JMIR Formative Research最新文献

{"title":"Improving the User Interface and Guiding the Development of Effective Training Material for a Clinical Research Recruitment and Retention Dashboard: Usability Testing Study.","authors":"Leah Leslie Gardner, Pezhman Raeisian Parvari, Mark Seidman, Richard J Holden, Nicole R Fowler, Ben L Zarzaur, Diana Summanwar, Cristina Barboi, Malaz Boustani","doi":"10.2196/66718","DOIUrl":"https://doi.org/10.2196/66718","url":null,"abstract":"<p><strong>Background: </strong>Participant recruitment and retention are critical to the success of clinical trials, yet challenges such as low enrollment rates and high attrition remain ongoing obstacles. RecruitGPS is a scalable dashboard with integrated control charts to address these issues by providing real-time data monitoring and analysis, enabling researchers to better track and improve recruitment and retention.</p><p><strong>Objective: </strong>This study aims to identify the challenges and inefficiencies users encounter when interacting with the RecruitGPS dashboard. By identifying these issues, the study aims to inform strategies for improving the dashboard's user interface and create targeted, effective instructional materials that address user needs.</p><p><strong>Methods: </strong>Twelve clinical researchers from the Midwest region of the United States provided feedback through a 10-minute, video-recorded usability test session, during which participants were instructed to explore the various tabs of the dashboard, identify challenges, and note features that worked well while thinking aloud. Following the video session, participants took a survey on which they answered System Usability Scale (SUS) questions, ease of navigation questions, and a Net Promoter Score (NPS) question.</p><p><strong>Results: </strong>A quantitative analysis of survey responses revealed an average SUS score of 61.46 (SD 23.80; median 66.25) points, indicating a need for improvement in the user interface. The NPS was 8, with 4 of 12 (33%) respondents classified as promoters and 3 of 12 (25%) as detractors, indicating a slightly positive satisfaction. When participants compared RecruitGPS to other recruitment and study management tools they had used, 8 of 12 (67%) of participants rated RecruitGPS as better or much better. Only 1 of 12 (8%) participants rated RecruitGPS as worse but not much worse. A qualitative analysis of participants' interactions with the dashboard diagnosed a confusing part of the dashboard that could be eliminated or made optional and provided valuable insight for the development of instructional videos and documentation. Participants liked the dashboard's data visualization capabilities, including intuitive graphs and trend tracking; progress indicators, such as color-coded status indicators and comparison metrics; and the overall dashboard's layout and design, which consolidated relevant data on a single page. Users also valued the accuracy and real-time updates of data, especially the integration with external sources like Research Electronic Data Capture (REDCap).</p><p><strong>Conclusions: </strong>RecruitGPS demonstrates significant potential to improve the efficiency of clinical trials by providing researchers with real-time insights into participant recruitment and retention. This study offers valuable recommendations for targeted refinements to enhance the user experience and maximize the dashboard's effectiveness. Additionally","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66718"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492197","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":"Development and Implementation of MyPainHub, a Web-Based Resource for People With Musculoskeletal Conditions and Their Health Care Professionals: Mixed Methods Study.","authors":"Kerrie Evans, Jonathan Ko, Dragana Ceprnja, Katherine Maka, Darren Beales, Michele Sterling, Kim L Bennell, Gwendolen Jull, Paul W Hodges, Marnee J McKay, Trudy J Rebbeck","doi":"10.2196/63780","DOIUrl":"https://doi.org/10.2196/63780","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal conditions, including low back pain (LBP), neck pain, and knee osteoarthritis, are the greatest contributors to years lived with disability worldwide. Resources aiming to aid both patients and health care professionals (HCPs) exist but are poorly implemented and adopted.</p><p><strong>Objective: </strong>We aimed to develop and implement MyPainHub, an evidence-based web-based resource designed to provide comprehensive, credible and accessible information for people with, and HCPs who manage, common musculoskeletal conditions.</p><p><strong>Methods: </strong>This mixed methods study adhered to the New South Wales Translational Research Framework and was evaluated against the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Consultation with key stakeholders (patients, HCPs, researchers, industry, consumer groups, and website developers) informed content, design, features, and functionality. Development then aimed to meet the identified need for a \"one-stop shop\"-a central location for information about common musculoskeletal conditions tailored to a person's condition and risk of poor outcomes. MyPainHub was then developed through an iterative process and implementation strategies were tailored to different health care settings. Quantitative and qualitative evaluation occurred with patients and HCPs.</p><p><strong>Results: </strong>In total, 127 stakeholders participated in the development phase; initial consultation with them led to embedding 2 validated screening tools (the Short Form Örebro Musculoskeletal Pain Screening Questionnaire and the Keele STarT MSK tool) in MyPainHub to guide information tailoring for patients based on risk of poor outcomes. Development occurred in parallel and feedback from stakeholders informed design and content including structure, functionality, and phrasing and images to use to emphasize key points. Consultation resulted in information for patients being categorized using key guideline-based messages (general information, your pathway, exercise, and imaging) while information for clinicians was categorized into assessment, management, and prognosis. Implementation occurred in different health care settings with the most effective strategies being interactive education via webinars and workshops. The evaluation phase involved web-based questionnaires (patients: n=44; HCPs: n=29) and focus groups (patients: n=6; HCPs: n=6). Patients and HCPs found MyPainHub user-friendly, acceptable, credible, and potentially able to support self-management. Patient participants identified areas for improvement such as including more specific information on preventative measures and pain relief options. Despite positive feedback, only 35% (10/29) of HCPs used MyPainHub with their patients. HCP participants identified challenges including insufficient training and lack of familiarity with using web-based resources in existing clinical workflows. Foll","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63780"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492189","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":"Evaluation of Financial Support Workshops for Patients Under State Pension Age With Degenerative Cervical Myelopathy: Survey Study.","authors":"Tanzil Rujeedawa, Zahabiya Karimi, Helen Wood, Irina Sangeorzan, Roy Smith, Iwan Sadler, Esther Martin-Moore, Adrian Gardner, Andreas K Demetriades, Rohitashwa Sinha, Gordan Grahovac, Antony Bateman, Naomi Deakin, Benjamin Davies","doi":"10.2196/59032","DOIUrl":"https://doi.org/10.2196/59032","url":null,"abstract":"<p><strong>Background: </strong>Degenerative cervical myelopathy (DCM), a form of slow-motion and progressive spinal cord injury caused by spinal cord compression secondary to degenerative pathology, leads to high levels of disability and dependence, and may reduce quality of life. Myelopathy.org is the first global scientific and clinical charity for DCM, providing an accessible platform freely disseminating information relevant to the DCM diagnosis and its treatment. Significant transient and long-term change to earnings do occur and can thrust individuals into poverty. People with DCM face many challenges accessing state financial assistance. This can have a cumulative negative financial effect due to the association between DCM and low socioeconomic index. Financial support available to patients under pension age include Universal Credit (UC), a payment that helps with living costs, and Personal Independence Payment (PIP), which helps with extra living costs if someone has both a long-term health condition or disability and difficulty doing certain everyday tasks.</p><p><strong>Objective: </strong>This study aimed to assess if delivering workshops centered around access to financial support could assist people with DCM living in the United Kingdom.</p><p><strong>Methods: </strong>A series of 2 internet-based workshops was targeted at accessing financial support for English patients under the state pension age, with an anonymized survey delivered to participants after each session. The first session was on UC and the second on PIP. The survey consisted of a mixture of Likert scales, free text and yes or no answers. Survey responses were analyzed using descriptive statistics and free text answers underwent inductive thematic analysis.</p><p><strong>Results: </strong>The average rating on the use of UC was 9.00/10. Presession self-rated confidence levels were 5.11/10 rising to 8.00/10. The mean score of wanting further similar sessions was 8.67/10 with 56% (5/9) of participants wanting one-to-one sessions. For PIP, the average session use rating was 10/10. Presession self-rated confidence levels were 4.43/10 rising to 9.57/10. The mean score of wanting further similar sessions was 8.71/10, with 43% (3/7) of participants wanting one-to-one sessions . Following inductive thematic analysis, themes regarding the usefulness of such sessions and the challenges to accessing financial support emerged. One participant gave negative feedback, which included the length of the session and perceived problems around confidentiality and data protection.</p><p><strong>Conclusions: </strong>The pilot series was largely perceived as a success, with participants finding them useful and increasing their self-rated confidence in navigating the UK financial support system. Given the small sample size, it is hard to predict the success of future sessions. Finally, given that the hurdles in accessing financial support extend beyond DCM, such workshops may be relevant t","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e59032"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492196","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":"A Classroom-Based Intervention for Reducing Sedentary Behavior and Improving Spinal Health: Pragmatic Stepped-Wedge Feasibility Randomized Controlled Trial.","authors":"Dominic Fisher, Rentia Maart, Lehana Thabane, Quinette Louw","doi":"10.2196/65169","DOIUrl":"https://doi.org/10.2196/65169","url":null,"abstract":"<p><strong>Background: </strong>Noncommunicable diseases (NCDs) resulting from sedentary behavior (SB) are adding a further strain on the South African health system, which is already struggling to manage infectious diseases. Some countries have enabled children to reduce SB at school by substituting traditional furniture with sit-stand classroom furniture, allowing learners to interrupt prolonged bouts of sitting with standing without interrupting their school work. Alternating between sitting and standing also benefits spinal health by interrupting prolonged periods of high spinal loading, but no such intervention has been trialed in South Africa. The potential to reduce strain on the health system by reducing the incidence of NCDs and improving spinal health requires further consideration. Before embarking on a large classroom-based trial, it is essential to determine the acceptability of the intervention, its impact on teachers' practices, and the logistical and pragmatic considerations of data collection.</p><p><strong>Objective: </strong>This study aimed to assess the feasibility of implementing a classroom-based intervention to reduce SB and improve spinal health in primary school learners, to assess the pragmatics of delivering and adherence to the intervention, and assess the pragmatics of measuring physical activity and postural dynamism data with wearable sensors.</p><p><strong>Methods: </strong>We used a stratified, closed-cohort, randomized, 2-cluster, stepped-wedge design with a pragmatic approach. One grade 5 and grade 6 class each was recruited from contrasting socioeconomically categorized, state-funded primary schools in the Western Cape province, South Africa. Classroom furniture was substituted with sit-stand desks, and health education and movement videos (HEMVs) were shown during class time. Skin-mounted activPAL physical activity monitors were used to measure SB and postural topography and Noraxon myoMOTION inertial measurement units (IMUs) to measure spinal movement. The study was evaluated for feasibility by tracking school retention, successful delivery of the HEMVs, the use of sit-stand desks, compliance with the wearable sensors, and data accuracy. We deductively analyzed teachers' interviews and learners' focus groups using Atlas.ti 9 software. Descriptive analysis of quantitative data was performed using Microsoft Excel.</p><p><strong>Results: </strong>Cluster 1 withdrew from the study before follow-up SB, postural topography, and spinal movements were measured. All feasibility outcomes, namely (1) classroom retention, (2) delivery of HEMVs, (3) learner and teacher acceptance and usage of sit-stand classroom furniture, (4) 100% compliance with wearing skin-mounted sensors for the duration of the intended measurement period, and (5) minimum 80% eligibility of sensor data gathered included in data analysis, were met in cluster 2. The study found that it is feasible to conduct a larger trial with minor modifications to ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e65169"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492187","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":"Effects of Missing Data on Heart Rate Variability Measured From A Smartwatch: Exploratory Observational Study.","authors":"Hope Davis-Wilson, Meghan Hegarty-Craver, Pooja Gaur, Matthew Boyce, Jonathan R Holt, Edward Preble, Randall Eckhoff, Lei Li, Howard Walls, David Dausch, Dorota Temple","doi":"10.2196/53645","DOIUrl":"https://doi.org/10.2196/53645","url":null,"abstract":"<p><strong>Background: </strong>Measuring heart rate variability (HRV) through wearable photoplethysmography sensors from smartwatches is gaining popularity for monitoring many health conditions. However, missing data caused by insufficient wear compliance or signal quality can degrade the performance of health metrics or algorithm calculations. Research is needed on how to best account for missing data and to assess the accuracy of metrics derived from photoplethysmography sensors.</p><p><strong>Objective: </strong>This study aimed to evaluate the influence of missing data on HRV metrics collected from smartwatches both at rest and during activity in real-world settings and to evaluate HRV agreement and consistency between wearable photoplethysmography and gold-standard wearable electrocardiogram (ECG) sensors in real-world settings.</p><p><strong>Methods: </strong>Healthy participants were outfitted with a smartwatch with a photoplethysmography sensor that collected high-resolution interbeat interval (IBI) data to wear continuously (day and night) for up to 6 months. New datasets were created with various amounts of missing data and then compared with the original (reference) datasets. 5-minute windows of each HRV metric (median IBI, SD of IBI values [STDRR], root-mean-square of the difference in successive IBI values [RMSDRR], low-frequency [LF] power, high-frequency [HF] power, and the ratio of LF to HF power [LF/HF]) were compared between the reference and the missing datasets (10%, 20%, 35%, and 60% missing data). HRV metrics calculated from the photoplethysmography sensor were compared with HRV metrics calculated from a chest-worn ECG sensor.</p><p><strong>Results: </strong>At rest, median IBI remained stable until at least 60% of data degradation (P=.24), STDRR remained stable until at least 35% of data degradation (P=.02), and RMSDRR remained stable until at least 35% data degradation (P=.001). During the activity, STDRR remained stable until 20% data degradation (P=.02) while median IBI (P=.01) and RMSDRR P<.001) were unstable at 10% data degradation. LF (rest: P<.001; activity: P<.001), HF (rest: P<.001, activity: P<.001), and LF/HF (rest: P<.001, activity: P<.001) were unstable at 10% data degradation during rest and activity. Median IBI values calculated from photoplethysmography sensors had a moderate agreement (intraclass correlation coefficient [ICC]=0.585) and consistency (ICC=0.589) and LF had moderate consistency (ICC=0.545) with ECG sensors. Other HRV metrics demonstrated poor agreement (ICC=0.071-0.472).</p><p><strong>Conclusions: </strong>This study describes a methodology for the extraction of HRV metrics from photoplethysmography sensor data that resulted in stable and valid metrics while using the least amount of available data. While smartwatches containing photoplethysmography sensors are valuable for remote monitoring of patients, future work is needed to identify best practices for using these sensors to evaluate HRV ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e53645"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492191","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":"The Feasibility of Large Language Models in Verbal Comprehension Assessment: Mixed Methods Feasibility Study.","authors":"Dorit Hadar-Shoval, Maya Lvovsky, Kfir Asraf, Yoav Shimoni, Zohar Elyoseph","doi":"10.2196/68347","DOIUrl":"https://doi.org/10.2196/68347","url":null,"abstract":"<p><strong>Background: </strong>Cognitive assessment is an important component of applied psychology, but limited access and high costs make these evaluations challenging.</p><p><strong>Objective: </strong>This study aimed to examine the feasibility of using large language models (LLMs) to create personalized artificial intelligence-based verbal comprehension tests (AI-BVCTs) for assessing verbal intelligence, in contrast with traditional assessment methods based on standardized norms.</p><p><strong>Methods: </strong>We used a within-participants design, comparing scores obtained from AI-BVCTs with those from the Wechsler Adult Intelligence Scale (WAIS-III) verbal comprehension index (VCI). In total, 8 Hebrew-speaking participants completed both the VCI and AI-BVCT, the latter being generated using the LLM Claude.</p><p><strong>Results: </strong>The concordance correlation coefficient (CCC) demonstrated strong agreement between AI-BVCT and VCI scores (Claude: CCC=.75, 90% CI 0.266-0.933; GPT-4: CCC=.73, 90% CI 0.170-0.935). Pearson correlations further supported these findings, showing strong associations between VCI and AI-BVCT scores (Claude: r=.84, P<.001; GPT-4: r=.77, P=.02). No statistically significant differences were found between AI-BVCT and VCI scores (P>.05).</p><p><strong>Conclusions: </strong>These findings support the potential of LLMs to assess verbal intelligence. The study attests to the promise of AI-based cognitive tests in increasing the accessibility and affordability of assessment processes, enabling personalized testing. The research also raises ethical concerns regarding privacy and overreliance on AI in clinical work. Further research with larger and more diverse samples is needed to establish the validity and reliability of this approach and develop more accurate scoring procedures.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e68347"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492198","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":"Effect on Response Rates of Adding a QR Code to Patient Consent Forms for Qualitative Research in Patients With Cancer: Pilot Randomized Controlled Trial.","authors":"Rebecca Wyse, Erin Forbes, Grace Norton, Priscilla Viana Da Silva, Kristy Fakes, Sally Ann Johnston, Stephen R Smith, Alison Zucca","doi":"10.2196/66681","DOIUrl":"https://doi.org/10.2196/66681","url":null,"abstract":"<p><strong>Background: </strong>The successful conduct of health and medical research is largely dependent on participant recruitment. Effective, yet inexpensive methods of increasing response rates for all types of research are required. QR codes are now commonplace, and despite having been extensively used to recruit study participants, a search of the literature failed to reveal any randomized trial investigating the effect of adding a QR code on qualitative research response rates.</p><p><strong>Objective: </strong>This study aimed to collect data on rates of response, consent, and decline among patients with cancer, and the average time taken to respond following randomization to receive either a QR code or no QR code on the patient consent form for a qualitative research study.</p><p><strong>Methods: </strong>This was a pilot randomized controlled trial (RCT) embedded within a qualitative research study. In total, 40 eligible patients received a recruitment pack for the qualitative study, which included an information statement, a consent form, and an addressed, stamped envelope to return their consent form. Patients were randomized 1:1 to the control (standard recruitment pack only) or intervention group (standard recruitment pack including modified consent form with a QR code).</p><p><strong>Results: </strong>In total, 27 out of 40 patients (age: mean 63.0, SD 14.8 years; 45% female) responded to the consent form. A lower proportion of the QR code group (60%) responded (odd ratio [OR] 0.57, 95% CI 0.14-2.37; P=.44), compared to 75% of the standard recruitment group. However, a higher proportion of the QR group (35%) consented (OR 1.84, 95% CI 0.41-8.29; P=.43), compared to the standard recruitment group (20%). A lower proportion of the QR group (25%) declined (OR 0.34, 95% CI 0.09-1.38; P=.13) relative to the standard recruitment group (55%). The mean response time of the QR code group was 16 days (rate ratio [RR] 0.79, 95% CI 0.47-1.35; P=.39) compared to 19 days for the standard recruitment group. None of the age-adjusted analyses were statistically significant.</p><p><strong>Conclusions: </strong>This underpowered pilot study did not find any evidence that offering an option to respond through a QR code on a patient consent form for a qualitative study increased the overall patient response rate (combined rate of consent and decline). However, there was a nonsignificant trend, indicating that more patients who received the QR code consented compared to those who did not receive the QR code. This study provides useful preliminary data on the potential impact of QR codes on patient response rates to invitations to participate in qualitative research and can be used to inform fully powered RCTs.</p><p><strong>Trial registration: </strong>OSF Registries 10.17605/OSF.IO/PJ25X; https://doi.org/10.17605/OSF.IO/PJ25X.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66681"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472526","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":"Investigating Reddit Data on Type 2 Diabetes Management During the COVID-19 Pandemic Using Latent Dirichlet Allocation Topic Modeling and Valence Aware Dictionary for Sentiment Reasoning Analysis: Content Analysis.","authors":"Meghan Nagpal, Niloofar Jalali, Diana Sherifali, Plinio Morita, Joseph A Cafazzo","doi":"10.2196/51154","DOIUrl":"10.2196/51154","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Type 2 diabetes (T2D) is a chronic disease that can be partially managed through healthy behaviors. However, the COVID-19 pandemic impacted how people managed T2D due to work and school closures and social isolation. Moreover, individuals with T2D were at increased risk of complications from COVID-19 and experienced worsened mental health due to stress and anxiety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to synthesize emerging themes related to the health behaviors of people living with T2D, and how they were affected during the early stages of the COVID-19 pandemic by examining Reddit forums dedicated to people living with T2D.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from Reddit forums related to T2D, from January 2018 to early March 2021, were downloaded using the Pushshift API; support vector machines were used to classify whether a post was made in the context of the pandemic. Latent Dirichlet allocation topic modelling was performed to identify topics of discussion across the entire dataset and a subsequent iteration was performed to identify topics specific to the COVID-19 pandemic. Sentiment analysis using the VADER (Valence Aware Dictionary for Sentiment Reasoning) algorithm was performed to assess attitudes towards the pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From all posts, the identified topics of discussion were classified into the following themes: managing lifestyle (sentiment score 0.25, 95% CI 0.25-0.26), managing blood glucose (sentiment score 0.19, 95% CI 0.18-0.19), obtaining diabetes care (sentiment score 0.19, 95% CI 0.18-0.20), and coping and receiving support (sentiment score 0.34, 95% CI 0.33-0.35). Among the COVID-19-specific posts, the topics of discussion were coping with poor mental health (sentiment score 0.04, 95% CI -0.01 to0.11), accessing doctor and medications and controlling blood glucose (sentiment score 0.14, 95% CI 0.09-0.20), changing food habits during the pandemic (sentiment score 0.25, 95% CI 0.20-0.31), impact of stress on blood glucose levels (sentiment score 0.03, 95% CI -0.03 to 0.08), changing status of employment and insurance (sentiment score 0.17, 95% CI 0.13-0.22), and risk of COVID-19 complications (sentiment score 0.09, 95% CI 0.03-0.14). Overall, posts classified as COVID-19-related (0.12, 95% CI 0.01-0.15) were associated with a lower sentiment score than those classified as nonCOVID (0.25, 95% CI 0.24-0.25). This study was limited due to the lack of a method for assessing the demographics of users and verifying whether users had T2D.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Themes identified from Reddit data suggested that the COVID-19 pandemic significantly influenced how people with T2D managed their disease, particularly in terms of accessing care and dealing with the complications of the virus. Overall, the early stages of the pandemic negatively impacted the attitudes of people living with T2D. This study demonstrates that social media data can be a qu","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e51154"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472527","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":"Planned Behavior in the United Kingdom and Ireland Online Medicine Purchasing Context: Mixed Methods Survey Study.","authors":"Bernard D Naughton","doi":"10.2196/55391","DOIUrl":"https://doi.org/10.2196/55391","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Online medicine purchasing is a growing health care opportunity. However, there is a scarcity of available evidence through a behavioral lens, which addresses why consumers buy medicines online. Governments try to influence online medicine purchasing behavior using health campaigns. However, there are little data regarding specific online medicine purchasing behaviors to support these campaigns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The theory of planned behavior explains that perceived behavioral control (PBC), attitudes, and norms contribute to intentions, leading to behaviors. This study challenges these assumptions, by testing them in an online medicine purchasing context. We asked: What is the role of attitudes, norms, and PBC in an online medicine purchasing context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An anonymous online snowball convenience sample survey, including open and closed questions concerning online medicine purchasing, was implemented. The data were thematically analyzed until data saturation. The emerging themes were applied to each individual response, as part of a case-by-case narrative analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 190 consumers from the United Kingdom and Ireland who consented to participate in the study, 46 participants had purchased medicines online, 9 of which were illegal sales. Of the 113 participants who demonstrated an intention to purchase, 42 (37.2%) completed a purchase. There were many cases in which participants demonstrated an intention to buy medicines online, but this intention did not translate to a purchasing behavior (71/190, 37.4%). Reasons for consumers progressing from intention to behavior are suggested to be impacted by PBC and attitudes. Qualitative data identified access to medicine as a factor encouraging online medicine purchasing behaviors and a facilitator of behavior transition. Despite understanding the importance of why some medicines required a prescription, which is described as an example of legal and health norms, and despite suspicion and concern categorized as negative attitudes in this paper, some participants were still buying products illegally online. Risk reduction strategies were performed by 17 participants (17/190, 9%). These strategies facilitated a transition from intention to behavior.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The study results indicate that a consumer's intention to buy does not automatically translate to a purchasing behavior online; instead, a transition phase exists. Second, consumers followed different pathways to purchase and used risk reduction practices while transitioning from an intention to a behavior. Finally, owing to the covert nature of online medicine purchasing, norms do not appear to be as influential as PBC and attitudes in an online medicine purchasing setting. Understanding how a consumer transitions from an intention to a behavior could be useful for researchers, health care professionals, and policym","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e55391"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472528","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":"Applying Critical Discourse Analysis to Cross-Cultural Mental Health Recovery Research.","authors":"Yasuhiro Kotera, Riddhi Daryanani, Oliver Skipper, Jonathan Simpson, Simran Takhi, Merly McPhilbin, Benjamin-Rose Ingall, Mariam Namasaba, Jessica Jepps, Vanessa Kellermann, Divya Bhandari, Yasutaka Ojio, Amy Ronaldson, Estefania Guerrero, Tesnime Jebara, Claire Henderson, Mike Slade, Sara Vilar-Lluch","doi":"10.2196/64087","DOIUrl":"https://doi.org/10.2196/64087","url":null,"abstract":"<p><p>The purpose of this paper is to demonstrate how critical discourse analysis (CDA) frameworks can be used in cross-cultural mental health recovery research. CDA is a qualitative approach that critically appraises how language contributes to producing and reinforcing social inequalities. CDA regards linguistic productions as reflecting, consciously or unconsciously, the narrators' understandings of, or attitudes about, phenomena. Mental health recovery research aims to identify and address power differentials, making CDA a potentially relevant approach. However, CDA frameworks have not been widely applied to mental health recovery research. We adapted established CDA frameworks to our cross-cultural mental health recovery study. The adapted methodology comprises (1) selecting discourses that indicate positive changes and (2) considering sociocultural practices informed by relevant cultural characteristics identified in our previous research, without placing value judgments. Our adapted framework can support cross-cultural mental health recovery research that uses CDA.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64087"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472511","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}