Sanna Iivanainen, Reetta Arokoski, Santeri Mentu, Laura Lang, Jussi Ekström, Henri Virtanen, Vesa Kataja, Jussi Pekka Koivunen
{"title":"Development of a Comprehensive Decision Support Tool for Chemotherapy-Cycle Prescribing: Initial Usability Study.","authors":"Sanna Iivanainen, Reetta Arokoski, Santeri Mentu, Laura Lang, Jussi Ekström, Henri Virtanen, Vesa Kataja, Jussi Pekka Koivunen","doi":"10.2196/62749","DOIUrl":"https://doi.org/10.2196/62749","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy cycle prescription is generally carried out through a multistep manual process that is prone to human error. Clinical decision support tools can provide patient-specific assessments that support clinical decisions, improve prescribing practices, and reduce medication errors.</p><p><strong>Objective: </strong>We hypothesized that a knowledge-based, patient-derived, evidence-directed decision support tool consisting of multiple modules focusing on the core duties preceding chemotherapy-cycle prescription could result in a more cost-effective and error-free approach and streamline the workflow.</p><p><strong>Methods: </strong>A 1-arm, multicenter, prospective clinical trial (\"Follow-up of Cancer Patients Receiving Chemotherapy or Targeted Therapy by Electronic Patient Reported Outcomes-tool\" [ECHO] 7/2019-1/2021; NCT04081558) was initiated to investigate the tool. The most important inclusion criteria were the presence of colorectal cancer (CRC) treated with oxaliplatin-based chemotherapy, age ≥18 years, Eastern Cooperative Oncology Group [ECOG] performance score of 0 to 2, and internet access. A decision support tool that included digital symptom monitoring, a laboratory value interface, and treatment schedule integration for semiautomated chemotherapy cycle prescribing was integrated into the care pathway. Performance was assessed by the percentage of chemotherapy cycles with sent and completed symptom questionnaires, while perceptions of health care professionals (HCPs) on the feasibility of the approach were collected through a 1-time semistructured interview.</p><p><strong>Results: </strong>The ECHO trial included 43 patients with CRC treated with doublet or triplet chemotherapy in an adjuvant or metastatic setting. Altogether, 843 electronic patient-reported outcome (ePRO) symptom questionnaires were completed. Of the 15 recorded symptoms, fatigue (n=446, 52.9%) and peripheral neuropathy (n=429, 50.9%) were reported most often, while 137 grade 3 to 4 symptoms were recorded, of which diarrhea (n=5, 4%) and peripheral neuropathy (n=4, 3%) were the most common. During the study, 339 chemotherapy cycles were prescribed, and for the 77% (n=262) of new chemotherapy cycles, ePRO questionnaire data were available within preset limits (completed within 3 days prior to chemotherapy scheduling) while 65% of the cycles (n=221) had symptom questionnaire grading at ≤1%, and 67% of the cycles (n=228) had laboratory values in a preset range. The recommendations by the tool for a new chemotherapy cycle were tier 1 (green; meaning \"go\") in 145 (42.8%) of the cycles, tier 2 (yellow; \"evaluate\") in 83 (25%), and tier 3 (red; \"hold\") in 111 (32.7%). HCPs (n=3) were interviewed with a questionnaire (comprising 8 questions), revealing that they most valued the improved workflow, faster patient evaluation, and direct messaging option.</p><p><strong>Conclusions: </strong>In this study, we investigated the feasibility of a d","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e62749"},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753031","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}
Areum Han, Robert Oster, Hon Yuen, Jeremy Jenkins, Jessica Hawkins, Lauren Edwards
{"title":"Videoconference-Delivered Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Pilot Randomized Controlled Trial.","authors":"Areum Han, Robert Oster, Hon Yuen, Jeremy Jenkins, Jessica Hawkins, Lauren Edwards","doi":"10.2196/67545","DOIUrl":"https://doi.org/10.2196/67545","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers of individuals with dementia face significant mental health challenges. Acceptance and commitment therapy (ACT) has emerged as a promising intervention for improving these caregivers' mental health. While various delivery modes of ACT have been explored, there is a need for evidence on the efficacy of videoconference-delivered ACT programs for this population.</p><p><strong>Objective: </strong>This pilot randomized controlled trial, conducted in the United States, aims to assess the effects of a videoconference-delivered, therapist-guided ACT program on reducing depressive symptoms and improving other mental health outcomes among family caregivers with depression who give care to individuals with dementia, compared to a control group that received psychoeducation materials only.</p><p><strong>Methods: </strong>This 2-arm, parallel-group pilot randomized controlled trial randomly assigned 33 family caregivers to either a 10-week videoconference-delivered ACT program (n=16, 48%) or a control group that received psychoeducation materials alone (n=17, 52%). Depressive symptoms (primary outcome) were measured using the Patient Health Questionnaire-9. Secondary outcomes included anxiety, stress, psychological quality of life (QoL), caregiver burden, predeath grief, guilt, and ACT process measures. Outcomes were assessed in the pretest, posttest (10-12 weeks after pretest), and a 3-month follow-up (3 months after posttest, approximately 5-6 months after pretest). An intent-to-treat approach was used for all outcome analyses. Linear mixed-effects models for repeated measures were used to analyze outcomes.</p><p><strong>Results: </strong>The ACT group reported significantly greater improvements in stress (P=.043) and psychological QoL (P=.014) in the posttest compared to the control group. Within the ACT group, participants experienced a significant decrease in depressive symptoms, with a mean (SE) change of -6.09 (1.16) points (95% CI -8.42 to -3.76; P<.001) in the posttest and -6.71 (1.45) points (95% CI -9.63 to -3.81; P<.001) in the 3-month follow-up. These changes exceed the estimated minimal clinically important difference on the Patient Health Questionnaire-9. In addition, the ACT group reported significant improvements in anxiety, stress, psychological QoL, caregiver burden, predeath grief, guilt, values-driven action, and experiential avoidance at both posttest and 3-month follow-up. A sensitivity analysis, excluding 1 participant with near-outlier data, revealed statistically significant between-group differences in depressive symptoms at posttest (P=.037); stress at posttest (P<.001) and in 3-month follow-up (P=.001); psychological QoL at posttest (P<.001); caregiver burden at posttest (P=.003) and in 3-month follow-up (P=.003); predeath grief in 3-month follow-up (P=.031); and values-driven action at posttest (P=.032).</p><p><strong>Conclusions: </strong>The videoconference-delivered ACT progra","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67545"},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753032","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}
Silke Wittmar, Tom Frankenstein, Vincent Timm, Peter Frei, Nicolas Kurpiers, Stefan Wölwer, Axel Georg Meender Schäfer
{"title":"User Experience With a Personalized mHealth Service for Physical Activity Promotion in University Students: Mixed Methods Study.","authors":"Silke Wittmar, Tom Frankenstein, Vincent Timm, Peter Frei, Nicolas Kurpiers, Stefan Wölwer, Axel Georg Meender Schäfer","doi":"10.2196/64384","DOIUrl":"https://doi.org/10.2196/64384","url":null,"abstract":"<p><strong>Background: </strong>Regular physical activity (PA) is known to offer substantial health benefits, including improved physical fitness, reduced risk of disease, enhanced psychological well-being, and better cognitive performance. Despite these benefits, many university students fail to meet recommended PA levels, risking long-term health consequences.</p><p><strong>Objective: </strong>This study evaluated the user experience (UX) of futur.move, a digital intervention aimed at promoting PA among university students. The service delivers personalized, evidence-based content to foster sustained engagement in PA.</p><p><strong>Methods: </strong>A mixed methods approach was used to evaluate the prototype of futur.move. UX assessments included on-site and online user tests, standardized questionnaires, and online focus groups. A total of 142 university students participated, with 23 joining additional focus groups. Each participant tested the service for 30 minutes. Quantitative data were collected using the User Experience Questionnaire and analyzed descriptively, followed by correlation analysis with variables such as PA level, age, gender, and experience with PA apps. Qualitative insights were gathered from transcribed focus group discussions and analyzed using content-structuring, qualitative content analysis. Quantitative findings were cross-validated with qualitative data.</p><p><strong>Results: </strong>The UX received positive ratings across 4 User Experience Questionnaire scales (range -3 to +3; higher numbers indicate positive UX): attractiveness (median 1.67, IQR 1.04-2.17), perspicuity (median 1.5, IQR 0.5-2), stimulation (median 1.5, IQR 1-2), and novelty (median 1.25, IQR 0.5-2). Weak correlations were found between adherence to World Health Organization guidelines for PA and the perspicuity subscale (η=0.232, P=.04), and between age and the perspicuity (Kendall τb=0.132, P=.03) and stimulation subscales (Kendall τb=0.144, P=.02), and a moderate correlation was found between gender and the novelty subscale (η=0.363, P=.004). Critical feedback from focus group discussions highlighted issues with manual data entry. Qualitative findings aligned with the quantitative results, emphasizing students' appreciation for the personalized, diverse content and social networking features of futur.move.</p><p><strong>Conclusions: </strong>futur.move demonstrates favorable UX and aligns with student needs, particularly through its personalized content and social features. Improvements should focus on reducing manual data entry and enhancing feature clarity, particularly for the features \"your condition\" and \"goal setting.\" While correlations between UX ratings and demographic variables were weak to moderate, they warrant further investigation to better address the diverse target audience. The feedback from the students serves as a basis for further adapting the service to their needs and expectations. Future work will involve coding an advance","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64384"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736039","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}
Angela Bermúdez-Millán, Rafael Pérez-Escamilla, Sofia Segura-Pérez, James Grady, Richard S Feinn Vi, Hanako Agresta, Dean Kim, Julie Ann Wagner
{"title":"The Monthly Cycling of Food Insecurity in Latinas at Risk for Diabetes: Methods, Retention, and Sample Characteristics for a Microlongitudinal Design.","authors":"Angela Bermúdez-Millán, Rafael Pérez-Escamilla, Sofia Segura-Pérez, James Grady, Richard S Feinn Vi, Hanako Agresta, Dean Kim, Julie Ann Wagner","doi":"10.2196/66970","DOIUrl":"https://doi.org/10.2196/66970","url":null,"abstract":"<p><strong>Background: </strong>Food insecurity (FI) is a risk factor for type 2 diabetes (T2D) that disproportionately affects Latinas. We conducted a microlongitudinal study to examine the relationship of monthly cycling of FI and diabetes risk factors.</p><p><strong>Objective: </strong>This study aimed to determine the quantitative methodology, recruitment and retention strategies, predictors of retention across time, and baseline sample demographics.</p><p><strong>Methods: </strong>Participants were adult Latinas living in Hartford, Connecticut who were recruited through a community agency, invited to participate if they were receiving Supplementary Nutrition Assistance Program (SNAP) benefits, screened positive for FI using the 2-item Hunger Vital Sign Screener, and had elevated risk factors for T2D using the American Diabetes Association risk factor test. Using a microlongitudinal design, we collected data twice per month for 3 months (week 2, which is a period of food budget adequacy; and week 4, which is a period of food budget inadequacy) to determine if the monthly cycling of FI was associated with near-term diabetes risk (fasting glucose, fructosamine, and glycosylated albumin) and long-term risk (BMI, waist circumference, and glycated hemoglobin) markers. We determined whether household food inventory, psychological distress, and binge eating mediated associations. We examined Health Action Process Approach model constructs. To assess the relationship between monthly cycling of FI with diabetes risk markers, we used repeated measures general linear mixed models. To assess the role of mediators, we performed a causal pathway analysis.</p><p><strong>Results: </strong>Participant enrollment was from April 1, 2021 to February 21, 2023. A total of 87 participants completed 420 assessments or a mean of 4.83 (SD 2.02) assessments. About half (47/87, 54%) of the sample self-identified as Puerto Rican, mean age was 35.1 (SD 5.8) years, with 17.1 (SD 11.6) years in the mainland United States. Just under half (41/87, 47.1%) spoke Spanish only, 69% (60/87) had no formal schooling, and 31% (27/87) had less than eighth grade education. Modal household size was 4 including 2 children; 44.8% (39/87) were not living with a partner. About half (47/87, 54%) were unemployed, 63.2% (55/87) reported a monthly income <US $1000, and 63.2% (55/87) used food pantries. In total, 61 participants (70.1%) completed all 6 assessments. On Pearson correlation analysis, having internet at home and having a tablet at home were associated with a higher number of completed assessments.</p><p><strong>Conclusions: </strong>This study demonstrated how FI cycles over the month and whether and to what degree the cycling itself is related to the risk for T2D development, as well as the evidence for some putative mechanisms of this association that can serve as future intervention targets including SNAP disbursement schedules.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66970"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736008","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}
Helen Razmjou, Suzanne Denis, Susan Robarts, Amy Wainwright, Patricia Dickson, John Murnaghan
{"title":"Convergent and Known-Groups Validity and Sensitivity to Change of the Virtual Performance Measure in Patients With Hip and Knee Osteoarthritis: Longitudinal Study.","authors":"Helen Razmjou, Suzanne Denis, Susan Robarts, Amy Wainwright, Patricia Dickson, John Murnaghan","doi":"10.2196/69001","DOIUrl":"https://doi.org/10.2196/69001","url":null,"abstract":"<p><strong>Background: </strong>Subsequent to the COVID-19 pandemic in 2020, a different approach to health care utilization was required to improve safety and efficiency. In the postpandemic era, virtual care and remote assessment of musculoskeletal conditions has become more common, and examining the accuracy of these remote encounters remains vital. In 2023, an innovative, video-based tool-the Virtual Performance Measure (VPM)-was introduced to assess the functional difficulties of patients with osteoarthritis of the knee joint. Further validation of this tool is warranted to expand its application longitudinally and in more diverse populations.</p><p><strong>Objective: </strong>This study examined the longitudinal validity of the VPM, a digitally based outcome tool, in patients with osteoarthritis of the hip and knee joints who had undergone arthroplasty.</p><p><strong>Methods: </strong>Patients completed a web-based survey after watching 40 videos that demonstrated 10 functional tasks with increasing difficulty, prior to and at approximately 3-5 months following surgery. The Lower Extremity Functional Scale (LEFS) was used as the reference measure. Longitudinal convergent and known-groups validity as well as sensitivity to change were assessed.</p><p><strong>Results: </strong>The data of 120 patients (n=80, 67% female; mean age 67, SD 9 years; n=58, 48% with hip osteoarthritis and n=62, 52% with knee osteoarthritis) were examined. There was a statistically significant improvement in both LEFS (t<sub>119</sub>=16.04, P<.001) and VPM total scores (t<sub>119</sub>=13.92, P<.001) over time. The correlation between the postoperative LEFS and VPM scores was higher (r=0.66; P<.001) than the correlation between the change scores of these measures (r=0.51; P<.001). The area under the curve value for the VPM's ability to differentiate between urgent and nonurgent candidates for surgery was 0.71 (95% CI 0.57-0.84). Sensitivity to change as measured by the standardized response mean was 1.27 (95% CI 1.09-1.45), indicating good ability to detect change over time.</p><p><strong>Conclusions: </strong>The VPM demonstrated sufficient longitudinal convergent and known-groups validity as well as sensitivity to change in patients with hip and knee osteoarthritis following arthroplasty. This tool has a potential to improve the delivery of care by increasing access, reducing the frequency of in-person visits, and improving the overall efficiency of the health care system following a major surgery.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e69001"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735871","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}
Jeffrey Brown, Zachary Mitchell, Yu Albert Jiang, Ryan Archdeacon
{"title":"Accuracy of Smartphone-Mediated Snore Detection in a Simulated Real-World Setting: Algorithm Development and Validation.","authors":"Jeffrey Brown, Zachary Mitchell, Yu Albert Jiang, Ryan Archdeacon","doi":"10.2196/67861","DOIUrl":"https://doi.org/10.2196/67861","url":null,"abstract":"<p><strong>Background: </strong>High-quality sleep is essential for both physical and mental well-being. Insufficient or poor-quality sleep is linked to numerous health issues, including cardiometabolic diseases, mental health disorders, and increased mortality. Snoring-a prevalent condition-can disrupt sleep and is associated with disease states, including coronary artery disease and obstructive sleep apnea.</p><p><strong>Objective: </strong>The SleepWatch smartphone app (Bodymatter, Inc) aims to monitor and improve sleep quality and has snore detection capabilities that were built through a machine-learning process trained on over 60,000 acoustic events. This study evaluated the accuracy of the SleepWatch snore detection algorithm in a simulated real-world setting.</p><p><strong>Methods: </strong>The snore detection algorithm was tested by using 36 simulated snoring audio files derived from 18 participants. Each file simulated a snoring index between 30 and 600 snores per hour. Additionally, 9 files with nonsnoring sounds were tested to evaluate the algorithm's capacity to avoid false positives. Sensitivity, specificity, and accuracy were calculated for each test, and results were compared by using Bland-Altman plots and Spearman correlation to assess the statistical association between detected and actual snores.</p><p><strong>Results: </strong>The SleepWatch algorithm showed an average sensitivity of 86.3% (SD 16.6%), an average specificity of 99.5% (SD 10.8%), and an average accuracy of 95.2% (SD 5.6%) across the snoring tests. The positive predictive value and negative predictive value were 98.9% (SD 2.6%) and 93.8% (SD 14.4%) respectively. The algorithm performed exceptionally well in avoiding false positives, with a specificity of 97.1% (SD 3.5%) for nonsnoring files. Inclusive of all snoring and nonsnore tests, the aggregated accuracy for all trials in this bench study was 95.6% (SD 5.3%). The Bland-Altman analysis indicated a mean bias of -29.8 (SD 41.7) snores per hour, and the Spearman correlation analysis revealed a strong positive correlation (rs=0.974; P<.001) between detected and actual snore rates.</p><p><strong>Conclusions: </strong>The SleepWatch snore detection algorithm demonstrates high accuracy and compares favorably with other snore detection apps. Aside from its broader use in sleep monitoring, SleepWatch demonstrates potential as a tool for identifying individuals at risk for sleep-disordered breathing, including obstructive sleep apnea, on the basis of the snoring index.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67861"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735961","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}
Johan Hylander, Lina Gyllencreutz, Michael Haney, Anton Westman
{"title":"Ambulance Commanders' Reluctance to Enter Road Tunnels in Simulated Incidents and the Effects of a Tunnel-Specific e-Learning Course on Decision-Making: Web-Based Randomized Controlled Trial.","authors":"Johan Hylander, Lina Gyllencreutz, Michael Haney, Anton Westman","doi":"10.2196/58542","DOIUrl":"https://doi.org/10.2196/58542","url":null,"abstract":"<p><strong>Background: </strong>The optimal response to a major incident in a road tunnel involves efficient decision-making among the responding emergency services (fire and rescue services, police, and ambulances). The infrequent occurrence of road tunnel incidents may entail unfamiliarity with the tunnel environment and lead to uncertain and inefficient decision-making among emergency services commanders. Ambulance commanders have requested tunnel-specific learning materials to improve their preparedness.</p><p><strong>Objective: </strong>We aimed to assess decision-making among ambulance commanders in simulated road tunnel incidents after they had participated in a tunnel-specific e-learning course designed to support timely and correct decisions in this context.</p><p><strong>Methods: </strong>We conducted a web-based intervention study involving 20 participants from emergency medical services in Sweden who were randomly allocated to a test or control group. The control group (n=10, 50%) received a lecture on general incident management, while the intervention group (n=10, 50%) completed an e-learning course consisting of 5 modules focused on tunnel structure, safety, and collaboration in response. The participants took part in 2 simulation-based assessments for ambulance commander decision-making in major road tunnel incidents 1 month and 6 months after their allocated study intervention. In each simulation, the participants decided on the best course of action at 15 independent decision points, designed as multiple-choice questions. The primary outcome was the correct response to the question regarding how to appropriately enter the road tunnel. The secondary outcome measurements were correct or incorrect responses and the time taken to decide for each of the 15 decisions. Limited in-depth follow-up interviews were conducted with participants (n=5, 25%), and collected data were analyzed using qualitative content analysis.</p><p><strong>Results: </strong>All 20 participants completed the first simulation, and 16 (80%) completed the second. The main finding was that none (0/20, 0%) of the participants correctly answered the question on entering the tunnel system in the 1-month assessment. There were no significant differences between the groups (P=.59; 2-sample test of proportions) in the second assessment. The e-learning course was not associated with more correct answers at the first assessment, including accounting for participant factors (mean difference between groups: -0.58 points, 95% CI -1.88 to 0.73; P=.36). The e-learning course was also not associated with a shorter time to completion compared to the nonintervention group in either assessment. Interviews identified 3 categories linked to the main outcome: information (lack of), risk (limited knowledge and equipment), and mitigation (access to maps and aide-mémoire).</p><p><strong>Conclusions: </strong>Participation in a tunnel-specific e-learning course did not result in a measura","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e58542"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735966","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}
Jamie Ghossein, Brett N Hryciw, Tim Ramsay, Kwadwo Kyeremanteng
{"title":"The AI Reviewer: Evaluating AI's Role in Citation Screening for Streamlined Systematic Reviews.","authors":"Jamie Ghossein, Brett N Hryciw, Tim Ramsay, Kwadwo Kyeremanteng","doi":"10.2196/58366","DOIUrl":"https://doi.org/10.2196/58366","url":null,"abstract":"","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e58366"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735920","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":"Personalized mHealth Intervention (StepAdd) for Increasing Physical Activity in Japanese Patients With Type 2 Diabetes: Secondary Analysis of Social Cognitive Theory Measurements of a Single-Arm Pilot Study.","authors":"Kayo Waki, Syunpei Enomoto, Toshimasa Yamauchi, Masaomi Nangaku, Kazuhiko Ohe","doi":"10.2196/60221","DOIUrl":"https://doi.org/10.2196/60221","url":null,"abstract":"<p><strong>Background: </strong>A 12-week pilot of the StepAdd mobile health (mHealth) behavior change intervention based on social cognitive theory (SCT) saw an 86.7% increase in mean daily step counts among patients with type 2 diabetes. Due to the lack of exploration of theoretical implications in mHealth intervention studies, there is a need to understand the mechanism underlying the behavioral change to inform the future design of digital therapeutics.</p><p><strong>Objective: </strong>This study aimed to examine the SCT drivers underlying the mean increase in exercise among Japanese patients with type 2 diabetes who participated in the StepAdd intervention.</p><p><strong>Methods: </strong>This is a post hoc analysis of data collected in the single-arm pilot study of the 32 patients who completed the StepAdd intervention. The StepAdd app uses self-mastery and coping strategies to increase self-efficacy and thus increase walking. Self-mastery was measured by the goal completion (GC) rate, which is the percentage of days in which patients met these adapting goals. The use of coping strategies was measured by the strategy implementation (SI) rate, which is the percentage of days in which patients applied their selected coping strategies. We assessed correlations between GC, SI, and self-efficacy to increase walking via linear regression and analyzed relationships via structural equation modeling.</p><p><strong>Results: </strong>We found statistically significant support for the SCT approach, including a correlation coefficient (ρ) of 0.649 between step increase and GC rate (P<.001); a ρ of 0.497 between the coping SI rate and self-efficacy increase (P=.004); a ρ of 0.446 between GC rate and self-mastery increase (P=.01); and a ρ of 0.355 between self-regulation increase and step increase (P=.046), giving us insight into why the behavior intervention succeeded. We also found significant correlations between self-efficacy for barriers and self-efficacy for task-specific behavior (ρ=0.358; P=.04), as well as self-regulation and self-efficacy for task-specific behavior (ρ=0.583; P<.001). However, a cross-lagged panel modeling analysis found no significant evidence that changes in self-efficacy preceded behavior changes in line with SCT.</p><p><strong>Conclusions: </strong>Self-mastery and coping strategies contributed to the walking behavior change in StepAdd, supporting the SCT model of behavior change. Future research is needed to better understand the causal pathways proposed by SCT.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60221"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735874","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}
Angga Prawira Kautsar, Rano Kurnia Sinuraya, Jurjen van der Schans, Maarten Jacobus Postma, Auliya A Suwantika
{"title":"Exploring Public Sentiment on the Repurposing of Ivermectin for COVID-19 Treatment: Cross-Sectional Study Using Twitter Data.","authors":"Angga Prawira Kautsar, Rano Kurnia Sinuraya, Jurjen van der Schans, Maarten Jacobus Postma, Auliya A Suwantika","doi":"10.2196/50536","DOIUrl":"https://doi.org/10.2196/50536","url":null,"abstract":"<p><p>A sentiment analysis of 5051 Twitter posts from January 2022 found that 53.4% of them expressed positive views on ivermectin as a COVID-19 treatment, 35.6% of them were neutral, and 11% of them were negative, highlighting the polarized public perception and the need for careful interpretation of social media data in health communication.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e50536"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730112","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}