Joaquin A Anguera, Aleem Choudhry, Michael Seaman, Dominick Fedele
{"title":"Assessing the Impact of a Virtual Reality Cognitive Intervention on Tennis Performance in Junior Tennis Players: Pilot Study.","authors":"Joaquin A Anguera, Aleem Choudhry, Michael Seaman, Dominick Fedele","doi":"10.2196/66979","DOIUrl":"10.2196/66979","url":null,"abstract":"<p><strong>Background: </strong>There is evidence that cognitive training interventions can positively impact executive functions, and that some studies have demonstrated that athletes typically exhibit greater accuracy and faster response times on select cognitive tasks. While the engagement of executive functions is suggested to be part of high-level sporting activities, it is unclear whether such training approaches could directly benefit athletic performance.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the impact of a combined virtual reality (VR)- and tablet-based cognitive training intervention on adolescent tennis players' performance. Here, we examined differences in Universal Tennis Rating (UTR) between players who supplemented their regular tennis training with a cognitive training intervention and a group that continued regular tennis training alone. This custom cognitive training program targeted specific cognitive control abilities including attention, working memory, and goal management.</p><p><strong>Methods: </strong>Data were collected from a cohort of tennis players in a randomized controlled trial design led by the dedicated research team. Participants (N=23, age: mean 14.8, SD 2.4 years) from the Czech Lawn Tenis Klub (Prague, Czech Republic) were invited to participate in this study. These individuals were randomized into an intervention + training-as-usual group (n=13) or training-as-usual group (control group; n=10), with the change in UTR score being the primary metric of interest.</p><p><strong>Results: </strong>There was no difference in UTR between the 2 groups at baseline (intervention: mean 8.32, SD 2.7; control: mean 7.60, SD 2.3). Following the treatment period, individuals in the intervention group showed a significant improvement in their UTR (an increase of 0.5; t<sub>12</sub>=4.88, P<.001) unlike the control group (an increase of 0.02; t<sub>9</sub>=1.77, P=.12). On comparing the change in UTR (posttraining UTR minus pretraining UTR) attained by each group, we found that the intervention group had a 38% greater improvement in UTR than the control group. An analysis of covariance revealed a significantly greater improvement in UTR for the intervention group than for the control group (F<sub>1,20</sub>=8.82, P=.008).</p><p><strong>Conclusions: </strong>The present findings suggest that training cognitive abilities through an immersive visual platform may benefit athletic performance, including tennis. Such a result warrants careful consideration, given the known difficulties in evidencing far transfer not only in cognitive studies but also in athletic activities. These preliminary pilot findings suggest that the Mastermind Cognitive Training program may be a viable tool for supplementing athletic training practices, although this result warrants further investigation and replication. However, many questions remain unanswered, and further work is needed to better understand the pot","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66979"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364718","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}
Krystyna Isaacs, Autumn Shifflett, Kajal Patel, Lacey Karpisek, Yi Cui, Maayan Lawental, Golfo Tzilos Wernette, Brian Borsari, Katie Chang, Tony Ma
{"title":"Women Empowered to Connect With Addiction Resources and Engage in Evidence-Based Treatment (WE-CARE)-an mHealth Application for the Universal Screening of Alcohol, Substance Use, Depression, and Anxiety: Usability and Feasibility Study.","authors":"Krystyna Isaacs, Autumn Shifflett, Kajal Patel, Lacey Karpisek, Yi Cui, Maayan Lawental, Golfo Tzilos Wernette, Brian Borsari, Katie Chang, Tony Ma","doi":"10.2196/62915","DOIUrl":"10.2196/62915","url":null,"abstract":"<p><strong>Background: </strong>Women of childbearing age (aged 18-44 years) face multiple barriers to receiving screening and treatment for unhealthy alcohol and substance use, depression, and anxiety, including lack of screening in the primary care setting and lack of support in accessing care. The Women Empowered to Connect with Addiction Resources and Engage in Evidence-based Treatment (WE-CARE) mobile app was developed to test universal screening with women of childbearing age and linkage to care after an anonymous assessment.</p><p><strong>Objective: </strong>In this study, we aimed to investigate the feasibility and acceptability of providing anonymous screening instruments through mobile phones for alcohol and substance use, as well as depression and anxiety, for women of childbearing age.</p><p><strong>Methods: </strong>We used agile development principles based on previous formative research to test WE-CARE mobile health app with women of childbearing age (N=30) who resided in 1 of 6 counties in central Florida. WE-CARE included screening instruments (for alcohol, substance use, depression, and anxiety), a moderated discussion forum, educational microlearning videos, a frequently asked questions section, and resources for linkage to treatment. Individuals were recruited using flyers, academic listserves, and a commercial human subject recruiting company (Prolific). Upon completion of the screening instruments, women explored the educational and linkage to care features of the app and filled out a System Usability Scale to evaluate the mobile health app's usability and acceptability. Postpilot semistructured interviews (n=4) were conducted to further explore the women's reactions to the app.</p><p><strong>Results: </strong>A total of 77 women downloaded the application and 30 completed testing. Women of childbearing age gave the WE-CARE app an excellent System Usability Scale score of 86.7 (SD 12.43). Our results indicate elevated risk for substance use in 18 of the 30 (60%) participants, 9/18 (50%) also had an elevated risk for anxiety or depression, and 11/18 (61%) had an elevated risk for substance use, anxiety, or depression. Participants reported that WE-CARE was easy to navigate and use but they would have liked to see more screening questions and more educational content. Linkage to care was an issue; however, as none of the women identified as \"at-risk\" for substance use disorders contacted the free treatment clinic for further evaluation.</p><p><strong>Conclusions: </strong>The mobile health app was highly rated for acceptability and usability, but participants were not receptive to seeking help at a treatment center after only a few brief encounters with the app. The linkage to care design features was likely insufficient to encourage them to seek treatment. The next version of WE-CARE will include normative scores for participants to self-evaluate their screening status compared with their age- and gender-matched peers and enh","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e62915"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364730","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}
Masushi Kohta, Mayumi Takahashi, Hiroe Koyanagi, Junko Sugama
{"title":"Evaluating the Knowledge Level, Practice, and Behavioral Change Potential of Care Managers in Pressure Injury Prevention Using a Mobile App Prototyping Model in the Home-Care Setting: Single-Arm, Pre-Post Pilot Study.","authors":"Masushi Kohta, Mayumi Takahashi, Hiroe Koyanagi, Junko Sugama","doi":"10.2196/57768","DOIUrl":"10.2196/57768","url":null,"abstract":"<p><strong>Background: </strong>The use of mobile apps to promote knowledge level, practice, and behavioral change potential has become increasingly common. However, studies on apps targeting social welfare employees working in the home-care setting to prevent pressure injury (PI) are lacking. The care manager (CM) plays a key role in connecting the demand and supply of home-care services. PI is more prevalent in the home-care setting, where resources are limited, than in acute settings.</p><p><strong>Objective: </strong>The research hypothesis was that CMs who use a mobile app will have improved general knowledge and heightened practice for PI prevention, compared to that before using the app. This study aimed to assess the effectiveness of a PI prevention support mobile app prototyping model (Pips-Map) in improving the knowledge level, practice, and behavioral change potential of CMs in PI prevention in the home-care setting.</p><p><strong>Methods: </strong>This was conducted between December 2021 and December 2023 as a single-arm, pre-post pilot study including 27 CMs who worked in a Japanese city. Pips-Map was used for 6 months in daily practice, and a self-administered test questionnaire was used to assess participants' knowledge and practice in PI prevention before or after using Pips-Map. At the end of the posttest, a validated App Behavior Change Scale was used to analyze behavioral change potential. This study followed the Consolidated Standards of Reporting Trials (CONSORT) extension to pilot and feasibility trials.</p><p><strong>Results: </strong>In total, 19 participants were analyzed. Out of 55 points, the total mean knowledge score significantly increased from 30.9 (SD 5.9) in the pretest group to 36.1 (SD 5.9) in the posttest group (P=.0003). The number of participants with a total score of >70% (adequate knowledge level) increased from 2 (11%) to 7 (36.8%), but the difference was not statistically significant (P=.07). For the level of practice, out of 21 points, the total score increased from 15.2 (SD 3.1) in the pretest group to 16.2 (SD 3.0) in the posttest group, but no statistically significant differences were observed (P=.16). The behavior change scale revealed that participants positively evaluated the Pips-Map to provide information on PI prevention guidelines but had concerns regarding inadequate usability and financial incentives of Pips-Map.</p><p><strong>Conclusions: </strong>The use of Pips-Map for 6 months in actual practice increased the knowledge level of Japanese CMs in PI prevention, but it did not change the level of practice. Considering the need for updating apps that aim to promote behavioral change, this study identified some limitations of Pips-Map. Thus, revisions must be made to adapt Pips-Map to home-based care needs.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e57768"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382445","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}
Kyungmi Lee, Andres Azuero, Sally Engler, Sidharth Kumar, Frank Puga, Alexi A Wright, Arif Kamal, Christine S Ritchie, George Demiris, Marie A Bakitas, J Nicholas Odom
{"title":"Exploring the Relationship Between Smartphone GPS Patterns and Quality of Life in Patients With Advanced Cancer and Their Family Caregivers: Longitudinal Study.","authors":"Kyungmi Lee, Andres Azuero, Sally Engler, Sidharth Kumar, Frank Puga, Alexi A Wright, Arif Kamal, Christine S Ritchie, George Demiris, Marie A Bakitas, J Nicholas Odom","doi":"10.2196/59161","DOIUrl":"10.2196/59161","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced cancer and their family caregivers often experience poor quality of life (QOL). Self-report measures are commonly used to quantify QOL of family caregivers but may have limitations such as recall bias and social desirability bias. Variables derived from passively obtained smartphone GPS data are a novel approach to measuring QOL that may overcome these limitations and enable detection of early signs of mental and physical health (PH) deterioration.</p><p><strong>Objective: </strong>This study explored the feasibility of a digital phenotyping approach by assessing participant adherence and examining correlations between smartphone GPS data and QOL levels among family caregivers and patients with advanced cancer.</p><p><strong>Methods: </strong>This was a secondary analysis involving 7 family caregivers and 4 patients with advanced cancer that assessed correlations between GPS sensor data captured by a personally owned smartphone and QOL self-report measures over 12 weeks through linear correlation coefficients. QOL as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health 10 was collected at baseline, 6, and 12 weeks. Using a Beiwe smartphone app, GPS data were collected and processed into variables including total distance, time spent at home, transition time, and number of significant locations.</p><p><strong>Results: </strong>The study identified relevant temporal correlations between QOL and smartphone GPS data across specific time periods. For instance, in terms of PH, associations were observed with the total distance traveled (12 and 13 wk, with r ranging 0.37 to 0.38), time spent at home (-4 to -2 wk, with r ranging from -0.41 to -0.49), and transition time (-4 to -2 wk, with r ranging -0.38 to -0.47).</p><p><strong>Conclusions: </strong>This research offers insights into using passively obtained smartphone GPS data as a novel approach for assessing and monitoring QOL among family caregivers and patients with advanced cancer, presenting potential advantages over traditional self-report measures. The observed correlations underscore the potential of this method to detect early signs of deteriorating mental health and PH, providing opportunities for timely intervention and support.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e59161"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382448","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}
Nishanth Thiagarajan, Hong Chang Tan, Suresh Rama Chandran, Phong Ching Lee, Yun Ann Chin, Wanling Zeng, Emily Tse Lin Ho, David Carmody, Su-Yen Goh, Yong Mong Bee
{"title":"Web-Based, Algorithm-Guided Insulin Titration in Insulin-Treated Type 2 Diabetes: Pre-Post Intervention Study.","authors":"Nishanth Thiagarajan, Hong Chang Tan, Suresh Rama Chandran, Phong Ching Lee, Yun Ann Chin, Wanling Zeng, Emily Tse Lin Ho, David Carmody, Su-Yen Goh, Yong Mong Bee","doi":"10.2196/68914","DOIUrl":"10.2196/68914","url":null,"abstract":"<p><strong>Background: </strong>Self-monitoring of blood glucose (SMBG) using web-based diabetes management platforms has demonstrated promise in managing type 2 diabetes (T2D). However, the effectiveness of such systems incorporating algorithm-guided insulin titration has not been extensively studied in Asian populations.</p><p><strong>Objective: </strong>This study evaluates the efficacy and safety of the ALRT telehealth solution-a US Food and Drug Administration-cleared, web-based platform that integrates SMBG with algorithm-driven insulin dose adjustments-in improving glycemia in insulin-treated T2D.</p><p><strong>Methods: </strong>This 24-week, pre-post intervention study enrolled 25 adults with T2D (mean age 58.9, SD 7.0 y; n=14, 56% male) on twice-daily premixed insulin. Inclusion criteria included a baseline hemoglobin A1c (HbA1c) level between 7.5% to 9.9% (58-86 mmol/mol), a BMI ≤40 kg/m², and experience with SMBG. Participants uploaded twice-daily SMBG data weekly via a mobile app, which generated insulin titration recommendations based on a predefined algorithm. Physicians reviewed and approved the recommendations, which were then communicated back to participants via the app. The primary outcome was the change in HbA1c level from baseline to 24 weeks. Secondary outcomes included changes in fasting plasma glucose, insulin dose, hypoglycemia incidence, and SMBG adherence.</p><p><strong>Results: </strong>Participants achieved significant reductions in HbA1c level from 8.6% (70 mmol/mol) at baseline to 7.4% (57 mmol/mol) at 24 weeks (P<.001), with reductions of 0.8% and 0.4% in the first and second 12 weeks, respectively. Fasting plasma glucose decreased from 8.7 (SD 2.0) mmol/L to 7.1 (SD 1.4) mmol/L (P<.001). Mean total daily insulin dose increased modestly from 0.73 (SD 0.31) units/kg/day to 0.79 (SD 0.34) units/kg/day (P=.007). Participants demonstrated high adherence, completing 97.3% (327/336) of prescribed SMBG measurements. During the study, 48% (12/25) of participants experienced at least 1 hypoglycemia episode, predominantly mild hypoglycemia (85/96, 88.5%; glucose 3.0-3.9 mmol/L). Hypoglycemia episodes increased from 24 during weeks 0-12 to 72 during weeks 13-24. There were no episodes of severe hypoglycemia requiring external assistance. BMI increased slightly from 29.0 (SD 3.6) kg/m² to 29.5 (SD 3.6) kg/m² (P=.03), reflecting a modest weight gain associated with improved glycemia.</p><p><strong>Conclusions: </strong>In conclusion, patients with insulin-treated T2D initiated on a web-based glucose monitoring system with algorithm-guided dosing recommendations showed significant improvement in glycemic control compared to baseline. High adherence rates underscore the feasibility of integrating algorithm-guided insulin titration into routine care. While hypoglycemia incidence rose slightly, episodes were predominantly mild, and no severe events occurred. This intervention shows promise for broader adoption in T2D management, pa","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e68914"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382474","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 Digital Capabilities by 9 Countries in the Alliance for Healthy Cities Using AI: Cross-Sectional Analysis.","authors":"Hocheol Lee","doi":"10.2196/62935","DOIUrl":"10.2196/62935","url":null,"abstract":"<p><strong>Background: </strong>The Alma-Ata Declaration of 1978 initiated a global focus on universal health, supported by the World Health Organization (WHO) through healthy cities policies. The concept emerged at the 1984 Toronto \"Beyond Health Care\" conference, leading to WHO's first pilot project in Lisbon in 1986. The WHO continues to support regional healthy city networks, emphasizing digital transformation and data-driven health management in the digital era.</p><p><strong>Objective: </strong>This study explored the capabilities of digital healthy cities within the framework of digital transformation, focusing on member countries of the Asian Forum of Healthy Cities. It examined the cities' preparedness and policy needs for transitioning to digital health.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted of 9 countries-Australia, Cambodia, China, Japan, South Korea, Malaysia, Mongolia, the Philippines, and Vietnam-from August 1 to September 21, 2023. The 6-section SPIRIT (setting approach and sustainability; political commitment, policy, and community participation; information and innovation; resources and research; infrastructure and intersectoral; and training) checklist was modified to assess healthy cities' digital capabilities. With input from 3 healthy city experts, the checklist was revised for digital capabilities, renaming \"healthy city\" to \"digital healthy city.\" The revised tool comprises 8 sections with 33 items. The survey leveraged ChatGPT (version 4.0; OpenAI, Microsoft), accessed via Python (Python Software Foundation) application programming interface. The openai library was installed, and an application programming interface key was entered to use ChatGPT (version 4.0). The \"GPT-4 Turbo\" model command was applied. A qualitative analysis of the collected data was conducted by 5 healthy city experts through group deep-discussions.</p><p><strong>Results: </strong>The results indicate that these countries should establish networks and committees for sustainable digital healthy cities. Cambodia showed the lowest access to electricity (70%) and significant digital infrastructure disparities. Efforts to sustain digital health initiatives varied, with countries such as Korea focusing on telemedicine, while China aimed to build a comprehensive digital health database, highlighting the need for tailored strategies in promoting digital healthy cities. Life expectancy was the highest in the Republic of Korea and Japan (both 84 y). Access to electricity was the lowest in Cambodia (70%) with the remaining countries having had 95% or higher access. The internet use rate was the highest in Malaysia (97.4%), followed by the Republic of Korea (97.2%), Australia (96.2%), and Japan (82.9%).</p><p><strong>Conclusions: </strong>This study highlights the importance of big data-driven policies and personal information protection systems. Collaborative efforts across sectors for effective implementation of digital healthy ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e62935"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382410","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}
Yang Luo, Sisi Li, Lijuan Feng, Junyi Zheng, Chunfen Peng, Lihong Bao
{"title":"Impact of Psychological Resilience on the Fear of Pain and Activity Recovery in Postsurgical Patients: Observational Cohort Study.","authors":"Yang Luo, Sisi Li, Lijuan Feng, Junyi Zheng, Chunfen Peng, Lihong Bao","doi":"10.2196/63556","DOIUrl":"10.2196/63556","url":null,"abstract":"<p><strong>Background: </strong>The fear of pain (FOP) and fear avoidance belief (FAB) play a crucial role in the occurrence and development of chronic pain. However, the dynamics of these factors in postsurgical pain appear to differ, with the FOP often learned from others rather than directly caused by painful experiences. Psychological resilience refers to an individual's capacity to adapt effectively to adversity, challenges, and threats, and may play a significant role in overcoming the FOP and avoidance behavior.</p><p><strong>Objective: </strong>The aim of this study was to investigate the role of psychological resilience in overcoming the FOP and avoidance behavior among surgical patients undergoing lung surgery.</p><p><strong>Methods: </strong>Participants were recruited at the Wuhan Union Hospital. Psychological resilience was measured using the Connor-Davidson Resilience Scale. The FOP was assessed using the simplified Chinese version of the Fear of Pain-9 items. The FAB was measured using the Physical Activity subscale of the Fear-Avoidance Beliefs Questionnaire. Activity recovery was assessed through questions related to social activities and household responsibilities. The adaptive least absolute shrinkage and selection operator (Lasso) regression analysis under nested cross-validation was used to identify key factors affecting postoperative FOP and activity recovery.</p><p><strong>Results: </strong>A total of 144 participants were included in the final analysis. The results showed that preoperative FOP (coefficient=8.620) and FAB (coefficient=8.560) were mainly positively correlated with postoperative FOP, while psychological resilience (coefficient=-5.822) and age (coefficient=-2.853) were negatively correlated with it. These average R2 of these models was 73% (SD 6%). Psychological resilience was the most important factor in predicting activity recovery, and these models obtained an average accuracy of 0.820 (SD 0.024) and an average area under the curve of 0.926 (SD 0.044).</p><p><strong>Conclusions: </strong>Psychological resilience was negatively associated with the postoperative FOP and positively with activity recovery in patients who underwent lung surgery. Patients with higher resilience are more likely to cope effectively with postsurgical pain and recover activities sooner. These findings highlight the importance of assessing and potentially enhancing psychological resilience in the perioperative period to improve postoperative outcomes.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63556"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382451","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}
Hui G Cheng, Brendan Noggle, Andrea R Vansickel, Edward G Largo, Pierpaolo Magnani
{"title":"Tobacco Use, Risk Perceptions, and Characteristics of Adults Who Used a Heated Tobacco Product (IQOS) in the United States: Cross-Sectional Survey Study.","authors":"Hui G Cheng, Brendan Noggle, Andrea R Vansickel, Edward G Largo, Pierpaolo Magnani","doi":"10.2196/57398","DOIUrl":"10.2196/57398","url":null,"abstract":"<p><strong>Background: </strong>The Tobacco Heating System (THS; commercialized as IQOS) is a smoke-free heated tobacco product introduced in the United States in 2019 and authorized by the US Food and Drug Administration as a modified risk tobacco product (MRTP) in 2020. THS consists of a holder and specially designed tobacco sticks that are heated instead of burned to produce a nicotine-containing aerosol. THS was available in Atlanta, Georgia; Richmond, Virginia; Charlotte, North Carolina; the Northern Virginia region; and South Carolina before its market removal in November 2021.</p><p><strong>Objective: </strong>This study aims to describe selected sociodemographic characteristics and self-reported health history of adults who used IQOS (AUIs), their tobacco use patterns (eg, tobacco use history, exclusive and dual-use, and switching from cigarette smoking), their risk perceptions of the product, and their understanding of MRTP messages.</p><p><strong>Methods: </strong>The IQOS Cross-Sectional Postmarket Adult Consumer Study was a study of AUIs aged 21 years or older who were recruited from a consumer database via direct postal mail and emails. Participants completed the online survey between September and November 2021.</p><p><strong>Results: </strong>The survey was completed by 645 current and 43 former AUIs who had used at least 100 tobacco sticks (considered established THS use) before the assessment. Of the 688 participants, 424 (61.6%) were male, 502 (73.0%) were non-Hispanic White, and the mean age was 45 years. The vast majority (680/688, 98.8%) of AUIs had ever smoked combusted cigarettes before first trying THS and 628 (91.3%) had smoked cigarettes in the 30 days before first using THS. At the time of assessment, 161 (23.4%) reported using e-cigarettes (vs 229, 33.3%, before THS use), 92 (13.4%) reported smoking cigars (vs 114, 16.6%, before THS use), and 338 (49.1%) were still smoking after an average of 1 year of THS use. Among those currently using THS who were still smoking (n=298), 249 (83.6%) smoked fewer cigarettes compared with before first trying THS; 362 of 688 (52.6%) AUIs reported having no physical health conditions evaluated in this study and almost three-quarters reported having no mental health conditions. Among all AUIs, over 563 (81.8%) had never used a cessation treatment or had not used it in the past 12 months, and 555 (80.7%) AUIs demonstrated a correct understanding of the MRTP message and AUIs perceived THS as having a lower risk than cigarettes (43.8 vs 64.4 on a 100-point composite score scale).</p><p><strong>Conclusions: </strong>This study provides evidence that THS can help adult smokers in the United States completely switch away from cigarettes or reduce smoking.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e57398"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370670","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}
Marshall K Cheney, Adam C Alexander, Lorra Garey, Matthew W Gallagher, Emily T Hébert, Anka A Vujanovic, Krista M Kezbers, Cameron T Matoska, Michael J Zvolensky, Michael S Businelle
{"title":"Adapting a Mobile Health App for Smoking Cessation in Black Adults With Anxiety Through an Analysis of the Mobile Anxiety Sensitivity Program Proof-of-Concept Trial: Qualitative Study.","authors":"Marshall K Cheney, Adam C Alexander, Lorra Garey, Matthew W Gallagher, Emily T Hébert, Anka A Vujanovic, Krista M Kezbers, Cameron T Matoska, Michael J Zvolensky, Michael S Businelle","doi":"10.2196/53566","DOIUrl":"10.2196/53566","url":null,"abstract":"<p><strong>Background: </strong>At least half of smokers make a serious quit attempt each year, but Black adults who smoke are less likely than White adults who smoke to quit smoking successfully. Black adults who smoke and have high anxiety sensitivity (an individual difference factor implicated in smoking relapse and culturally relevant to Black adults) are even less successful. The Mobile Anxiety Sensitivity Program for Smoking (MASP) is a smoking cessation smartphone app culturally tailored to Black adults who smoke to increase smoking cessation rates by targeting anxiety sensitivity.</p><p><strong>Objective: </strong>This study examined the acceptability and feasibility of the MASP smartphone app following a 6-week pilot test through postintervention qualitative interviews.</p><p><strong>Methods: </strong>The MASP smoking cessation app was adapted from an evidence-based app by adding culturally tailored narration and images specific to the Black community, educational content on tobacco use in the Black community and the role of menthol, culturally tailored messages, and addressing tobacco use and racial discrimination. The MASP app was piloted with 24 adults with high anxiety sensitivity who identified as Black, smoked daily, and were not currently using medications or psychotherapy for smoking cessation. At the end of the 6-week pilot test, 21/24 participants (67% female; 95.2% non-Hispanic; mean age=47.3 years; 43% college educated; 86% single or separated) completed an audio-recorded semistructured interview assessing the acceptability and utility of the app, individual experiences, barriers to use, the cultural fit for Black adults who wanted to quit smoking, and identified areas for improvement. Transcribed interviews were coded using NVivo (Lumivero), and then analyzed for themes using an inductive, use-focused process.</p><p><strong>Results: </strong>Most participants (17/21, 81%) had smoked for more than 20 years and 29% (6/21) of them smoked more than 20 cigarettes daily. Participants felt the MASP app was helpful in quitting smoking (20/21, 95%) and made them more aware of smoking thoughts, feelings, and behaviors (16/19, 84%). Half of the participants (11/21, 52%) thought the combination of medication and smartphone app gave them the best chance of quitting smoking. Themes related to participant experiences using the app included establishing trust and credibility through the recruitment experience, providing personally tailored content linked to evidence-based stress reduction techniques, and self-reflection through daily surveys. The culturally tailored material increased app relevance, engagement, and acceptability. Suggested improvements included opportunities to engage with other participants, more control over app functions, and additional self-monitoring functions.</p><p><strong>Conclusions: </strong>Adding culturally tailored material to an evidence-based mobile health (mHealth) intervention could increase the use of smok","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e53566"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364716","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}
Laurence Astill Wright, Matthew Moore, Stuart Reeves, Elvira Perez Vallejos, Richard Morriss
{"title":"Improving the Utility, Safety, and Ethical Use of a Passive Mood-Tracking App for People With Bipolar Disorder Using Coproduction: Qualitative Focus Group Study.","authors":"Laurence Astill Wright, Matthew Moore, Stuart Reeves, Elvira Perez Vallejos, Richard Morriss","doi":"10.2196/65140","DOIUrl":"10.2196/65140","url":null,"abstract":"<p><strong>Background: </strong>Coproduction with users of new digital technology, such as passive mood monitoring, is likely to improve its utility, safety, and successful implementation via improved design and consideration of how such technology fits with their daily lives. Mood-monitoring interventions are commonly used by people with bipolar disorder (BD) and have promising potential for digitization using novel technological methods.</p><p><strong>Objective: </strong>This study aims to explore how a passive behavioral monitoring platform, Remote Assessment of Disease and Relapse, would meet the needs of people with BD by specifically considering purpose and function, diversity of need, personal preference, essential components and potential risks, and harms and mitigation strategies through an iterative coproduction process.</p><p><strong>Methods: </strong>A total of 17 people with BD were recruited via national charities. We conducted 3 web-based focus groups as a part of an iterative coproduction process in line with responsible research and innovation principles and with consideration of clinical challenges associated with BD. Data were analyzed thematically. Results were cross-checked by someone with lived experience of BD.</p><p><strong>Results: </strong>Focus groups were transcribed and analyzed using thematic analysis. Six themes were identified as follows: (1) the purpose of using the app, (2) desired features, (3) when to use the app, (4) risks of using the app, (5) sharing with family and friends, and (6) sharing with health care professionals.</p><p><strong>Conclusions: </strong>People with BD who are interested in using passive technology to monitor their mood wish to do so for a wide variety of purposes, identifying several preferences and potential risks. Principally, people with BD wished to use this novel technology to aid them in self-managing their BD with greater insight and a better understanding of potential triggers. We discuss key features that may aid this functionality and purpose, including crisis plans and sharing with others. Future development of passive mood-monitoring technologies should not assume that the involvement of formal mental health services is desired.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e65140"},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364649","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}