JMIR Formative Research最新文献

{"title":"Educational Impact of an Instagram Account on Histology Teaching: Mixed Methods Approach in Medical Education.","authors":"Fatéméh Dubois, Damien Ambrosetti, Lucie Tosca","doi":"10.2196/89044","DOIUrl":"10.2196/89044","url":null,"abstract":"<p><strong>Background: </strong>Morphology-based disciplines such as histology, embryology, and cytogenetics require strong visual learning and rely heavily on visual pattern recognition, with more complex integrative processes, that is, higher-order cognitive skills that connect, interpret, and apply knowledge across contexts. These skills may be supported by social media formats. In parallel, medical students increasingly engage with digital and social media platforms, prompting interest in their potential educational value. Instagram (Meta Platforms, Inc), as an image-centered and interactive medium, has emerged as a potential pedagogical tool. The Histo.Embryo Instagram account was launched in 2023 under the auspices of the French National College of Histologists, Embryologists, and Cytogeneticists (CHEC) to complement traditional teaching with bilingual, interactive, image-based posts.</p><p><strong>Objective: </strong>This study aimed to evaluate the pedagogical contribution of the Histo.Embryo Instagram account with a focus on students' engagement, usage patterns, perceived learning outcomes, and qualitative user experience. This learning platform was developed as a visual and interactive tool to complement traditional teaching in histology, embryology, and cytogenetics.</p><p><strong>Methods: </strong>A mixed methods design combined a structured online survey (N>100), Instagram analytics (90-day period), and qualitative feedback. Quantitative data assessed usage frequency, preferred content formats, perceived utility, and self-reported learning outcomes. Qualitative data were analyzed thematically to explore how students interacted with and integrated the content into their learning practices.</p><p><strong>Results: </strong>Instagram was the dominant platform among students, with 81% (101/125) reporting daily use. The account reached 2582 unique users and 168,778 views. Static quiz-based posts generated 96% (203/207) of engagement, highlighting a strong preference for active recall formats. Survey data showed that 98% (122/125) perceived improved understanding, 64% (80/125) enhanced visual recognition, and over two-thirds reused content in academic settings. Qualitative findings provided additional insight into these patterns. Students described the content as accessible, visually clear, and aligned with exam expectations, emphasizing its role in simplifying complex concepts and supporting memorization. Many reported using posts for rapid revision, self-assessment, and consolidation of prior knowledge, suggesting integration into self-regulated learning strategies. The interactive quiz format was perceived as motivating and cognitively engaging.</p><p><strong>Conclusions: </strong>The Histo.Embryo Instagram account suggests that Instagram, when intentionally structured, may complement traditional teaching by supporting visual learning, active recall, and flexible study practices. Nevertheless, these findings should be interpreted cautiou","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e89044"},"PeriodicalIF":2.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206865","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":"Digital Nudges Among New Gym Members: Controlled Formative Evaluation of Gym Attendance, Exercise Self-Efficacy, Habit Strength, and Exercise Adherence.","authors":"Maor Gabay, Ofer Levi, Lupsa Marius Matichescu, Mihaela Oravitan","doi":"10.2196/93800","DOIUrl":"10.2196/93800","url":null,"abstract":"<p><strong>Background: </strong>Digital nudging strategies are increasingly implemented to promote physical activity; yet, evidence from real-world fitness settings remains limited. The early membership period in fitness centers is characterized by high dropout rates, emphasizing the need for formative evaluations that clarify behavioral mechanisms underlying exercise engagement.</p><p><strong>Objective: </strong>This study aimed to evaluate the formative impact of WhatsApp (Meta Platforms, Inc)-based digital nudges on objectively measured weekly gym visits among new fitness club members and to examine behavioral determinants associated with exercise engagement.</p><p><strong>Methods: </strong>This controlled intervention study used a 2-parallel-group design with quasi-random individual allocation conducted separately within 2 fitness clubs. The complete-case sample comprised 61 new gym members (mean age 29.05, SD 8.06 years; 21/61, 34.4% female), including 27 participants in the intervention group and 34 in the control group. During the 3-week intervention period, participants in the intervention group received brief digital nudges through designated WhatsApp groups. The messages were developed according to the Easy, Attractive, Social, and Timely (EAST) framework. Participants in the control group received no nudge messages. Gym visits were recorded electronically over 12 weeks through the fitness clubs' computerized entry systems. Self-reported measures included exercise self-efficacy, habit strength, and exercise adherence. Statistical analyses included descriptive statistics, longitudinal analysis of weekly gym attendance using generalized estimating equations (GEE), correlation analyses, and exploratory regression analysis.</p><p><strong>Results: </strong>Longitudinal GEE analysis showed a significant decline in weekly gym attendance over time (b=-0.074, SE 0.016; <i>P</i><.001, incidence rate ratio [IRR]=0.929), corresponding to an approximately 7.1% decrease in expected weekly visits per study week. However, the group×week interaction was not significant (b=.009, SE 0.022; <i>P</i>=.68, IRR=1.009). Participants attending the gym at least twice weekly reported greater exercise habit strength (mean 33.89, SD 6.49 vs mean 28.70<i>,</i> SD 9.05; <i>P</i>=.02) and greater baseline exercise self-efficacy (mean 71.37, SD 12.50 vs mean 57.24, SD 14.61; <i>P</i>=.001). Mean weekly gym visits were positively correlated with exercise habit strength (<i>r</i>=0.444), exercise self-efficacy (<i>r</i>=0.498), and exercise adherence (<i>r</i>=0.507; all <i>P</i><.001). In the exploratory regression analysis, exercise adherence was the only variable retained, and the model explained 25.7% of the variance in mean weekly gym visits (<i>R</i><sup>2</sup>=.257; <i>P</i><.001).</p><p><strong>Conclusions: </strong>Weekly gym attendance declined significantly over the 12-week follow-up period, but the rate of decline did not differ significantly between the int","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e93800"},"PeriodicalIF":2.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206868","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":"App-Based Stabilization Phase Within Blended Trauma-Focused Cognitive Behavioral Therapy With Compassion for Adolescents With Posttraumatic Stress Disorder: Formative Qualitative Study.","authors":"Linda Wallin, Nick Nilsson, Inga Dennhag","doi":"10.2196/95633","DOIUrl":"10.2196/95633","url":null,"abstract":"<p><strong>Background: </strong>Digital tools may support early phases of trauma therapy for adolescents, yet little is known about how an app-based stabilization phase functions in routine child and adolescent psychiatry clinics. To our knowledge, no previous study has qualitatively examined a compassion-integrated, app-based stabilization phase delivered before trauma processing within trauma-focused cognitive behavioral therapy (TF-CBT) for adolescents.</p><p><strong>Objective: </strong>This formative qualitative pretrial study explored the acceptability, feasibility, and contextual fit of an app-based stabilization phase within blended TF-CBT with compassion (bTF-CBT-C) for adolescents with posttraumatic stress disorder (PTSD). The aim was to inform the refinement of intervention content, caregiver support, and clinical workflow prior to a planned pilot randomized controlled trial (RCT).</p><p><strong>Methods: </strong>Four adolescent girls with PTSD (aged 14-16 years) completed a 5-week app-based stabilization program integrating TF-CBT coping skills and compassion-focused practices, while 5 caregivers received parallel content in a nonapp format. Three adolescents and 4 caregivers participated in postintervention semistructured interviews, and 4 clinicians completed a brief open-ended survey. Data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>One overarching theme, <i>\"</i>Navigating digital stabilization within shifting conditions,\" captured how engagement fluctuated with emotional capacity, cognitive load, relational dynamics, and logistical stability. Adolescents and caregivers experienced the intervention content as grounding and meaningful but difficult to sustain amid fatigue, school pressure, neurodivergent attention patterns, and family strain. Clinicians similarly noted varying capacity, the need for scaffolding, and the importance of reminders and smooth access. Clear content could exceed users' cognitive bandwidth; adolescents preferred autonomy, while caregivers were unsure how to support them; and technical friction sometimes disrupted momentum. Across the groups, participants described grounding and compassion-based practices as supporting emotional safety, shared understanding, and readiness for trauma-focused work.</p><p><strong>Conclusions: </strong>The findings suggest that app-based stabilization within bTF-CBT-C may be acceptable and potentially feasible for adolescents with PTSD, their caregivers, and clinicians. Feasibility appears to depend on flexible pacing, cognitive accessibility, caregiver guidance, and technical reliability. The study identifies candidate refinements to be evaluated in the pilot RCT and provides preliminary insight into how compassion-integrated digital stabilization may support preparation for trauma-focused therapy.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e95633"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194120","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 Moderating Effects of Race and Ethnicity on a Motivational Interviewing Intervention for Improving Physical Health Among Patients With Peripheral Artery Disease: Secondary Analysis of a Pilot Randomized Trial.","authors":"Yiliang Zhu, Tracie Collins","doi":"10.2196/82926","DOIUrl":"10.2196/82926","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In a pilot randomized trial, face-to-face or telephone motivational interviewing (MI) was more efficacious than a smartphone app after 3 months for increasing 6-minute walk distance (primary outcome) and reducing body weight (secondary outcome) in patients with peripheral artery disease (PAD). Little is known about intervention heterogeneity related to social determinants of health (SDOH).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore whether SDOH are associated with the MI intervention effects on walking distance and weight loss and generate intervention heterogeneity hypotheses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Community dwellers in Wichita, Kansas, were recruited through community outlets and screened for PAD. Consented participants were randomly assigned to MI (n=16) or an app (n=13). Survey instruments were used to measure SDOH, demographics, and adverse childhood experiences, which were assessed for their associations with 6-minute walk distance change and weight loss. Difference-in-differences (DiD) comparisons of median changes between SDOH strata were conducted using Wilcoxon and Kruskal-Wallis nonparametric tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For 6-minute walk distance, pretest-posttest changes were significantly greater among participants of \"other\" race and ethnicity than among non-Hispanic White participants (DiD=44.0 m, 95% CI 19.2-164.2; P=.004), and no DiDs for other SDOH were significant. Significant median pretest-posttest increases in walking distance were observed in those with a college or higher educational attainment (48.8 m, 95% CI 28.0-61.4), unmarried individuals (40.4 m, 95% CI 0.5-56.0), those living with family (55.7 m, 95% CI 30.5-199.5), those who talked to and saw family or friends 3 or more times a week (46.4 m, 95% CI 17.2-69.4), and those without unmet daily needs (46.5 m, 95% CI 7.6-67.1). For weight loss, we did not observe significant DiDs with any SDOH. However, a significant median weight loss was observed in every SDOH stratum where we observed a significant increase in 6-minute walk distance. Significant weight loss was also observed in 5 additional SDOH strata: male individuals, household income below US $30,000, never served in military, employed status, and no stress. The improvements in weight loss and walking distance were highly consistent in both direction and size across SDOH strata.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot study was the first to explore potential SDOH-related intervention effect modification and heterogeneity. The significant association between walking distance and race and ethnicity suggested a potential effect modification. Significant pretest-posttest improvements in both outcomes were found in the same SDOH strata. The highly consistent evidence across both outcomes and all SDOH strata provided confidence in potential intervention efficacy and heterogeneity despite the small sample size. Our findings were consistent wit","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e82926"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194150","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":"Child and Adolescent Mental Health Misinformation on TikTok: Cross-Sectional Mixed Methods Study.","authors":"Constanza Testart Aguirre, Drigissa-Andrada Ilies, Alexandre Hudon","doi":"10.2196/105698","DOIUrl":"https://doi.org/10.2196/105698","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;TikTok is an important source of mental health information for children, adolescents, and young adults, but the accuracy of psychoeducational content remains uncertain. Misleading information may be particularly consequential for younger users, who may have limited digital and health literacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to characterize misinformation and disinformation in TikTok content related to child and adolescent mental health, identify mental health topics disproportionately represented in misleading content, examine whether platform-observable video characteristics could discriminate videos containing misinformation, and explore how viewers responded to this content.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional mixed methods secondary analysis of 122 child and adolescent mental health videos identified from a previously collected dataset of 1000 publicly available TikTok videos. Videos were independently coded for content, intent, authenticity, clinical topic, presenter characteristics, and engagement. An L2-penalized logistic regression using only platform-observable characteristics was evaluated using stratified 5-fold cross-validation; 95% CIs for predictive metrics were estimated using 5000 stratified bootstrap resamples of out-of-fold predictions. Disinformation was analyzed descriptively because only 2 cases were identified. An exploratory thematic analysis was conducted on 116 selected viewer comments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Misinformation was identified in 21 of 122 (17.2%; 95% CI 11.5%-24.9%) videos, whereas disinformation occurred in 2 of 122 (1.6%; 95% CI 0.5%-5.8%). Misinformation was most frequent among videos addressing autism spectrum disorders (11/27, 40.7%), impulse control disorders (1/3, 33.3%), and mood disorders (4/13, 30.8%). Professional credentials were not disclosed in 63 of 122 (51.6%) videos, and only 9 of 122 (7.4%) referenced an external scientific source. The observable-feature model demonstrated modest discrimination, with an area under the receiver operating characteristic curve of 0.70 (95% CI 0.56-0.82), balanced accuracy of 0.69 (95% CI 0.58-0.79), recall of 0.67 (95% CI 0.48-0.86), and F&lt;sub&gt;1&lt;/sub&gt;-score of 0.44 (95% CI 0.32-0.56). Qualitative analysis identified 5 recurring patterns in viewer responses: sharing and validation of lived experiences, discussion of diagnosis and misdiagnosis, frustration with mental health care, peer support and encouragement, and exchanges about treatment and medication experiences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A substantial minority of the analyzed TikTok videos contained misinformation, with particularly high proportions among some neurodevelopmental and mood-related topics. Platform-observable characteristics provided only modest discrimination of misinformation, underscoring the difficulty of identifying misleading mental health content from surface-level features alone. Viewer c","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e105698"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194171","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":"Feasibility of Using a Wearable Device to Identify Loneliness Among Older Adults Living Alone: Mixed Methods Study.","authors":"Rajna Ogrin, Georgina Johnstone, Bradley R Crammond, Judy A Lowthian","doi":"10.2196/94027","DOIUrl":"10.2196/94027","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Addressing loneliness is a public health priority, with increasing interest in technological solutions for older adults. However, evidence on real-world feasibility and acceptability of such technologies remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated the feasibility and acceptability of the Conversation as Therapy (CaT) Pin, a wearable device designed to capture time spent in conversation among older adults living alone, following prototype refinement. Specifically, the study assessed whether a sufficient amount of synchronized, device-derived conversation data and self-reported loneliness data could be generated to explore the relationship between conversation time and loneliness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 2-phase, mixed methods feasibility study was conducted. In phase 1, a Consumer Advisory Group (CAG) participated in a 1-hour discussion to inform study processes and device design, followed by a 1-week prototype test with older adults (n=3). Prototype usability, device design, and study procedures were explored through interviews and informed iterative refinement. In phase 2, community-dwelling adults aged 65 years or older living alone trialed the device for 2 weeks. Participants completed activity logs capturing loneliness, activity engagement, device wear, and conversations at 6-hour intervals. Device-captured conversation time was compared with self-reported data where available. Qualitative interviews were analyzed using reflexive thematic analysis to understand participant experiences of device acceptability and feasibility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In phase 1, 6 CAG participants, including 3 prototype testers, identified usability and design issues that led to modifications before phase 2. Phase 2 involved 23 participants (15 women; mean age 79.4 y, SD 6.7 y), with 7 classified as lonely using the UCLA-3 scale. However, only 8 (34.8%) participants generated sufficient concurrent device and activity log data, preventing meaningful assessment of the relationship between conversation time and loneliness. Feasibility challenges were driven by device acceptability, namely usability, comfort, aesthetics, and integration into daily life, which limited sustained wear and data synchronization. Qualitative findings indicated that participants prioritized quality rather than quantity of social interaction, and many did not perceive personal benefit from device use, citing lack of perceived need or concerns related to functionality and design. Together, methodological and conceptual challenges were identified in using conversation time as a potential indicator of loneliness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrated that, in its current form, using a wearable device to capture time spent in conversation and align these data with self-reported loneliness was not feasible among older adults living alone. Feasibility was constrained by device acceptability relate","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e94027"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194112","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":"Selection of Outcomes and Measurement Methods in Clinical Trials for Digital Therapeutics: Qualitative Analysis.","authors":"Johannes Mahlmann, Anne Mainz, Vera Weirauch, Achim Mortsiefer, Sven Meister","doi":"10.2196/86437","DOIUrl":"10.2196/86437","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the availability of digital therapeutic apps in medicine, digital therapeutics (DTx), has significantly increased. To evaluate the therapeutic efficacy of DTx, an increasing number of scientific studies have been conducted in this field. Several authors have pointed out that a standardized approach to DTx evaluation is relevant to improving the comparability of apps in the future. Currently, it is unclear how study authors proceed when selecting outcomes and measurement methods (O&M) for DTx studies.</p><p><strong>Objective: </strong>The primary aim of this study was to investigate how study authors currently select O&M in DTx studies, specifically for applications delivered in the form of apps. The secondary objectives were to collect suggestions for improving the comparability of DTx apps and studies in the future and to examine whether core outcome sets (COS) could represent a possible solution for enhancing comparability.</p><p><strong>Methods: </strong>This study was based on 19 semistructured interviews. All interview partners had prior experience in planning and conducting DTx studies. The interviews were conducted between August 2024 and November 2024. Subsequently, qualitative data analysis was performed according to Kuckartz and Rädiker using a deductive-inductive research approach.</p><p><strong>Results: </strong>The results of this study showed that the methodological approach for selecting O&M in DTx studies was primarily based on research, as well as on personal prior experience and individual ideas. Interview participants indicated that when selecting O&M, they particularly focused on aspects such as scientific quality criteria or practical implementation and feasibility. A suggestion for achieving better comparability of DTx studies in the future was to use standardized O&M per therapeutic indication area. Almost all interviewees considered COS to be a suitable approach for improving the comparability of DTx and associated studies. However, we also identified critical perspectives that questioned their application.</p><p><strong>Conclusions: </strong>Across professional groups, both commonalities and differences were observed in methodological approaches as well as in the selection of O&M in DTx studies. To improve the comparability of DTx interventions and trials, several approaches have been developed, for example, through the use of guidance frameworks, artificial intelligence programs, or the establishment of COS. However, further research is warranted to advance this field.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e86437"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194088","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 the Influence of Substance Use, Mental Health, and Stigma on Smoking Behavior Among People Living With HIV: Rapid Qualitative Analysis.","authors":"Narayani Ballambat, Dylan R Rice, Reem Najjar, Jessica G Wijesundara, Celine Larkin, Andrew W Liu, Yvonne P Nguyen, Hai Tran, Thi Thanh Xuan Nguyen, Anh Ngoc Do, Nguyen Vu, Melissa Goulding, Jeroan J Allison, Hoa L Nguyen, Rajani Shankar Sadasivam","doi":"10.2196/97427","DOIUrl":"10.2196/97427","url":null,"abstract":"<p><strong>Background: </strong>In Vietnam, an upper-middle-income country, the majority of people living with HIV smoke. Vietnam has established quitline services to support this population, but they remain underused. Text messaging is widely used in Vietnam, and studies in other countries have shown that text messaging interventions can promote smoking cessation. Our goal was to conduct a formative study to inform the development of a text messaging intervention to increase access to quitline services and promote smoking cessation among people living with HIV who smoke in Vietnam.</p><p><strong>Objective: </strong>This study aimed to identify factors influencing smoking behaviors among people living with HIV in Vietnam through qualitative interviews to inform a tailored text messaging intervention.</p><p><strong>Methods: </strong>In October 2022, study staff conducted 30- to 45-minute qualitative interviews with 20 people living with HIV from clinics in Hai Phong and Quang Ninh provinces, Vietnam. Interviews explored factors that influenced smoking, such as substance use, mental health, HIV stigma, social context, and health. A rapid qualitative analysis approach was used to synthesize themes from the data, including identifying key domains based on prior literature, developing a semistructured interview guide, and organizing data within domains to support iterative theme development. These interviews were used to develop prompts to guide people living with HIV who smoke in writing peer messages for a text messaging intervention.</p><p><strong>Results: </strong>Across 6 themes, participants described smoking as part of their everyday lives, shaped by social situations, stress, alcohol use, and their experiences living with HIV. Social smoking and early initiation were important influences on smoking behaviors, whereas financial concerns and protecting family members and others from secondhand smoke promoted cessation. Some participants used smoking to cope, whereas others wished to quit for better health. HIV stigma was a major contributor to smoking, with many participants describing increased smoking after diagnosis. Participants suggested that cessation support should be better tailored to their needs.</p><p><strong>Conclusions: </strong>Smoking behaviors among people living with HIV are shaped by overlapping influences, including societal norms, mental health, HIV-related stigma, and other structural stressors. An understanding of these overlapping factors can inform the development of text-based interventions that offer effective cessation support tailored to this population.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e97427"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194091","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":"AI-Enabled Telerehabilitation for Chronic Nonspecific Neck Pain: Multicenter Randomized Controlled Trial.","authors":"Yiwei Zhao, Yanbin Zhang, Ye Lin, Di Liu, Jiamin Zheng, Siyi Cai","doi":"10.2196/87487","DOIUrl":"10.2196/87487","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Exercise therapy is effective in managing chronic nonspecific neck pain (CNP). Nevertheless, the high burden of CNP continues to place pressure on existing rehabilitation services, especially in remote or resource-constrained settings where continuous and standardized physical therapy may be difficult to access. By combining home-based exercise with remote supervision and movement feedback, AI-enabled telerehabilitation may broaden access to rehabilitation and support the continued management of CNP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study examined whether an AI-enabled telerehabilitation program was noninferior to standard outpatient rehabilitation for improving neck-related disability in individuals with CNP and compared the effects of the 2 interventions on pain, health-related quality of life, and cervical range of motion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This multicenter, prospective, parallel-group randomized noninferiority trial was conducted at Peking Union Medical College Hospital and Beijing Jishuitan Hospital. Patients with CNP of at least 3 months' duration were randomized 1:1 to a telerehabilitation group (TG) or outpatient rehabilitation group (OG) using concealed, web-based, variable blocks stratified by center and baseline Neck Disability Index (NDI) severity. Both groups completed identical 24-week strengthening and stretching programs (3 sessions per wk; ≈30 min per session) and were assessed at weeks 0, 4, 8, 12, and 24. TG trained at home using sensor-based movement recognition and threshold rules; OG received face-to-face outpatient rehabilitation. Week-24 NDI was the primary outcome; Numeric Pain Rating Scale (NPRS), EQ-5D, and cervical range of motion were secondary. Noninferiority required the upper 95% CI bound of the TG-OG NDI difference to be &lt;10 percentage points (5/50). Analyses were intention-to-treat; assessors and statisticians were blinded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 312 individuals screened, 116 were randomized (58 per group). At week 24, 55 TG and 53 OG participants completed assessments; all 116 participants were included in the primary intention-to-treat analysis using observed or imputed data. The between-group differences in NDI (TG - OG) were -2.8 (95% CI -6.3 to 0.7; &lt;i&gt;P&lt;/i&gt;=.11) at week 12 and -2.5 (95% CI -6.2 to 1.2; &lt;i&gt;P&lt;/i&gt;=.15) at week 24. At week 24, the upper 95% CI bound was below the prespecified noninferiority margin of 10 percentage points on the 0 to 100 NDI scale, equivalent to 5 points on the original 0 to 50 scale, demonstrating noninferiority of TG. Both groups showed clinically meaningful reductions in NDI, with comparable improvements in NPRS, EQ-5D, and cervical range of motion. No intervention-related harms occurred.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Over 24 weeks, AI-enabled telerehabilitation was noninferior to exercise-matched outpatient rehabilitation for neck-related disability, with broadly comparable improvements in pain, health-rel","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e87487"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Digital Tool for Culturally Responsive Reflection and Case Conceptualization in First-Line Services to Support Children With a Refugee Background: Development and Usability Study.","authors":"Charlotte Angela Van Bogaert, Benji Jame, Geertrui Maria Serneels, Tom Van Daele","doi":"10.2196/86809","DOIUrl":"10.2196/86809","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In 2023, over 117 million people were forcibly displaced worldwide, 40% of them children. Refugee children are at higher risk for posttraumatic stress disorder, depression, and anxiety, while professionals may struggle to address mental health and trauma-related concerns across unfamiliar cultural contexts. The Psychiatry Assisting the Culturally Diverse Community in Creating Healing Ties (PACCT) approach supports culturally responsive care for culturally diverse families, but first-line professionals often lack practical support to apply such an approach in routine care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The study aimed to (1) identify professionals' support to inform the development of Implementing PACCT through a Culturally Contextualized Tool (IMPACCT), a digital decision-support tool; (2) map these needs onto the initial IMPACCT conceptualization; and (3) gather initial feedback from professionals to guide further refinement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a qualitative descriptive study in 3 phases. First, we analyzed 905 anonymized help desk questions submitted between May 2021 and November 2023 to Solentra, a Belgian center of expertise providing transcultural mental health support and consultation for refugees and other vulnerable migrant populations. Questions were coded using a predeveloped framework to identify recurrent professional needs. Second, we mapped all help desk question categories onto the different components of the first conceptualization of IMPACCT to ensure that its content reflected users' questions and expectations. Third, 19 professionals working with refugee and migrant populations in Belgium were recruited through an open call between December 2024 and February 2025 using convenience sampling. After hands-on experience with a first iteration of IMPACCT, they provided feedback during semistructured interviews. These interviews were subsequently analyzed using deductive qualitative content analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the help desk questions, trauma-related concerns were the most common, followed by anxiety/stress and depressive symptoms. Acculturation was the most dominant culture-migration category. Most contexts were family- and school-oriented, and professionals were primarily asking for supervision or concrete next-step guidance. The interviews (N=19) found that the professionals thought that IMPACCT provided them with better-structured and early reflection, lessened some of the decision-making burden, and enabled a more structurally informed understanding of culture in the context of migration. Reported barriers included the time required and a lack of adaptation in workflow, with more experienced professionals reporting less perceived value. Additionally, participants suggested using IMPACCT as a training and/or supervision aid in first-line services and as standard decision support in ambulatory and inpatient care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/stro","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e86809"},"PeriodicalIF":2.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194123","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}