JMIR Formative Research最新文献

{"title":"Use of Generative AI for Substance-Related Information Among Young Adults (Aged 18-29 Years) in the United States: Cross-Sectional Survey.","authors":"Mireia Triguero Roura, Pia M Mauro","doi":"10.2196/100667","DOIUrl":"https://doi.org/10.2196/100667","url":null,"abstract":"<p><strong>Unlabelled: </strong>One in three young adults reported substance-related generative AI use, mainly for seeking information on substances, with higher prevalence among Black and male respondents; findings highlight that generative AI might be shaping the substance-use ecosystem among young adults and further research is needed to understand its public health implications.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e100667"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224045","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":"Tuberculosis Among Artisanal Miners in the Mulongo Health Zone, Democratic Republic of Congo: Unmatched Case-Control Study.","authors":"Josué Mutangala Muloye, Fiston Ilunga Mbayo, Jacques Muteba Kakoma, François Kitobo Mashika, Jean Claude Banze Kabwe Ilunga, Pacifique Kanku Wa Ilunga, Gloire Kasongo Lupitshi, Didy Lwamba Kabiya, Paulin Beya Wa Bitadi Mutombo","doi":"10.2196/93635","DOIUrl":"https://doi.org/10.2196/93635","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a major global health challenge, with 10.6 million new cases and 1.3 million deaths reported in 2022. Artisanal miners in sub‑Saharan Africa are particularly vulnerable due to poverty, overcrowded living conditions, and high HIV prevalence. In the Democratic Republic of Congo (DRC), TB prevalence among miners is high, yet determinants remain insufficiently studied.</p><p><strong>Objective: </strong>This study aimed to identify sociodemographic, behavioral, and clinical factors associated with TB among artisanal miners in the Mulongo health zone, Haut‑Lomami Province, DRC.</p><p><strong>Methods: </strong>We conducted an unmatched case-control study among miners aged ≥15 years. Data were collected using a validated questionnaire covering socioeconomic, behavioral, and biomedical variables. Interviewers were blinded to TB status to minimize bias. Determinants were assessed using bivariate and multivariable logistic regression.</p><p><strong>Results: </strong>Poverty was strongly associated with TB (adjusted odds ratio [aOR] 3.16, 95% CI 1.95-5.11; P<.001). Primary education was associated with increased TB risk (aOR 2.78, 95% CI 1.04-7.44; P=.04), while secondary education showed a borderline association (aOR 2.53, 95% CI 0.93-6.89; P=.07). Higher education was protective (aOR 0.62, 95% CI 0.40-0.95; P=.03). Poor knowledge of TB transmission (aOR 2.11, 95% CI 1.16-3.83; P=.02), cause (aOR 1.79, 95% CI 1.00-3.20; P=.049), and diagnosis (aOR 2.49, 95% CI 1.48-4.17; P=.001) were consistently linked to higher vulnerability. HIV infection was significantly associated with TB (aOR 4.65, 95% CI 1.00-21.74; P=.049). Overcrowding was more frequent among TB cases, but in adjusted models, the association was borderline (aOR 1.65, 95% CI 0.95-2.85; P=.07). Tobacco use (aOR 1.47, 95% CI 0.83-2.61; P=.18), alcohol consumption (aOR 1.18, 95% CI 0.70-1.98; P=.54), and nutritional status (aOR 1.36, 95% CI 0.78-2.37; P=.28) were not significantly associated with TB.</p><p><strong>Conclusions: </strong>TB among artisanal miners appears to be driven primarily by poverty, limited education, poor knowledge, and HIV infection. Overcrowding showed a suggestive but nonsignificant association. Integrated interventions should prioritize poverty alleviation, improved housing, tailored health education, and strengthened TB and HIV services, while further studies are needed to clarify the role of overcrowding and other contextual factors.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e93635"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224124","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":"Artificial Intelligence Use Among Health Care Professionals in the United States and United Kingdom: Cross-National Survey.","authors":"Emre Sezgin, Jennifer Lee, Tomasz Jadczyk, Alysha J Taxter","doi":"10.2196/100681","DOIUrl":"https://doi.org/10.2196/100681","url":null,"abstract":"<p><strong>Unlabelled: </strong>This cross-sectional study examined AI use among 524 health care professionals in the United States and United Kingdom, focusing on current applications, access, barriers, and factors that could support adoption. AI use was common but varied across professional and national contexts, with findings highlighting the importance of evidence, organizational guidance, training, privacy safeguards, and integration into clinical workflows for responsible adoption.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e100681"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224097","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":"Bridgedd, a Health Care Staff-Facing Community Resource Navigation Tool for an Urban Safety-Net Hospital: Cross-Sectional Formative Pilot Study.","authors":"Aravind Venkatachalam, Charles E Moore","doi":"10.2196/101610","DOIUrl":"https://doi.org/10.2196/101610","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Health care professionals in safety-net settings often rely on lengthy and inconsistently maintained community health resource lists when connecting patients with services. Bridgedd is a health care staff-facing web application designed to generate geographically and categorically filtered community resources in a unique format that makes information about each resource more accessible.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This formative pilot study aimed to characterize the perceptions of behavioral health professionals toward Bridgedd's usability, comparative value relative to existing community resource filtering and communication tools, and their intent to use it with patients if made available.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a single-site, cross-sectional formative pilot of the web-based tool we developed, Bridgedd, within Grady Health System's Integrated Behavioral Health Program between April 23 and May 14, 2026. All 21 program team members attending an all-staff meeting received a presentation about Bridgedd and were given the opportunity to try the tool and ask questions. Then, they independently evaluated it using a self-generated hypothetical patient scenario. Eleven completed an investigator-developed anonymous feedback survey assessing perceived ease of use, comparative value relative to existing tools, intent to use the tool with patients, and open-ended feedback. Quantitative responses were summarized using raw counts, and open-ended responses were summarized as descriptive observations. A post hoc descriptive analysis excluded 2 potentially direction-confused response patterns. The post hoc descriptive analysis did not materially change the overall interpretation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eleven behavioral health professionals (therapists, n=4; licensed professional counselors, n=3; social workers, n=2; mental health counselor, n=1; certified peer specialist-mental health, n=1) completed the survey. Of the 11 respondents, 9 rated the tool as very easy to use, none reported technical problems, 8 agreed or strongly agreed that Bridgedd was better than the tools they currently use to help patients navigate community health resources, and 8 reported an intent to use the tool with patients if it were made available. In the open-ended responses, 7 of the 11 respondents suggested that nothing was missing or offered no additional suggestions for improvement, while the remaining 4 open-ended responses centered on expanding mental or behavioral health resources, providing additional county coverage, including more resources within each category, and building a mechanism for updating resource information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this small, single-setting formative pilot study using hypothetical patient scenarios, participating behavioral health professionals generally reported favorable perceptions of Bridgedd's usability and potential utility. Further evaluation during routin","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e101610"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224104","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":"Data-Driven Comorbidity Phenotypes and In-Hospital Outcomes Among Patients With Nonvariceal Upper Gastrointestinal Bleeding: Formative Retrospective Cohort Study.","authors":"Fangning Wang, Yuhang Zhou, Qin Zhang, Yuan Liu, Yanli Zhang, Shiyu Du","doi":"10.2196/108793","DOIUrl":"https://doi.org/10.2196/108793","url":null,"abstract":"<p><strong>Background: </strong>Existing risk scores for nonvariceal upper gastrointestinal bleeding (NVUGIB) may not adequately represent the heterogeneity of coexisting chronic conditions. Routinely collected hospital discharge records may enable data-driven characterization of clinically meaningful comorbidity profiles.</p><p><strong>Objective: </strong>This formative study aimed to identify reproducible comorbidity profiles among patients hospitalized with NVUGIB and examine their associations with in-hospital outcomes and health care use.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 3193 adults hospitalized with NVUGIB at a tertiary hospital in China between 2015 and 2025. Of 55 prespecified chronic conditions, 33 with a prevalence of at least 1% were included as binary clustering variables. Patients were randomly divided into an 80% training subset and a 20% held-out validation subset. Comorbidity profiles were identified in the training subset using a self-organizing map and Ward hierarchical clustering and then assigned to the validation subset using the fixed clustering solution. Profile reproducibility was evaluated by comparing condition prevalence vectors between subsets. Multivariable regression models assessed associations with severe in-hospital outcomes, intensive care unit admission, in-hospital death, length of stay, and hospital costs.</p><p><strong>Results: </strong>At least 1 selected comorbidity was recorded in 89.7% (2864/3193) of patients. Six profiles were identified: low-burden heterogeneous (cluster 1), non-upper gastrointestinal neoplastic-metastatic (cluster 2), circulatory-renal (cluster 3), cardiometabolic-renal (cluster 4), atherosclerotic-vascular (cluster 5), and rheumatologic-neurological (cluster 6). Profile composition was broadly reproducible between the training and validation subsets (weighted mean Spearman correlation=0.891, SD 0.04; <i>P</i>=.001). The circulatory-renal profile had the strongest associations with severe in-hospital outcomes (adjusted odds ratio [aOR] 8.57, 95% CI 5.39-14.01), intensive care unit admission (aOR 10.38, 95% CI 4.87-25.76), and in-hospital death (aOR 4.66, 95% CI 1.97-13.75). The rheumatologic-neurological and cardiometabolic-renal profiles were also associated with higher odds of these outcomes. All 6 profiles were associated with longer hospital stays and higher hospital costs.</p><p><strong>Conclusions: </strong>Using routinely collected hospital discharge records, we identified clinically interpretable comorbidity profiles among patients with NVUGIB. The profiles were broadly reproducible within the study population and showed different associations with clinical outcomes and resource use. Profile-based information may complement established risk assessment and could be examined further as an electronic health record-based approach to clinical management and resource planning.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e108793"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224068","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":"Physiological Responses, Exercise Intensity, and Enjoyment During Ring Fit Adventure in Adults With Chronic Diseases: Single-Arm, Pre-Post Experimental Study.","authors":"Muhammad Jazimin Haron, Shiek Abdullah Ismail, Gilbert Tian Seng Yeo","doi":"10.2196/92345","DOIUrl":"https://doi.org/10.2196/92345","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Physical inactivity and insufficient muscle-strengthening exercise remain important public health concerns among adults with chronic diseases. Active video games may offer an accessible way to support exercise participation, but many may not provide sufficient exercise intensity to produce meaningful physiological responses. Ring Fit Adventure (RFA) is an active video game that combines aerobic and resistance-based exercise. However, little is known about its physiological demands among adults with chronic diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This pilot study aimed to examine the acute physiological responses, exercise intensity, perceived exertion, and enjoyment during RFA gameplay in adults with stable chronic diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-arm, pre-post experimental study was conducted among 20 adults aged 40 to 65 years with at least one chronic disease. Participants were recruited through convenience and snowball sampling from a hospital-based setting and public recruitment channels. After baseline assessment and familiarization, participants completed 2 stages of RFA gameplay. Heart rate (HR) was continuously monitored, while blood pressure (BP), capillary blood glucose (BG), and the rate of perceived exertion were measured at baseline and immediately after each stage. Enjoyment was assessed using the Exergame Enjoyment Questionnaire (EEQ).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 20 participants completed the study, with no adverse events or missing data. The mean age was 54.3 (95% CI 51.25-57.25) years, and 10 participants were male. Hypertension was the most common condition (n=14, 70%), followed by hyperlipidemia (n=11, 55%), obesity (n=8, 40%), and diabetes (n=5, 25%). The mean continuous HR during gameplay was 111.6 (95% CI 102.6-120.6) bpm, corresponding to 67.2% of the age-predicted maximum HR, while peak HR reached 138.6 (95% CI 128.9-148.3) bpm, corresponding to 83.5% of the age-predicted maximum HR. HR increased significantly after World 1 by 16.7 (95% CI 11.42-21.88; &lt;i&gt;P&lt;/i&gt;&lt;.001) bpm and after World 2 by 20.7 (95% CI 13.28-28.12; &lt;i&gt;P&lt;/i&gt;&lt;.001) bpm. Rate of perceived exertion also increased significantly after World 1 by 2.83 (95% CI 2.32-3.33; &lt;i&gt;P&lt;/i&gt;&lt;.001) points and after World 2 by 3.75 (95% CI 3.18-4.32; &lt;i&gt;P&lt;/i&gt;&lt;.001) points. Capillary BG decreased after World 1 by 1.4 (95% CI -1.95 to 0.78; &lt;i&gt;P&lt;/i&gt;&lt;.001) mmol/L and after World 2 by 1.6 (95% CI -2.46 to -0.80; &lt;i&gt;P&lt;/i&gt;=.01) mmol/L, with no hypoglycemic events. No significant changes were observed in systolic or diastolic BP. The mean enjoyment score was 77.6 out of 100 (95% CI 74.7-80.5).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;RFA elicited moderate average exercise intensity with periods of vigorous intensity, reductions in capillary BG, stable postexercise BP, and high enjoyment among adults with stable chronic diseases. These findings suggest that RFA may be a feasible and engaging home-based exercise option for this","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e92345"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224066","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":"Characterizing Behavioral Engagement in Smartphone Cognitive Behavioral Therapy for Obsessive Compulsive Disorder: Secondary Analysis of a Randomized Controlled Trial.","authors":"Hilary Weingarden, Geneva K Jonathan, Susanne S Hoeppner, Sara Velazquez, Ryan J Jacoby, Jennifer L Greenberg, Oliver Harrison, Sabine Wilhelm","doi":"10.2196/98129","DOIUrl":"https://doi.org/10.2196/98129","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital mental health interventions (DMHIs) are increasingly popular for their ability to disseminate evidence-based treatments in a scalable, accessible way. Engagement with digital treatments is critical for effectiveness but remains poorly defined and measured. Most studies rely on subjective self-reports or 1 or 2 objective metrics, overlooking the multidimensional nature of how users interact with DMHIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This exploratory secondary analysis applied a road map for comprehensive behavioral engagement measurement, developed for a prior smartphone cognitive behavioral therapy program for body dysmorphic disorder, to a 12-week randomized controlled trial of smartphone cognitive behavioral therapy for obsessive compulsive disorder (OCD; N=60). Aims were to (1) comprehensively characterize behavioral engagement using 21 objective app analytics-based variables, (2) identify distinct behavioral engagement profiles via cluster analysis, (3) assess whether profiles were differentially associated with OCD symptom change, and (4) evaluate associations between profiles and pretreatment credibility, expectancy, posttreatment satisfaction, and perceived app quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Behavioral engagement was measured via 21 objective variables derived from app analytics, spanning use volume, frequency, feature usage, session duration, and temporal patterns. Hierarchical agglomerative cluster analysis identified engagement profiles. Associations between cluster membership and OCD severity change (Yale-Brown Obsessive Compulsive Scale) were examined using hierarchical generalized linear mixed models. Objective measures were complemented with subjective self-reports: namely, cluster differences in treatment credibility, expectancy, satisfaction, and perceived app quality were examined using ANOVAs and Wilcoxon rank-sum tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Cluster analysis indicated a 3-cluster solution representing high (cluster 1: 21/60, 35%), moderate (cluster 2: 31/60, 52%), and low (cluster 3: 8/60, 13%) app users. All 3 clusters experienced significant reductions in OCD severity, with no significant differences in pre- to posttreatment Yale-Brown Obsessive Compulsive Scale change across clusters. Descriptively, cluster 1 had a higher rate of treatment responders than cluster 3. While clusters 1 and 2 had similar perceptions of treatment credibility and expectancy at baseline and satisfaction at posttreatment, cluster 3 perceived the intervention as significantly less credible, had lower expectations, and reported significantly lower satisfaction than cluster 2. All clusters rated app quality as similarly high.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Comprehensive behavioral engagement measurement is feasible and informative across different DMHIs and clinical populations. The finding that all engagement profiles showed comparable symptom improvement challenges simple dose-respon","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e98129"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224087","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":"Symptom Trajectories and Attendance in Face-to-Face and Online Psychiatric Follow-Up for Major Depressive Disorder and Anxiety Symptoms: Prospective Observational Cohort Study.","authors":"Doğan Akalın, Vesile Şentürk Cankorur","doi":"10.2196/97656","DOIUrl":"https://doi.org/10.2196/97656","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Major depressive disorder is a leading cause of disability, and access to specialist psychiatric follow-up remains limited in many settings. Telepsychiatry may reduce logistical barriers to care, but data on video-based follow-up under routine outpatient conditions in Türkiye are scarce, and comparisons of delivery modalities are frequently limited by baseline imbalance between self-selected groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of the study is to describe symptom trajectories and attendance over 6 months of routine psychiatric follow-up delivered either face-to-face or online and to examine whether outcomes differed between modalities after adjustment for baseline severity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective, nonrandomized observational cohort study, 120 adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) major depressive disorder were followed for 6 months at a university hospital psychiatry department in Ankara, Türkiye (September 2021 to May 2022). Participants entered face-to-face (n=60) or online (n=60) follow-up according to their own preference. Seven sessions were scheduled at approximately 4-week intervals; the Hamilton Depression Rating Scale (HAM-D; primary outcome), the Hamilton Anxiety Rating Scale, and DSM-5 Level 1 and Level 2 measures were administered at baseline and at sessions 1, 2, 4, and 6. Attendance was recorded at all sessions. Between-group comparisons used analysis of covariance adjusted for the corresponding baseline score and for prespecified covariates. Linear mixed models incorporating a group-by-time interaction were fitted to all available observations, and multiple imputation (m=20) was performed as a sensitivity analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Depressive symptoms decreased substantially in both groups: mean HAM-D fell from 26.6 to 5.0 in the face-to-face group (81.2% reduction; Cohen d=4.86; P&lt;.001; n=43) and from 24.1 to 3.3 in the online group (86.3% reduction; Cohen d=6.06; P&lt;.001; n=49). Response rates were 41 of 43 (95.3%) and 48 of 49 (98%; P=.60), and remission rates were 32 of 43 (74.4%) and 43 of 49 (87.8%; P=.11). Unadjusted between-group differences at sessions 4 and 6 did not persist after adjustment for baseline severity (session 4: -0.47, 95% CI -1.71 to 0.77; P=.46; session 6: -0.79, 95% CI -2.22 to 0.65; P=.28), and the group-by-time interaction was not significant (χ&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;3&lt;/sub&gt;=1.9; P=.59). Anxiety scores did not differ at any time point. Findings were unchanged under multiple imputation, and prescribing patterns were comparable. Attendance across all 7 scheduled sessions was higher in the online group overall (373/420, 88.8% vs 319/420, 76%; P&lt;.001), with differences at sessions 2 through 5.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Both modalities were followed by large reductions in depressive symptoms, and between-group differences did not persist after adjustment for baseline s","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e97656"},"PeriodicalIF":2.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224058","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":"Educational Impact of an Instagram Account on Histology Teaching: Mixed Methods Approach in Medical Education.","authors":"Fatéméh Dubois, Damien Ambrosetti, Lucie Tosca","doi":"10.2196/89044","DOIUrl":"10.2196/89044","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Morphology-based disciplines such as histology, embryology, and cytogenetics require strong visual learning and rely heavily on visual pattern recognition, with more complex integrative processes, that is, higher-order cognitive skills that connect, interpret, and apply knowledge across contexts. These skills may be supported by social media formats. In parallel, medical students increasingly engage with digital and social media platforms, prompting interest in their potential educational value. Instagram (Meta Platforms, Inc), as an image-centered and interactive medium, has emerged as a potential pedagogical tool. The Histo.Embryo Instagram account was launched in 2023 under the auspices of the French National College of Histologists, Embryologists, and Cytogeneticists (CHEC) to complement traditional teaching with bilingual, interactive, image-based posts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the pedagogical contribution of the Histo.Embryo Instagram account with a focus on students' engagement, usage patterns, perceived learning outcomes, and qualitative user experience. This learning platform was developed as a visual and interactive tool to complement traditional teaching in histology, embryology, and cytogenetics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A mixed methods design combined a structured online survey (N&gt;100), Instagram analytics (90-day period), and qualitative feedback. Quantitative data assessed usage frequency, preferred content formats, perceived utility, and self-reported learning outcomes. Qualitative data were analyzed thematically to explore how students interacted with and integrated the content into their learning practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Instagram was the dominant platform among students, with 81% (101/125) reporting daily use. The account reached 2582 unique users and 168,778 views. Static quiz-based posts generated 96% (203/207) of engagement, highlighting a strong preference for active recall formats. Survey data showed that 98% (122/125) perceived improved understanding, 64% (80/125) enhanced visual recognition, and over two-thirds reused content in academic settings. Qualitative findings provided additional insight into these patterns. Students described the content as accessible, visually clear, and aligned with exam expectations, emphasizing its role in simplifying complex concepts and supporting memorization. Many reported using posts for rapid revision, self-assessment, and consolidation of prior knowledge, suggesting integration into self-regulated learning strategies. The interactive quiz format was perceived as motivating and cognitively engaging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The Histo.Embryo Instagram account suggests that Instagram, when intentionally structured, may complement traditional teaching by supporting visual learning, active recall, and flexible study practices. Nevertheless, these findings should be interpreted cautiou","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e89044"},"PeriodicalIF":2.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206865","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":"Digital Nudges Among New Gym Members: Controlled Formative Evaluation of Gym Attendance, Exercise Self-Efficacy, Habit Strength, and Exercise Adherence.","authors":"Maor Gabay, Ofer Levi, Lupsa Marius Matichescu, Mihaela Oravitan","doi":"10.2196/93800","DOIUrl":"10.2196/93800","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital nudging strategies are increasingly implemented to promote physical activity; yet, evidence from real-world fitness settings remains limited. The early membership period in fitness centers is characterized by high dropout rates, emphasizing the need for formative evaluations that clarify behavioral mechanisms underlying exercise engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the formative impact of WhatsApp (Meta Platforms, Inc)-based digital nudges on objectively measured weekly gym visits among new fitness club members and to examine behavioral determinants associated with exercise engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This controlled intervention study used a 2-parallel-group design with quasi-random individual allocation conducted separately within 2 fitness clubs. The complete-case sample comprised 61 new gym members (mean age 29.05, SD 8.06 years; 21/61, 34.4% female), including 27 participants in the intervention group and 34 in the control group. During the 3-week intervention period, participants in the intervention group received brief digital nudges through designated WhatsApp groups. The messages were developed according to the Easy, Attractive, Social, and Timely (EAST) framework. Participants in the control group received no nudge messages. Gym visits were recorded electronically over 12 weeks through the fitness clubs' computerized entry systems. Self-reported measures included exercise self-efficacy, habit strength, and exercise adherence. Statistical analyses included descriptive statistics, longitudinal analysis of weekly gym attendance using generalized estimating equations (GEE), correlation analyses, and exploratory regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Longitudinal GEE analysis showed a significant decline in weekly gym attendance over time (b=-0.074, SE 0.016; &lt;i&gt;P&lt;/i&gt;&lt;.001, incidence rate ratio [IRR]=0.929), corresponding to an approximately 7.1% decrease in expected weekly visits per study week. However, the group×week interaction was not significant (b=.009, SE 0.022; &lt;i&gt;P&lt;/i&gt;=.68, IRR=1.009). Participants attending the gym at least twice weekly reported greater exercise habit strength (mean 33.89, SD 6.49 vs mean 28.70&lt;i&gt;,&lt;/i&gt; SD 9.05; &lt;i&gt;P&lt;/i&gt;=.02) and greater baseline exercise self-efficacy (mean 71.37, SD 12.50 vs mean 57.24, SD 14.61; &lt;i&gt;P&lt;/i&gt;=.001). Mean weekly gym visits were positively correlated with exercise habit strength (&lt;i&gt;r&lt;/i&gt;=0.444), exercise self-efficacy (&lt;i&gt;r&lt;/i&gt;=0.498), and exercise adherence (&lt;i&gt;r&lt;/i&gt;=0.507; all &lt;i&gt;P&lt;/i&gt;&lt;.001). In the exploratory regression analysis, exercise adherence was the only variable retained, and the model explained 25.7% of the variance in mean weekly gym visits (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=.257; &lt;i&gt;P&lt;/i&gt;&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Weekly gym attendance declined significantly over the 12-week follow-up period, but the rate of decline did not differ significantly between the int","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e93800"},"PeriodicalIF":2.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206868","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}