JMIR Formative Research最新文献

{"title":"Informal Caregivers Connecting on the Web: Content Analysis of Posts on Discussion Forums.","authors":"Michelle L Foster, Chinenye Egwuonwu, Erin Vernon, Mohammad Alarifi, M Courtney Hughes","doi":"10.2196/64757","DOIUrl":"10.2196/64757","url":null,"abstract":"<p><strong>Background: </strong>About 53 million adults in the United States offer informal care to family and friends with disease or disability. Such care has an estimated economic value of US $600 million. Most informal caregivers are not paid nor trained in caregiving, with many experiencing higher-than-average levels of stress and depression and lower levels of physical health. Some informal caregivers participate in web-based forums related to their caregiving role.</p><p><strong>Objective: </strong>This study aimed to explore how informal caregivers use easy-to-access caregiving web-based forums, including the types of information they share and seek from others. It also aimed to gain insights into the informal caregiver experience from the content these informal caregivers posted.</p><p><strong>Methods: </strong>The study population consisted of participants who posted on 5 web-based forums for informal caregivers between February and April 2024. Researchers extracted the first 6 responses to the first 20 questions and comments to appear posted by the informal caregivers in each of the 5 forums, removing any individually identifying information. We used a codebook thematic analysis approach to examine the data with Dedoose (SocioCultural Research Consultants). Researchers independently read all posts and coded the data. The author group discussed the codes, reiteratively refined them, and identified themes within the data.</p><p><strong>Results: </strong>The data consisted of 100 initial posts and 600 responses. Over half of the initial posts included specific questions, with the remaining initial posts sharing experiences or reflections. Posts ranged in length from a sentence to more than 500 words. Domains identified included handling interpersonal challenges, navigating complicated systems, gathering tactical coping strategies, managing emotions, and connecting with others in similar situations. Negative interpersonal interactions were mentioned 123 times, with 77 posts describing challenging situations with extended family. Posters inquired about accessing resources, with health care and health insurance included 51 times, while legal and financial concerns were addressed 124 times. Caregiving challenges were mentioned hundreds of times, including discussion of hygiene (n=18), nutrition (n=21), and desire for a caregiving break (n=47). Posters expressed emotion in their comments 180 times, which included 32 mentions of guilt and 26 mentions of positive emotion. The importance of web-based group support was mentioned 301 times.</p><p><strong>Conclusions: </strong>Informal caregivers play an essential role in society. Many experience multifaceted challenges related to their caregiving role, and some turn to the internet for community. Accessing web-based discussion forums is a low-barrier method for informal caregivers to connect with others who may be experiencing similar emotions and challenges. Gaining a greater understanding of the ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64757"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005728","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 Mindfulness-Based App Intervention for Pregnant Women: Qualitative Evaluation of a Prototype Using Multiple Case Studies.","authors":"Silvia Rizzi, Maria Chiara Pavesi, Alessia Moser, Francesca Paolazzi, Michele Marchesoni, Stefania Poggianella, Erik Gadotti, Stefano Forti","doi":"10.2196/58265","DOIUrl":"10.2196/58265","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is a complex period characterized by significant transformations. How a woman adapts to these changes can affect her quality of life and psychological well-being. Recently developed digital solutions have assumed a crucial role in supporting the psychological well-being of pregnant women. However, these tools have mainly been developed for women who already present clinically relevant psychological symptoms or mental disorders.</p><p><strong>Objective: </strong>This study aimed to develop a mindfulness-based well-being intervention for all pregnant women that can be delivered electronically and guided by an online assistant with wide reach and dissemination. This paper aimed to describe a prototype technology-based mindfulness intervention's design and development process for pregnant women, including the exploration phase, intervention content development, and iterative software development (including design, development, and formative evaluation of paper and low-fidelity prototypes).</p><p><strong>Methods: </strong>Design and development processes were iterative and performed in close collaboration with key stakeholders (N=15), domain experts including mindfulness experts (n=2), communication experts (n=2), and psychologists (n=3), and target users including pregnant women (n=2), mothers with young children (n=2), and midwives (n=4). User-centered and service design methods, such as interviews and usability testing, were included to ensure user involvement in each phase. Domain experts evaluated a paper prototype, while target users evaluated a low-fidelity prototype. Intervention content was developed by psychologists and mindfulness experts based on the Mindfulness-Based Childbirth and Parenting program and adjusted to an electronic format through multiple iterations with stakeholders.</p><p><strong>Results: </strong>An 8-session intervention in a prototype electronic format using text, audio, video, and images was designed. In general, the prototypes were evaluated positively by the users involved. The questionnaires showed that domain experts, for instance, positively evaluated chatbot-related aspects such as empathy and comprehensibility of the terms used and rated the mindfulness traces present as supportive and functional. The target users found the content interesting and clear. However, both parties regarded the listening as not fully active. In addition, the interviews made it possible to pick up useful suggestions in order to refine the intervention. Domain experts suggested incorporating auditory components alongside textual content or substituting text entirely with auditory or audiovisual formats. Debate surrounded the inclusion of background music in mindfulness exercises, with opinions divided on its potential to either distract or aid in engagement. The target users proposed to supplement the app with some face-to-face meetings at crucial moments of the course, such as the beginning and","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":"e58265"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768956","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":"Sentiments of Individuals with Interstitial Cystitis/Bladder Pain Syndrome Toward Pentosan Polysulfate Sodium: Infodemiology Study.","authors":"Yulin Hswen, Qiuyuan Qin, Pressley Smith, Alison Swierczynski, Stuart Bauer, Erika Ladson, Amanda Leigh Garrett, Catherine A Brownstein","doi":"10.2196/54209","DOIUrl":"https://doi.org/10.2196/54209","url":null,"abstract":"<p><strong>Background: </strong>Interstitial cystitis/bladder pain syndrome (IC/BPS) is a multifactorial, chronic syndrome involving urinary frequency, urgency, and bladder discomfort. These IC/BPS symptoms can significantly impact individuals' quality of life, affecting their mental, physical, sexual, and financial well-being. Individuals sometimes rely on peer-to-peer support to understand the disease and find methods of alleviating symptoms. The only US Food and Drug Administration-approved medication to treat IC/BPS is pentosan polysulfate sodium (PPS). However, ocular pigmentary maculopathy has been described in some individuals, with greater severity associated with prolonged PPS exposure.</p><p><strong>Objective: </strong>While prior research has separately assessed the benefits and side effects of PPS, this study sought to identify (1) sentiments of individuals with IC/BPS toward PPS and (2) topics discussed by individuals with IC/BPS in conjunction with PPS through use of an internet peer-to-peer forum.</p><p><strong>Methods: </strong>Data were collected from Inspire-an anonymous web-based health community where individuals gather by condition to find support and information. Sentiment analysis and percentages of negative, positive, and neutral sentiment for PPS discussions encompassing each topic was conducted using VADER (Valence Aware Dictionary for Sentiment Reasoning). Topic modeling was conducted using latent Dirichlet allocation. Words with the highest probability were ranked to categorize each topic, and authors manually investigated and labeled discussions.</p><p><strong>Results: </strong>There were 354 forum posts related to PPS. Topic modeling with latent Dirichlet allocation revealed 5 topic categories: \"ineffectiveness or discontinued use,\" \"alternative treatments,\" \"personal treatment suggestions based on experience,\" \"severe side effects,\" and \"risk of long-term use.\" Topics related to \"severe side effects\" and \"risk of long-term use\" garnered less discussion, with the former also having the lowest positive sentiment (4.28, 14.29%). The topic \"ineffectiveness or discontinued use\" was most frequently discussed. This topic also had the highest percentage of negative posts (52/152, 34.21%). However, the average compound score was within the neutral compound score range (-0.094, SD 0.625). In addition, forum data highlighted individuals' acknowledgment of the efficacy of PPS in improving their quality of life, with statements such as \"saved my sanity\" being representative. The overall compound individuals' sentiment toward PPS was -0.083, split across 32.49% (115/354) negative, 22.03% (78/354) positive, and 45.48% (161/354) neutral sentiment categories.</p><p><strong>Conclusions: </strong>The overall authentic sentiment toward PPS is broad but balances to neutral. This neutral sentiment suggests that while some individuals express concerns about the side effects and long-term risks associated with PPS, others appreciate its po","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e54209"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046943","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":"Assessing the Current Limitations of Large Language Models in Advancing Health Care Education.","authors":"JaeYong Kim, Bathri Narayan Vajravelu","doi":"10.2196/51319","DOIUrl":"10.2196/51319","url":null,"abstract":"<p><strong>Unlabelled: </strong>The integration of large language models (LLMs), as seen with the generative pretrained transformers series, into health care education and clinical management represents a transformative potential. The practical use of current LLMs in health care sparks great anticipation for new avenues, yet its embracement also elicits considerable concerns that necessitate careful deliberation. This study aims to evaluate the application of state-of-the-art LLMs in health care education, highlighting the following shortcomings as areas requiring significant and urgent improvements: (1) threats to academic integrity, (2) dissemination of misinformation and risks of automation bias, (3) challenges with information completeness and consistency, (4) inequity of access, (5) risks of algorithmic bias, (6) exhibition of moral instability, (7) technological limitations in plugin tools, and (8) lack of regulatory oversight in addressing legal and ethical challenges. Future research should focus on strategically addressing the persistent challenges of LLMs highlighted in this paper, opening the door for effective measures that can improve their application in health care education.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e51319"},"PeriodicalIF":2.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005706","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":"Assessment, Decision, Adaptation, Production, Topical Experts-Integration, Training, and Testing (ADAPT-ITT) Framework to Tailor Evidence-Based Posttraumatic Stress Disorder Treatment for People With HIV to Enhance Engagement and Adherence: Qualitative Results from a Feasibility Randomized Controlled Trial.","authors":"Cristina M Lopez, Angela D Moreland, Stephanie Amaya, Erin Bisca, Christin Mujica, Tayler Wilson, Nathaniel Baker, Lauren Richey, Allison Ross Eckard, Patricia A Resick, Steven A Safren, Carla Kmett Danielson","doi":"10.2196/64258","DOIUrl":"https://doi.org/10.2196/64258","url":null,"abstract":"<p><strong>Background: </strong>Individuals with co-occurring posttraumatic stress disorder (PTSD) and HIV are at high-risk for negative HIV-related outcomes, including low adherence to antiretroviral therapy, faster disease progression, more hospitalizations, and almost twice the rate of death. Despite high rates of PTSD in persons with HIV (PWH) and poor HIV-related health outcomes associated with PTSD, an effective evidence-based treatment for PTSD symptoms in PWH does not exist.</p><p><strong>Objective: </strong>This study aimed to describe the adaptation and theater testing of an evidence-based intervention designed for people with co-occurring PTSD and HIV.</p><p><strong>Methods: </strong>The Assessment, Decision, Adaptation, Production, Topical experts-integration, Training, and Testing (ADAPT-ITT) framework guided the formative process used to modify an evidence-based PTSD treatment (cognitive processing therapy; CPT) to meet the unique needs of PWH experiencing PTSD. With the integration of Life-Steps for Medication Adherence (Life-Steps), the adapted protocol (CPT-Life-Steps for integration of adherence; CPT-L) targeted HIV-related stigma and HIV medication adherence within a trauma-informed framework. Theater testing was completed with 7 participants to evaluate acceptability of CPT-L for PWH. The qualitative data (N=54 recordings) used to evaluate and adapt CPT-L emerged from individual interviews conducted with participants after each therapy session as well as exit interviews conducted at posttreatment data collection.</p><p><strong>Results: </strong>After challenging stigma-related appraisals, participants expressed feeling less constrained by maladaptive thoughts. These shifts translated to increased self-efficacy with both HIV-related care and mental health.</p><p><strong>Conclusions: </strong>These results indicate that trauma-informed work with PWH should consider the impact of HIV on trauma-related stuck points, intersecting identities (including living with HIV), and challenging internalized stigma. Findings provide evidence that CPT-L is acceptable and effective in addressing internalized HIV stigma that impacts PTSD symptom maintenance and HIV treatment engagement.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov; NCT05275842; https://clinicaltrials.gov/study/NCT05275842?id=NCT05275842&rank=1.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1016/j.conctc.2023.101150.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64258"},"PeriodicalIF":2.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005708","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":"Resilience Informatics in Public Health: Qualitative Analysis of Conference Proceedings.","authors":"Maiya G Block Ngaybe, Lidia Azurdia Sierra, Andrew McNair, Myla Gonzalez, Mona Arora, Kacey Ernst, Enrique Noriega-Atala, M Sriram Iyengar","doi":"10.2196/63217","DOIUrl":"https://doi.org/10.2196/63217","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In recent years, public health has confronted 2 formidable challenges: the devastating COVID-19 pandemic and the enduring threat of climate change. The convergence of these crises underscores the urgent need for resilient solutions. Resilience informatics (RI), an emerging discipline at the intersection of informatics and public health, leverages real-time data integration from health systems, environmental monitoring, and technological tools to develop adaptive responses to multifaceted crises. It offers promising avenues for mitigating and adapting to these challenges by proactively identifying vulnerabilities and fostering adaptive capacity in public health systems. Addressing critical questions regarding target audiences, privacy concerns, and scalability is paramount to fostering resilience in the face of evolving health threats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The University of Arizona held a workshop, titled Resilience Informatics in Public Health, in November 2023 to serve as a pivotal forum for advancing these discussions and catalyzing collaborative efforts within the field. This paper aims to present a qualitative thematic analysis of the findings from this workshop.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A purposive sampling strategy was used to invite 40 experts by email from diverse fields, including public health, medicine, weather services, informatics, environmental science, and resilience, to participate in the workshop. The event featured presentations from key experts, followed by group discussions facilitated by experts. The attendees engaged in collaborative reflection and discussion on predetermined questions. Discussions were systematically recorded by University of Arizona students, and qualitative analysis was conducted. A detailed thematic analysis was performed using an inductive approach, supported by MAXQDA software to manage and organize data. Two independent researchers coded the transcripts; discrepancies in coding were resolved through consensus, ensuring a rigorous synthesis of the findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The workshop hosted 27 experts at the University of Arizona, 21 (78%) of whom were from public health-related fields. Of these 27 experts, 8 (30%) were from the field of resilience. In addition, participants from governmental agencies, American Indian groups, weather services, and a mobile health organization attended. Qualitative analysis identified major themes, including the potential of RI tools, threats to resilience (eg, health care access, infrastructure, and climate change), challenges with RI tools (eg, usability, funding, and real-time response), and standards for RI tools (eg, technological, logistical, and sociological). The attendees emphasized the importance of equitable access, community engagement, and iterative development in RI projects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The RI workshop emphasized the necessity for accessible, user-friendly tools ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63217"},"PeriodicalIF":2.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005735","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":"Mobile Phone App to Promote Lifestyle Change in People at Risk of Type 2 Diabetes: Feasibility 3-Arm Randomized Controlled Trial.","authors":"Gyri Skoglund, Gunvor Hilde, Pernille Lunde, Venessa Vera Cruz Naceno, Cecilie Fromholt Olsen, Birgitta Blakstad Nilsson","doi":"10.2196/63737","DOIUrl":"https://doi.org/10.2196/63737","url":null,"abstract":"<p><strong>Background: </strong>The use of mobile health interventions, such as apps, are proposed to meet the challenges faced by preventive health care services due to the increasing prevalence of type 2 diabetes (T2D). Thus, we developed and conducted initial feasibility testing of the Plunde app for promoting and monitoring individual goals related to lifestyle change for people at risk of T2D.</p><p><strong>Objective: </strong>The primary aim of this study was to assess the feasibility of an app for promoting lifestyle change in people at risk of T2D. The secondary aim was to assess recruitment rate, resource requirements, and change in potential outcomes for a full scale randomized controlled trial (RCT) study .</p><p><strong>Methods: </strong>A 3-arm feasibility RCT lasting 12 weeks was designed. Participants were recruited from 9 general practitioners in Norway. Eligible participants were randomized to either (1) app follow-up; (2) app follow-up and referral to care as usual in Healthy Life Centers; or (3) referral to care as usual in a Healthy Life Center, only. The primary outcome was feasibility and was measured by app adherence (actual usage of the app), the System Usability Scale, and app motivation score gained from a questionnaire designed for this study. Criteria for success were preset based on these measures. Secondary outcomes included recruitment rate, resource requirements, and potential primary outcomes of a full-scale RCT. This included change in body weight, waist circumference, and self-evaluated functional health status, assessed with the Dartmouth Primary Care Cooperative Research Network/World Organization of Family Doctors (COOP/WONCA) functional health assessment chart.</p><p><strong>Results: </strong>Within 8 months, 9 general practitioners recruited a total of 54 participants, of which 45 were eligble for participation in the study. Mean age was 61 (SD 13) years and 53% (n=24) were female. App adherence was 86%, the mean System Usability Scale score was 87.3 (SD 11.9), and the mean app motivation score was 74.8 (SD 30.3). Throughout the intervention period, health care professionals spent on average 3.0 (SD 1.0) minutes per participant per week providing follow-up. Statistically significant reduction in body weight and waist circumference was shown in group 1 and 3.</p><p><strong>Conclusions: </strong>Based on the preset criteria for success, the Plunde app is feasible in providing support for lifestyle change. The Plunde app had excellent user satisfaction. The amount of time spent on monitoring and promoting lifestyle change through the app was low; however, the recruitment was slow. Results from this study will guide the development of further research within this field.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63737"},"PeriodicalIF":2.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046916","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":"Using Health Information Resources for People With Cognitive Impairment (digiDEM Bayern): Registry-Based Cohort Study.","authors":"Florian Weidinger, Nikolas Dietzel, Elmar Graessel, Hans-Ulrich Prokosch, Peter Kolominsky-Rabas","doi":"10.2196/54460","DOIUrl":"https://doi.org/10.2196/54460","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Dementia is a growing global health challenge with significant economic and social implications. Underdiagnosis of dementia is prevalent due to a lack of knowledge and understanding among the general population. Enhancing dementia literacy through improved health information-seeking behavior is crucial for the self-determined management of the disease by those affected. Understanding the relationship between dementia literacy, health information-seeking behavior, and the use of various information sources among individuals with cognitive impairment is of high importance in this context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study was to analyze the relevance of different sources of health information from the perspective of people with cognitive impairment, while also evaluating differences based on age, gender, and disease progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study is part of the ongoing project \"Digital Dementia Registry Bavaria - digiDEM Bayern.\" The Digital Dementia Registry Bavaria is a multicenter, prospective, longitudinal register study in Bavaria, Germany. People with cognitive impairment rated several information sources by using Likert scales with the values unimportant (1) to very important (5). Data were analyzed descriptively, and multiple 2-sample, 2-tailed t tests were used to evaluate differences by cognitive status and gender and using multiple one-way ANOVA to evaluate differences by age group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Data of 924 people with cognitive impairment (531 with dementia, 393 with mild cognitive impairment) were evaluated. The most relevant health information sources were \"Personal visit to a medical professional\" (mean 3.9, SD 1.1) and \"Family / Friends\" (mean 3.9, SD 1.2). \"Internet\" was 1 of the 2 lowest-rated information sources by people with cognitive impairment (mean 1.6, SD 1.1), with nearly three-quarters (684/924, 74%) of the participants rating the source as unimportant. The age-specific analyses showed significant differences for the sources \"Internet\" (F2,921=61.23; P&lt;.001), \"Courses / Lectures\" (F2,921=18.88; P&lt;.001), and \"Family / Friends\" (F2,921=6.27; P=.002) for the 3 defined age groups. There were several significant differences between people with mild cognitive impairment and dementia whereby the first group evaluated most sources higher, such as \"Internet\" (mean difference=0.6; t640=7.52; P&lt;.001). The only sources rated higher by the dementia group were \"TV / Radio\" and \"Family / Friends,\" with none of them showing significant differences. Gender-specific analyses showed women with cognitive impairment valuing every evaluated source higher than men apart from \"Internet\" (mean difference=0.4; t685=4.97; P&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;To enhance health and dementia literacy, the best way to communicate health information to people with cognitive impairment is through interpersonal contact with medical professionals and t","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e54460"},"PeriodicalIF":2.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046948","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":"Cardiomeds, an mHealth App for Self-Management to Support Swiss Patients With Heart Failure: 2-Stage Mixed Methods Usability Study.","authors":"Lisa Simioni, Elena Tessitore, Hamdi Hagberg, Aurélie Schneider-Paccot, Katherine Blondon, Liliane Gschwind, Philippe Meyer, Frederic Ehrler","doi":"10.2196/63941","DOIUrl":"10.2196/63941","url":null,"abstract":"<p><strong>Background: </strong>Mobile health apps have shown promising results in improving self-management of several chronic diseases in patients. We have developed a mobile health app (Cardiomeds) dedicated to patients with heart failure (HF). This app includes an interactive medication list; daily self-monitoring of symptoms, weight, blood pressure, and heart rate; and educational information on HF delivered through various formats.</p><p><strong>Objective: </strong>This study aimed to perform a mixed methods usability study of Cardiomeds.</p><p><strong>Methods: </strong>Smartphone users with HF were recruited from the HF outpatient clinic at the University Hospital of Geneva. The usability test was conducted in 2 stages, with modifications made to the app after the first stage to address major usability issues. Each stage required 10 participants to perform 14 tasks, such as entering vital signs, entering a new medication and time of intake, or finding information about HF. Each task was timed, sessions were recorded, and all data were anonymized. After completing the tasks, patients completed the System Usability Scale 10-item questionnaire and answered 5 open questions about their perceptions of Cardiomeds.</p><p><strong>Results: </strong>Twenty patients with HF, 75% (15/20) of whom were men, with a mean age of 55 years, were included in this study. The average time to complete all 14 tasks was 18 (SD 5.7) minutes. Manual medication entry was the most time-consuming task, taking an average of 154.40 (SD 68.08) seconds in the first stage, 103.10 (SD 42.76) seconds in the second stage, and 128 (SD 63) seconds overall. The mean overall success rate was 77% (SD 0.23%) for the first stage and 94% (SD 0.07%) for the second stage. A total of 30% (3/10) of participants in the first stage completed all tasks without any help compared with 50% (5/10) of participants during the second stage. The average System Usability Scale score was 80% (SD 17%), showing a slight increase from 79% (SD 16%) in the first stage to 80% (SD 28%) in the second stage, which qualifies the app as \"good\" in terms of usability. Between the 2 stages, part of the app interface was redesigned to address the key issues identified in the first stage. Despite these improvements, problems related to guidance were frequent and comprised 36% (8/22) of the problems in the first stage and 40% (6/15) in the second stage. In response to open questions, 85% (17/20) of the participants responded that they would like to use the app when it became available.</p><p><strong>Conclusions: </strong>The usability test indicated that Cardiomeds is a suitable and user-friendly app for patients with HF. The app will be further tested in a randomized clinical trial (2022-00731) after acute HF hospitalization to assess its impact on patients' knowledge about HF, self-care, and quality of life.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63941"},"PeriodicalIF":2.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983645","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":"Testing a Web-Based Interactive Comic Tool to Decrease Obesity Risk Among Racial and Ethnic Minority Preadolescents: Randomized Controlled Trial.","authors":"May May Leung, Katrina F Mateo, Marlo Dublin, Laura Harrison, Sandra Verdaguer, Katarzyna Wyka","doi":"10.2196/58460","DOIUrl":"https://doi.org/10.2196/58460","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Childhood obesity prevalence remains high, especially in racial and ethnic minority populations with low incomes. This epidemic is attributed to various dietary behaviors, including increased consumption of energy-dense foods and sugary beverages and decreased intake of fruits and vegetables. Interactive, technology-based approaches are emerging as promising tools to support health behavior changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to assess the feasibility and acceptability of Intervention INC (Interactive Nutrition Comics for Urban, Minority Preadolescents), a 6-chapter web-based interactive nutrition comic tool. Its preliminary effectiveness on diet-related psychosocial variables and behaviors was also explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 89 Black or African American and Hispanic preadolescents with a mean age of 10.4 (SD 1.0) years from New York City participated in a pilot 2-group randomized study, comprising a 6-week intervention and a 3-month follow-up (T4) period. Of the 89 participants, 61% were female, 62% were Black, 42% were Hispanic, 53% were overweight or obese, and 34% had an annual household income of &lt;US $20,000. Participants were randomly assigned to the experimental group (45/89, 50% received the web-based comic tool), or the comparison group (44/89, 50% received web-based nutrition newsletters). Primary measures included feasibility and usability at intervention midpoint (T2) and intervention end (T3). Semistructured interviews were conducted at the same time to assess acceptability and satisfaction. Secondary measures, collected at baseline (T1), T2, T3, and at T4, included attitudes, beliefs, and behaviors related to fruit, vegetable, water, sugar, and junk food intake. Descriptive analyses were conducted for use and usability data. Interviews were systematically analyzed to facilitate identification of patterns and themes. Secondary data were analyzed using descriptive statistics. Within- and between-group effect sizes were reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 72% (33/45) and 60% (27/44) of the experimental and comparison groups, respectively, accessed their tool weekly. The mean total usability score was high and moderately high for the experimental and comparison groups, respectively (mean 4.01, SD 0.37 and mean 3.81, SD 0.51; P=.048), based on a 5-point Likert scale). Children in both groups found the tool acceptable, and few reported difficulties logging in or accessing content. Between-group effect sizes for beliefs and attitudes related to dietary intake, while favoring the experimental group at T3, were in the small range. These improvements in both groups were largely diminished by T4. However, between-group effect sizes for behaviors related to fruit, vegetable, and water intake, favoring the experimental group, were medium to large and were maintained at T4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot feasibility study suggests tha","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e58460"},"PeriodicalIF":2.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983665","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}