JMIR Formative Research最新文献

{"title":"Characteristics, Barriers, and Facilitators of Virtual Decision-Making Capacity Assessments During the COVID-19 Pandemic: Online Survey.","authors":"Lesley Charles, Eileen Tang, Peter George Jaminal Tian, Karenn Chan, Suzette Brémault-Phillips, Bonnie Dobbs, Camelia Vokey, Sharna Polard, Jasneet Parmar","doi":"10.2196/60574","DOIUrl":"https://doi.org/10.2196/60574","url":null,"abstract":"<p><strong>Background: </strong>With a growing older adult population, the number of persons with dementia is expected to rise. Consequently, the number of persons needing decision-making capacity assessments (DMCA) will increase. The COVID-19 pandemic has impacted how we deliver patient care including DMCAs with a much more rapid shift to virtual assessments. Virtual DMCAs offer patients and health care professionals distinct advantages over in-person delivery by improving reach, access, and timely provision of health care. However, questions have arisen as to whether DMCAs can be effectively conducted virtually.</p><p><strong>Objective: </strong>This study aimed to determine the characteristics, barriers, and facilitators of conducting virtual DMCA during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We conducted an online survey among health care providers who perform DMCAs in Alberta from March 2022 to February 2023. The survey consisted of 25 questions on demographics, preferences, and experience in conducting DMCAs virtually, and risks and barriers to doing virtual DMCAs. The data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>There were 31 respondents with a mean age of 51.1 (SD 12.7) years. The respondents consisted of physicians (45.2%, 14/31), occupational therapists (29%, 9/31), and social workers (16.1%, 5/31), with a majority (93.6%, 29/31) based in Edmonton. The mean number of years of experience conducting DMCAs was 12.3 (SD 10.7), with a median of 8 DMCAs (IQR 18.5) conducted per year. Most respondents conduct capacity interviews, with a majority (55.2%, 16/29) being associated primarily with acute care services. Furthermore, 54.8% (17/31) were interested in conducting DMCAs virtually; however, only 25.8% (8/31) had administered DMCAs virtually. Barriers and facilitators to virtual DMCAs relate to patients' characteristics and environment (such as communication difficulties, hearing or visual impairment, language barriers, ease of use of technology, or cognitive impairment), technology and technical support (need for technical support in both the client's and assessor's sides, the unreliability of internet connection in rural settings, and the availability of high-fidelity equipment), and assessors' ability to perform DMCA's virtually (ability to observe body language, interact with the client physically when needed, and build rapport can all be affected when conducting a DMCA virtually). In terms of implications for clinical practice, it is recommended that the patient or caregiver be familiar with technology, have a stable internet connection, use a private room, not be recorded, use a standardized assessment template, and have a backup plan in case of technical difficulties.</p><p><strong>Conclusions: </strong>Conducting DMCAs virtually is a relatively infrequent undertaking. Barriers and facilitators to adequate assessment need to be addressed given that virtual assessments are time-saving","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e60574"},"PeriodicalIF":2.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710351","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":"Short-Form Video Informed Consent Compared With Written Consent for Adolescents and Young Adults: Randomized Experiment.","authors":"Aliyyat Afolabi, Elaine Cheung, Joanne Chen Lyu, Pamela M Ling","doi":"10.2196/57747","DOIUrl":"10.2196/57747","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and young adults have the highest prevalence of e-cigarette use (\"vaping\"), but they are difficult to enroll in health research studies. Previous studies have found that video consent can improve comprehension and make informed consent procedures more accessible, but the videos in previous studies are much longer than videos on contemporary social media platforms that are popular among young people.</p><p><strong>Objective: </strong>This study aimed to examine the effectiveness of a short-form (90-second) video consent compared with a standard written consent for a vaping cessation study for adolescents and young adults.</p><p><strong>Methods: </strong>We conducted a web-based experiment with 435 adolescents and young adults (aged 13-24 years) recruited by a web-based survey research provider. Each participant was randomly assigned to view either a short-form video consent or a written consent form describing a behavioral study of a social media-based vaping cessation program. Participants completed a postexposure survey measuring three outcomes: (1) comprehension of the consent information, (2) satisfaction with the consent process, and (3) willingness to participate in the described study. Independent sample 2-tailed t tests and chi-square tests were conducted to compare the outcomes between the 2 groups.</p><p><strong>Results: </strong>In total, 435 cases comprised the final analytic sample (video: n=215, 49.4%; written: n=220, 50.6%). There was no significant difference in characteristics between the 2 groups (all P>.05). Participants who watched the short-form video completed the consent review and postconsent survey process in less time (average 4.5 minutes) than those in the written consent group (5.1 minutes). A total of 83.2% (179/215) of the participants in the video consent condition reported satisfaction with the overall consent process compared with 76.3% (168/220) in the written consent condition (P=.047). There was no difference in the ability to complete consent unassisted and satisfaction with the amount of time between study conditions. There was no difference in the composite measure of overall comprehension, although in individual measures, participants who watched the short-form video consent performed better in 4 measures of comprehension about risk, privacy, and procedures, while participants who read the written document consent had better comprehension of 2 measures of study procedures. There was no difference between the groups in willingness to participate in the described study.</p><p><strong>Conclusions: </strong>Short-form informed consent videos had similar comprehension and satisfaction with the consent procedure among adolescents and young adults. Short-form informed consent videos may be a feasible and acceptable alternative to the standard written consent process, although video and written consent forms have different strengths with respect to comprehension. Because t","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e57747"},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687131","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":"Embedding Technology-Assisted Parenting Interventions in Real-World Settings to Empower Parents of Children With Adverse Childhood Experiences: Co-Design Study.","authors":"Grace Aldridge, Ling Wu, Joshua Paolo Seguin, Jennifer Robinson, Elizabeth Battaglia, Patrick Olivier, Marie B H Yap","doi":"10.2196/55639","DOIUrl":"10.2196/55639","url":null,"abstract":"<p><strong>Background: </strong>Adverse childhood experiences are strongly associated with mental disorders in young people. Parenting interventions are available through community health settings and can intervene with adverse childhood experiences that are within a parent's capacity to modify. Technology can minimize common barriers associated with engaging in face-to-face parenting interventions. However, families experiencing adversity face unique barriers to engaging with technology-assisted parenting interventions. Formative research using co-design methodology to provide a deep contextual understanding of these barriers can help overcome unique barriers and ensure these families can capitalize on the benefits of technology-assisted parenting interventions.</p><p><strong>Objective: </strong>This study aims to innovate the parenting support delivered by a community health and social service with technology by adapting an existing, evidence-based, technology-assisted parenting intervention.</p><p><strong>Methods: </strong>Staff (n=3) participated in dialogues (n=2) and co-design workshops (n=8) exploring needs and preferences for a technology-assisted parenting intervention and iteratively developing a prototype intervention (Parenting Resilient Kids [PaRK]-Lite). Parents (n=3) received PaRK-Lite and participated in qualitative interviews to provide feedback on their experience and PaRK-Lite's design.</p><p><strong>Results: </strong>PaRK-Lite's hybrid design leverages simple and familiar modes of technology (podcasts) to deliver intervention content and embeds reflective practice into service provision (microcoaching) to enhance parents' empowerment and reduce service dependency. A training session, manuals, session plans, and templates were also developed to support the delivery of microcoaching. Feedback data from parents overall indicated that PaRK-Lite met their needs, suggesting that service providers can play a key role in the early phases of service innovation for parents.</p><p><strong>Conclusions: </strong>The co-designed technology-assisted parenting intervention aims to offer both parents and clinicians a novel and engaging resource for intervening with maladaptive parenting, contributing to efforts to respond to childhood adversity and improve child mental health. Future research in the field of human-computer interaction and health service design can consider our findings in creating engaging interventions that have a positive impact on the well-being of children and families.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e55639"},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687130","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":"Web-Based Platform for Systematic Reviews and Meta-Analyses of Traditional Chinese Medicine: Platform Development Study.","authors":"Weiqiang Zhou, Dongliang Liu, Zhaoxu Yi, Yang Lei, Zhenming Zhang, Yu Deng, Ying Tan","doi":"10.2196/49328","DOIUrl":"10.2196/49328","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There are many problems associated with systematic reviews of traditional Chinese medicine (TCM), such as considering \"integrated traditional Chinese and Western medicine\" or treatment methods as intervention measures without considering the differences in drug use, disregarding dosage and courses of treatment, disregarding interindividual differences in control groups, etc. Classifying a large number of heterogeneous intervention measures into the same measure is easy but results in inaccurate results. In April 2023, Cochrane launched RevMan Web to digitalize systematic reviews and meta-analyses. We believe that this web-based working model helps solve the abovementioned problems.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to (1) develop a web-based platform that is more suitable for systematic review and meta-analysis of TCM and (2) explore the characteristics and future development directions of this work through the testing of digital workflow.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We developed TCMeta (Traditional Chinese Medicine Meta-analysis)-a platform focused on systematic reviews of TCM types. All systematic review-related work can be completed on the web, including creating topics, writing protocols, arranging personnel, obtaining literature, screening literature, inputting and analyzing data, and designing illustrations. The platform was developed using the latest internet technology and can be continuously modified and updated based on user feedback. When screening the literature on the platform, in addition to the traditional manual screening mode, the platform also creatively provides a query mode where users input keywords and click on Search to find literature with the same characteristics; this better reflects the objectivity of the screening with higher efficiency. Productivity can be improved by analyzing data and generating graphs digitally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We used some test data in TCMeta to simulate data processing in a systematic review. In the literature screening stage, researchers could rapidly screen 19 sources of literature from among multiple sources with the manual screening mode. This traditional method could result in bias due to differences in the researchers' cognitive levels. The query mode is much more complex and involves inputting of data regarding drug compatibility, dosage, syndrome type, etc; different query methods can yield very different results, thus increasing the stringency of screening. We integrated data analysis tools on the platform and used third-party software to generate graphs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;TCMeta has shown great potential in improving the quality of systematic reviews of TCM types in simulation tests. Several indicators show that this web-based mode of working is superior to the traditional way. Future research is required to focus on validating and refining the performance of TCMeta, emphasizing the ability to handle c","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e49328"},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686505","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":"Willingness to Be Contacted via a Patient Portal for Health Screening, Research Recruitment, and at-Home Self-Test Kits for Health Monitoring: Pilot Quantitative Survey.","authors":"Elizabeth Lockhart, Jordan Gootee, Leah Copeland, DeAnne Turner","doi":"10.2196/59837","DOIUrl":"https://doi.org/10.2196/59837","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patient portals are being increasingly used by health systems in the United States. Although some patients use portals for clinical use, patient perspectives on using portals for research-related activities, to complete health screenings, and to request at-home self-test kits are unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to understand patient perspectives on using electronic health portals for research; health-related screenings; and patient-initiated, home-based self-testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients (N=105) from the Patient Engaged Research Center at a large, urban, midwestern health system completed a 23-item web-based survey on patient portal (MyChart) use and willingness to use the patient portal for research, risk assessments, and self-test kits. Frequencies and percentages were generated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Almost all participants (102/105, 97.1%) had accessed MyChart at least once, with most (44/102, 43.1%) indicating they logged in at least once per month. Participants indicated logging into MyChart to check laboratory results or other health data (89/105, 84.8%), because they received a message to log in (85/105, 81%), and to message their health care professional (83/105, 79%). Fewer participants logged in to see what medications they had been prescribed (16/105, 15.2%) and to learn more about their health conditions (29/105, 27.6%). Most participants indicated logging into MyChart on a computer via a website (70/105, 66.7%) or on a smartphone via an app (54/105, 51.4%). When asked about how likely they would be to participate in different types of research if contacted via MyChart, most (90/105, 85.7%) said they would be likely to answer a survey, fill out a health assessment (87/105, 82.9%), or watch a video (86/105, 81.9%). Finally, participants would be willing to answer risk assessment questions on MyChart regarding sleep (74/101, 73.3%), stress (65/105, 61.9%), diabetes (60/105, 57.1%), anxiety (59/105, 56.2%), and depression (54/105, 51.4%) and would be interested in receiving an at-home self-test kit for COVID-19 (66/105, 62.9%), cholesterol (63/105, 60%), colon cancer (62/105, 59%), and allergies (56/105, 53.3%). There were no significant demographic differences for any results (all P values were &gt;.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patient portals may be used for research recruitment; sending research-related information; and engaging patients to answer risk assessments, read about health information, and complete other clinical tasks. The lack of significant findings based on race and gender suggests that patient portals may be acceptable tools for recruiting research participants and conducting research. Allowing patients to request self-test kits and complete risk assessments in portals may help patients to take agency over their health care. Future research should examine if patient portal recruitment may help address persistent biases in clinica","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e59837"},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709075","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":"Population Characteristics in Justice Health Research Based on PubMed Abstracts From 1963 to 2023: Text Mining Study.","authors":"Wilson Lukmanjaya, Tony Butler, Patricia Taflan, Paul Simpson, Natasha Ginnivan, Iain Buchan, Goran Nenadic, George Karystianis","doi":"10.2196/60878","DOIUrl":"https://doi.org/10.2196/60878","url":null,"abstract":"<p><strong>Background: </strong>The field of epidemiological criminology (or justice health research) has emerged in the past decade, studying the intersection between the public health and justice systems. To ensure research efforts are focused and equitable, it is important to reflect on the outputs in this area and address knowledge gaps.</p><p><strong>Objective: </strong>This study aimed to examine the characteristics of populations researched in a large sample of published outputs and identify research gaps and biases.</p><p><strong>Methods: </strong>A rule-based, text mining method was applied to 34,481 PubMed abstracts published from 1963 to 2023 to identify 4 population characteristics (sex, age, offender type, and nationality).</p><p><strong>Results: </strong>We evaluated our method in a random sample of 100 PubMed abstracts. Microprecision was 94.3%, with microrecall at 85.9% and micro-F₁-score at 89.9% across the 4 characteristics. Half (n=17,039, 49.4%) of the 34,481 abstracts did not have any characteristic mentions and only 1.3% (n=443) reported sex, age, offender type, and nationality. From the 5170 (14.9%) abstracts that reported age, 3581 (69.3%) mentioned young people (younger than 18 years) and 3037 (58.7%) mentioned adults. Since 1990, studies reporting female-only populations increased, and in 2023, these accounted for almost half (105/216, 48.6%) of the research outputs, as opposed to 33.3% (72/216) for male-only populations. Nordic countries (Sweden, Norway, Finland, and Denmark) had the highest number of abstracts proportional to their incarcerated populations. Offenders with mental illness were the most common group of interest (840/4814, 17.4%), with an increase from 1990 onward.</p><p><strong>Conclusions: </strong>Research reporting on female populations increased, surpassing that involving male individuals, despite female individuals representing 5% of the incarcerated population; this suggests that male prisoners are underresearched. Although calls have been made for the justice health area to focus more on young people, our results showed that among the abstracts reporting age, most mentioned a population aged <18 years, reflecting a rise of youth involvement in the youth justice system. Those convicted of sex offenses and crimes relating to children were not as researched as the existing literature suggests, with a focus instead on populations with mental illness, whose rates rose steadily in the last 30 years. After adjusting for the size of the incarcerated population, Nordic countries have conducted proportionately the most research. Our findings highlight that despite the presence of several research reporting guidelines, justice health abstracts still do not adequately describe the investigated populations. Our study offers new insights in the field of justice health with implications for promoting diversity in the selection of research participants.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e60878"},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692365","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":"Presenting and Evaluating a Smartwatch-Based Intervention for Smoking Relapse (StopWatch): Feasibility and Acceptability Study.","authors":"Chris Stone, Rosie Essery, Joe Matthews, Felix Naughton, Marcus Munafo, Angela Attwood, Andy Skinner","doi":"10.2196/56999","DOIUrl":"10.2196/56999","url":null,"abstract":"<p><strong>Background: </strong>Despite the benefits of smoking cessation, maintaining abstinence during a quit attempt is difficult, and most attempts result in relapse. Innovative, evidence-based methods of preventing relapse are needed. We present a smartwatch-based relapse prevention system that uses passive detection of smoking to trigger just-in-time smoking cessation support.</p><p><strong>Objective: </strong>This study aims to evaluate the feasibility of hosting just-in-time smoking cessation support on a smartwatch and the acceptability of the \"StopWatch\" intervention on this platform.</p><p><strong>Methods: </strong>The person-based approach for intervention development was used to design the StopWatch smoking relapse prevention intervention. Intervention delivery was triggered by an algorithm identifying hand movements characteristic of smoking from the smartwatch's motion sensors, and the system-generated intervention messages (co-designed by smokers) were delivered on the smartwatch screen. A total of 18 smokers tested the intervention over a 2-week period, and at the end of this period, they provided qualitative feedback on the acceptability of both the intervention and the smartwatch platform.</p><p><strong>Results: </strong>Participants reported that the smartwatch intervention increased their awareness of smoking and motivated them to quit. System-generated intervention messages were generally felt to be relevant and timely. There were some challenges with battery life that had implications for intervention adherence, and the bulkiness of the device and the notification style reduced some participants' acceptability of the smartwatch platform.</p><p><strong>Conclusions: </strong>Our findings indicate our smoking relapse prevention intervention and the use of a smartwatch as a platform to host a just-in-time behavior change intervention are both feasible and acceptable to most (12/18, 66%) participants as a relapse prevention intervention, but we identify some concerns around the physical limitations of the smartwatch device. In particular, the bulkiness of the device and the battery capacity present risks to adherence to the intervention and the potential for missed detections. We recommend that a longer-term efficacy trial be carried out as the next step.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e56999"},"PeriodicalIF":2.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681862","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":"Web-Based Intervention Using Self-Compassionate Writing to Induce Positive Mood in Family Caregivers of Older Adults: Quantitative Study.","authors":"Farah Wiita, Aileen K Ho, Netta Weinstein","doi":"10.2196/52883","DOIUrl":"https://doi.org/10.2196/52883","url":null,"abstract":"<p><strong>Background: </strong>Caregiver burden can impact the mental health of family caregivers, but self-compassion may help reduce this impact. Brief self-compassion interventions have been shown to be useful but have not been tested in family caregivers of older adults.</p><p><strong>Objective: </strong>This study aimed to test the effects of a brief self-compassion intervention and its components (self-kindness, common humanity, and mindfulness) on mental well-being and mood when reflecting on difficult family caregiving experiences.</p><p><strong>Methods: </strong>British caregivers were recruited through a web-based panel. Three experimental studies manipulated the self-compassion intervention. In study 1 (n=206) and study 2 (n=224), participants wrote about a difficult caregiving experience while focusing on 1 self-compassion component (self-kindness, common humanity, or mindfulness). In study 3 (n=222) participants focused on all components. Self-compassion, serenity, guilt, and sadness were measured.</p><p><strong>Results: </strong>In studies 1 and 2, condition effects showed mindfulness unexpectedly lowered mood. Inconsistent and modest benefits to affect were achieved by engagement in self-kindness and common humanity in study 1 (guilt [lowered]: P=.02 and sadness [lowered]: P=.04; serenity [nonsignificantly raised]: P=.20) and also in study 2 (sadness [nonsignificantly lowered]: P=.23 and guilt [nonsignificantly lowered]: P=.26; serenity [raised]: P=.33); significant benefits for self-compassion and mood were found in study 3 (serenity [raised]: P=.01, kindness [raised]: P=.003, and common humanity [raised]: P≤.001; guilt [lowered]: P<.001 and sadness [lowered]: P≤.001). More intensive efforts should be made to promote self-compassion in caregivers of older adults, with caution advised when relying primarily on mindfulness approaches.</p><p><strong>Conclusions: </strong>Self-compassionate writing may be beneficial for family caregivers, but more intensive interventions are needed. Further research is needed to determine the optimal dosage and content for achieving the greatest effects.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e52883"},"PeriodicalIF":2.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686500","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":"Engagement and Acceptability of Acceptance and Commitment Therapy in Daily Life in Early Psychosis: Secondary Findings From a Multicenter Randomized Controlled Trial.","authors":"Evelyne van Aubel, Thomas Vaessen, Lotte Uyttebroek, Henrietta Steinhart, Annelie Beijer-Klippel, Tim Batink, Ruud van Winkel, Lieuwe de Haan, Mark van der Gaag, Thérèse van Amelsvoort, Machteld Marcelis, Frederike Schirmbeck, Ulrich Reininghaus, Inez Myin-Germeys","doi":"10.2196/57109","DOIUrl":"10.2196/57109","url":null,"abstract":"<p><strong>Background: </strong>Acceptance and commitment therapy (ACT) is promising in the treatment of early psychosis. Augmenting face-to-face ACT with mobile health ecological momentary interventions may increase its treatment effects and empower clients to take treatment into their own hands.</p><p><strong>Objective: </strong>This study aimed to investigate and predict treatment engagement with and acceptability of acceptance and commitment therapy in daily life (ACT-DL), a novel ecological momentary intervention for people with an ultrahigh risk state and a first episode of psychosis.</p><p><strong>Methods: </strong>In the multicenter randomized controlled trial, 148 individuals with ultrahigh risk or first-episode psychosis aged 15-65 years were randomized to treatment as usual only (control) or to ACT-DL combined with treatment as usual (experimental), consisting of 8 face-to-face sessions augmented with an ACT-based smartphone app, delivering ACT skills and techniques in daily life. For individuals in the intervention arm, we collected data on treatment engagement with and acceptability of ACT-DL during and after the intervention. Predictors of treatment engagement and acceptability included baseline demographic, clinical, and functional outcomes.</p><p><strong>Results: </strong>Participants who received ACT-DL in addition to treatment as usual (n=71) completed a mean of 6 (SD 3) sessions, with 59% (n=42) of participants completing all sessions. App engagement data (n=58) shows that, on a weekly basis, participants used the app 13 times and were compliant with 6 of 24 (25%) notifications. Distribution plots of debriefing scores (n=46) show that 85%-96% of participants reported usefulness on all acceptability items to at least some extent (scores ≥2; 1=no usefulness) and that 91% (n=42) of participants reported perceived burden by number and length of notifications (scores ≥2; 1=no burden). Multiple linear regression models were fitted to predict treatment engagement and acceptability. Ethnic minority backgrounds predicted lower notification response compliance (B=-4.37; P=.01), yet higher app usefulness (B=1.25; P=.049). Negative (B=-0.26; P=.01) and affective (B=0.14; P=.04) symptom severity predicted lower and higher ACT training usefulness, respectively. Being female (B=-1.03; P=.005) predicted lower usefulness of the ACT metaphor images on the app.</p><p><strong>Conclusions: </strong>Our results corroborate good treatment engagement with and acceptability of ACT-DL in early psychosis. We provide recommendations for future intervention optimization.</p><p><strong>Trial registration: </strong>OMON NL46439.068.13; https://onderzoekmetmensen.nl/en/trial/24803.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e57109"},"PeriodicalIF":2.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681850","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":"Assessing Digital Phenotyping for App Recommendations and Sustained Engagement: Cohort Study.","authors":"Bridget Dwyer, Matthew Flathers, James Burns, Jane Mikkelson, Elana Perlmutter, Kelly Chen, Nanik Ram, John Torous","doi":"10.2196/62725","DOIUrl":"10.2196/62725","url":null,"abstract":"<p><strong>Background: </strong>Low engagement with mental health apps continues to limit their impact. New approaches to help match patients to the right app may increase engagement by ensuring the app they are using is best suited to their mental health needs.</p><p><strong>Objective: </strong>This study aims to pilot how digital phenotyping, using data from smartphone sensors to infer symptom, behavioral, and functional outcomes, could be used to match people to mental health apps and potentially increase engagement.</p><p><strong>Methods: </strong>After 1 week of collecting digital phenotyping data with the mindLAMP app (Beth Israel Deaconess Medical Center), participants were randomly assigned to the digital phenotyping arm, receiving feedback and recommendations based on those data to select 1 of 4 predetermined mental health apps (related to mood, anxiety, sleep, and fitness), or the control arm, selecting the same apps but without any feedback or recommendations. All participants used their selected app for 4 weeks with numerous metrics of engagement recorded, including objective screentime measures, self-reported engagement measures, and Digital Working Alliance Inventory scores.</p><p><strong>Results: </strong>A total of 82 participants enrolled in the study; 17 (21%) dropped out of the digital phenotyping arm and 18 (22%) dropped out from the control arm. Across both groups, few participants chose or were recommended the insomnia or fitness app. The majority (39/47, 83%) used a depression or anxiety app. Engagement as measured by objective screen time and Digital Working Alliance Inventory scores were higher in the digital phenotyping arm. There was no correlation between self-reported and objective metrics of app use. Qualitative results highlighted the importance of habit formation in sustained app use.</p><p><strong>Conclusions: </strong>The results suggest that digital phenotyping app recommendation is feasible and may increase engagement. This approach is generalizable to other apps beyond the 4 apps selected for use in this pilot, and practical for real-world use given that the study was conducted without any compensation or external incentives that may have biased results. Advances in digital phenotyping will likely make this method of app recommendation more personalized and thus of even greater interest.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"8 ","pages":"e62725"},"PeriodicalIF":2.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667599","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}