JMIR mHealth and uHealth最新文献

{"title":"Using Social Media to Recruit a Diverse Sample of Participants for a Mobile Health (mHealth) Intervention to Increase Physical Activity: Exploratory Study.","authors":"Laura Pathak, Rosa Hernandez-Ramos, Karina Rosales, Jose Miramontes-Gomez, Faviola Garcia, Vivian Yip, Suchitra Sudarshan, Anupama Gunshekar Cemballi, Courtney Lyles, Adrian Aguilera","doi":"10.2196/56329","DOIUrl":"https://doi.org/10.2196/56329","url":null,"abstract":"<p><strong>Background: </strong>Recruitment of demographically diverse samples in clinical research is often challenging and even more so during the COVID-19 pandemic when traditional in-person recruitment methods could not be implemented. Social media platforms offer an alternative approach for recruiting diverse samples of participants for clinical trials, including those testing digital health interventions. This approach allowed for a quicker recruitment process without the physical constraints associated with traditional in-person methods.</p><p><strong>Objective: </strong>This study aimed to detail the online and social media campaigns used to recruit participants for \"Diabetes and Mental Health Adaptive Notification Tracking and Evaluation\" (DIAMANTE), a randomized controlled trial testing a smartphone-based intervention (a text messaging system that uses machine learning to personalize content) to increase physical activity for patients with diabetes and depression. In describing the recruitment process, we seek to offer insights to the research community on recruitment through online and social media advertisements for diverse communities.</p><p><strong>Methods: </strong>This study sought to recruit demographically diverse individuals in the United States through social media, including paid advertisements on Craigslist and Facebook (Meta). For the DIAMANTE project recruitment, we created 18 personas that mapped into the population's target demographics using a user-centered design methodology. We deployed targeted English and Spanish ads on Craigslist and Facebook in 78 cities based on county-level demographics and diabetes prevalence data to target diverse individuals aged 18-75 years old, who had been diagnosed with diabetes and had documented depressive symptoms.</p><p><strong>Results: </strong>A total of 1379 individuals completed the study's initial screening survey. Of those, 71 respondents on Facebook and 508 on Craigslist were interested in enrolling in our study. In total, 26 out of 58 (45%) eligible respondents from Facebook and 50 out of 235 (21.3%) eligible respondents from Craigslist were eventually recruited in the randomized controlled trial. In all, both platforms showed poor performance in recruiting Spanish speakers, with Facebook advertisements accounting for 0 and Craigslist for 4 (5.3%) of such participants. When it came to English speakers, Craigslist proved to be the better performing platform compared to Facebook, both in terms of reach (579 vs 71) and cost-effectiveness (US $67.61 in average cost per recruited participant vs US $80.16). While Craigslist ads reached more people, resulting in more completed screening surveys than Facebook ads, there was a higher number of ineligible and incomplete enrollment from Craigslist compared with Facebook, leading to a relatively lower conversion rate (9.4% vs 36.6%). Importantly, participants recruited through Craigslist were more ethnically and racially diverse than thos","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e56329"},"PeriodicalIF":5.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for Mobile App Features to Support People Living With Chronic Heart Diseases: Discrete Choice Study.","authors":"Sumudu Avanthi Hewage, Sameera Senanayake, David Brain, Michelle J Allen, Steven M McPhail, William Parsonage, Tomos Walters, Sanjeewa Kularatna","doi":"10.2196/58556","DOIUrl":"https://doi.org/10.2196/58556","url":null,"abstract":"<p><strong>Background: </strong>Using digital health technologies to aid individuals in managing chronic diseases offers a promising solution to overcome health service barriers such as access and affordability. However, their effectiveness depends on adoption and sustained use, influenced by user preferences.</p><p><strong>Objectives: </strong>This study quantifies the preferences of individuals with chronic heart disease (CHD) for features of a mobile health app to self-navigate their disease condition.</p><p><strong>Methods: </strong>We conducted an unlabeled web-based choice survey among adults older than 18 years with CHD living in Australia, recruited via a web-based survey platform. Four app attributes-ease of navigation, monitoring of blood pressure and heart rhythm, health education, and symptom diary maintenance-were systematically chosen through a multistage process. This process involved a literature review, stakeholder interviews, and expert panel discussions. Participants chose a preferred mobile app out of 3 alternatives: app A, app B, or neither. A D-optimal design was developed using Ngene software, informed by Bayesian priors derived from pilot survey data. Latent class model analysis was conducted using Nlogit software (Econometric Software, Inc). We also estimated attribute importance and anticipated adoption rates for 3 app versions.</p><p><strong>Results: </strong>Our sample included 302 participants with a mean age of 50.5 (SD 18.2) years. Latent class model identified 2 classes. Older respondents with education beyond high school, prior experience with mobile health apps, and a positive perception of app usefulness were more likely to be in class 1 (257/303, 85%) than in class 2 (45/303, 15%). Class 1 membership preferred adopting a mobile app (app A: β coefficient 0.74, 95% uncertainty interval (UI) 0.41-1.06; app B: β coefficient 0.53, 95% UI 0.22-0.85). Participants favored apps providing postmonitoring recommendations (β coefficient 1.45, 95% UI 1.26-1.64), tailored health education (β coefficient 0.50, 95% UI 0.36-0.64), and unrestricted symptom diary entry (β coefficient 0.58, 95% UI 0.41-0.76). Class 2 showed no preference for app adoption (app A: β coefficient -1.18, 95% UI -2.36 to 0.006; app B: β coefficient -0.78, 95% UI -1.99 to 0.42) or any specific attribute levels. Vital sign monitoring was the most influential attribute among the 4. Scenario analysis revealed an 84% probability of app adoption with basic features, rising to 92% when app features aligned with respondents' preferences.</p><p><strong>Conclusions: </strong>The study's findings suggest that designing preference-informed mobile health apps could significantly enhance adoption rates and engagement among individuals with CHD, potentially leading to improved clinical outcomes. Adoption rates were notably higher when app attributes included easy navigation, vital sign monitoring, feedback provision, personalized health education, and flexible data en","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e58556"},"PeriodicalIF":5.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Hand Hygiene During the COVID-19 Pandemic: Randomized Controlled Trial of the Optimized Soapp+ App.","authors":"Dario Baretta, Carole Lynn Rüttimann, Melanie Alexandra Amrein, Jennifer Inauen","doi":"10.2196/57191","DOIUrl":"https://doi.org/10.2196/57191","url":null,"abstract":"<p><strong>Background: </strong>The adoption of protective behaviors represents a crucial measure to counter the spread of infectious diseases. The development of effective behavior change techniques therefore emerged as a public health priority during the COVID-19 pandemic, but randomized controlled trials (RCTs) testing such interventions during the pandemic were scarce. We conducted a Multiphase Optimization Strategy to develop, optimize, and evaluate a smartphone app, Soapp+, to promote hand hygiene during the COVID-19 pandemic.</p><p><strong>Objective: </strong>This RCT aims to evaluate the efficacy of the Soapp+ app (intervention group) targeting motivation and habit compared to a simplified version of the app mainly delivering hand hygiene information (active control group). We hypothesize that, compared to the control group, the intervention group will show greater improvements in hand hygiene behavior and behavioral determinants post intervention and at a 6-month follow-up.</p><p><strong>Methods: </strong>We conducted an RCT from March 2022 to April 2023, recruiting 193 adults living in Switzerland online. Following baseline assessment, the intervention lasted 32 days, followed by a postintervention assessment and a 6-month follow-up. The primary outcome was the change in hand hygiene behavior from pre- to postintervention and preintervention to follow-up. Hand hygiene was assessed with electronic diaries. The intervention group received content incorporating various behavior change techniques designed to address key motivational and volitional determinants of hand hygiene behavior (eg, skills, knowledge, intention, attitudes toward hand hygiene, risk perception, outcome expectancies, self-efficacy, action planning, coping planning, action control, habit). In contrast, the active control group was exposed to behavior change techniques targeting only a subset of these determinants (ie, skills, knowledge, and intention). The delivery of the intervention content was fully automated. Group differences were tested using an intention-to-treat approach with the nonparametric Wilcoxon rank sum test.</p><p><strong>Results: </strong>Of the 193 randomized participants, 146 completed the first hand hygiene diary preintervention and were included in the main analysis. The mean age was 41 (SD 17) years, and 69.2% (n=101) were women. The main analysis revealed significant superiority of the intervention compared to controls in the change in hand hygiene pre-post intervention (W=2034; P<.04; effect size r=0.17) and between preintervention and follow-up (W=2005; P<.03; effect size r=0.18). Regarding behavioral determinants, the change in coping planning pre-post intervention (W=3840; P=.03, effect size r=0.16) was significantly greater in the intervention group using Soapp+ compared to controls.</p><p><strong>Conclusions: </strong>Soapp+ was developed through a rigorous experimental method during the ongoing COVID-19 pandemic. The RCT provided evidence f","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e57191"},"PeriodicalIF":5.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of an App-Based Sleep Program to Improve Sleep Outcomes in a Clinical Insomnia Population: Randomized Controlled Trial.","authors":"Walter Staiano, Christine Callahan, Michelle Davis, Leah Tanner, Chelsea Coe, Sarah Kunkle, Ulrich Kirk","doi":"10.2196/68665","DOIUrl":"10.2196/68665","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is the most commonly reported sleep disturbance and significantly impacts mental health and quality of life. Traditional treatments for insomnia include pharmacological interventions or cognitive behavioral therapy for insomnia (CBT-I), but these options may not be accessible to everyone who needs treatment.</p><p><strong>Objective: </strong>This study aims to assess the effectiveness of the app-based Headspace Sleep Program in adults with clinical insomnia on sleep disturbance and mental health outcomes, compared with a waitlist control group.</p><p><strong>Methods: </strong>This randomized controlled trial included 132 adults with clinical insomnia who were assigned to either the Headspace Sleep Program (an 18-session self-guided, in-app program utilizing CBT-I techniques augmented by mindfulness) or a waitlist control group. Sleep disturbance outcomes were assessed by changes in insomnia symptoms (measured using the Insomnia Severity Index) and sleep efficiency (measured via sleep diary and actigraphy). Mental health outcomes included perceived stress (measured by the 10-item Perceived Stress Scale), depressive symptoms (measured by the 8-item Patient Health Questionnaire), sleep quality (measured by the Pittsburgh Sleep Quality Index), anxiety symptoms (measured by the 7-item Generalized Anxiety Disorder Scale), and mindfulness (measured by the Mindful Attention Awareness Scale). Changes from baseline to postintervention and follow-up were assessed for each outcome.</p><p><strong>Results: </strong>Participants had a mean (SD) age of 37.2 (10.6) years, with 69 out of 132 (52.3%) identifying as female. Those randomized to the Headspace Sleep Program group experienced significantly greater improvements in insomnia symptoms from baseline to postintervention and follow-up compared with participants in the waitlist control group (P<.001, η²p=0.107). Improvements from baseline to postintervention and follow-up were also observed in the Headspace Sleep Program group for sleep efficiency, as measured by both sleep diary (P=.01, η²p=.03) and actigraphy outcomes (P=.01, η²p=.03). Participants in the Headspace Sleep Program group showed greater improvements in insomnia remission rates (8/66, 12%, at postintervention and 9/66, 14%, at follow-up) and treatment response (11/66, 17%, at postintervention and 15/66, 23%, at follow-up) compared with the control group (remission rate 2/66, 3%, at postintervention and 0/66, 0%, at follow-up; treatment response 3/66, 5%, at postintervention and 1/66, 2%, at follow-up). The results suggest significant improvements in depressive symptoms (P=.01, η²p=.04), anxiety symptoms (P=.02, η²p=.02), and mindfulness (P=.01, η²p=.03) in the Headspace Sleep Program group.</p><p><strong>Conclusions: </strong>The Headspace Sleep Program is an effective intervention for improving sleep disturbances in adults with clinical insomnia.</p><p><strong>Trial registration: </strong>ClinicalTrials.go","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e68665"},"PeriodicalIF":5.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Smartphone App Self-Management Program for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial of Clinical Outcomes.","authors":"Lisa Glynn, Eddie Moloney, Stephen Lane, Emma McNally, Carol Buckley, Margaret McCann, Catherine McCabe","doi":"10.2196/56318","DOIUrl":"https://doi.org/10.2196/56318","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) negatively impacts clinical health outcomes, resulting in frequent exacerbations, increased hospitalizations, reduced physical activity, deteriorated quality of life, and diminished self-efficacy. Previous studies demonstrated that a self-management program tailored for adults with COPD improves self-management decisions, resulting in a positive effect on clinical health outcomes. Limitations of these studies include issues regarding heterogeneity among interventions used, patient population characteristics, outcome measures, and longitudinal studies. Limited studies focused on the use of a comprehensive self-management program using a smartphone app for adults with COPD over 12 months.</p><p><strong>Objective: </strong>This study aimed to explore the effectiveness of a smartphone app self-management program and monthly phone calls compared with standard respiratory outpatient care on clinical health outcomes in adults with COPD.</p><p><strong>Methods: </strong>This was a 3-arm parallel pilot randomized controlled trial (RCT) that included 92 participants. Participants were randomized into intervention arm 1, which included a self-management smartphone app and monthly phone calls (n=31); intervention arm 2, which included a self-management smartphone app (n=31); and arm 3, which was standard respiratory outpatient care (n=30). All arms received standard respiratory outpatient care. The primary outcome was a binary indicator equal to 1 if participants reported attendance to a general practitioner (GP) and or a hospital setting as a result of an exacerbation and 0 otherwise. This indicator was recorded at 6 months and 12 months from the baseline. Secondary outcomes included engagement, breathlessness, physical activity, health-related quality of life, and self-efficacy.</p><p><strong>Results: </strong>There was a statistically significant difference (P=.03), indicating fewer exacerbations in the intervention arm 2 compared with the control arm at 6 months in the hospital setting. The intervention arms had a statistically significant difference indicating a lower risk of developing an exacerbation at 6 months in both the GP (P=.01) and hospital setting (P=.006) compared to the control arm. Furthermore, intervention arm 1 demonstrated a statistically significant difference in exercise capacity at 6 and 12 months (P=.02 and P=.03). The intervention arm 2 illustrated a statistically significant difference in step count (P=.009) compared to the control arm. The majority of participants (60%, 33/55) used the app over the 12-month period.</p><p><strong>Conclusions: </strong>This study demonstrated that a smartphone app self-management program had a positive effect on clinical health outcomes for participants with COPD in comparison to standard respiratory outpatient care. This study illustrated benefits such as reduced exacerbations resulting in fewer hospitalizations, improved e","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e56318"},"PeriodicalIF":5.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment Approach.","authors":"Bada Kang, Dahye Hong, Seolah Yoon, Chaeeun Kang, Jennifer Ivy Kim","doi":"10.2196/64853","DOIUrl":"https://doi.org/10.2196/64853","url":null,"abstract":"<p><strong>Background: </strong>Frail older adults are at greater risk of adverse health-related outcomes such as falls, disability, and mortality. Mild behavioral impairment (MBI), which is characterized by neurobehavioral symptoms in individuals without dementia, is a crucial factor in identifying at-risk groups and implementing early interventions for frail older adults. However, the specific role of social functioning, which encompasses social interaction and loneliness levels, in relation to frailty within this group remains unclear.</p><p><strong>Objective: </strong>This study investigated the association between frailty status, social interaction frequency, and loneliness levels among older adults with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) while adjusting for MBI symptoms in 2 contexts: the presence and severity of MBI symptoms.</p><p><strong>Methods: </strong>Older adults with SCD or MCI were recruited from an outpatient clinic specializing in the early diagnosis and care management of dementia at a community health center, as well as from a community service center in Seoul, South Korea. Using an ecological momentary assessment approach, participants reported their daily social interaction frequency and loneliness level via a mobile app, 4 times daily for 2 weeks. Frailty status, the outcome variable, was assessed using the Korean version of the frailty phenotype questionnaire. Additionally, MBI symptoms were assessed using the 34-item MBI-Checklist covering 5 domains. Multinomial logistic regression analyses were performed to investigate the association between frailty status (robust, prefrail, and frail), and the independent variables, adjusting for the presence or severity of MBI symptoms.</p><p><strong>Results: </strong>Among the 101 participants analyzed, 29.7% (n=30) of participants were classified as prefrail, and 12.8% (n=13) of participants were classified as frail. Higher average daily social interaction scores were consistently associated with lower odds of a frail status compared to a robust status. This was evident in the models adjusted for both the global presence (relative risk ratio [RRR] 0.18, P=.02) and global severity (RRR 0.20, P=.02) of MBI symptoms.</p><p><strong>Conclusions: </strong>Frequent social interaction was inversely associated with frail status in older adults with SCD or MCI, even after adjusting for the presence and severity of MBI symptoms. These findings highlight the potential of social functioning as a modifiable factor for addressing frailty among older adults at risk of cognitive and functional decline. Future prospective studies using real-time measurements are needed to refine these findings and further investigate additional risk factors and functional outcomes in this group.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e64853"},"PeriodicalIF":5.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trustworthiness of Web-Based Pharmacy Apps in Pakistan Based on the Mobile App Rating Scale: Content Analysis and Quality Evaluation.","authors":"Anum Sattar, Hina Rehman, Safila Naveed, Sumaira Khadim, Nargis Khan, Ahmad Furqan Kazi, Wajid Syed, Mahmood Basil A Al-Rawi, Shazia Jamshed","doi":"10.2196/59884","DOIUrl":"https://doi.org/10.2196/59884","url":null,"abstract":"<p><strong>Background: </strong>Web-based pharmacy apps facilitate the electronic exchange of health-related supplies. They are digital platforms that run on websites and smartphones. Pakistan is experiencing significant progress in smartphone integration and digital services, leading to the expansion of the online pharmacy business. However, concerns remain over the legitimacy and precision of these apps.</p><p><strong>Objective: </strong>The aim of this study was to undertake a thorough assessment of digital pharmacy apps accessible in Pakistan. Specifically, our focus was on apps accessible via the Google Play Store and the iOS App Store. To fulfill this objective, an evaluation of these apps was performed using the Mobile App Rating Scale (MARS).</p><p><strong>Methods: </strong>A research investigation was conducted to analyze the online pharmacy apps in Pakistan. Initially, 50 apps were identified, but 10 were excluded for not meeting pre-established criteria, 10 were excluded for being in languages other than English, and 7 could not be downloaded. All paid and non-English apps were also excluded. A total of 23 apps were selected for the study, acquired via the Google Play Store and iOS App Store. The evaluation was conducted by 2 researchers who maintained independence from one another by using the MARS.</p><p><strong>Results: </strong>Initially, 50 apps were identified, of which 27 were excluded for not meeting the predetermined criteria. A total of 23 apps were selected for the study, acquired via the Google Play Store and iOS App Store. Strong positive correlations between higher user engagement and better app functionality and information quality were observed. The average rating of the 23 apps ranged between 2.64 and 4.00 on a scale up to 5. The aesthetics dimension had the highest mean score of 3.6, while the information dimension had the lowest mean score of 3.2. For credibility and reliability, different tests (intraclass correlation, Cohen κ, Krippendorff α, and Cronbach α) on each dimension of the MARS were performed by using SPSS Statistics 27. The intraclass correlation of all MARS dimensions ranged from 0.702-0.913 (95% CI 0.521-0.943), the Cohen κ of all MARS dimensions ranged from 0.388-0.907 (95% CI 0.151-0.994), the Krippendorff α of all MARS dimensions ranged from 0.705-0.979 (95% CI 0.657-0.923), and Cronbach α had a lower score of 0.821 in the information dimension and a higher score of .911 in the subjective quality dimension of the MARS.</p><p><strong>Conclusions: </strong>This study evaluated online pharmacy apps in Pakistan by using the MARS. It is the first study on online pharmacy apps in Pakistan. The findings of the evaluation have provided insights into the reliability and efficacy of these apps.</p>","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e59884"},"PeriodicalIF":5.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Self-Management Support Apps for Spinal Cord Injury: The Missing Role of Caregivers.","authors":"Cheila Pessoa","doi":"10.2196/72037","DOIUrl":"https://doi.org/10.2196/72037","url":null,"abstract":"","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e72037"},"PeriodicalIF":5.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Potential of a Digital Intervention to Enhance Couple Relationships (the Paired App): Mixed Methods Evaluation.","authors":"Catherine Aicken, Jacqui Gabb, Salvatore Di Martino, Tom Witney, Mathijs Lucassen","doi":"10.2196/55433","DOIUrl":"https://doi.org/10.2196/55433","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite the effects of poor relationship quality on individuals', couples', and families' well-being, help seeking often does not occur until problems arise. Digital interventions may lower barriers to engagement with preventive relationship care. The Paired app, launched in October 2020, aims to strengthen and enhance couple relationships. It provides daily questions, quizzes, tips, and detailed content and facilitates in-app sharing of question and quiz responses and tagged content between partners.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the potential of mobile health to benefit couple relationships and how it may do this, we examined (1) Paired's impact on relationship quality and (2) its mechanisms of action.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This mixed methods evaluation invited Paired subscribers to complete (1) brief longitudinal surveys over 3 months (n=440), (2) a 30-item web-based survey (n=745), and (3) in-depth interviews (n=20). For objective 1, survey results were triangulated to determine associations between relationship quality measures and the duration and frequency of Paired use, and qualitative data were integrated to provide explanatory depth. For objective 2, mechanisms of action were explored using a dominant qualitative approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Relationship quality improved with increasing duration and frequency of Paired use. Web-based survey data indicate that the Multidimensional Quality of Relationship Scale score (representing relationship quality on a 0-10 scale) was 35.5% higher (95% CI 31.1%-43.7%; P=.002), at 7.03, among people who had used Paired for &gt;3 months compared to 5.19 among new users (≤1 wk use of Paired), a trend supported by the longitudinal data. Of those who had used Paired for &gt;1 month, 64.3% (330/513) agreed that their relationship felt stronger since using the app (95% CI 60.2%-68.4%), with no or minimal demographic differences. Regarding the app's mechanisms of action, interview accounts demonstrated how it prompted and habituated meaningful communication between partners, both within and outside the app. Couples made regular times in their day to discuss the topics Paired raised. Daily questions were sometimes lighthearted and sometimes concerned topics that couples might find challenging to discuss (eg, money management). Interviewees valued the combination of fun and seriousness. It was easier to discuss challenging topics when they were raised by the \"neutral\" app, rather than during stressful circumstances or when broached by 1 partner. Engagement seemed to be enhanced by users' experience of relationship benefits and by the app's design.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates proof of concept, showing that Paired may have the potential to improve relationship quality over a relatively short time frame. Positive relationship practices became embedded within couples' daily routines, suggesting that relationship quality ","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e55433"},"PeriodicalIF":5.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Relationship Between Ecological Momentary Assessment Methods, Sensed Behavior, and Responsiveness: Cross-Study Analysis.","authors":"Diane Cook, Aiden Walker, Bryan Minor, Catherine Luna, Sarah Tomaszewski Farias, Lisa Wiese, Raven Weaver, Maureen Schmitter-Edgecombe","doi":"10.2196/57018","DOIUrl":"https://doi.org/10.2196/57018","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ecological momentary assessment (EMA) offers an effective method to collect frequent, real-time data on an individual's well-being. However, challenges exist in response consistency, completeness, and accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study examines EMA response patterns and their relationship with sensed behavior for data collected from diverse studies. We hypothesize that EMA response rate (RR) will vary with prompt time of day, number of questions, and behavior context. In addition, we postulate that response quality will decrease over the study duration and that relationships will exist between EMA responses, participant demographics, behavior context, and study purpose.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from 454 participants in 9 clinical studies were analyzed, comprising 146,753 EMA mobile prompts over study durations ranging from 2 weeks to 16 months. Concurrently, sensor data were collected using smartwatch or smart home sensors. Digital markers, such as activity level, time spent at home, and proximity to activity transitions (change points), were extracted to provide context for the EMA responses. All studies used the same data collection software and EMA interface but varied in participant groups, study length, and the number of EMA questions and tasks. We analyzed RR, completeness, quality, alignment with sensor-observed behavior, impact of study design, and ability to model the series of responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The average RR was 79.95%. Of those prompts that received a response, the proportion of fully completed response and task sessions was 88.37%. Participants were most responsive in the evening (82.31%) and on weekdays (80.43%), although results varied by study demographics. While overall RRs were similar for weekday and weekend prompts, older adults were more responsive during the week (an increase of 0.27), whereas younger adults responded less during the week (a decrease of 3.25). RR was negatively correlated with the number of EMA questions (r=-0.433, P&lt;.001). Additional correlations were observed between RR and sensor-detected activity level (r=0.045, P&lt;.001), time spent at home (r=0.174, P&lt;.001), and proximity to change points (r=0.124, P&lt;.001). Response quality showed a decline over time, with careless responses increasing by 0.022 (P&lt;.001) and response variance decreasing by 0.363 (P&lt;.001). The within-study dynamic time warping distance between response sequences averaged 14.141 (SD 11.957), compared with the 33.246 (SD 4.971) between-study average distance. ARIMA (Autoregressive Integrated Moving Average) models fit the aggregated time series with high log-likelihood values, indicating strong model fit with low complexity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;EMA response patterns are significantly influenced by participant demographics and study parameters. Tailoring EMA prompt strategies to specific participant characteristics can improve RRs and qual","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"13 ","pages":"e57018"},"PeriodicalIF":5.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}