JMIR Formative Research最新文献

{"title":"The Influence of the COVID-19 Pandemic on Current Teaching Methods, Training, and Perception Among Romanian Surgery-Oriented Students: Cross-Sectional Study.","authors":"Ionut Dudau, Dumitru Sutoi, Bogdan Chiu, Raluca Radbea, George Marin, Anda Nicoleta Ciontos, Vlad Mulcutan-Chis, Daian Ionel Popa, Maria Sutoi, Andrei Catalin Zavragiu, Ovidiu Alexandru Mederle, Bogdan Nicolae Deleanu","doi":"10.2196/92294","DOIUrl":"10.2196/92294","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic prompted rapid changes in medical education, accelerating the adoption of online and distance learning methods as alternatives to traditional teaching. While these approaches offered logistical advantages, students worldwide reported significant limitations, particularly in terms of motivation, clinical exposure, and hands-on skill acquisition. Despite the increased use of digital teaching during the pandemic, core educational objectives and the mission of medical training remained unchanged, emphasizing the continued importance of practical experience.</p><p><strong>Objective: </strong>This study aims to investigate the impact of the COVID-19 pandemic on current teaching methods in medical education and to explore students' perceptions of online learning, telemedicine, artificial intelligence, and other modern educational alternatives.</p><p><strong>Methods: </strong>This observational, cross-sectional multicentric study surveyed a cohort of Romanian medical students using a self-developed 48-item online questionnaire distributed via social media. Data were collected over 6 weeks (February-March), yielding 451 responses, of which eligible participants included students in clinical years or preclinical students interested in surgical or orthopedic careers, with a heavy representation of the Medicine and Pharmacy University of Timisoara. Statistical analysis was performed using Microsoft Excel and JASP (University of Amsterdam; version 0.95.4).</p><p><strong>Results: </strong>A total of 436 responses were analyzed, with students favoring online or hybrid formats for lectures but preferring on-site teaching for practical training. Reduced patient interaction and limited skill acquisition were the main drawbacks of online practical education. Acceptance of hybrid learning correlated with more positive perceptions of teaching methods and a lower perceived desire to cheat.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic brought significant changes to the way medicine is being taught in Romania, but it also brought a clearer picture for students and medical staff on how they want medical education to be done. Online cheating remains a significant challenge, but it is being tackled at the moment with different algorithms being tested.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":"e92294"},"PeriodicalIF":2.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491165","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":"Acute Physiological and Emotional Responses to a Brief 24-Minute Yoga Session: Randomized Exploratory Pilot Study With Waitlist Comparison.","authors":"Ying Zhou, Ping Chen, Yuma Morisaki, Naoko Yamada, Risa Kuwahara, Atsuro Tsutsumi, Akihiro Nomura","doi":"10.2196/87077","DOIUrl":"10.2196/87077","url":null,"abstract":"<p><strong>Background: </strong>Wellness tourism increasingly incorporates short yoga sessions for stress management, yet evidence on their immediate physiological and emotional responses remains limited.</p><p><strong>Objective: </strong>This exploratory pilot study aimed to generate preliminary data on acute physiological and emotional responses to a single 24-minute yoga session (breathing, postures, and meditation) compared with quiet sitting in novice practitioners.</p><p><strong>Methods: </strong>In this single-center, randomized waitlist-controlled exploratory pilot study (1:1 allocation), 19 university-affiliated adults with self-reported daily stress and no prior guided yoga experience were allocated to an immediate 24-minute yoga session (n=10) or quiet sitting (n=9). The primary outcome was change in salivary cortisol from baseline to postintervention. Secondary outcomes included salivary alpha-amylase, heart rate (Apple Watch [Apple Inc], subset n=12), and real-time emotional indices (stress, calmness, and concentration) measured by a commercial single-channel electroencephalogram (EEG) device (Kansei Analyzer [Dentsu ScienceJAM], subset n=8). Data were analyzed using change scores relative to the breathing phase, with between-group comparison performed by independent t tests or multivariable linear regression adjusted for age, sex, and baseline values as appropriate.</p><p><strong>Results: </strong>No significant between-group differences were observed for salivary cortisol or alpha-amylase. In the yoga group, heart rate increased during postures and remained mildly elevated during meditation relative to the breathing phase, consistent with mild physical exertion. Exploratory individual EEG analyses suggested reduced stress and increased concentration during breathing and meditation phases in some participants.</p><p><strong>Conclusions: </strong>In this small exploratory pilot study, a single 24-minute yoga session did not significantly alter salivary stress biomarkers at the group level. However, it induced measurable cardiovascular activation and heterogeneous EEG-derived emotional responses. These hypothesis-generating findings demonstrate marked interindividual variability, suggesting the need for larger validation studies with improved control conditions.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e87077"},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673495","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":"Comparing Large Language Models and Traditional Machine Translation Tools for Translating Medical Consultation Summaries: Quantitative Pilot Feasibility Study.","authors":"Andy Li, Wei Zhou, Rashina Hoda, Chris Bain, Peter Poon","doi":"10.2196/85169","DOIUrl":"10.2196/85169","url":null,"abstract":"<p><strong>Background: </strong>Translation of medical consultation summaries is essential for equitable health care communication in culturally and linguistically diverse populations. While machine translation (MT) tools and large language models (LLMs) are widely accessible, their feasibility and safety for health care contexts remain underexplored.</p><p><strong>Objective: </strong>This pilot study investigates the feasibility and limitations of using LLMs and traditional MT tools to translate medical consultation summaries from English into the most common languages other than English spoken in Australia-Arabic, Chinese (simplified written form), and Vietnamese.</p><p><strong>Methods: </strong>Two simulated summaries-a simple patient-facing summary and a complex clinician-oriented interprofessional letter-were translated using 3 LLMs (GPT-4o, Llama-3.1, and Gemma-2) and 3 MT tools (Google Translate, Microsoft Bing Translator, and DeepL). Translations were benchmarked against professional third-party interpreter translations using Bilingual Evaluation Understudy, Character-level F-score, and Metric for Evaluation of Translation with Explicit Ordering metrics.</p><p><strong>Results: </strong>The translation performance varied across languages, tools, and summary complexity when assessed using automatic evaluation metrics. Traditional MT tools outperformed LLMs on surface-level metrics, while LLMs showed relative strengths in semantic similarity for Vietnamese and Chinese. Arabic translations improved with complex input, suggesting morphological advantages. The metric-based evaluation highlighted feasibility but also risks, particularly in Chinese clinical contexts.</p><p><strong>Conclusions: </strong>This pilot study provides formative evidence of opportunities and limitations in applying artificial intelligence translation for health care communication. Findings underscore the importance of human oversight; domain-specific evaluation metrics; and further formative and clinical research to guide the safe, equitable use of artificial intelligence translation tools.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e85169"},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673637","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":"Designing Psychologically Grounded Artificial Intelligence for Supporting Bystander-Based Cyberaggression Intervention: Mixed Methods Exploratory Study.","authors":"Jinkyung Katie Park, Pinxuan Alina Yu, Vignesh Krishnan, Huaye Li, Linda A Reddy, Vivek K Singh","doi":"10.2196/84391","DOIUrl":"10.2196/84391","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cyberaggression poses a growing threat to mental health, contributing to increased distress, reduced self-esteem, and other adverse psychosocial outcomes. Although bystander intervention can mitigate the escalation and impact of cyberaggression, individuals often lack the confidence, strategies, or language to respond effectively in these high-stakes online interactions. Advances in generative artificial intelligence (AI) present a novel opportunity to facilitate digital behavior change by assisting bystanders with contextually appropriate, theory-informed intervention messages that promote safer online environments and support mental well-being.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This mixed methods design study aimed to explore the feasibility of using generative AI to support bystander intervention in cyberaggression on social media. Specifically, we examined whether AI can generate effective responses aligned with established intervention strategies and how these responses are perceived in terms of their potential to de-escalate online harm and foster behavior change.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We collected 1000 real-world cyberaggression examples from public social media datasets and generated bystander intervention responses using 3 distinct prompt strategies: a generic policy reminder, a baseline GPT prompt, and a theory-driven GPT prompt (AllyGPT). To evaluate the responses, we conducted computational linguistic analyses to assess their psycholinguistic features and carried out a mixed methods evaluation. Three trained coders rated each message on favorability, conversational impact, and potential to change behavior and later participated in semistructured interviews to reflect on their evaluation process and perceptions of intervention effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Linguistic analyses revealed that baseline GPT responses exhibited more emotionally positive and authentic language compared to AllyGPT responses, which showed a more analytical and assertive tone. Policy reminder messages were linguistically rigid and lacked emotional nuance. Human evaluation results showed that AllyGPT responses received the highest effectiveness ratings for low-incivil cyberaggression cases in 2 dimensions (favorability and changing behavior), and baseline GPT works better for mid and high levels for all effectiveness dimensions. For medium- and high-incivility aggressions, baseline GPT responses received the highest ratings across all 3 dimensions of effectiveness (favorability, discussion-shifting potential, and likelihood of changing bullying behavior), followed by AllyGPT, with policy reminders rated lowest. Qualitative feedback further emphasized that baseline GPT responses were perceived as natural and inclusive, while AllyGPT responses, although grounded in psychological theory, were sometimes viewed as overly direct. Policy reminders were considered clear but lacked persuasive impact.&lt;/p&gt;&lt;p&gt;&lt;strong","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e84391"},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673595","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":"Co-Design of a Depression Self-Management Tool for Adolescent and Young Adult Cancer Survivors: Rapid Qualitative Analysis of Interview Feedback on a Prototype.","authors":"Karly M Ingram, Grace Westcott, Antonija Augustinovic, Rachel Glock, AnneMarie Coffey, David Victorson, DerShung Yang, Madhu Reddy, Sarah A Birken, John M Salsman","doi":"10.2196/77994","DOIUrl":"10.2196/77994","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Over 2.1 million adolescent and young adult cancer survivors (AYACS) live in the United States. Recent estimates suggest that up to one-third of AYACS experience major depressive disorder. Although several efficacious evidence-based interventions are available to manage symptoms of depression, these interventions are often inaccessible to AYACS who have many competing commitments. Digital mental health tools hold promise for this population; however, only a few have been tailored to meet the unique needs of AYACS, and findings to date have yielded mixed results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to obtain feedback from AYACS on a mid-fidelity prototype of a depression self-management tool being tailored for AYACS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Individuals with a history of cancer diagnosed at age 12 or older who were between the ages of 15 and 39 and had completed primary treatment were identified through a review of medical records from a comprehensive cancer center in the Southeastern United States. Potentially eligible participants were contacted by study staff to conduct additional screening and obtain informed consent via REDCap (Research Electronic Data Capture; Vanderbilt University). Upon enrollment, participants provided demographic and clinical information, as well as their availability for an interview. The principal investigator (KMI) conducted semistructured individual interviews with consented AYACS. Most of the interview was dedicated to showing participants the mid-fidelity prototype of the tool, explaining how the prototype might work, and requesting targeted feedback. Demographic and clinical characteristics, as well as some aspects of feedback on the prototype, were summarized using descriptive statistics. Interviews were audio- and video-recorded and transcribed. The transcriptions underwent rapid qualitative analysis guided by the Rigorous and Accelerated Data Reduction technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 14 AYACS (n=9, 64%, female; n=9, 64%, white; ages 15-38) completed an individual interview. Participant preferences for mood tracking, content presentation, user input, and duration of use were captured qualitatively but analyzed quantitatively. For example, most participants (n=10, 71%) indicated that they preferred a mood-tracking option that included emojis and would be willing to track their mood at least once per day (n=11, 79%). Participant preferences captured qualitatively fell into 4 themes: (1) features to promote user engagement (eg, the use of gamification); (2) tailored content presentation (eg, authenticity in the portrayal of the cancer experience); (3) perceived usability (eg, simplifying user input); and (4) interface design (eg, implementing a coherent design theme and color scheme).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Findings indicated that AYACS highly value personalization, flexibility, and peer support in digital interventions. Based o","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e77994"},"PeriodicalIF":2.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673528","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":"Outdoor Secondhand Smoke Exposure in a Public Smoking Area: Formative Field Study Using Passive Wi-Fi Packet Sensing.","authors":"Ryo Horiike, Kazuya Taira, Izumi Kondo, Motoyo Nawate, Harumi Bando","doi":"10.2196/90261","DOIUrl":"10.2196/90261","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Outdoor secondhand smoke (SHS) remains a public health concern, particularly around designated outdoor smoking areas where nonsmokers may pass through or remain nearby. Although prior studies have quantified outdoor SHS concentrations, fewer have examined how many people may be present within a plausible exposure setting. Estimating exposure opportunity level requires methods that are feasible, scalable, and minimally intrusive.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the feasibility of using passive Wi-Fi packet sensing, calibrated with brief onsite observation, to estimate the number of smokers and passersby within a plausible SHS exposure range at a public outdoor smoking area in Japan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a formative field study at a designated outdoor smoking area of the Asia Pacific Trade Center in Osaka, Japan. A passive Wi-Fi packet sensor collected timestamps, anonymized device identifiers, organizationally unique identifiers, and received signal strength indicator values from October 13 to 29, 2023. The main analysis focused on October 28, 2023, a high football event day selected for direct calibration. Episodes were classified using empirically derived received signal strength indicator thresholds and class specific calibration ratios were applied to estimate day level counts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 128,313 anonymized detections recorded on October 28, 115,950 occurred during business hours. Among these, 11,068 identifiers were detected more than once, dwell time could be calculated for 1,817 identifiers, and 659 eligible presence episodes remained after preprocessing. During a 30 minutes validation window, smokers and passersby were counted manually within a 25 m radius. During the validation window, 6,230 signal records formed 104 stays, with a mean stay duration of 9.89 minutes (SD 7.89). During the validation window, direct observation recorded 14 smokers and 207 passersby within the 25 m radius. Applying the rule based classification and calibration ratios to business hours data yielded estimated day totals of 262 smokers and 3,907 passersby within the plausible SHS exposure range. Estimated smoker counts showed 2 peaks, around 12:00 and 16:00, whereas passerby volume peaked around midday. In an exploratory analysis, a random forest model using stay duration, mean received signal strength indicator, and received signal strength indicator variability achieved an accuracy of 0.95, sensitivity of 0.75, specificity of 0.97, and area under the receiver operating characteristic curve of 0.99.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This formative field study suggests that passive Wi-Fi packet sensing, combined with brief on site observation, can be used to estimate population level exposure opportunity around an outdoor smoking area. The　method identified substantial numbers of potentially exposed passersby in a high footfall public setting. Although","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690205","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":"Evaluating an Incentive-Based mHealth App for Physical Activity Promotion Using the Obesity-Related Behavioral Intervention Trial Model: Small Cohort Study.","authors":"Babac Salmani, Madison S Hiemstra, Harry Prapavessis, Leigh M Vanderloo, Marc S Mitchell","doi":"10.2196/85484","DOIUrl":"10.2196/85484","url":null,"abstract":"<p><strong>Background: </strong>Physical inactivity remains a public health concern, with 42% (around 1 in 2) of women and 34% (around 1 in 3) of men in the United Kingdom, for example, failing to meet moderate-to-vigorous physical activity guidelines. To promote physical activity (PA) at scale, smartphone-based mHealth (mobile health) software apps offer a promising solution.</p><p><strong>Objective: </strong>This study aims to evaluate the feasibility of implementing an mHealth app offering very small (\"micro\") financial incentives for PA in Leeds, United Kingdom.</p><p><strong>Methods: </strong>A 5-week single-arm proof-of-concept study was conducted with rolling recruitment among Caterpillar Health app users between September 12 and December 12, 2022 (Obesity-Related Behavioral Intervention Trial model, phase IIa). Users earned microincentives in the form of \"points,\" redeemable for consumer rewards (eg, movie tickets and gym passes), for meeting personalized daily step goals (US $0.13 per goal achieved; set using data from a 5-day baseline) and completing educational quizzes (US $0.33 per quiz). Descriptive statistics assessed feasibility outcomes (ie, reach, recruitment, retention, engagement, and acceptability) and preliminary effectiveness. Paired-samples t tests (P<.05) examined changes in weekly mean daily step count (from baseline) and step goal achievement over 5 weeks.</p><p><strong>Results: </strong>Of 285 app downloads, 46 users consented to participate (recruitment rate: 16.1%). Participants (mean age: 39.9, SD 11.1 y; 71.1%, 33/46 woman) had a baseline step count of 5598 (SD 2664) steps/day. A total of 25 participants remained engaged (ie, completed at least 1 quiz) at study week 5 (retention rate: 54.3%). Acceptability was high, with 75% of respondents (12/16) indicating they would recommend the app. Weekly mean daily step count did not significantly increase from baseline (mean difference 317, SD 2273, P=.53). Weekly daily step goal achievement rate (%) decreased from study week 1 to 5 (-23.23, SD 22.85, P=.02).</p><p><strong>Conclusions: </strong>Despite lower-than-expected recruitment and no statistically significant PA increase, relatively high engagement and acceptability suggest future pilot testing (Obesity-Related Behavioral Intervention Trial model, phase IIb) of a refined intervention (eg, wider selection of loyalty reward partners) and modified study protocol (eg, simplified consent process) is warranted.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e85484"},"PeriodicalIF":2.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Text Messaging-Based Program to Transition From Basal Insulin to Glucagon-Like Peptide-1 Receptor Agonists in Safety-Net Diabetes Care: Pilot Quality Improvement Intervention Study.","authors":"Natalie Levy, Katie Nerlino, Sherlane Bongalos, Alex Dasilva, Chinye Uzor, Ying Jie Liang, Olubunmi Sonubi","doi":"10.2196/76993","DOIUrl":"10.2196/76993","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and basal insulin both lower blood sugar, but while insulin puts people at risk of hypoglycemia and weight gain, GLP-1 RAs do not. In addition, GLP-1 RAs have added cardiometabolic and renal benefits. For these reasons, when possible, many primary care providers prefer their patients with well-controlled type 2 diabetes to be transitioned from basal insulin to a GLP-1 RA. This transition process can be labor intensive, requiring multiple dosing adjustments and a watchful eye for hypoglycemia and hyperglycemia. The Mobile Insulin Titration Intervention (MITI)-GLP1 program uses SMS text messaging-based technology to support a streamlined and supervised transition process from basal insulin to a GLP-1 RA. This program takes place at a multilingual safety-net clinic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Our objectives were to assess program feasibility and acceptability to determine whether the intervention was doable, practical, and worthy of further investigation via a larger controlled trial. Preliminary clinical outcomes are also discussed in this paper.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients were enrolled on a secure web platform that sent them a daily SMS text message asking the following: \"What was your fasting blood sugar this morning?\" Each weekday, texted responses containing patients' fasting blood sugar levels were checked for alarm values, and once weekly, patients were called and advised on whether and how to lower their basal insulin and increase their GLP-1 RA dose. The program was co-run by general internal medicine physicians and nurses and continued until the patient had their insulin stopped completely and/or their GLP-1 RA dose reached the maximum, or 16 weeks elapsed. All enrolled patients were included in the analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 72 patients completed the pilot program. Feasibility and acceptability were high. Of 3671 SMS text messages sent by the program, 3520 (95.89%) received a response from patients. Of 719 cumulative weeks in which Thursday titration phone calls were attempted, successful connections with patients were made in 649 (90.26%) instances. Preliminary clinical outcomes were promising. Insulin doses were meaningfully reduced (55/72, 76.39% had their basal insulin reduced by at least 50%; 45/72, 62.5% had their insulin stopped completely). GLP-1 RA doses were meaningfully increased (64/72, 88.89% had their GLP-1 RA dose increased by ≥1 level; 45/72, 62.5% were discharged on the maximum dose of their GLP-1 RA). There was minimal hypoglycemia (5/3520, 0.14% of the SMS text messages reported a value of &lt;80 mg/dL) and hyperglycemia (1/3520, 0.03% of the SMS text messages reported a value of &gt;400 mg/dL).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A general internal medicine-run MITI-GLP1 pilot program using SMS text messaging and interdisciplinary teamwork between internists and nurses is a feasible and accepta","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e76993"},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645298","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":"Rangatahi Youth-Led Dissemination Campaign for Cocreated Eating and Well-Being Guidelines: Process and Pilot Implementation Evaluation.","authors":"Layla Christison, Renee Railton, Rachael Glassey, Raun Makirere-Haerewa, David Tipene-Leach, Boyd Swinburn","doi":"10.2196/71833","DOIUrl":"10.2196/71833","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Youth should be partners in the development and dissemination of health information created for their demographic. The Manaora Rangatahi (youth) Guidelines comprise 10 eating and 10 wellbeing messages that were cocreated with rangatahi Māori (Māori youth) in Hawke's Bay, New Zealand, and then disseminated through a digital media campaign.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to present the process evaluation of the co-design and implementation of the pilot digital media dissemination campaign of the Manaora Rangatahi Guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The 17 rangatahi who were involved in the cocreation of the guidelines codeveloped a dissemination plan, filmed video clips for each of the 20 messages, and supported the 20-week digital media campaign. The codevelopment process over 4 wānanga (workshops) is described and critiqued, and the implementation was assessed using the data analytics from Instagram and TikTok, the main social media platforms for dissemination. The rangatahi participated in a short postcampaign review survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The dissemination plan included a website for the messages, a campaign name and logo, apparel with messaging and QR codes, and the design of a digital media campaign featuring the participating rangatahi. Video clips of each of the guideline messages featuring the rangatahi were professionally developed with support from 3 Māori influencers and a video production company. The 10 phases of the campaign involved the release of 2 messages (one eating and one wellbeing) every fortnight over 20 weeks. Instagram and TikTok analytics showed that the campaign achieved &gt;1.48 million impressions and &gt;19,000 engagement actions (eg, likes, comments, and sharing). The mean engagement rate (Instagram 6.2%, TikTok 1.2%) was greater than or similar to the platforms' medians across all industries (0.36% and 1.73%, respectively). Various paid promotion strategies boosted the number of impressions, and paying one of the influencers to promote the messages in phase 8 created a more than 10-fold increase in impressions on Instagram. The estimated cost of the overall campaign was NZ $125,000 (US $72,500). The majority (about 60%) of rangatahi felt the campaign was successful and engaging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Rangatahi have expert knowledge in how to disseminate messages to their peers. They successfully co-designed and pilot-tested the implementation of a low-cost digital media campaign using peer-to-peer messaging and videos, which achieved substantial reach. The dissemination reach was good, but was significantly influenced by paid promotions. The cost per thousand impressions was equivalent to or better than much larger government-funded health promotion social media campaigns targeting youth. The development and dissemination of eating and well-being messages aimed at youth should ideally involve partnering with the target audience to e","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e71833"},"PeriodicalIF":2.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645288","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":"Provider-Engaged Development of a Sexual Dysfunction Screening Approach for Adolescents and Young Adult Childhood Cancer Survivors: Iterative Co-Design Study.","authors":"Jenna Demedis, Julia Reedy, Eric J Chow, Pamela N Peterson, Brooke Dorsey, Christina R Studts","doi":"10.2196/85905","DOIUrl":"10.2196/85905","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sexual dysfunction (SD) is common among childhood cancer survivors, affecting approximately 20% to 50% of patients. National guidelines recommend discussions about sexuality throughout cancer care, and prior work demonstrates patient interest in SD conversations. Despite its prevalence and importance, SD is widely underrecognized and undertreated, creating gaps in comprehensive whole-person care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Our research aims to collaborate with provider partners to co-design an SD screening intervention prototype for implementation in a clinical oncology setting. This study outlines the co-design process to serve as a case study, highlighting challenges and strategies to achieve a consensus-driven intervention and implementation plan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We engaged pediatric cancer providers in a series of co-design sessions at a National Cancer Institute-designated cancer center within an academic children's hospital. For each co-design session, the research team created a template outlining considerations from formative work (eg, patient privacy) and key decisions to be made (eg, screening modality). Co-design session moderators facilitated discussion, guiding participants toward a consensus decision for each intervention component. A final process mapping session reviewed and outlined the entire SD prototype. We conducted a rapid qualitative analysis, compiling a templated summary synthesizing and organizing findings by discussion topic and decision point. Based on co-design discussions, the research team compiled a menu of options outlining key thematic findings, core screening intervention functions, and intervention form options to allow for future expansion and tailoring of the SD prototype.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Six provider participants, including attending physicians, advanced practice providers, and registered nurses representing multiple oncology subspecialty groups, engaged in a series of 5 co-design sessions. Participants assessed specific intervention component options, reached consensus on component decisions, and determined an intervention and implementation workflow for each. Throughout, providers needed to ensure workflows aligned with patient and provider priorities from foundational work and to ensure design feasibility, acceptability, and appropriateness. Key intervention and implementation decisions included target population, screening frequency, screening modality and workflow, management of screening results, clinic reminders and cues, and provider education and training. With several decisions being interconnected, there was often a cascade effect in which one decision influenced or limited future decisions and, in some cases, required revisiting prior decisions to ensure cohesive alignment into a single prototype. Co-design session moderators used several strategies (eg, reminders, redirection, providing information on feasibility, etc) to fac","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e85905"},"PeriodicalIF":2.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13060744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638924","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}