JMIR Formative Research最新文献

{"title":"Acceptability of a Web-Based Financial Education Intervention for Latino Caregivers: Mixed Methods Evaluation.","authors":"Susanna Mage, Donna Benton, Kathleen Wilber, Rocio Aguila Rodriguez, David Silva, Alexander Gonzalez, Frank Puga, Kylie Meyer","doi":"10.2196/70471","DOIUrl":"10.2196/70471","url":null,"abstract":"<p><strong>Background: </strong>Latino caregivers of persons living with dementia face distinct financial challenges, spending nearly half of their annual household income on caregiving expenses, almost twice as much as non-Latino caregivers. Cultural norms, limited access to financial resources, and underrepresentation in intervention research compound this economic burden. There remains a critical gap in evidence-based, culturally tailored programs designed to reduce financial stress among Latino caregivers.</p><p><strong>Objective: </strong>This study examines the acceptability and perceived value of the Confidently Navigating Financial Decisions and Enhancing Financial Well-Being in Dementia Caregiving (CONFIDENCE) program, a culturally tailored, web-based psychoeducational intervention designed to reduce financial stress and improve financial well-being among Latino caregivers of persons living with dementia.</p><p><strong>Methods: </strong>We applied a multimethod approach to evaluate the acceptability of the CONFIDENCE pilot. Following completion, 14 caregivers participated in in-depth, semistructured interviews, and 27 (39% of program participants) completed a 14-item satisfaction survey. The study was guided by a theoretical framework of acceptability composed of 7 domains: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. Interview transcripts were analyzed independently by 4 coders (SM, RAR, DS, and KM) using thematic analysis, and survey responses were summarized using descriptive statistics.</p><p><strong>Results: </strong>Participants overall reported satisfaction with the CONFIDENCE program. Qualitative analysis of interview transcripts revealed four themes: (1) the perceived need for financial intervention; (2) perceived intervention effectiveness, particularly in improving financial knowledge, communication skills, and mental health; (3) positive emotional responses to participation, with high praise for the program's group setting and cultural relevance; and (4) recommendations for intervention improvement, including shorter sessions and technology support. Survey results confirmed high acceptability, with 96% (n=26) of respondents reporting they enjoyed the program. All participants (n=27, 100%) said they would recommend CONFIDENCE to other Latino caregivers. Participants reported improved awareness of available resources, increased confidence in financial decision-making, and reduced financial stress. Caregivers appreciated the group setting, which allowed for mutual interaction and learning; discussions fostered emotional connection and peer learning. Participants praised the content's trustworthiness and relevance. Although most agreed that participation required minimal effort, barriers such as time constraints and technology challenges were noted.</p><p><strong>Conclusions: </strong>Findings suggest that CONFIDENCE is acceptable among Latino careg","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e70471"},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642614","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":"Bringing Executive Function Testing Online: Assessment Validation Study.","authors":"Mouna Attarha, Ana Carolina de Figueiredo Pelegrino, Lydia Ouellet, Sarah-Jane Grant, Etienne de Villers-Sidani, Thomas Van Vleet","doi":"10.2196/75687","DOIUrl":"https://doi.org/10.2196/75687","url":null,"abstract":"<p><strong>Background: </strong>Executive function encompasses a set of higher-order cognitive processes, including planning, cognitive flexibility, and inhibitory control, that are essential for goal-directed behavior. These abilities are adversely affected by age, with executive dysfunction ultimately impairing the performance of activities of daily living.</p><p><strong>Objective: </strong>This study aimed to assess the validity of a computerized cognitive assessment in predicting executive function performance in healthy older adults.</p><p><strong>Methods: </strong>This retrospective analysis utilized baseline data from the Improving Neurological Health in Aging via Neuroplasticity-Based Computerized Exercise (INHANCE) trial. The study provides normative data for cognitively healthy older adults (aged 65 years and above) and evaluates the usability and validity of Freeze Frame, a cognitive assessment available on the BrainHQ platform. Performance on Freeze Frame was analyzed in relation to self-reported demographic variables and neuropsychological function, using a standardized measure of executive function, the National Institutes of Health Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (NIH EXAMINER).</p><p><strong>Results: </strong>The intent-to-treat analysis included 92 cognitively healthy older adults (mean age 71.9, SD 4.86, range: 65-83 years), of whom 66% (61/92) were female, with a mean education level of 16.45 (SD 3.40, range: 9-27) years. Performance on Freeze Frame was modestly associated with executive function scores on NIH EXAMINER (P=.02), accounting for 6.8% of the variance. The assessment showed a small but statistically significant relationship to age (ρ=-0.22, P=.046) and gender, with no significant influence of education. Psychometric evaluation supported its usability, with an average completion time of 4 (SD 0.16) minutes.</p><p><strong>Conclusions: </strong>Freeze Frame is a brief, scalable, and accessible computerized cognitive assessment with demonstrated concurrent validity for executive function. Its efficiency and ease of administration across internet-connected devices suggests potential applications for cognitive screening. Future research should explore its utility in detecting executive dysfunction in clinical populations and its potential role in predicting functional performance across activities of daily living.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e75687"},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626392","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":"Continuous Rural High School Educational Outreach and Lasting Impact on Health Care Career Attitudes: Qualitative Pilot Study.","authors":"Rebecca Bolen, Meagan Flesch, Jerrica Dennis, Logan Shouse, Mark Payton, David Ross","doi":"10.2196/70505","DOIUrl":"https://doi.org/10.2196/70505","url":null,"abstract":"<p><strong>Background: </strong>Rural communities face persistent challenges in recruiting and retaining health care professionals. Research has shown that individuals from rural backgrounds are more likely to return to practice in these areas, yet most existing pipeline programs focus on undergraduate and medical students rather than high school students. Early exposure to health care careers is essential, as many students have already selected their career paths by the time they enter college. A previous study conducted in 2020 analyzed the effects of a single educational workshop at a rural high school in New Hampshire. The results suggested that students had a better understanding of the health care field.</p><p><strong>Objective: </strong>This study evaluates the impact of an ongoing educational outreach program designed to introduce rural high school students to diverse health care professions.</p><p><strong>Methods: </strong>This study was conducted at West Grand High School, a rural high school in Kremmling, Colorado, between September and December 2023. The intervention consisted of 4 monthly sessions, each focusing on a different medical specialty-primary care, sports medicine, dermatology, and neurology. These sessions, led by second-year medical students, provided an overview of common conditions, treatment approaches, and various health care roles involved in patient care. Participants completed pre- and postsession surveys assessing their interest in health care careers, perceived barriers, and likelihood of returning to their rural hometown to practice. A follow-up survey was conducted 4 months after the final session to assess long-term impact.</p><p><strong>Results: </strong>While individual session surveys showed no significant changes, overall interest in and likelihood of pursuing a health care career increased significantly over the course of the presentation series (P=.03 and P=.04, respectively). However, there was no significant change in students' likelihood of returning to their rural hometowns to practice or their perceived access to resources for a health care career. Financial constraints (43/66, 65%) were identified as the most significant barrier, followed by lack of exposure (19/66, 29%) and support (17/66, 26%), while interest and education were least likely perceived as obstacles.</p><p><strong>Conclusions: </strong>This study highlights the importance of early and sustained outreach efforts in rural communities to increase awareness of diverse health care career pathways. While short-term educational interventions can positively influence career interest, long-term mentorship and structured support systems are essential for fostering a sustained commitment to rural health care careers. Future initiatives should integrate financial counseling, ongoing mentorship, and collaborations with existing rural pipeline programs to enhance the effectiveness of such interventions.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e70505"},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637069","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":"Developing and Integrating Digital Sources in an Accessible and Sustainable Online Platform for Adolescents and Young Adult Cancer Survivors: Collaborative Design Approach.","authors":"Carla Vlooswijk, Sophia He Sleeman, Jonas Pluis, Daphne Bakker, Lisanne de Groot, Eveliene Manten, Peter Heine, Olga Husson, Mies C van Eenbergen, Pieter Vandekerckhove","doi":"10.2196/60897","DOIUrl":"https://doi.org/10.2196/60897","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital support for adolescent and young adult cancer survivors is fragmented and results in lacking a reliable overview of support services available to them. Collaborative design promises to integrate perspectives of diverse stakeholders and could help to develop an online platform, which increases access and has a long-term perspective. However, it has not yet been explored how collaborative design can be used more strategically to develop an online platform with these aims.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore how a collaborative design approach could be applied to develop an online platform for adolescent and young adult cancer survivors, focusing on three key objectives: integrating existing resources, improving accessibility, and ensuring long-term financial sustainability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this action research study, we reflect on a collaborative design process to develop an online platform for adolescent and young adult cancer survivors. A quantitative questionnaire was sent out to adolescent and young adult cancer survivors and health care professionals. Stakeholders were actively engaged in stakeholder consensus meetings, and project management was carried out through monthly design meetings to facilitate coordination and decision-making of the development of the platform. Afterwards, a focus group was conducted among the project group to evaluate the collaborative design approach, analyzed using an inductive thematic approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Through the collaborative design approach, several Dutch organizations collaborated to develop, enhance, and combine online services for adolescent and young adult cancer survivors and their relatives. A dedicated online \"young and cancer\" platform for adolescent and young adult cancer survivors was developed, which integrates different types of information tools and supportive interactive elements from different sources. The integration of different resources into one platform improves the access and user experience of adolescent and young adult cancer survivors when it comes to online support. Through the reflection about the collaborative process, three themes were identified: (1) value of stakeholder participation; (2) conditions for working with adolescents and young adults with lived experience; and (3) collaboration between adolescents and young adults with lived experience and professionals from different backgrounds and organizations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A collaborative design approach can be used to efficiently develop an online platform for adolescent and young adult cancer survivors. The collaboration among professionals, including online developers, researchers, and adolescents and young adults with lived experience facilitated a direct translation of insights into the platform, while the support of the national cancer platform provides long-term sustainability. This study highl","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60897"},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612163","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":"GamePlan4Care, a Web-Based Adaptation of the Resources for Enhancing Alzheimer's Caregiver Health II Intervention for Family Caregivers of Persons Living With Dementia: Formative, Qualitative Usability Testing Study.","authors":"Jinmyoung Cho, Thomas Birchfield, Jennifer L Thorud, Marcia G Ory, Alan B Stevens","doi":"10.2196/60143","DOIUrl":"10.2196/60143","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The negative consequences of caregiving can be mitigated by providing caregivers with support programs that increase their dementia care skills and provide emotional and tangible support. Web-based technology can increase the availability of evidence-based caregiver interventions. GamePlan4Care (GP4C) is a web-based adaptation of the Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) intervention, redesigned and reformatted for web-based delivery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The goal of GP4C is to create a web-based family caregiver support platform that facilitates self-directed exposure to evidence-based skills training and support for caregivers of persons living with dementia. This multidimensional approach of using technology enhanced with live support has the potential for improved scalability and sustainability. In preparation for a randomized clinical trial of the new intervention, the GP4C platform underwent user interface/user experience (UI/UX) testing with caregivers as part of an iterative design process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;UI/UX testing of caregivers' reactions to technical and content-related aspects of the platform was conducted with 31 caregivers recruited through partnerships with community-based organizations in central Texas. Usability testing consisted of performing system tasks, answering open-ended questions on the tasks, and providing feedback on their experience with the platform. Two researchers used an inductive thematic approach to data analysis using transcripts of individual audio and screen-recorded sessions with each participant. The analysis consisted of 3 phases: data familiarization, coding, and theme formulation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 18 participants tested technical-related aspects of the GP4C platform, and 13 participants tested content-related aspects. The average age of participants was 62 (SD 12.2, range 31-86). A majority of participants were female (27/31, 87.1%) and White or Caucasian (26/31, 83.1%) while almost one-third were Hispanic (10/31, 32.3%). The thematic analysis revealed 3 themes: supportive resources as a common theme, active engagement for technical aspects of the platform, and a comprehensive approach for content aspects of the platform. Participants also suggested changes in navigation and content.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Findings from the usability testing sessions indicate that the platform provided engaging, useful content that the caregiver would continue to use, resonated with their caregiving experience, helped the caregivers think through their choices and emotions, and could be used to help communicate with the person living with dementia. Caregivers appreciated the personalization based on what they had already completed and the concept of having a Dementia Care Navigator when they needed additional help. Caregivers also provided multiple suggestions on how to improve the system, in","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60143"},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626393","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":"Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses.","authors":"Natalia Ramos, Skylar Jones, Lily Zhang, Miriam Nuño, Benita Ramsey, Dannie Ceseña, Alyssa Mireles, Kenneth Wells","doi":"10.2196/67082","DOIUrl":"10.2196/67082","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) individuals faced greater mental health challenges during the COVID-19 pandemic than binary-gender heterosexual (non-LGBTQ+) adults. The Together for Wellness/Juntos por Nuestro Bienestar website with free well-being resources, developed during the COVID-19 pandemic with partner input, included LGBTQ+ resources. A pilot evaluation among adults (aged ≥18 years) found engagement with and use of the website 4 to 6 weeks before follow-up was associated with reduced (pretest-posttest) depression. Results for LGBTQ+ participants were not reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study describes baseline depression, anxiety, and website engagement for LGBTQ+ compared with non-LGBTQ+ adults and pretest-posttest changes in depression and anxiety (the primary outcome).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Community partners invited health and social services providers, clients, and partners to visit the website and complete a survey app (Chorus Innovations) at baseline (September 20, 2021-April 4, 2022) and a 4- to 6-week follow-up (October 22, 2021-May 17, 2022). LGBTQ+ adults were compared to non-LGBTQ+ adults in demographics, website use, depression, and anxiety. Sensitivity analyses were adjusted for nonresponse (inverse probability weighting). Regression analyses identified predictors for reduction (pretest-posttest) in depression (2-item Patient Health Questionnaire [PHQ-2]) and anxiety (2-item Generalized Anxiety Disorder scale [GAD-2]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 315 adults who completed the baseline survey and 193 who completed the follow-up survey, 64 (20.3%) and 37 (19.2%), respectively, were LGBTQ+. At baseline, LGBTQ+ compared to non-LGBTQ+ adults had higher scores on the PHQ-2 (mean 2.4, SD 1.7 vs 1.3, SD 1.3; t&lt;sub&gt;294&lt;/sub&gt;=5.31; P&lt;.001) and GAD-2 (mean 2.7, SD 1.7 vs 1.6, SD 1.5; t&lt;sub&gt;295&lt;/sub&gt;=4.96; P&lt;.001) and more COVID-19 stressors (mean score 8.1, SD 4.4 vs 6.5, SD 4.0; t&lt;sub&gt;298&lt;/sub&gt;=2.8; P=.003). Before follow-up, LGBTQ+ adults had similar website use (P=.65) and likelihood to recommend the website to others (P=.26) compared to non-LGBTQ+ adults. LGBTQ+ adults had more reduction (pretest-posttest) in mean GAD-2 scores (-0.8, SD 2.0 vs 0.0, SD 1.2; t&lt;sub&gt;177&lt;/sub&gt;=-3.08; P=.002) and mean PHQ-2 scores (-0.7, SD 1.7 vs -0.1, SD 1.4; t&lt;sub&gt;180&lt;/sub&gt;=-2.16; P=.03) compared to non-LGBTQ+ adults. For LGBTQ+ adults, predictors of pretest-posttest decline (adjusting for nonresponse) in mean GAD-2 scores included visiting the website and using resources 4 to 6 weeks before (β=-1.95, 95% CI -3.20 to -0.70; P=.003); for decline in mean PHQ-2, visiting website/using resources had a trend as predictor that was not significant adjusting for nonresponse (β=-.94 (-2.00, 0.013), P=.09).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;LGBTQ+ adults reported higher baseline depression, anxiety, and COVID-19 stressors than non-LGBTQ+ adults. Among LGBTQ+","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67082"},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612164","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":"Expressions of \"Ikizurasa\" on X (Twitter) in Japan: A Descriptive Analysis of Posts in 2023.","authors":"Kanami Tsuno, Azusa Arimoto, Yuki Imamatsu, Yumiko Kobayashi, Miho Satoh, Masayuki Miyazaki","doi":"10.2196/70613","DOIUrl":"https://doi.org/10.2196/70613","url":null,"abstract":"<p><strong>Unstructured: </strong>This study analyzed all public X posts from Japan in 2023 and identified a substantial number mentioning ikizurasa (pain in living), with notable fluctuations over time. The findings suggest a link between ikizurasa and minority stress, particularly related to ethnicity and sexuality.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618103","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":"Correlation of Biomechanical Variables of Lower Extremity Movement During Functional Tests and Tasks in Youth League Football Players: Cross-Sectional Correlation Study.","authors":"Anna Davidoviča, Sergejs Davidovičs, Guna Semjonova, Alexei Katashev, Alexander Oks, Linda Lancere, Signe Tomsone, Maksims Zolovs","doi":"10.2196/69046","DOIUrl":"10.2196/69046","url":null,"abstract":"<p><strong>Background: </strong>Football is the most widely played sport globally but carries a high risk of lower limb injuries, particularly among youth athletes. Real-time biomechanical monitoring can play a critical role in injury prevention. However, traditional lab-based systems are often complex and impractical for field use. Recent advances in wearable technology, such as inertial sensors and smart socks, provide more accessible solutions for movement analysis. The DAid smart sock system is a promising tool, but further evidence is needed to support its use in lower extremity functional assessments.</p><p><strong>Objective: </strong>This correlational study aimed to investigate the correlation between lower limb joint angles, muscle activity, and plantar pressure distribution during the \"Single Leg Squat\" (SLS) and its variations in youth football players, using wireless wearable sensors in a field-based setting.</p><p><strong>Methods: </strong>In total, 32 youth football players (16 male and 16 female individuals; mean age 14.6, SD 0.5 years) performed SLS movements while wearing the NOTCH inertial motion sensors, DAid smart socks (plantar pressure), and PLUX muscleBAN EMG system. Spearman correlation was used to explore relationships between hip, knee, and ankle joint kinematics; muscle activity (gluteus medius, gluteus maximus [GMx], vastus lateralis, and biceps femoris); and changes in center of pressure (COP) on the plantar surface.</p><p><strong>Results: </strong>A strong positive correlation was found between hip adduction and medial foot pressure (COP1X: ρ=0.785, P<.001). Knee flexion was strongly correlated with gluteus medius (ρ=0.809) and GMx (ρ=0.841) muscle activity. Hip internal rotation also showed moderate to strong correlations with both COP variables (COP1Y: ρ=0.585) and GMx activation (ρ=0.477). Significant gender-specific differences were identified: male individuals showed stronger correlations between joint angles and muscle activation, while female individuals demonstrated a strong correlation between knee flexion and overall plantar pressure (COP2W: ρ=0.818). Several moderate correlations (0.35<ρ<0.47) further confirmed interactions between joint movement, muscle activity, and plantar pressure.</p><p><strong>Conclusions: </strong>The findings support the feasibility and utility of wireless wearable sensors-including inertial measurement units and smart socks-for in-field biomechanical analysis in youth football players. The study confirmed key relationships between joint mechanics and plantar pressure distribution, suggesting their relevance in injury risk screening. The DAid smart sock system, in particular, demonstrated reliable performance for assessing medial-lateral loading patterns associated with hip and knee movement. These insights may help guide neuromuscular training and individualized injury prevention strategies in young athletes.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e69046"},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637070","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":"Use of a Wearable Self-Tracking Instrument by Refugees With Complex Posttraumatic Stress Disorder: A Qualitative Study of Psychotherapeutic Mediation and Engagement.","authors":"Lisa Groenberg Riisager, Stine Bjerrum Moeller, Jakob Eg Larsen, Thomas Blomseth Christiansen, Jesper Aagaard, Lotte Huniche","doi":"10.2196/70511","DOIUrl":"10.2196/70511","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Wearable self-tracking technologies are increasingly used in mental health care to enhance engagement and personalize treatment. However, most existing instruments focus on passive data collection or predefined symptom monitoring. Less attention has been given to tools that enable patients to actively track personally meaningful, self-defined mental health experiences as part of psychotherapy, particularly in vulnerable populations such as refugees with complex posttraumatic stress disorder (CPTSD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore how the One Button Tracker (OBT), a novel single-purpose wearable self-tracking instrument that enables in-the-moment active registration of self-defined, personally relevant mental health phenomena, supports therapeutic engagement among refugees receiving psychotherapeutic treatment for CPTSD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This qualitative study was part of a larger participatory action research project conducted from 2022 to 2024 at a specialized clinic for trauma-affected refugees in Denmark. A total of 9 adult refugees diagnosed with CPTSD used the OBT during psychotherapy to actively track a personally relevant and collaboratively defined target phenomenon through a button press. The OBT provided vibrotactile feedback and stored timestamped data for therapeutic use. A total of 25 semistructured interviews were conducted across 3 time points: before, during, and after treatment. Reflexive thematic analysis guided by a postphenomenological framework was used to explore how the technologies mediate experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants (6 women and 3 men, median age 47 years, IQR 31-57 years) had lived in Denmark for an average of 21.4 years. The duration of OBT use ranged from 22 to 366 days. Participants tracked between 2 and 14 different phenomena and registered between 37 and 4733 events in total during their courses of treatment. Thematic analysis revealed five central themes that captured the multistable character of the OBT: (1) from external instrument to extension of the self, (2) mental switch, (3) faithful companion, (4) scarlet letter, and (5) emergency lifeline. Patients described the OBT as a meaningful anchor in distressing moments, enhancing emotional regulation, self-awareness, and continuity between sessions. The OBT's vibrotactile feedback was experienced as affirming and responsive, reinforcing a sense of being acknowledged and connected, even in the absence of direct therapist contact. However, the visibility of the OBT also introduced challenges, including stigma and altered social dynamics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The OBT functioned as an active mediator in therapy. It supported in-the-moment tracking of personal experiences, encouraged agency and emotional regulation, and helped patients feel connected to their therapist outside of sessions. The vibrotactile feedback played a key role in how the OBT w","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e70511"},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600480","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":"Multidomain Behavioral Change Digital Coaching for Chronic Disease Management in Patients With Type 2 Diabetes: Framework Development and Preliminary Evaluation.","authors":"Konstantina Kostopoulou, Danae Lekka, Aristodemos Pnevmatikakis, Nelina Angelova, Panagiotis Stafylas, Stefanos Tamouridis, Alexandra Bargiota, Sofoklis Kyriazakos","doi":"10.2196/73807","DOIUrl":"https://doi.org/10.2196/73807","url":null,"abstract":"<p><strong>Background: </strong>Unhealthy lifestyle behaviors have been identified as a major cause of numerous health issues, with a steady global increase in their prevalence. Addressing this challenge requires comprehensive behavioral changes to promote the adoption of a sustainable healthier lifestyle. However, despite the prevalent need, cost-effective and successful digital coaching for health-related behavior change remains scarce.</p><p><strong>Objective: </strong>This study aimed to present a holistic framework for designing, modeling, and executing behavior change strategies through a multiagent reasoning system that selected optimal digital coaching techniques based on individual assessments and integrated data-driven decision-making.</p><p><strong>Methods: </strong>Behavioral change theories have been explored to design a multiagent system aimed at achieving sustainable lifestyle changes. This system selected behavior change techniques based on individual user assessments, prioritizing those with the strongest impact on key behavioral components. The framework incorporated evidence-based practices stemming from behavioral change science and integrated them into Healthentia's behavioral change coaching scheme. Healthentia, a certified software as a medical device, implemented this framework in its non-medical modules that aim for lifestyle behavioral change and wellbeing specifically for chronic disease management, serving as an eHealth solution that advances decentralized care by enabling remote monitoring, data-driven content selection, and personalized digital coaching that adjusts to patient progress and engagement patterns.</p><p><strong>Results: </strong>This study explored the application of the Healthentia behavioral change coaching scheme in patients with type 2 diabetes. Behavioral attributes have been evaluated in 9 patients, yielding notable results in terms of fasting glucose dropping by an average of -17.3 mg/dL (Cohen d=1.5; P=.002), further underscored by a narrow 95% CI (-26.1 to -8.43), and in terms of weight and BMI, with mean reductions of -2.89 kg and -1.05 kg/m², respectively. These changes yielded large effect sizes (Cohen d approximately 1.05) and were statistically significant (P=.01). The positive outcomes were at least partly attributed to the personalized delivery of content, 71.66% (1125/1570) of which was well received by the patients.</p><p><strong>Conclusions: </strong>Our study of this multiagent system, which was tested through simulated patient behavior and preliminary, limited behavior observations of patients with type 2 diabetes, promises improved health outcomes using personalized digital coaching strategies. Future directions include optimizing the multiagent selection process; further exploring the type 2 diabetes program; conducting an in-depth evaluation of its results, including glycated hemoglobin measurements; and expanding its applications to other chronic conditions.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e73807"},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600479","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}