery, limited specialist availability, late presentation, and significant financial hardship continue to hinder access to timely and effective cancer care, particularly in rural and underserved regions. A comprehensive, system-level assessment is essential to inform evidence-based planning and strengthen cancer services nationwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to assess the availability, readiness, accessibility, and quality of cancer care services across primary, secondary, and tertiary health care facilities in India. Specifically, it will evaluate infrastructure, human resources, diagnostic and treatment capacity, referral pathways, and service delivery across the 6 Institute of Medicine quality domains (equitable, effective, patient-centered, safe, efficient, and timely); compare rural-urban and public-private disparities; and use these findings to develop an evidence-informed framework for strengthening cancer care services and informing national policy and program planning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 3-year cross-sectional descriptive study was conducted across 31 states and union territories using proportionate district sampling based on rural-urban population distribution. Nodal hospitals coordinated data collection from primary, secondary, and tertiary health care facilities. Facility-level data were collected using 3 standardized electronic forms-developed separately for primary, secondary, and tertiary levels of care-covering infrastructure, workforce, diagnostic and treatment services, referral systems, and service. Descriptive statistics will be used to summarize service availability and readiness, and chi-square tests to compare rural-urban, public-private, and facility-level differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study received funding in October 2023. Facility-level data collection took place between July 2024 and March 2026. We enrolled 6896 health facilities (4353 primary, 1979 secondary, and 564 tertiary) from 352 districts across 31 states and union territories, with participation rates of 64.6% (4353/6735) for primary health centers, 75.7% (1979/2612) for secondary-level facilities, and 63.9% (564/902) for tertiary hospitals. Data cleaning and quality checks are complete, and analysis is complete but unpublished; we will report results on service availability, readiness, and regional variation separately.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This nationwide assessment is expected to provide one of the most comprehensive evaluations of cancer care preparedness undertaken in India. Findings are anticipated to inform national policy and program planning, including investment priorities under the NP-NCD, Ayushman Bharat, and related initiatives to support progress","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e99765"},"PeriodicalIF":1.6,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Novel Real-Time Computer-Assisted Colonoscopy Diagnostic Tool for Colorectal Neoplasia and Cancer to Enable Personalized Patient Management: Protocol for a Multicenter Proof-of-Concept Study.","authors":"Olaolu Olabintan, Angelo Brunori, Natalie Halvorsen, Nils Andersen, Verónica G Zubiaurre, Mehrnaz Mirzaei, Ina Dam Pedersen, Alessandro D'Aprano, Johnathan Sun, Ahmed Ghazwan Waraich, Omer Ahmad, Nastazja Pilonis, Michal Kaminski, Francisco Lamosa, Rune Erichsen, Johannes Blom, Thomas Rosch, Maria Pellise, Ignasi Puig, Cesare Hassan, Kensaku Mori, Yuichi Mori, Massashi Misawa, Shraddha Gulati","doi":"10.2196/77277","DOIUrl":"10.2196/77277","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Accurate real-time classification of colorectal polyps during colonoscopy is essential for risk stratification, therapeutic decision-making, and surveillance planning, with important implications for colorectal cancer prevention, health care costs, and patient burden. Despite advances in optical diagnosis techniques, including virtual chromoendoscopy and magnification, widespread adoption remains limited because of high operator dependency and variable diagnostic accuracy. Existing computer-assisted diagnosis (CADx) systems predominantly provide binary classification of colorectal lesions, thereby constraining their clinical utility for nuanced endoscopic decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to develop and validate a real-time, multiclass AI-based CADx system capable of classifying colorectal lesions into 5 categories: nonneoplastic lesions, low-grade adenomas, high-grade adenomas, sessile serrated lesions (SSL), and invasive colorectal cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This multicenter international study consists of 2 phases: model development and proof-of-concept validation. During the model development phase, a large, diverse dataset of &gt;17,000 deidentified endoscopic images and video frames will be prospectively collected from 8 European centers and 1 Japanese center, capturing a broad spectrum of lesion types and patient demographics. A semisupervised learning framework using contrastive representation learning (SimCLR [simple framework for contrastive learning of visual representations]) will be used to leverage both labeled and unlabeled data, enhancing feature extraction and classification performance. Expert consensus annotation will be used for labeled data. Lesion localization will be supported by an integrated computer-assisted detection (CADe) module, while model interpretability will be facilitated through gradient-weighted class activation mapping (Grad-CAM). Proof-of-concept validation will be conducted using 250 previously unseen lesion images that will be independently assessed by expert endoscopists. The primary outcome is multiclass diagnostic accuracy, with a predefined target accuracy threshold of 85%, alongside sensitivity and specificity for invasive cancer detection. Secondary outcomes include interobserver agreement, performance across demographic and lesion subgroups, and a qualitative analysis of misclassification patterns. All data will be securely managed within a REDCap database, with strict deidentification protocols and plans to generate an open-access research resource.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ethics approval has been obtained at all participating centres. Data transfer agreements have been executed by the majority of collaborating sites, with de-identified polyp images and videos currently being uploaded to a secure central database.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study aims to deliver a clinically applicable, real-time multic","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e77277"},"PeriodicalIF":1.6,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multifaceted Intervention to Reduce Obesity Among Preschool Children in Suzhou City: Protocol for a Randomized Controlled Trial.","authors":"Pan Yang, Ying Wang, Xiao Jiang, Ziyao Ding, Liye Zhang, Xinyu Bao, Di Han, Hui Shen, Jia Hu, Jieyun Yin","doi":"10.2196/94697","DOIUrl":"10.2196/94697","url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of obesity among preschool children has become a critical public health concern in Suzhou, China. Nevertheless, evidence-based, personalized, and multicomponent intervention strategies tailored to children with overweight or obesity remain inadequately established in current practice.</p><p><strong>Objective: </strong>This study aims to investigate the prevalence and pathogenic factors of obesity among preschool children in Suzhou and to develop a comprehensive and multifaceted integrated intervention program. Through systematic assessment of its short-term effectiveness and long-term sustainability in improving obesity-related indicators and preventing overweight, it provides a scientific basis for obesity prevention and control.</p><p><strong>Methods: </strong>This cluster randomized controlled trial is being conducted among children aged 3 to 6 years in Suzhou City, Jiangsu Province. Children from 3 kindergartens were randomly assigned to the intervention group and children from 3 other kindergartens were assigned to the control group. The 1-year intervention includes health education, dietary guidance, and increased physical activity, adopting a multilevel approach that engages children, families, schools, communities, and society. Children participate in health education and physical activity courses in the kindergarten, while parents receive educational materials online. Parental education and regular assessment of knowledge, attitudes, and practices are key components of the family-based intervention. Body measurements will be taken at baseline, 6 months, 12 months, and thereafter, alongside questionnaires for both parents and children to evaluate their own health behaviors. The primary outcome will be the difference in BMI, BMI <i>z</i> scores, and body fat percentage between the 2 groups of children at the end of the intervention.</p><p><strong>Results: </strong>The study received ethical approval in March 2025. Baseline assessments were conducted from March to June 2025, followed by the initiation of the intervention, which will be completed by June 2026. Participants will then enter a noninterventional long-term follow-up until June 2032, with annual surveys conducted during this period.</p><p><strong>Conclusions: </strong>This program will test the effectiveness of comprehensive multifaceted interventions on children. The results of this study will provide scientific evidence for formulating effective intervention strategies for childhood overweight and obesity and are also expected to offer crucial practical references for the formulation and improvement of treatment guidelines for childhood obesity in China.</p>","PeriodicalId":14755,"journal":{"name":"JMIR Research Protocols","volume":"15 ","pages":"e94697"},"PeriodicalIF":1.6,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}