JMIR Formative Research最新文献

{"title":"Psychological and Behavioral Insights From Social Media Users: Natural Language Processing-Based Quantitative Study on Mental Well-Being.","authors":"Xingwei Yang, Guang Li","doi":"10.2196/60286","DOIUrl":"https://doi.org/10.2196/60286","url":null,"abstract":"<p><strong>Background: </strong>Depression significantly impacts an individual's thoughts, emotions, behaviors, and moods; this prevalent mental health condition affects millions globally. Traditional approaches to detecting and treating depression rely on questionnaires and personal interviews, which can be time consuming and potentially inefficient. As social media has permanently shifted the pattern of our daily communications, social media postings can offer new perspectives in understanding mental illness in individuals because they provide an unbiased exploration of their language use and behavioral patterns.</p><p><strong>Objective: </strong>This study aimed to develop and evaluate a methodological language framework that integrates psychological patterns, contextual information, and social interactions using natural language processing and machine learning techniques. The goal was to enhance intelligent decision-making for detecting depression at the user level.</p><p><strong>Methods: </strong>We extracted language patterns via natural language processing approaches that facilitate understanding contextual and psychological factors, such as affective patterns and personality traits linked with depression. Then, we extracted social interaction influence features. The resultant social interaction influence that users have within their online social group is derived based on users' emotions, psychological states, and context of communication extracted from status updates and the social network structure. We empirically evaluated the effectiveness of our framework by applying machine learning models to detect depression, reporting accuracy, recall, precision, and F₁-score using social media status updates from 1047 users along with their associated depression diagnosis questionnaire scores. These datasets also include user postings, network connections, and personality responses.</p><p><strong>Results: </strong>The proposed framework demonstrates accurate and effective detection of depression, improving performance compared to traditional baselines with an average improvement of 6% in accuracy and 10% in F₁-score. It also shows competitive performance relative to state-of-the-art models. The inclusion of social interaction features demonstrates strong performance. By using all influence features (affective influence features, contextual influence features, and personality influence features), the model achieved an accuracy of 77% and a precision of 80%. Using affective features and affective influence features also showed strong performance, achieving 81% precision and an F₁-score of 79%.</p><p><strong>Conclusions: </strong>The developed framework offers practical applications, such as accelerating hospital diagnoses, improving prediction accuracy, facilitating timely referrals, and providing actionable insights for early interventions in mental health treatment plans.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60286"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005729","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 of an eHealth Intervention Including Self-Management for Reducing Sedentary Time in the Transition to Retirement: Participatory Design Study.","authors":"Lisa Hultman, Caroline Eklund, Petra von Heideken Wågert, Anne Söderlund, Maria Lindén, Magnus L Elfström","doi":"10.2196/63567","DOIUrl":"https://doi.org/10.2196/63567","url":null,"abstract":"<p><strong>Background: </strong>Having a great amount of sedentary time is common among older adults and increases with age. There is a strong need for tools to reduce sedentary time and promote adherence to reduced sedentary time, for which eHealth interventions have the potential to be useful. Interventions for reducing sedentary time in older adults have been found to be more effective when elements of self-management are included. When creating new eHealth interventions, accessibility and effectiveness can be increased by including end users as co-designers in the development process.</p><p><strong>Objective: </strong>The aim was to explore the desired features of an eHealth intervention including self-management for reducing sedentary time and promoting adherence to reduced sedentary time in older adults transitioning from working life to retirement. Further, the aim was to develop a digital prototype of such an eHealth intervention.</p><p><strong>Methods: </strong>The study used the participatory design approach to include end users, researchers, and a web designer as equal partners. Three workshops were conducted with 6 older adults transitioning to retirement, 2 researchers, and 1 web designer. Thematic analysis was used to analyze the data from the workshops.</p><p><strong>Results: </strong>Participants expressed a desire for an easy-to-use eHealth intervention, which could be accessed from mobile phones, tablets, and computers, and could be individualized to the user. The most important features for reducing sedentary time were those involving finding joyful activities, setting goals, and getting information regarding reduced sedentary time. Participants expressed that the eHealth intervention would need to first provide the user with knowledge regarding sedentary time, then offer features for measuring sedentary time and for setting goals, and lastly provide support in finding joyful activities to perform in order to avoid being sedentary. According to the participants, an eHealth intervention including self-management for reducing sedentary time in older adults in the transition to retirement should be concise, accessible, and enjoyable. A digital prototype of such an eHealth intervention was developed.</p><p><strong>Conclusions: </strong>The developed eHealth intervention including self-management for reducing sedentary time in older adults transitioning to retirement is intended to facilitate behavior change by encouraging the user to participate in autonomously motivated activities. It uses several behavior change techniques, such as goal setting and action planning through mental contrasting and implementation intention, as well as shaping knowledge. Its active components for reducing sedentary time can be explained using the integrated behavior change model. Further research is needed to evaluate the feasibility and effectiveness of the eHealth intervention.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63567"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005721","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":"Public Understanding and Expectations of Digital Health Evidence Generation: Focus Group Study.","authors":"Paulina Bondaronek, Jingfeng Li, Henry W W Potts","doi":"10.2196/56523","DOIUrl":"10.2196/56523","url":null,"abstract":"<p><strong>Background: </strong>The rapid proliferation of health apps has not been matched by a comparable growth in scientific evaluations of their effectiveness, particularly for apps available to the public. This gap has prompted ongoing debate about the types of evidence necessary to validate health apps, especially as the perceived risk level varies from wellness tools to diagnostic aids. The perspectives of the general public, who are direct stakeholders, are notably underrepresented in discussions on digital health evidence generation.</p><p><strong>Objective: </strong>This study aimed to explore public understanding and expectations regarding the evidence required to demonstrate health apps' effectiveness, including at varying levels of health risk.</p><p><strong>Methods: </strong>A total of 4 focus group discussions were held with UK residents aged 18 years and older, recruited through targeted advertisements to ensure demographic diversity. Participants discussed their views on evidence requirements for 5 hypothetical health apps, ranging from low-risk wellness apps to high-risk diagnostic tools. Focus groups were moderated using a structured guide, and data were analyzed using reflexive thematic analysis to extract common themes.</p><p><strong>Results: </strong>A total of 5 key themes were established: personal needs, app functionality, social approval, expectations of testing, and authority. Participants relied on personal experiences and social endorsements when judging the effectiveness of low-risk digital health interventions, while making minimal reference to traditional scientific evidence. However, as the perceived risk of an app increased, there was a noticeable shift toward preferring evidence from authoritative sources, such as government or National Health Service endorsements.</p><p><strong>Conclusions: </strong>The public have a preference for evidence that resonates on a personal level, but also show a heightened demand for authoritative guidance as the potential risk of digital health interventions increases. These perspectives should guide developers, regulators, and policy makers as they balance how to achieve innovation, safety, and public trust in the digital health landscape. Engaging the public in evidence-generation processes and ensuring transparency in app functionality and testing can bridge the gap between public expectations and regulatory standards, fostering trust in digital health technologies.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e56523"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046852","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":"Reflections of Foster Youth Engaging in the Co-Design of Digital Mental Health Technology: Duoethnography Study.","authors":"Ifunanya Ezimora, Tylia Lundberg, Dylan Miars, Jeruel Trujeque, Ashley Papias, Margareth V Del Cid, Johanna B Folk, Marina Tolou-Shams","doi":"10.2196/53231","DOIUrl":"10.2196/53231","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Current research on digital applications to support the mental health and well-being of foster youth is limited to theoretical applications for transition-aged foster youth and support platforms developed without intentional input from foster youth themselves. Centering the lived expertise of foster youth in digital solutions is crucial to dismantling barriers to care, leading to an increase in service access and improving mental health outcomes. Co-design centers the intended end users during the design process, creating a direct relationship between potential users and developers. This methodology holds promise for creating tools centered on foster youth, yet little is known about the co-design experience for foster youth. Understanding foster youth's experience with co-design is crucial to identifying best practices, knowledge of which is currently limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this paper is to reflect on the experiences of 4 foster youth involved in the co-design of FostrSpace, a mobile app designed through a collaboration among foster youth in the San Francisco Bay Area; clinicians and academics from the Juvenile Justice Behavioral Health research team at the University of California, San Francisco; and Chorus Innovations, a rapid technology development platform specializing in participatory design practices. Key recommendations for co-designing with foster youth were generated with reference to these reflections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A duoethnography study was conducted over a 1-month period with the 4 transition-aged former foster youth co-designers of FostrSpace via written reflections and a single in-person roundtable discussion. Reflections were coded and analyzed via reflexive thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 4 main themes were identified from coding of the duoethnography reflections: power and control, resource navigation, building community and safe spaces, and identity. Themes of power and control and resource navigation highlighted the challenges FostrSpace co-designers experienced trying to access basic needs, support from caregivers, and mental health resources as foster youth and former foster youth. Discussions pertaining to building community and safe spaces highlighted the positive effect of foster youth communities on co-designers, and discussions related to identity revealed the complexities associated with understanding and embracing foster youth identity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This duoethnography study highlights the importance of centering the lived expertise of co-designers throughout the app development process. As the digital health field increasingly shifts toward using co-design methods to develop digital mental health technologies for underserved youth populations, we offer recommendations for researchers seeking to ethically and effectively engage youth co-designers. Actively reflecting throughout the co-de","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e53231"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005730","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, User Acceptance, and Outcomes of Using a Cancer Prehabilitation App for Exercise: Pilot Cohort Study.","authors":"Fuquan Zhang, Deepali Bang, Christine Alejandro Visperas, Mon Hnin Tun, San San Tay","doi":"10.2196/64427","DOIUrl":"https://doi.org/10.2196/64427","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The efficacy of cancer prehabilitation programs is supported by international reviews and meta-analyses. Technology has been deployed in cancer prehabilitation to address challenges such as access or limited resources. This study evaluated the feasibility, user acceptance, safety, and program outcomes of a newly developed mobile app for cancer prehabilitation. The app integrates with Singapore's existing health care mobile app, Health Buddy, and provides instructional videos for prescribed exercises.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objectives of this study were to investigate the feasibility, user experience, safety, and outcomes of a mobile app for cancer prehabilitation within a hospital-associated, home-based, multimodal cancer prehabilitation program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study analyzed the records of patients enrolled in the cancer prehabilitation program from September 1, 2022, to March 30, 2023. Patients who participated in the prehabilitation program (n=63) were categorized into 2 groups: those prescribed the app (n=41) and those who were not (n=22). There was further subgroup analysis of those who were prescribed: app users (n=25) versus those who were non-app users (n=16). Demographics, Fried Frailty Phenotype, prehabilitation duration, app use, and functional outcome measures (6-minute walk test [6MWT], 30-second sit-to-stand test [STS], timed up and go test [TUG], and Hospital Anxiety and Depression Scale [HADS]) were collected. Compliance was determined by the completion of prescribed exercises and the accuracy of executing these exercises, with a high compliance rate considered to be at 80% or more. Baseline characteristics and preoperative outcomes were compared between the groups. User satisfaction was assessed through surveys among app users (n=25).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 63 patients, 41 (65.1%) patients were prescribed the app, of which 22 (34.9%) patients were users. No significant differences in preoperative functional improvements were observed between app users and nonusers (6MWT: P=.60; STS: P=.81; TUG: P=.53; HADS: P=.36), or between those prescribed and not prescribed the app (6MWT: P=.94; STS: P=.26; TUG: P=.39; HADS: P=.62). However, high compliance rates (80%) were observed among app users. Patient satisfaction with the app was high (&gt;90%), with positive feedback on ease of use and technical reliability. Baseline measures revealed significantly lower functional scores and higher mean frailty scores in the nonprescribed group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This preliminary study demonstrates the acceptability, feasibility, and safety of Singapore's first smartphone app for exercise prescription in cancer prehabilitation. Lower baseline functional outcome measures and a higher mean frailty score in the unprescribed group have implications for the selection process and patient participation. Further studies should include strategies t","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64427"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Machine Learning-Based Automated Patient Engagement Estimator for Telehealth: Algorithm Development and Validation Study.","authors":"Pooja Guhan, Naman Awasthi, Kathryn McDonald, Kristin Bussell, Gloria Reeves, Dinesh Manocha, Aniket Bera","doi":"10.2196/46390","DOIUrl":"https://doi.org/10.2196/46390","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patient engagement is a critical but challenging public health priority in behavioral health care. During telehealth sessions, health care providers need to rely predominantly on verbal strategies rather than typical nonverbal cues to effectively engage patients. Hence, the typical patient engagement behaviors are now different, and health care provider training on telehealth patient engagement is unavailable or quite limited. Therefore, we explore the application of machine learning for estimating patient engagement. This can assist psychotherapists in the development of a therapeutic relationship with the patient and enhance patient engagement in the treatment of mental health conditions during tele-mental health sessions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to examine the ability of machine learning models to estimate patient engagement levels during a tele-mental health session and understand whether the machine learning approach could support therapeutic engagement between the client and psychotherapist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We proposed a multimodal learning-based approach. We uniquely leveraged latent vectors corresponding to affective and cognitive features frequently used in psychology literature to understand a person's level of engagement. Given the labeled data constraints that exist in health care, we explored a semisupervised learning solution. To support the development of similar technologies for telehealth, we also plan to release a dataset called Multimodal Engagement Detection in Clinical Analysis (MEDICA). This dataset includes 1229 video clips, each lasting 3 seconds. In addition, we present experiments conducted on this dataset, along with real-world tests that demonstrate the effectiveness of our method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our algorithm reports a 40% improvement in root mean square error over state-of-the-art methods for engagement estimation. In our real-world tests on 438 video clips from psychotherapy sessions with 20 patients, in comparison to prior methods, positive correlations were observed between psychotherapists' Working Alliance Inventory scores and our mean and median engagement level estimates. This indicates the potential of the proposed model to present patient engagement estimations that align well with the engagement measures used by psychotherapists.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patient engagement has been identified as being important to improve therapeutic alliance. However, limited research has been conducted to measure this in a telehealth setting, where the therapist lacks conventional cues to make a confident assessment. The algorithm developed is an attempt to model person-oriented engagement modeling theories within machine learning frameworks to estimate the level of engagement of the patient accurately and reliably in telehealth. The results are encouraging and emphasize the value of combining psychology and machine lear","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e46390"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005717","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":"Insights From Diverse Perspectives on Social Media Messages to Inform Young Adults With Cancer About Clinical Trials: Focus Group Study.","authors":"Melissa P Beauchemin, Desiree Walker, Allison Rosen, Maria Frazer, Meital Eisenberger, Rhea K Khurana, Edward Bentlyewski, Victoria Fedorko, Corey H Basch, Grace C Hillyer","doi":"10.2196/64265","DOIUrl":"https://doi.org/10.2196/64265","url":null,"abstract":"<p><strong>Background: </strong>Low rates of adolescent and young adult (YA; aged 15-39 y) clinical trial enrollment (CTE), particularly among underserved groups, have resulted in a lack of standardized cancer treatments and follow-up guidelines for this group that may limit improvement in cancer treatments and survival outcomes for YAs.</p><p><strong>Objective: </strong>To understand and address unique barriers to CTE, we conducted focus groups to learn about informational, financial, and psychosocial needs of YAs surrounding CTE and identify strategies to address these barriers.</p><p><strong>Methods: </strong>We conducted 5 focus groups in 2023 among a diverse sample of YA patients from across the United States. An interview guide was developed collaboratively with YA advocates. Specifically, informational needs, financial concerns, and psychosocial issues were explored, and participants were probed to suggest strategies, especially those that leverage technology, to address these barriers. Sessions were audio recorded, transcribed, and coded using direct content analysis. Findings were synthesized through consensus discussions.</p><p><strong>Results: </strong>We confirmed the previously proposed thematic barriers regarding YA CTE and identified 9 subthemes: awareness, lack of clear and accessible CTE information, fear of the unknown, assumptions about costs, insurance coverage, navigating financial responsibilities, clinical trial discussions, clinical trial misconceptions, and desire for a support network. Throughout, YAs mentioned needs that might be addressed through informational outreach leveraging digital technology, the internet, and social media.</p><p><strong>Conclusions: </strong>This study expands knowledge of YA perceived barriers to CTE. These findings suggest that leveraging digital technology to disseminate reliable information to address needs may be an effective strategy to improve clinical trial participation in the YA population.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64265"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046907","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 Mobile Health Intervention to Support Collaborative Decision-Making in Mental Health Care: Development and Usability.","authors":"Kristin Lie Romm, Mari Skoge, Elizabeth Ann Barrett, Lars-Christian Berentzen, Dagfinn Bergsager, Pål Fugelli, Thomas Bjella, Erlend Strand Gardsjord, Kristine Kling, Sindre Hembre Kruse, Kari Jorunn Kværner, Ingrid Melle, Erlend Mork, Henrik Myhre Ihler, Eline Borger Rognli, Carmen Simonsen, Tor Gunnar Værnes, Sofie Ragnhild Aminoff","doi":"10.2196/57614","DOIUrl":"https://doi.org/10.2196/57614","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Shared decision-making between clinicians and service users is crucial in mental health care. One significant barrier to achieving this goal is the lack of user-centered services. Integrating digital tools into mental health services holds promise for addressing some of these challenges. However, the implementation of digital tools, such as mobile apps, remains limited, and attrition rates for mental health apps are typically high. Design thinking can support the development of tools tailored to the needs of service users and clinicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to develop and beta test a digital tool designed for individuals with severe mental disorders or substance use disorders to facilitate shared decision-making on treatment goals and strategies within mental health services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used a user-centered design approach to develop iTandem, an app facilitating collaborative treatment between service users and clinicians. Through qualitative interviews and workshops, we engaged 6 service users with severe mental disorders or substance use disorders, 6 clinicians, and 1 relative to identify and design relevant app modules. A beta test of iTandem was conducted to refine the app and plan for a pilot trial in a clinical setting. After 6 weeks of app use, 5 clinicians and 4 service users were interviewed to provide feedback on the concept, implementation, and technical issues. Safety and ethical considerations were thoroughly discussed and addressed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;To avoid overload for the service users, we applied a pragmatic take on module content and size. Thus, iTandem includes the following 8 modules, primarily based on the needs of service users and clinicians: Sleep (sleep diary), Medication (intake and side effects), Recovery (measures, including well-being and personal recovery, and exercises, including good things and personal strengths), Mood (mood diary and report of daily feelings), Psychosis (level of positive symptoms and their consequences and level of negative symptoms), Activity (goal setting and progress), Substance use (weekly use, potential triggers or strategies used to abstain), and Feedback on therapy (of individual sessions and overall rating of the past week). For the beta testing, service users and clinicians collaborated in choosing 2-3 modules in iTandem to work with during treatment sessions. The testing showed that the app was well received by service users, and that facilitation for implementation is crucial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;iTandem and similar apps have the potential to enhance treatment outcomes by facilitating shared decision-making and tailoring treatment to the needs of service users. However, successful implementation requires thorough testing, iterative development, and evaluations of both utility and treatment effects. There is a critical need to focus on how technology integrates into cli","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e57614"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005691","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":"Sexual and Gender Minority Adolescents' Preferences for HIV Pre-Exposure Prophylaxis Social Marketing Campaigns: Qualitative Preimplementation Study.","authors":"Kathryn Macapagal, Juan Pablo Zapata, Junye Ma, Jacob D Gordon, Christopher Owens, Silvia Valadez-Tapia, Peter Cummings, Nathan Walter, Jim Pickett","doi":"10.2196/60398","DOIUrl":"https://doi.org/10.2196/60398","url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender minority (SGM) adolescents in the United States are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical HIV prevention method, but its awareness and uptake among SGM adolescents are low. There are no adolescent-centered PrEP social marketing campaigns in the United States that have the potential to increase awareness and interest in PrEP.</p><p><strong>Objective: </strong>To address this gap, this qualitative study aims to examine SGM adolescents' needs and preferences regarding adolescent-centered PrEP social marketing campaigns.</p><p><strong>Methods: </strong>SGM adolescents from Chicago and its surrounding areas participated in web-based asynchronous focus groups from February to May 2021. Questions elicited their preferences for content, design, and delivery of SGM adolescent-centered PrEP campaigns. We used rapid qualitative data analysis and organized the findings around key components of social marketing, known as the 4 Ps: product, price, place, and promotion.</p><p><strong>Results: </strong>Participants (N=56) were aged 14 to 19 years (mean 18.16, SD 1.22 y), and 64% (36/56) of them identified as a racial or ethnic minority. Among the 56 participants, 70% (n=39) were aware of PrEP; however, 95% (n=53) did not know that PrEP could be prescribed to those aged under 18 years. Adolescents expressed a need for PrEP campaign messaging that provides simple, accurate, and easily accessible information (eg, what is PrEP, for whom PrEP is indicated, and where and how to access PrEP). For product and price, SGM adolescents wanted a campaign to address barriers to, costs of, and how to access PrEP and desired to know about other adolescents' PrEP experiences to improve campaign relatability. For place and promotion, participants preferred digital campaigns on social media to reduce the possibility of embarrassment and stigma and increase the accessibility of health content.</p><p><strong>Conclusions: </strong>These findings lay the groundwork for designing adolescent-centered educational PrEP campaigns that prioritize both user preferences in PrEP marketing design and strategies to overcome common barriers to PrEP awareness.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60398"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005736","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":"Recruitment Challenges and Strategies in a Technology-Based Intervention for Dementia Caregivers: Descriptive Study.","authors":"Eunjung Ko, Ye Gao, Peng Wang, Lahiru Wijayasingha, Kathy D Wright, Kristina C Gordon, Hongning Wang, John A Stankovic, Karen M Rose","doi":"10.2196/59291","DOIUrl":"https://doi.org/10.2196/59291","url":null,"abstract":"<p><strong>Background: </strong>Researchers have encountered challenges in recruiting unpaid caregivers of people living with Alzheimer disease and related dementias for intervention studies. However, little is known about the reasons for nonparticipation in in-home smart health interventions in community-based settings.</p><p><strong>Objective: </strong>This study aimed to (1) assess recruitment rates in a smart health technology intervention for caregivers of people living with Alzheimer disease and related dementias and reasons for nonparticipation among them and (2) discuss lessons learned from recruitment challenges and strategies to improve recruitment.</p><p><strong>Methods: </strong>The smart health intervention was a 4-month, single-arm trial designed to evaluate an in-home, technology-based intervention that monitors stressful moments for caregiving dyads through acoustic signals and to provide the caregivers with real-time stress management strategies. The recruitment involved two main methods: on-site engagement by a recruiter from a memory clinic and social media advertising. Caregivers were screened for eligibility by phone between January 2021 and September 2023. The recruitment rates, reasons for nonparticipation, and participant demographics were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Of 201 caregivers contacted, 11 were enrolled in this study. Eighty-two caregivers did not return the screening call, and others did not participate due to privacy concerns (n=30), lack of interest (n=29), and burdensome study procedures (n=26). Our recruitment strategies included addressing privacy concerns, visualizing collected data through a dashboard, boosting social media presence, increasing the recruitment budget, updating advertisements, and preparing and deploying additional study devices.</p><p><strong>Conclusions: </strong>This study highlighted barriers to participation in the smart health intervention. Despite several recruitment strategies, enrollment rates remained below expectations. These findings underscore the need for future research to explore alternative methods for increasing the recruitment of informal dementia caregivers in technology-based intervention studies.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e59291"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046941","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}