JMIR Formative Research最新文献

{"title":"Opportunities and Challenges of Generative AI in Postgraduate Health Professions Education Assessments From Educator and Learner Perspectives: Qualitative Study.","authors":"Carys Phillips, David Harrison","doi":"10.2196/87121","DOIUrl":"10.2196/87121","url":null,"abstract":"<p><strong>Background: </strong>The application of artificial intelligence (AI) is increasingly valuable as a tool and assistant in many areas of clinical and academic medicine. Generative AI (GenAI) creates new content used by large language models, which can generate language that strongly resembles or even improves on that of humans. Learners and educators in many areas of education are using GenAI for essays and assessments, raising issues regarding learning and assessment. GenAI is also raising new concerns in health professions education (HPE), an area of health professions training that sometimes has different aims and assessment methods compared to its clinical counterparts. HPE needs to assess levels of knowledge and understanding of pedagogy, and the use of GenAI presents challenges to its current assessments, which are predominantly written.</p><p><strong>Objective: </strong>The study aimed to investigate educators' and learners' perspectives on the opportunities and challenges presented by GenAI in postgraduate HPE assessments. It particularly focused on perspectives of how GenAI may influence the future of assessment and essay-based assessments in HPE.</p><p><strong>Methods: </strong>Informed by a constructivist paradigm, a qualitative approach was adopted, undertaking 8 semistructured interviews conducted via Microsoft Teams. Purposive sampling ensured a mixture of educators and learners in current HPE courses from a range of health care professions. Data were thematically analyzed.</p><p><strong>Results: </strong>There was no difference between educator and learner perspectives. Four themes were identified: AI is here, students are at a disservice if we do not embrace it; AI as an opportunity to rethink HPE assessments; AI is a \"gray area\"; and AI is fallible.</p><p><strong>Conclusions: </strong>The findings present AI as an external catalyst, highlighting the current internal desire for assessment change within HPE. It offers opportunities for creative, authentic assessments that reflect real-life academic and clinical practice, aiming to develop competent future HPE educators and keep courses relevant. These findings contribute to the debate around the future potential and development of AI in HPE assessments.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e87121"},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838135","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 Around 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 the 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 on-site 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 at 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 (RSSI) values from October 13 to 29, 2023. The main analysis focused on October 28, 2023, a high-footfall event day selected for direct calibration. Episodes were classified using empirically derived RSSI 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, 90.3% (115,950/128,313) occurred during business hours. Among these, 8.6% (n=11,068) identifiers were detected more than once. Dwell time could be calculated for 1.4% (n=1817) of the identifiers, and 0.5% (n=659) eligible presence episodes remained after preprocessing. During a 30-minute validation window, smokers and passersby were counted manually within a 25-m radius. During the validation window, 6230 signal records formed 104 stays, with a mean stay duration of 9.89 (SD 7.89) minutes. 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 3907 passersby within the plausible SHS exposure range. Estimated smoker counts showed 2 peaks, around noon and 4 PM, whereas passerby volume peaked around midday. In an exploratory analysis, a random forest model using stay duration, mean RSSI, and RSSI 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 the findings are site specific a","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e90261"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13146234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838056","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 Acceptance of a Clinical Workflow Tool in the Swedish Prosthetics and Orthotics Sector: Qualitative Study.","authors":"João Rafael Calixto, Nadia Davoody","doi":"10.2196/82584","DOIUrl":"10.2196/82584","url":null,"abstract":"<p><strong>Background: </strong>The global demand for assistive devices, such as prosthetics and orthotics, is increasing. A shortage of trained professionals contributes to suboptimal care. To improve clinical workflows, the Life Lounge Clinical Workflow (LLCW) has been developed. Understanding user acceptance is essential for ensuring its successful implementation.</p><p><strong>Objective: </strong>This study explored prosthetists and orthotists professionals' perceptions and acceptance of LLCW, as well as the perceived benefits and challenges associated with its use.</p><p><strong>Methods: </strong>A postdemonstration mixed methods study was conducted using the unified theory of acceptance and use of technology framework, combining Likert-scale summaries with thematic analysis of open-text responses. The study included 18 prosthetists and orthotists professionals working at orthotic and prosthetic clinics across Sweden. After an interactive session about LLCW, feedback was collected via questionnaires. Thematic analysis was used to analyze the data.</p><p><strong>Results: </strong>Participants rated several acceptance-related constructs positively. Performance expectancy and facilitating conditions emerged as the most favorably discussed areas in the qualitative responses. Descriptive ratings showed high mean scores for motivation to use (4.61), management encouragement (4.56), ease of use (4.11), and willingness to use voluntarily (4.11). However, colleagues' perceptions had a lower mean rating (2.72). Participants highlighted centralized data access, reduced administrative tasks, and improved clinical preparation as key benefits. At the same time, concerns were raised regarding data accuracy, questionnaire length, and the need for structured training before implementation.</p><p><strong>Conclusions: </strong>Participants reported generally positive experiences with LLCW, particularly regarding usability and performance. However, successful implementation requires integration into existing clinical workflows and attention to training and patient engagement. Addressing these elements can support broader adoption and contribute to digital transformation in prosthetics and orthotics care.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e82584"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838234","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":"Anxiety and Depression Associated With the Dependent Use of Generative AI in Medical Students: Cross-Sectional Study.","authors":"Janett V Chavez Sosa, Salomon Huancahuire-Vega","doi":"10.2196/82667","DOIUrl":"10.2196/82667","url":null,"abstract":"<p><strong>Background: </strong>The growing integration of artificial intelligence (AI) in higher education has transformed learning processes but also raised concerns about potential mental health risks. Medical students represent a particularly vulnerable group due to high academic stress and increasing reliance on generative AI tools for study and decision-making tasks. Despite this, the relationship between AI dependence and psychological distress remains underexplored in Latin American contexts.</p><p><strong>Objective: </strong>This study aimed to evaluate the association between generative AI dependence and levels of stress, anxiety, and depression among medical students.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 187 human medicine students from a Peruvian university during the first academic semester of 2025. The Dependence on Artificial Intelligence Scale and the Depression, Anxiety, and Stress Scale-21 were applied. Negative binomial regression models, both crude and adjusted for sex, age, income, and year of study, were used to assess associations, reporting rate ratios (RRs) and 95% CIs.</p><p><strong>Results: </strong>Participants had a median age of 22 (IQR 19-24) years, and 58.8% (110/187) were female. The median Dependence on Artificial Intelligence Scale score was 10 (IQR 7-14). Generative AI dependence showed significant correlations with anxiety (ρ=0.336, 95% CI 0.22-0.44) and depression (ρ=0.316, 95% CI 0.20-0.43) and a smaller correlation with stress (ρ=0.277, 95% CI 0.16-0.39). In the adjusted regression models, each 1-point increase in generative AI dependence was associated with a 5% higher expected anxiety score (RR 1.05, 95% CI 1.01-1.09; P=.01) and a 4% higher depression score (RR 1.04, 95% CI 1.01-1.08; P=.03), whereas the association with stress was positive but nonsignificant (RR 1.03, 95% CI 1.00-1.07; P=.08). Fifth-year students had significantly greater anxiety levels than their sixth-year peers (RR 1.82, 95% CI 1.09-3.01; P=.02). No significant effects were observed for sex, age, or income.</p><p><strong>Conclusions: </strong>This study empirically examined generative AI dependence as a distinct behavioral construct and its association with mental health symptoms in medical students. Unlike prior research, this study evaluated psychological dependence on generative AI and modeled its relationship with anxiety and depression using appropriate count-based regression techniques. By providing early evidence from a Latin American context, it contributes to the emerging field of digital mental health and medical education research. These findings underscore the need for universities to promote balanced and responsible AI use, integrate digital literacy with mental health support strategies, and develop preventive policies that mitigate potential maladaptive reliance on generative AI tools.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e82667"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838193","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":"Effect of Wearable Activity Tracker Social Behaviors on Physical Activity and Exercise Self-Efficacy: Real-World Pilot Study.","authors":"Amanda Bireline, Derek J Hevel, Paul G Davis","doi":"10.2196/75133","DOIUrl":"10.2196/75133","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Wearable activity trackers are useful tools to track and monitor physical activity (PA), especially considering their use in free-living environments. Users often see moderate improvements in step count, but consistent increases at various intensities of PA are inconclusive. While wearable research is growing, no known studies specifically examine the relationship between how the use of self-selected social features on wearables affects PA and exercise self-efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to compare weekly PA, approximating moderate-to-vigorous intensity, of adults from the New York City metropolitan area assigned to either use or not use social engagement PA features on their device. Exercise self-efficacy was also measured. Additionally, a preliminary examination into the use of 3 different social features was conducted to inform where controlled parameters on feature use may be needed in future work.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The researchers conducted a real-world pilot study by recruiting wearable users aged 18 years and older in the New York City area to wear their devices in free-living environments. After consent, participants were randomized into 1 of 2 conditions: the condition that involved use of the social engagement PA features or the condition that did not for 8 weeks. Participants submitted objective data from their device and completed a self-efficacy measure at baseline, week 4, and week 8. Those in the intervention group also answered questions about which social feature they used the most throughout the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Data from 123 participants were analyzed using mixed methods analysis. Principal findings included no difference between wearable social feature users and nonusers in weekly PA (P=.55) or exercise self-efficacy (P=.47). There was an overall effect of time across the repeated measures on PA (P=.006) with an average increase of 72 (SD 3) minutes. Secondary findings highlight the need to control for the use of only a single social feature to identify more concrete effects. An effect of time was found across the repeated measures (P=.01) in the intervention group, showing an increase of 49 to 126 minutes of PA, depending on the feature used most. The mixed methods analysis also found that exercise self-efficacy did not significantly change based on which social feature was used most (P=.24).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Consistent with other literature, this pilot study demonstrates that using wearables can lead to increases in PA and that sharing one's PA data with others may amplify the effect. However, the novelty of this study is that although carefully implied, specific social features on a wearable may have a greater effect than others. This study identified the need for further investigation into which features may be more effective. With the increased prevalence of device ownership, knowing if certain social featur","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e75133"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838244","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":"Understanding Online Health Information Consumption Through Web Analytics of the Italian Society of Pharmacology Magazine: 3-Year Descriptive Analysis.","authors":"Agnese Graziosi, Michele Santoni, Luigi Cari, Lucia Gozzo, Stefania Crucitta, Antonella Di Sotto, Concetta Altamura, Silvia Di Giacomo, Laura Rizzi, Chiara Ruocco, Alessandra Bitto, Gianni Sava","doi":"10.2196/93245","DOIUrl":"https://doi.org/10.2196/93245","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic underscored that access to reliable and expert-driven scientific information is not only essential but also lifesaving. Since 2020, the Italian Society of Pharmacology has been publishing SIF Magazine, an online magazine dedicated to citizens. This journal was created to make pharmacology accessible to the public, highlighting its impact on health and quality of life while clarifying the truths, theories, and misconceptions surrounding drugs and their use.</p><p><strong>Objective: </strong>This work analyzed web interaction data from SIF Magazine to understand how the public reaches and engages with an online scientific journal and gather practical insights for improving digital scientific communication.</p><p><strong>Methods: </strong>The data analyzed in this study were obtained from the web analytics of the SIF Magazine website. The analysis covers 3 years (2022-2024). By studying patterns of access, navigation, and engagement, the analysis clarified which types of scientific content connect most with users, how people find and choose trustworthy sources, and what they do after reaching them.</p><p><strong>Results: </strong>Average monthly site visits increased from 120,024 in the partial period examined in 2022 to 128,059 in 2023 and 200,379 in 2024, paralleled by higher monthly views (155,785 in 2022, 165,438 in 2023, and 254,297 in 2024). The engagement rate declined modestly (36% in late 2022, 35% in 2023, and 29% in 2024), consistent with scale-related dilution from an expanding top-of-funnel audience. Category-level analyses of top-performing articles indicated disproportionate interest in renal, urogenital, and sexual disorders followed by inflammation and pain and gastrointestinal diseases. Seasonal analyses showed recurrent peaks for season-linked topics (eg, motion sickness, photosensitivity reactions, and influenza vaccination) during expected periods.</p><p><strong>Conclusions: </strong>Together, these findings underscore the importance of data-driven content planning and continuous performance monitoring to sustain the effectiveness of digital scientific communication platforms.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e93245"},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838066","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":"Older Adults' Experiences Navigating Setup of Digital Health Technology: Implementation Report.","authors":"P Jeffrey Brady, Rachel McCloud, Erin Higgins, Aishwarya Mahesh, Keith LeJeune, Jon Black, Anil Singh","doi":"10.2196/70319","DOIUrl":"https://doi.org/10.2196/70319","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital health and connected technologies may support better health outcomes among older adults, including those with multiple chronic conditions or low engagement in health behaviors. However, initial experiences with technology, including during unboxing, setup, and first use, can influence emotional reactions and perceptions and can ultimately determine sustained, meaningful use. Older adults with low technology experience or poor health may be particularly vulnerable to frustration, stress, or abandonment of devices when early interactions are negative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this implementation study was to closely observe the initial engagements with a telehealth treatment app and connected blood pressure monitor (BPM) among a group of older adults with low prior technology use and reported low health behavior engagement. The goal was to identify setup \"pain points\" that may influence initial impressions and intention to use the technology over time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 24 older adults (aged ≥65 years) were recruited for a 4-week trial of a telehealth app. Participants were provided with a box containing a tablet preloaded with the app, paper instructions, and a BPM and cuff. Researchers first conducted in-home ethnographic interviews with participants to observe the unboxing and setup process, documenting experiences with reading instructions, using the BPM, and engaging with customer support. Weekly check-in calls and a final exit interview captured ongoing experiences and likelihood of continued use. Interview recordings were transcribed and independently coded, guided by the unified theory of acceptance and use of technology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Most of the sample were White (20/24, 83%) and female (14/24, 58%). Negative experiences with the app's customer support were the top challenge for participants, with representatives providing confusing steps or conflicting terminology. Other common challenges were understanding instructions, connecting to Bluetooth, and correctly using the BPM. While 67% (16/24) of the participants indicated that they were likely or very likely to continue to use the app after the study ended at the end of week 1, this number dropped to 54% (13/24) by the end of the 4 weeks. Participants who reported lower technology self-efficacy at the beginning of the study also experienced frustration, anxiety, and embarrassment as friction with the setup process continued.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;First impressions of digital health apps play a critical role in influencing older adults' emotions and perceptions regarding the technology and may impact the likelihood of longer-term engagement. Those with lower technology self-efficacy are particularly susceptible to experiencing negative emotions such as frustration, stress, or shame. Mobile health apps and interventions targeting older adults should incorporate simplified","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e70319"},"PeriodicalIF":2.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838072","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":"At-Home Sleep Electroencephalography Assessment in Young and Older Adults Using a Novel Wireless Soft Electronics Sleep Monitoring System: Experimental Study.","authors":"Hyeonseok Kim, Simran Saha, Aiden Wachnin, Seunghyeb Ban, Yoon Jae Lee, Youngjin Kwon, Jaeho Lee, Isha Chhabra, Sahana Ram, Chuu Nyan, Lynn Marie Trotti, Woon-Hong Yeo, Audrey Duarte","doi":"10.2196/80286","DOIUrl":"10.2196/80286","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sleep quality declines with age and is a known contributor to multiple chronic health conditions, including Alzheimer disease. Emerging evidence suggests that certain electroencephalography (EEG) neural signatures measured during sleep may be predictive of cognitive decline in older adults. Sleep EEG signals are traditionally measured using bulky, rigid, and uncomfortable equipment in an unfamiliar laboratory setting, which can negatively impact sleep signals. Due to these limitations, sleep EEG data acquisition is typically limited to a single night.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to validate our recently developed portable, skin-like EEG monitoring patch for 7 nights in the home environment in a pilot sample of young and older adults by evaluating usability and acceptance, and replicating age-related differences in sleep architecture observed in the polysomnography literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eighteen young adults and 18 cognitively unimpaired older adults without sleep disorders were enrolled (data from 11 young adults and 12 older adults were included in the analyses) in a 7-night study during which they wore novel, gel-free, wireless, ultrathin, skin-conforming, sleep monitoring, fabric-based patches. These patches were self-applied to the forehead and face for optimal usability and comfort. The patches incorporate laser-cut mesh electrodes with low-profile electronics (including a rechargeable battery and amplifier) and transmit EEG signals to a participant-controlled, Bluetooth-enabled, tablet-based data acquisition app. An automated algorithm was used to stage sleep and assess microarchitecture features from the EEG commonly impacted for each participant. Averages across nights were computed for these sleep features for each participant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Young and older adults reported that the sleep patch was easy to use and comfortable to wear. There was no loss of signal power over 7 nights of wear across participants (retained-data signal-to-noise ratio over the 7-d period: young adult, mean 20.69, SD 12.78, maximum 52.13, minimum 5.19; older adult, mean 22.10, SD 9.39, maximum 49.96, minimum 13.79). Most datasets not retained were lost due to poor reference electrode adhesion on the nose (75/101, 74% of lost datasets in young adults and 57/88, 65% in older adults). Trained sleep technologists verified that the retained datasets were of sufficient quality to be scored without difficulty. Expected age-group differences in sleep features were observed, including age-related reductions in stage N3 sleep (young adult, mean 18.55, SD 6.70; older adult, mean 10.40, SD 6.43; Mann-Whitney U=42.0; P=.01) and reduced sleep spindle density (young adult, mean 2.92, SD 2.24; older adult, mean 0.94, SD 1.33; Mann-Whitney U=45.0; P=.006).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates that our novel, comfortable, wearable patch can reliably measure physio","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e80286"},"PeriodicalIF":2.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838207","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":"Peer Support in Online Women's Health Communities: Mixed Methods Formative Analysis of Reddit Discourse.","authors":"Kimia Tuz Zaman, Wordh Ul Hasan, Nova Ahmed, Juan Li","doi":"10.2196/87782","DOIUrl":"https://doi.org/10.2196/87782","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Stigmatized women's health issues, such as polycystic ovary syndrome (PCOS) and endometriosis, are often marginalized or dismissed in traditional clinical settings. This drives individuals to seek peer support in anonymous online communities such as Reddit. While these digital platforms host critical discussions, they are often designed as static information repositories, failing to account for the complex emotional, temporal, and cultural dynamics that shape users' support needs. There is a disconnect between the lived experiences of users-particularly feelings of clinical dismissal and the need for culturally specific advice-and the design of the sociotechnical systems they rely on.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to deconstruct support practices in online women's health forums to provide a formative basis for designing more responsive digital health systems. We analyzed the intersections of discussion topics, emotional expression, temporal shifts (specifically the impact of the COVID-19 pandemic), and culturally situated discourse to identify unmet user needs and effective peer-support patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a large-scale, mixed-methods analysis of 4995 posts and 460,317 comments from 5 major women's health subreddits (r/WomensHealth, r/TwoXChromosomes, r/BirthControl, r/Endometriosis, and r/PCOS). Computational methods included Latent Dirichlet Allocation for topic modeling, Valence Aware Dictionary for Sentiment Reasoning for sentiment analysis, and the NRC Emotion Lexicon for granular emotion classification. We segmented the data into pre-, during-, and post-COVID-19 periods to analyze temporal shifts. This quantitative analysis was complemented by a 2-phase qualitative thematic analysis to identify and characterize engagement patterns within 147 validated culturally situated threads.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our analysis revealed that the most prevalent and emotionally negative topic was \"Pain & Doctor Visits,\" which was uniquely characterized by high levels of fear and sadness linked to systemic clinical dismissal. The COVID-19 pandemic triggered a significant topical \"turn inward,\" with discussions shifting away from social or political issues and toward somatic concerns (eg, \"PCOS\" \"Pain & Doctor Visits\"). Paradoxically, this period saw a simultaneous rise in both negative emotions (eg, fear and sadness) and expressions of community trust. Critically, our qualitative analysis of culturally situated discourse uncovered a consistent three-stage \"playbook\" for effective support: (1) Affirmation to establish psychological safety and validate cultural experiences; (2) Information Scaffolding to provide actionable, culturally tailored advice; and (3) Intercultural Bridging to facilitate community-wide learning and empathy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Online health forums operate as essential, resilient sociotechnical infrastructures that actively","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e87782"},"PeriodicalIF":2.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838075","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":"The Role of Trust in Text Messaging for Promoting Patient Portal Activation Among Low-Income Patients: Quality Improvement Project.","authors":"Kevin Fiscella, Mechelle Sanders","doi":"10.2196/80255","DOIUrl":"https://doi.org/10.2196/80255","url":null,"abstract":"<p><strong>Background: </strong>The increasing reliance on patient portals for electronic health records has widened the digital health care access gap, particularly among low-income and Medicaid-insured populations. However, resources exist to assist low-income patients with portal enrollment; in obtaining a free smartphone; and, in New York, in obtaining low-cost internet. Automated bidirectional SMS text messaging offers a scalable and cost-effective strategy for identifying low-income patients' digital health needs and eligibility for resources by using screening questions and providing tailored information on how to access available resources.</p><p><strong>Objective: </strong>This study aimed to increase portal access among low-income patients using automated bidirectional SMS text messaging and assess its feasibility and acceptability.</p><p><strong>Methods: </strong>This quality improvement initiative involved sending automated, bidirectional SMS text messages in English to 12,381 Medicaid-insured and/or low-income patients from a primary care practice. Messages assessed patients' digital health needs and provided adaptive, personalized resources and assistance for enrolling in the patient portal and for accessing digital technology. We assessed response rates and follow-up portal enrollment rates. We surveyed participants regarding the acceptability, appropriateness, and usability of the SMS text messaging intervention, as well as their subsequent use of the patient portal. We performed descriptive statistics and a binomial probability test.</p><p><strong>Results: </strong>In total, 9.2% (1140/12,381) of patients responded to the SMS text messages, with 3.9% (481/12,381) opting out and 5.3% (659/12,381) actively engaging. Among respondents, 71.1% (469/659) completed the follow-up survey. Respondents were predominantly female (336/469, 71.6%), with ages ranging from 18 to 65 years or older. Most respondents rated the message's clarity (420/469, 89.6%), its usefulness (400/469, 85.2%), and the demonstration of care by their health team (350/469, 74.6%) favorably. Concerns regarding privacy (61/469, 13%) and trustworthiness (71/469, 15%) were noted. Notably, 71% of initially unenrolled patients activated their patient portals after the intervention (P=.007), exceeding the hypothesized expectations.</p><p><strong>Conclusions: </strong>Automated bidirectional SMS text messaging had mixed effects on promoting patient portal use among low-income patients. Response rates to SMS text messages were low when delivered from an unknown phone number. Among responders, most reported that these messages were useful and that they would recommend them to others. Research is needed to determine optimal strategies for introducing the program and vendor phone numbers to patients to improve engagement.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e80255"},"PeriodicalIF":2.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838112","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}