JMIR Formative Research最新文献

{"title":"Development of a Clinical Decision Support Tool to Implement Asthma Management Guidelines in Pediatric Primary Care: Qualitative Study.","authors":"David A Fedele, Jessica M Ray, Jaya L Mallela, Jiang Bian, Aokun Chen, Xiao Qin, Ramzi G Salloum, Maria Kelly, Matthew J Gurka, Jessica Hollenbach","doi":"10.2196/65794","DOIUrl":"https://doi.org/10.2196/65794","url":null,"abstract":"<p><strong>Background: </strong>There is a longstanding gap between national asthma guidelines and their implementation in primary care. Primary care providers (PCPs) endorse numerous provider and practice or clinic-related barriers to providing guidelines-based asthma care. To reduce asthma morbidity in primary care, PCPs need access to tools that facilitate adherence to national guidelines, which can be delivered at the point of care, are minimally burdensome, and fit within the clinic workflow. Clinical decision support (CDS) tools are health IT systems that can be housed in the electronic health record (EHR) system.</p><p><strong>Objective: </strong>This study aimed to follow user-centered design principles and describe the formative qualitative work with target stakeholders (ie, PCPs and IT professionals) to inform our design of an EHR-embedded CDS tool that adheres to recent, significant changes in asthma management guidelines.</p><p><strong>Methods: </strong>Purposive sampling was used to recruit three separate subgroups of professionals (n=15) between (1) PCPs with previous experience using a paper-based CDS tool for asthma management, (2) PCPs without previous experience using CDS tools for asthma management, and (3) health care IT professionals. The PCP interview guide focused on their practice, familiarity with national asthma guidelines, and how a CDS tool embedded in the EHR might help them provide guideline-based care. The health care IT professional guide included questions on the design and implementation processes of CDS tools into the EHR. Qualitative data were audio-recorded, transcribed, and then analyzed using an inductive approach to develop themes.</p><p><strong>Results: </strong>Themes were organized into 2 domains, current practice and CDS tool development. The themes that emerged from PCPs included descriptions of assessments conducted to make an asthma diagnosis, previous attempts or opportunities to implement updated national asthma guidelines, and how a CDS tool could be implemented using the EHR and fit into the current asthma management workflow. The themes that emerged from health care IT professionals included processes used to design CDS tools and strategies to collect evidence that indicated a tool's value to a practice and the broader health system.</p><p><strong>Conclusions: </strong>In this study, user-centered design principles were used to guide a qualitative study on perceived barriers and facilitators to a primary care-based, EHR-integrated asthma CDS tool. PCPs expressed their interest in adopting an asthma CDS tool that was low burden and efficient but could help them adhere to national asthma guidelines and improve clinic workflow. Similarly, health care IT professionals perceived an asthma CDS tool to be useful, if it adhered to EHR design standards. Implementation of a CDS tool to improve adherence of PCPs to recently updated national asthma guidelines could be beneficial in reducing pediatric asthma","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e65794"},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657236","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":"Kinetic Pattern Recognition in Home-Based Knee Rehabilitation Using Machine Learning Clustering Methods on the Slider Digital Physiotherapy Device: Prospective Observational Study.","authors":"Clement Twumasi, Mikail Aktas, Nicholas Santoni","doi":"10.2196/69150","DOIUrl":"https://doi.org/10.2196/69150","url":null,"abstract":"<p><strong>Background: </strong>Recent advancements in rehabilitation sciences have progressively used computational techniques to improve diagnostic and treatment approaches. However, the analysis of high-dimensional, time-dependent data continues to pose a significant problem. Prior research has used clustering techniques on rehabilitation data to identify movement patterns and forecast recovery outcomes. Nonetheless, these initiatives have not yet used force or motion datasets obtained outside a clinical setting, thereby limiting the capacity for therapeutic decisions. Biomechanical data analysis has demonstrated considerable potential in bridging these gaps and improving clinical decision-making in rehabilitation settings.</p><p><strong>Objective: </strong>This study presents a comprehensive clustering analysis of multidimensional movement datasets captured using a novel home exercise device, the \"Slider\". The aim is to identify clinically relevant movement patterns and provide answers to open research questions for the first time to inform personalized rehabilitation protocols, predict individual recovery trajectories, and assess the risks of potential postoperative complications.</p><p><strong>Methods: </strong>High-dimensional, time-dependent, bilateral knee kinetic datasets were independently analyzed from 32 participants using four unsupervised clustering techniques: k-means, hierarchical clustering, partition around medoids, and CLARA (Clustering Large Applications). The data comprised force, laser-measured distance, and optical tracker coordinates from lower limb activities. The optimal clusters identified through the unsupervised clustering methods were further evaluated and compared using silhouette analysis to quantify their performance. Key determinants of cluster membership were assessed, including demographic factors (eg, gender, BMI, and age) and pain levels, by using a logistic regression model with analysis of covariance adjustment.</p><p><strong>Results: </strong>Three distinct, time-varying movement patterns or clusters were identified for each knee. Hierarchical clustering performed best for the right knee datasets (with an average silhouette score of 0.637), while CLARA was the most effective for the left knee datasets (with an average silhouette score of 0.598). Key predictors of the movement cluster membership were discovered for both knees. BMI was the most influential determinant of cluster membership for the right knee, where higher BMI decreased the odds of cluster-2 membership (odds ratio [OR] 0.95, 95% CI 0.94-0.96; P<.001) but increased the odds for cluster-3 assignment relative to cluster 1 (OR 1.05, 95% CI 1.03-1.06; P<.001). For the left knee, all predictors of cluster-2 membership were significant (.001≤P≤.008), whereas only BMI (P=.81) could not predict the likelihood of an individual belonging to cluster 3 compared to cluster 1. Gender was the strongest determinant for the left knee, with male participants s","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e69150"},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657237","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":"Use of Video Consultation Between 2017 and 2020 in Outpatient Medical Care in Germany and Characteristics of Their User Groups: Analysis of Claims Data.","authors":"Theresa Hüer, Anke Walendzik, Lara Kleinschmidt, Klemens Höfer, Beatrice Nauendorf, Juliane Malsch, Matthias Brittner, Paul Brandenburg, André Aeustergerling, Udo Schneider, Anja Wadeck, Sebastian Liersch, Stephanie Sehlen, Katharina Schwarze, Jürgen Wasem","doi":"10.2196/60170","DOIUrl":"10.2196/60170","url":null,"abstract":"<p><strong>Background: </strong>Supplementing outpatient medical care with the use of video consultations could, among other benefits, improve access, especially in structurally disadvantaged areas.</p><p><strong>Objective: </strong>This claims data analysis, carried out as part of the German research project \"Preference-based use of video consultation in urban and rural regions,\" aimed to analyze the use of video consultations and the characteristics of its user groups.</p><p><strong>Methods: </strong>Claims data from 3 Statutory Health Insurance Funds (SHIFs) and 4 Associations of Statutory Health Insurance Physicians (ASHIPs) from the period April 2017 to the end of 2020 were used. Data from a sample of about 6.1 million insured and 33,100 physicians and psychotherapists were analyzed. In addition to data on the use of video consultations, patient data on sociodemographic characteristics, diagnoses, and place of residence were included. To analyze the physicians' perspectives, specialty groups, demographic characteristics, and the type of practice location were also included. In consideration of the principles of data economy and the fact that data analysis represents merely a preliminary phase within the broader project, the SHIFs and ASHIPs transmitted aggregated data (cross-tabulations per subgroup analysis) to the evaluator. For this reason, the analyses were constrained to a comparison of video consultation users versus nonusers, differentiated according to the aforementioned subgroups. Furthermore, the association between place of residence or type of region of the practice location and the use of video consultation was examined. A significance level of P<.05 was set for chi-square tests.</p><p><strong>Results: </strong>From 2017 to 2019, almost no video consultations were used in outpatient care in the German health care system. Although this changed considerably in relative terms with the start of the COVID-19 pandemic (but still at a very low absolute level), there was also a clear decline in the use of video consultations as the number of infections flattened out. Physicians working in psychotherapy and psychological psychotherapists used video consultations with around 16% (44,808/282,530) of their treatment cases in the second quarter of 2020, followed by psychotherapists using video consultations for children (10,828/113,293, 10%). Although the absolute number of treatment cases with video consultations among general practitioners was very high compared with other specialist groups, their share of video consultations in all treatment cases was very low at 0.3% (29,600/9,837,118). Younger age groups and those located in urban areas used video consultations more frequently; this applies to both patients (age groups: χ<sup>2</sup><sub>7</sub>=9903.2, P<.001; region types: χ<sup>2</sup><sub>2</sub>=3746.2, P<.001) and service providers (age groups: χ<sup>2</sup><sub>3</sub>=11,338.2, P<.001; region types: χ<sup>2</sup><sub>2</sub>=847","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60170"},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624743","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 Translation Platform (Translatly) to Overcome Communication Barriers in Clinical Care: Pilot Study.","authors":"Victor Olsavszky, Mutaz Bazari, Taieb Ben Dai, Ana Olsavszky, Fabian Finkelmeier, Mireen Friedrich-Rust, Stefan Zeuzem, Eva Herrmann, Jan Leipe, Florian Alexander Michael, Hans von Westernhagen, Olivier Ballo","doi":"10.2196/63095","DOIUrl":"10.2196/63095","url":null,"abstract":"<p><strong>Background: </strong>Language barriers in health care can lead to misdiagnosis, inappropriate treatment, and increased medical errors. Efforts to mitigate these include using interpreters and translation tools, but these measures often fall short, particularly when cultural nuances are overlooked. Consequently, medical professionals may have to rely on their staff or patients' relatives for interpretation, compromising the quality of care.</p><p><strong>Objective: </strong>This formative pilot study aims to assess the feasibility of Translatly, a digital translation platform, in clinical practice. Specifically, the study focuses on evaluating (1) how health care professionals overcome language barriers and their acceptance of an on-demand video telephony platform, (2) the feasibility of the platform during medical consultations, and (3) identifying potential challenges for future development.</p><p><strong>Methods: </strong>The study included ethnographic interviews with health care professionals and an observational pilot to assess the use of the Translatly platform in clinical practice. Translatly was developed to make real-time translation easy and accessible on both Android and iOS devices. The system's backend architecture uses Java-based services hosted on DigitalOcean. The app securely exchanges data between mobile devices and servers, with user information and call records stored in a MySQL database. An admin panel helps manage the system, and Firebase integration enables fast push notifications to ensure that health care professionals can connect with translators whenever they need to. The platform was piloted in a German university hospital with 170 volunteer nonprofessional translators, mainly medical students, supporting translation in over 20 languages, including Farsi, Dari, and Arabic.</p><p><strong>Results: </strong>Ethnographic research conducted by interviewing health care professionals in Frankfurt am Main and other German cities revealed that current practices for overcoming language barriers often rely on family members or digital tools such as Google Translate, raising concerns about accuracy and emotional distress. Respondents preferred an on-demand translation service staffed by medically experienced translators, such as medical students, who understand medical terminology and can empathize with patients. The observational pilot study recorded 39 requests for translation services, 16 (41%) of which were successfully completed. The translations covered 6 different languages and were carried out by a team of 10 translators. Most requests came from departments such as infectious diseases (5/16, 31%) and emergency (4/16, 25%). Challenges were identified around translator availability, with 23 (59%) total requests (N=39) going unanswered, which was further evidenced by user feedback.</p><p><strong>Conclusions: </strong>This pilot study demonstrates the feasibility of the Translatly platform in real-world health care ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":"e63095"},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500848","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":"YouTube User Traffic to Paired Epilepsy Education Videos in English and Spanish: Comparative Study.","authors":"Luna Kimahri Varela, Stephanie Horton, Ahmed Abdelmoity, Jean-Baptiste Le Pichon, Mark A Hoffman","doi":"10.2196/56720","DOIUrl":"10.2196/56720","url":null,"abstract":"<p><strong>Background: </strong>Effectively managing epilepsy in children necessitates the active engagement of parents, a factor that is reliant on their understanding of this neurological disorder. Widely available, high-quality, patient-focused, bilingual videos describing topics important for managing epilepsy are limited. YouTube Analytics is a helpful resource for gaining insights into how users of differing backgrounds consume video content.</p><p><strong>Objective: </strong>This study analyzes traffic to paired educational videos of English and Spanish versions of the same content. By examining the use patterns and preferences of individuals seeking information in different languages, we gained valuable insights into how language influences the use of clinical content.</p><p><strong>Methods: </strong>Physician experts created epilepsy management videos for the REACT (Reaching Out for Epilepsy in Adolescents and Children Through Telemedicine) YouTube channel about 17 subjects, with an English and Spanish version of each. The Children's Mercy Kansas City neurology clinic incorporated these into the department's educational process. YouTube Analytics enabled analysis of traffic patterns and video characteristics between September 2, 2021, and August 31, 2023.</p><p><strong>Results: </strong>The Spanish group had higher engagement and click-through rates. The English versions of all videos had 141,605 total impressions, while impressions for the Spanish versions totaled 156,027. The Spanish videos had 11,339 total views, while the English videos had 3366. The views per month were higher for the Spanish videos (mean 472, SD 292) compared to the English set (mean 140, SD 91; P<.001). The two groups also differed in search behavior and external traffic sources, with WhatsApp driving more traffic to the Spanish videos than the English versions (94 views compared to 1). The frequency of search terms used varied by language. For example, \"tonic clonic\" was the most frequent term (n=372) resulting in views for English videos, while \"tipos de convulsiones\" (types of convulsions) was the most common expression (n=798) resulting in views for Spanish videos. We noted increased monthly views for all videos after adding tags on YouTube. Before tagging, the mean number of views per month for the English-language group was 61 (SD 28), which increased to 220 (SD 53) post tagging. A similar trend can be observed in the Spanish-language group as well. Before tagging, the mean number of monthly views was 201 (SD 71), which increased to 743 (SD 144) after tagging.</p><p><strong>Conclusions: </strong>This study showed high traffic for Spanish video content related to epilepsy in a set of paired English/Spanish videos. This highlights the importance of bilingual health content and optimizing video content based on viewer preferences and search behavior. Understanding audience engagement patterns through YouTube Analytics can further enhance the dissemination of cl","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e56720"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624746","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":"Teen Perspectives on Integrating Digital Mental Health Programs for Teens Into Public Libraries (\"I Was Always at the Library\"): Qualitative Interview Study.","authors":"Ashley A Knapp, Katherine Cohen, Kaylee P Kruzan, Rachel Kornfield, Miguel Herrera, Aderonke B Pederson, Sydney Lee, Kathryn Macapagal, Chantelle A Roulston, Kaleigh Clarke, Clarisa Wijaya, Robert Simmons, Latonia Jackson, Simrandeep Kour, Sandra Franco, David C Mohr","doi":"10.2196/67454","DOIUrl":"10.2196/67454","url":null,"abstract":"<p><strong>Background: </strong>Rising rates of anxiety among teens necessitate innovative approaches for implementing evidence-based mental health support. Public libraries, seen as safe spaces for patrons with marginalized identities, offer free public services such as broadband internet access. Many teens spend significant amounts of time in their local libraries due to the safety of this space as well as the trusted adults working there. The American Library Association has shifted its priorities to focus more on mental health through employing social workers and providing mental health programs. As such, public libraries may be promising sites for the implementation of digital mental health (DMH) programs for teens.</p><p><strong>Objective: </strong>This study aimed to examine how teens who attended their local public library experienced and managed their anxiety, what mental health supports they were interested in receiving, and how DMH programs and public libraries can meet their needs.</p><p><strong>Methods: </strong>We interviewed 16 teens aged 12-18 (mean 15.2, SD 2.0) years who used the library frequently at the time of the interviews. Of these teen patrons, 56% (9/16) identified as female, 31% (5/16) identified as male, and 12% (2/16) identified as nonbinary. Most (11/16, 69%) identified as either White or Black or African American individuals, with the remainder (5/16, 31%) identifying as Hispanic or Latino or Chinese American individuals or with ≥2 races. The interviews were individual and semistructured, designed to elicit recommendations for designing and implementing digital tools in libraries to improve teen mental health. Interview transcripts were coded by multiple coders using thematic analysis to synthesize key themes.</p><p><strong>Results: </strong>Teens reported experiencing uncontrollability, unpredictability, and anger related to their anxiety, which they managed using strategies such as guided breathing, distress tolerance, and social connection. They also talked about other helpful management techniques (eg, progressive muscle relaxation, journaling, and mood tracking). Teens underscored the importance of pairing mood tracking with daily activities to reveal patterns. They also stressed the significance of context and anxiety severity when choosing anxiety management strategies. Teens underscored the centrality of the public library in their lives and their view of it as a safe space where they can easily access resources and connect with friends and trusted adults. When considering the design of a DMH program implemented in libraries, they suggested including personalization for different identities, gamification, and simple navigation. Teens emphasized the importance of protecting their privacy within digital programs and that their end goal was to use the skills learned in the DMH program offline.</p><p><strong>Conclusions: </strong>Teens who frequently used their local public library expressed interest in receivin","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67454"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624740","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":"Interprofessional Discussion for Knowledge Transfer in a Digital \"Community of Practice\" for Managing Pneumoconiosis: Mixed Methods Study.","authors":"Varinn Avi Sood, Heidi Rishel Brakey, Orrin Myers, Xin Shore, Akshay Sood","doi":"10.2196/67999","DOIUrl":"10.2196/67999","url":null,"abstract":"<p><strong>Background: </strong>Pneumoconiosis prevalence is increasing in the United States, especially among coal miners. Contemporaneously with an increased need for specialized multidisciplinary care for miners, there is a shortage of experts to fulfill this need. Miners' Wellness ECHO (Extension for Community Health Outcomes) is a digital community of practice based on interprofessional discussion for knowledge transfer. The program has been demonstrated to increase participants' self-efficacy for clinical, medicolegal, and \"soft\" skills related to miners' health.</p><p><strong>Objective: </strong>We aimed to examine characteristics associated with interprofessional discussions and suggest ways to strengthen knowledge transfer.</p><p><strong>Methods: </strong>This mixed methods study used an exploratory sequential design. We video-recorded and transcribed ECHO sessions over 14 months from July 2018 to September 2019 and analyzed content to examine participant discussions. We focused on participants' statements of expertise followed by other participants' acceptance or eschewal of these statements (utterances). We conducted quantitative analyses to examine the associations of active participation in discussion (primary outcome variable, defined as any utterance). We analyzed the association of the outcome on the following predictors: (1) participant group status, (2) study time frame, (3) participant ECHO experience status, (4) concordance of participant group identity between presenter and participant, (5) video usage, and (6) attendance frequency. We used the generalized estimating equations approach for longitudinal data, logit link function for binary outcomes, and LSMEANS to examine least squares means of fixed effects.</p><p><strong>Results: </strong>We studied 23 sessions with 158 unique participants and 539 total participants, averaging 23.4 (SD 5.6) participants per session. Clinical providers, the largest participant group, constituting 36.7% (n=58) of unique participants, were the most vocal group (mean 21.74, SD 2.11 average utterances per person-session). Benefits counselors were the least vocal group, with an average utterance rate of 0.57 (SD 0.29) per person-session and constituting 8.2% (n=13) of unique participants. Thus, various participant groups exhibited different utterance rates across sessions (P=.003). Experienced participants may have dominated active participation in discussion compared to those with less or intermediate experience, but this difference was not statistically significant (P=.11). When the didactic presenter and participant were from the same participant group, active participation by the silent group participants was greater than when both were from different groups. This association was not seen in vocal group participants (interaction P=.003). Compared to those participating by audio, those participating on video tended to have higher rates of active participation, but this difference was not statis","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67999"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624736","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 Assessment of Cognitive Health in Outpatient Primary Care: Usability Study.","authors":"Adam J Doerr, Taylor A Orwig, Matthew McNulty, Stephanie Denise M Sison, David R Paquette, Robert Leung, Huitong Ding, Stephen B Erban, Bruce R Weinstein, Yurima Guilarte-Walker, Adrian H Zai, Allan J Walkey, Apurv Soni, David D McManus, Honghuang Lin","doi":"10.2196/66695","DOIUrl":"10.2196/66695","url":null,"abstract":"<p><strong>Background: </strong>Screening for cognitive impairment in primary care is important, yet primary care physicians (PCPs) report conducting routine cognitive assessments for less than half of patients older than 60 years of age. Linus Health's Core Cognitive Evaluation (CCE), a tablet-based digital cognitive assessment, has been used for the detection of cognitive impairment, but its application in primary care is not yet studied.</p><p><strong>Objective: </strong>This study aimed to explore the integration of CCE implementation in a primary care setting.</p><p><strong>Methods: </strong>A cohort of participants was recruited from the upcoming schedules of participating PCPs at UMass Memorial Medical Center. Eligibility criteria included individuals aged ≥65 years; ability to read, write, and speak in English or Spanish; no previous diagnosis of cognitive impairment; and no known untreated hearing or vision impairment. Research coordinators collected consent from participants and facilitated the screening process. PCPs reviewed reports in real time, immediately before the scheduled visits, and shared results at their discretion. A report was uploaded to each participant's REDCap (Research Electronic Data Capture; Vanderbilt University) record and linked to the encounter in the electronic health record. Feedback from patients and their caregivers (if applicable) was collected by a tablet-based survey in the clinic before and after screening. Participating PCPs were interviewed following the completion of the study.</p><p><strong>Results: </strong>The screened cohort included 150 patients with a mean age of 74 (SD 7) years, of whom 65% (97/150) were female. The CCE identified 40 patients as borderline and 7 as positive for cognitive impairment. A total of 84 orders were placed for select laboratory tests or referrals to neurology and neuropsychology within 20 days of CCE administration. Before the assessment, 95% (143/150) of patients and all 15 caregivers expressed a desire to know if their or their loved one's brain health was declining. All except one patient also completed the postassessment survey. Among them, 96% (143/149) of patients reported finding the CCE easy to complete, and 70% (105/149) felt that the experience was beneficial. In addition, 87% (130/149) of patients agreed or strongly agreed that they wanted to know their CCE results. Among the 7 participating PCPs, 6 stated that the CCE results influenced their patient care management, and all 7 indicated they would continue using the CCE if it were made available after the study.</p><p><strong>Conclusions: </strong>We explored the integration of the CCE into primary care visits, which showed minimal disruption to the practice workflow. Future studies will be warranted to further validate the implementation of digital cognitive impairment screening tools within primary care settings in the real world.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66695"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615580","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 of Fraud Deterrence and Detection Procedures Used in a Web-Based Survey Study With Adult Black Cisgender Women: Description of Lessons Learned and Recommendations.","authors":"Amber I Sophus, Jason W Mitchell","doi":"10.2196/59955","DOIUrl":"10.2196/59955","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Online research studies enable engagement with more Black cisgender women in health-related research. However, fraudulent data collection responses in online studies raise important concerns about data integrity, particularly when incentives are involved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this study was to assess the strengths and limitations of fraud deterrence and detection procedures implemented in an incentivized, cross-sectional, online study about HIV prevention and sexual health with Black cisgender women living in Texas.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data for this study came from a cross-sectional web-based survey that examined factors associated with potential pre-exposure prophylaxis use among a convenience sample of adult Black cisgender women from 3 metropolitan areas in Texas. Each eligibility screener and associated survey entry was evaluated using 4 fraud deterrence features and 7 fraud detection benchmarks with corresponding decision rules.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 5862 respondents provided consent and initiated the eligibility screener, of whom 2150 (36.68%) were ineligible for not meeting the inclusion criteria, and 131 (2.23%) completed less than 80% of the survey and were removed from further consideration. Other entries were removed for not passing level 1 fraud deterrent safeguards: duplicate entries with the same IP address (388/5862, 6.62%), same telephone number (69/5862, 1.18%), same email address (114/5862, 1.94%), and same telephone number and email address (17/5862, 0.29%). Of the remaining 2993 entries, 1652 entries were removed for not passing the first 2 items of the level 2 fraud detection benchmarks: screeners and surveys with latitude and longitude coordinates outside of the United States (347/2993, 11.59%) and survey completion time of less than 10 minutes (1305/2993, 43.6%). Of the remaining 1341 entries, 130 (9.69%) passed all 5 of the remaining level 2 data validation benchmarks, and 763 (56.89%) entries were removed due to passing less than 3. An additional 33.4% (423/1341) entries were removed after passing 4 of the 5 remaining validation benchmarks, being contacted to verify survey information, and not providing legitimate contact information or being unable to confirm personal information. The final enrolled sample in this online study consisted of 155 respondents who provided consent, were deemed eligible, and passed fraud deterrence features and fraud detection benchmarks. In this paper, we discuss the lessons learned and provide recommendations for leveraging available features in survey software programs to help deter bots and enhance fraud detection procedures beyond relying on survey software options.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Effectively identifying fraudulent responses in online surveys is an ongoing challenge. The data validation approach used in this study establishes a robust protocol for identifying genuine participa","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e59955"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615576","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":"Exploratory Co-Design on Electronic Health Record Nursing Summaries: Case Study.","authors":"Suhyun Park, Jenna L Marquard, Robin R Austin, Christie L Martin, David S Pieczkiewicz, Connie W Delaney","doi":"10.2196/68906","DOIUrl":"10.2196/68906","url":null,"abstract":"<p><strong>Background: </strong>Although electronic health record nursing summaries aim to provide a concise overview of patient data, they often fall short of meeting nurses' information needs, leading to underutilization. This gap arises from a lack of involvement of nurses in the design of health information technologies.</p><p><strong>Objective: </strong>The purpose of this exploratory co-design case study was to solicit insights from nurses regarding nursing summary design considerations, including key information types and the preferred design prototype.</p><p><strong>Methods: </strong>We recruited clinical nurses (N=33) from 7 inpatient units at a university hospital in the Midwestern United States using a purposive sampling method. We used images from a simulated nursing summary to generate visual card versions of the 46 information types currently included in an electronic health record vendor-generated nursing summary. Participants selected which cards to include and arranged them in their designs based on their perceived relevance of the information types to the summary and their preferred reading layout. The nurses' perceived relevance of information types to the summary was analyzed by quantifying the frequency of included cards, while the nurses' preferred reading layout was analyzed by quantifying the occurrence of closely paired cards to identify common groupings. After participants evaluated the information type cards, debriefing interviews were conducted and analyzed thematically to explore their rationales for the desired content and its arrangement.</p><p><strong>Results: </strong>The participants demonstrated a high level of engagement in the activities. On average, all 33 participants included 61% (n=28) of the total information types (n=46). The most frequently included cards were \"unit specimen\" (results of the analysis of body fluid, tissue, or urine), \"activity,\" \"diet,\" and \"hospital problems,\" each included by 33 participants. Participants most frequently preferred adjacency of the following pairs: \"activity\" and \"diet\" (paired by 26 participants; 79%) and \"notes to physicians\" and \"notes to treatment team\" (paired by 25 participants; 76%). Participants preferred arranging the cards to improve information accessibility, focusing on key information types.</p><p><strong>Conclusions: </strong>Involving nurses in the co-design process may result in more useful and usable designs, thereby reducing the time required to navigate nursing summaries. Future work should include refining and evaluating prototypes based on the designs created by the nurses.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e68906"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11918977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604966","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}