JMIR Formative Research最新文献

{"title":"The Effectiveness of Live and Prerecorded Video Demonstrations in Teaching Restorative Dentistry to Undergraduate Students: Cohort Study.","authors":"Rana Alkattan, Lulwah Alreshaid","doi":"10.2196/74383","DOIUrl":"10.2196/74383","url":null,"abstract":"<p><strong>Background: </strong>Mastering complex psychomotor skills is essential in undergraduate dental education; however, traditional live demonstrations (LDs) face limitations such as high instructor-to-student ratios and restricted viewing angles. Prerecorded video demonstrations (VDs) offer scalable, repeatable instructions and the ability to integrate multimedia cues but may lack real-time interaction and immediate feedback. There is limited evidence comparing these teaching modalities, particularly regarding gender differences, in the acquisition of restorative dentistry skills.</p><p><strong>Objective: </strong>This study aimed to (1) compare first-year dental students' knowledge acquisition and procedural performance following a LD versus a prerecorded VD of a class II amalgam restoration and (2) evaluate whether gender influences outcomes within each demonstration method.</p><p><strong>Methods: </strong>A total of 51 students enrolled in an Introduction to Operative Dentistry course (2024-2025) participated in this cohort study. The students were randomized into 2 groups: LD (26/51, 51%) or VD (25/51, 49%). Both groups received identical lectures and demonstrations of a standardized class II cavity preparation and amalgam restoration. Knowledge was assessed via preprocedural and postprocedural multiple-choice questionnaires, and the procedural performance was graded by 2 blinded raters using a 10-point rubric. Student perceptions were measured with an 8-item Likert survey. Mixed ANOVA and independent and paired 2-tailed t tests evaluated between-group and within-group differences, while gender analyses used factorial ANOVA. Interrater reliability (interclass correlation coefficient=0.991) was confirmed.</p><p><strong>Results: </strong>The baseline knowledge scores did not differ between the 2 groups. After the demonstration, knowledge was significantly higher with LD (mean 71.22, SD 17.3) than VD (mean 58.4, SD 21.7; P=.02; Cohen d=0.65). The LD method demonstrated significant within-group improvement (P<.001; Cohen d=0.83). Procedural grading favored LD (mean 8.3, SD 0.9 vs mean 7.9, SD 1.0); however, results were not statistically significant (P=.08; Cohen d=0.50). No significant differences were found in the student perception survey. Gender analysis revealed that male students in the LD group achieved higher postknowledge scores (mean 74.0, SD 12.3 vs mean 55.0, SD 24.3; P=.03), greater score improvements (P=.03), and higher grading scores (mean 8.5, SD 0.6 vs mean 7.6, SD 1.3; P=.03) compared to those in the VD group. No significant differences were observed among female students.</p><p><strong>Conclusions: </strong>LDs yielded superior knowledge acquisition and better performance compared to VDs, particularly for male students. VDs remain a viable alternative when supplemented with interactive elements and instructor feedback. Blended teaching models integrating live and video methods may optimize the demonstration experience fo","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e74383"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148978","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":"Changes in Skeletal Muscle Mass Index With Personalized Exercise and Meal Photo Analysis via Nutrition Applications: Single-Arm Pilot Study.","authors":"Hidenori Onishi, Yasutaka Mizukami, Yuki Niida, Kazue Fujita, Osamu Yamamura","doi":"10.2196/71807","DOIUrl":"10.2196/71807","url":null,"abstract":"<p><strong>Unlabelled: </strong>This study evaluated changes in the skeletal muscle mass index (SMI) in community residents who received a photos-based dietary guidance system, personalized exercise plans, and meal photography feedback to address sarcopenia. These findings indicated a possible upward trend in SMI within 3 months.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e71807"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148795","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 Behavioral Science-Informed Agentic Workflow for Personalized Nutrition Coaching: Development and Validation Study.","authors":"Eric Yang, Tomas Garcia, Hannah G Williams, Bhawesh Kumar, Martin Ramé, Eileen Rivera, Yiran Ma, Jonathan Amar, Caricia Catalani, Yugang Jia","doi":"10.2196/75421","DOIUrl":"10.2196/75421","url":null,"abstract":"<p><strong>Background: </strong>Effective management of cardiometabolic conditions requires sustained positive nutrition habits, often hindered by complex and individualized barriers. Direct human management is simply not scalable, and deterministic automated approaches to nutrition coaching may lack the personalization needed to address these diverse challenges.</p><p><strong>Objective: </strong>We report the development and validation of a novel large language model (LLM)-powered agentic workflow designed to provide personalized nutrition coaching by directly identifying and mitigating patient-specific barriers.</p><p><strong>Methods: </strong>We used behavioral science principles to create a comprehensive workflow that can map nutrition-related barriers to corresponding evidence-based strategies. First, a specialized LLM agent to intentionally probe for and identify root causes of a patient's dietary struggles. Subsequently, a separate LLM agent to deliver tailored tactics that were designed to overcome those specific barriers. We conducted a user study with individuals with cardiometabolic conditions (N=16) to inform our workflow design and then validated our approach through an additional user study (n=6). We also conducted a large-scale simulation study, grounding on real patient vignettes and expert-validated metrics, where human experts evaluated the system's performance across multiple scenarios and domains.</p><p><strong>Results: </strong>In our user study, the system accurately identified barriers and provided personalized guidance. Five out of 6 participants agreed that the LLM agent helped them recognize obstacles preventing them from being healthier, and all participants strongly agreed that the advice felt personalized to their situation. In our simulation study, experts agreed that the LLM agent accurately identified primary barriers in more than 90% of cases (27 or 28/30). Additionally, experts determined that the workflow delivered personalized and actionable tactics empathetically, with average ratings of 4.17-4.79 on a 5-point Likert scale.</p><p><strong>Conclusions: </strong>Our findings demonstrate the potential of this LLM-powered agentic workflow to improve nutrition coaching by providing personalized, scalable, and behaviorally informed interventions.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e75421"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Technology by the Rural-Dwelling Caregivers of People Living With Dementia to Support Caregiving: Qualitative Interview Study.","authors":"Anna Jolliff, Sarah Boucher, Jordan R Hill, Kristen Allen-Watts, Miriam J Rodriguez, Christian Elliott, Matthew Zuraw, Nicole E Werner","doi":"10.2196/77231","DOIUrl":"10.2196/77231","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers of people living with dementia who live in rural areas face challenges distinctly different from those experienced by their urban counterparts. Technology is a promising but underused method for delivering interventions to rural caregivers.</p><p><strong>Objective: </strong>This study aims to describe the technologies used by rural caregivers of people living with dementia, how these caregivers use technology to support caregiving, and the barriers and facilitators they encounter in using technology.</p><p><strong>Methods: </strong>We conducted online, semistructured interviews with rural caregivers of people living with dementia. The objective of the primary study was to understand how caregivers access support, including the types of support used, strategies used to find support, and any unmet support needs. This study was a secondary analysis focused exclusively on caregivers' technology use. Summative, content, and thematic analyses were used to understand patterns of technology use and the associated facilitators.</p><p><strong>Results: </strong>A total of 19 caregivers were included in this study, of whom 14 (74%) were female. The average age was 66.4 (SD 10.1) years. The 5 most frequently endorsed technologies were phones for calling (n=19, 100%) and texting (n=14, 74%), websites (n=17, 89%), television and movies (n=15, 79%), and emails (n=13, 68%). Technology provided the following types of support: informational (n=19, 100%), emotional (n=13, 68%), instrumental (n=12, 63%), entertainment (n=10, 53%), safety (n=6, 32%), and caregiver personal health (n=4, 21%). Thematic analysis yielded 4 characteristics of caregivers that facilitated technology use, including access to technology, technological savviness, preference for technology, and having a technology broker. In addition, analyses yielded 4 characteristics of technology that facilitated technology use, including appeal, efficiency, ease of use, and trustworthiness.</p><p><strong>Conclusions: </strong>All rural caregivers in this study used technology to access caregiving support, which suggests that this population is prepared for remote interventions. Our findings can be used to help determine optimal delivery and content of these interventions and instruct interventionists on caregiver and technology characteristics that may facilitate uptake. Rural caregivers may be receptive to interventions delivered through texts, websites, and videos, particularly those that focus on meeting informational and instrumental needs.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e77231"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131061","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":"Surveillance of Twitter Data on COVID-19 Symptoms During the Omicron Variant Period: A Sentiment Analysis.","authors":"Kaiyue Zhang, Zhaojin Guo, Yujie Ai, An-Ran Li, Anlin Li, Ziyu Liu, Yittie Yi Ting Tse, Xinyu Zhou, Taoran Liu, Chuxi Xiong, Jian Huang, Wai-Kit Ming","doi":"10.2196/66237","DOIUrl":"10.2196/66237","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The global outbreak of COVID-19 has significantly impacted health care systems and has necessitated timely access to information for effective decision-making by health care authorities. Conventional methods for collecting patient data and analyzing virus mutations are resource-intensive. In the current era of rapid internet development, information on COVID-19 infections could be collected by a novel approach that leverages social media, particularly Twitter (subsequently rebranded X).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study was to analyze the trending patterns of tweets containing information about various COVID-19 symptoms, explore their synchronization and correlation with conventional monitoring data, and provide insights into the evolution of the virus. We categorized tweet sentiments to understand the predictive power of negative emotions of different symptoms in anticipating the emergence of new Omicron subvariants and offering real-time assistance to affected individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Relevant user tweets from 2022 containing information about COVID-19 symptoms were extracted from Twitter. Our fine-tuned RoBERTa model for sentiment analysis, achieving 99.7% accuracy for sentiment analysis, was used to categorize tweets as negative, positive, or neutral. Joinpoint regression analysis was used to examine the trends in weekly negative tweets related to COVID-19 symptoms, aligning these trends with the transition periods of SARS-CoV-2 Omicron subvariants from 2022. Real-time Twitter users with negative sentiments were geographically plotted. A total of 105,934 tweets related to fever, 120,257 to cough, 55,790 to headache, 101,220 to sore throat, 3410 to vomiting, and 5913 to diarrhea were collected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The most prominent topics of discussion were fever, sore throat, and headache. The weekly average daily tweets exhibited different fluctuation patterns in different stages of subvariants. Specifically, fever-related negative tweets were more sensitive to Omicron subvariant evolution, while discussions of other symptoms declined and stabilized following the emergence of the BA.2 variant. Negative discussions about fever rose to nearly 40% at the beginning of 2022 and showed 2 distinct peaks during the absolute dominance of BA.2 and BA.5, respectively. Headache and throat-related negative sentiment exhibited the highest levels among the analyzed symptoms. Tweets containing geographic information accounted for 1.5% (1351/391,508) of all collected data, with negative sentiment users making up 0.35% (5873/391,508) of all related tweets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study underscores the potential of using social media, particularly tweet trends, for real-time analysis of COVID-19 infections and has demonstrated correlations with major symptoms. The degree of negative emotions expressed in tweets is valuable in predicting the emergence of new ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66237"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Health Care Workers' Attitudes and Preferences Toward Digital Patient Monitoring Platforms: Cross-Country Survey Study.","authors":"Costanza Tortù, Chiara Seghieri, Ditila Doracaj, Natalya Usheva, Natalia Giménez-Legarre, Yannis Manios","doi":"10.2196/67142","DOIUrl":"10.2196/67142","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The integration of digital health tools into the routines of health care workers (HCWs) holds potential to enhance health care delivery. In particular, digital tools for patient data monitoring allow HCWs to quickly access patient health information and detect early warning signs of potential issues. However, while interest in these tools, such as telemedicine and mobile health, has rapidly grown in recent years, limited research has explored HCWs' attitudes toward digital innovations or their feature preferences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to (1) assess HCWs' attitudes toward digital health tools for patient data monitoring, (2) identify socioeconomic factors influencing these attitudes, (3) determine HCWs' preferences for features of a novel digital health platform for patient data monitoring, and (4) examine whether HCWs' baseline attitudes impact their feature preferences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study uses an integrated approach combining item response theory (IRT) and discrete choice experiment to evaluate the attitudes and preferences of HCWs. Data come from a web conjoint survey distributed to an international cohort of HCWs across the following 4 European countries: Spain, Albania, Bulgaria, and Greece.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Survey respondents comprise 260 HCWs from the 4 countries. The findings indicate that HCWs generally hold a positive attitude toward technological devices (all the IRT coefficients are statistically significant with P&lt;.05). Socioeconomic characteristics, including factors such as gender (P=0.05), professional role (P=0.01), and educational background (P=0.01), significantly influence these attitudes. Results show that highly educated female HCWs are those who are mostly inclined to use technologies. In addition, the specific features of a digital health platform for patient data monitoring highly impact HCWs' willingness to incorporate such a tool into their daily practice (all coefficients related to the attributes' effects in the models for the discrete choice experiment results are significant (all P=0.01 except the data looking attribute which has P=0.03) . The findings suggest that an ideal digital health platform for patient data monitoring should offer intuitive graphs, comparative statistics against standards, and include patients' family clinical history. In addition, health workers should receive instructor-led group training to effectively use the platform.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study shows that health workers generally support the use of digital health tools, which have the potential to improve health care efficiency and patient outcomes through enhanced monitoring and timely interventions. To facilitate adoption, policymakers should strengthen infrastructure, enact supportive legislation, and tailor interventions for groups less inclined to use these tools. Aligning digital health platform features with HCW p","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67142"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131063","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":"Disease Activity Assessment Frequency in Rheumatoid Arthritis: A Retrospective Observational Study of the Medical Support System for Rheumatoid Arthritis System Implementation.","authors":"Mari Yamamoto, Yuki Kataoka, Yasushi Tsujimoto, Fumika Nagase, Keita Iwasaki, Yuuki Ito, Hiroki Ikai, Tsuyoshi Watanabe, Waka Yokoyama-Kokuryo, Naoho Takizawa, Yoshiro Fujita","doi":"10.2196/74222","DOIUrl":"10.2196/74222","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a global health concern with increasing prevalence. Despite recommendations for regular disease activity assessments, their implementation in routine clinical practice remains challenging. The Medical Support System for Rheumatoid Arthritis (MiRAi) is an offline, semi-automated system that calculates disease activity indices by integrating patient and clinician inputs from electronic health records (EHRs).</p><p><strong>Objective: </strong>This study evaluated the association between MiRAi implementation and the frequency of disease activity assessments in patients with RA.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with RA treated at a tertiary hospital in Japan between April 2022 and March 2023. We included all adult outpatients (aged ≥18 years) with RA diagnosed according to the 2010 ACR/EULAR [American College of Rheumatology/European Alliance of Associations for Rheumatology] classification criteria. The hospital introduced MiRAi in June 2022 and achieved full deployment by October 2022. MiRAi calculated the clinical disease activity index (CDAI) and the modified health assessment questionnaire (mHAQ) through automated extraction of joint counts, patient global assessment, and functional status from structured EHR fields. Primary outcomes included the frequency of CDAI and mHAQ assessments. We administered a structured post-implementation survey to assess rheumatologists' perceptions of MiRAi.</p><p><strong>Results: </strong>Physicians used MiRAi for 236/884 (26.7%) patients with RA. Patients with documented CDAI and mHAQ scores increased from 29 (5.9%) in June 2022 to 81 (19.0%) in November 2022, representing a 3.2-fold increase. Among surveyed rheumatologists (n=10), 5 (50%) reported the regular use of MiRAi. Physicians who regularly used MiRAi (n=5) cited improved accuracy in disease assessment and enhanced treatment decision-making. Non-users and occasional users (n=5) identified three primary barriers: limited familiarity with MiRAi, time constraints, and discrepancies between clinical judgment and MiRAi-generated outputs. Despite MiRAi's availability, only 168 (19%) patients underwent quantitative disease activity assessment by the study end. Among 15 patients with high disease activity (CDAI >22), physicians recorded 3 treatment modifications and 2 intra-articular steroid injections.</p><p><strong>Conclusions: </strong>MiRAi implementation increased disease activity assessment frequency by 3.2-fold over 6 months; however, physician adoption remained at 26.7%, below the 80% target for routine care. Future implementation strategies should address identified barriers through system integration, structured user training, and workflow optimization to achieve guideline-concordant care for patients with RA.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e74222"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of a Patient-Centered Digital Health Care Technology for Young Adults in Opioid Use Disorder Treatment: Qualitative Study.","authors":"Karen Alexander, Madison Scialanca","doi":"10.2196/67401","DOIUrl":"10.2196/67401","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Young adults, defined as individuals between the ages of 18 and 29 years, drop out of opioid use disorder (OUD) treatment more often than older adults. Premature treatment drop-out substantially increases fatal overdose risk. Self-monitoring through text messaging has been researched extensively among people with OUD to identify drop-out risk factors. Self-monitoring could potentially improve methadone treatment engagement among young adults, who are a population that is both hard to reach and more likely to use technology compared to older adults. Self-monitoring can increase risk factor awareness and help patients and counselors develop targeted coping strategies and treatment plans. However, embedding a discussion of risk factor information into existing counseling sessions has been limited and may offer a promising opportunity to improve engagement among young adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This pilot proof-of-concept study examined the implementation of self-monitoring intervention, AWARE (Awareness and Response to the Environment), designed to bring attention to treatment drop-out risk factors among young adults and create discussion about risk factors with their existing treatment counselor.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this formative research, a convenience sample (N=8) of young adults (n=3, 38%) in methadone treatment, their counselors (n=3, 38%), and clinic leadership (n=2, 25%) were recruited from an opioid treatment program after referral from treatment staff. Participants were interviewed to obtain feedback as AWARE was developed. In semistructured interviews, perspectives regarding barriers to treatment for young adults and AWARE utility were obtained. Concurrently, 3 dyads of young adults (n=3, 38%) and counselors (n=3, 38%) piloted the intervention daily for 4 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 3 consented young adults with OUD participants (n=2, 67% female; n=2, 67% Latino/a) were sent daily surveys for 28 days (53% overall completion rate). Young adults and counselors found AWARE relevant to their treatment experience and acceptable to complete over 4 weeks. The most reported daily stressors included concerns about the health and well-being of a family member, challenges with staying organized, and feeling overwhelmed by responsibilities without adequate support. In qualitative interviews, counselors and clinic leadership reported that AWARE presented a relevant, new way to engage young adults daily, in addition to weekly counseling sessions. Young adults felt that prompts sent by AWARE offered a type of social support they lacked, like \"someone checking in on them.\"&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Overall, young adult and counselor participants were able to engage in AWARE in a busy clinic environment, and participants and clinic leadership found it valuable. By addressing common stressors and providing a sense of social connection, AWARE may help fill a gap in suppor","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67401"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131006","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":"Exploring the Impact of a Remote Monitoring System for Palliative and End-of-Life Care (CARE-PAC): Mixed Methods Feasibility Study.","authors":"Roma Maguire, Lisa McCann, Claire Singleton, Paul Perkins, Ollie Minton, Nicola McCann, Emma Longford, Alistair Dermot McKeown, Kimberley Kavanagh, Morven Miller","doi":"10.2196/69394","DOIUrl":"10.2196/69394","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the United Kingdom, access to and the quality of palliative and end-of-life care (PEOLC) vary widely. In the final months of life, many patients face avoidable accident and emergency (A&E) visits and hospital admissions, driven by gaps in out-of-hours support and poorly coordinated care. This not only increases stress for patients and carers but also places avoidable strain and cost on the National Health Service (NHS). There is an urgent need for more compassionate, person-centered models that support people to remain at home, improve their quality of life (QoL), and reduce unnecessary use of acute services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore the usability, user experiences, and impact of the digital dyadic remote monitoring Care and Support System for Patients and Carers (CARE-PAC) for patients in the last year of life, their informal carers, and health professionals involved in their care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients and informal carers were recruited to use CARE-PAC for up to 12 weeks. A mixed methods approach was used. Quantitative methods included the use of validated QoL scales and the System Usability Scale (SUS). Paired QoL and usability data were analyzed using the Wilcoxon (Pratt) signed-rank test, while unpaired usability data were analyzed using the Wilcoxon rank-sum test. Qualitative methods involved short catch-up calls, in-depth interviews, and focus groups conducted using topic guides informed by the domains of the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework. Data were analyzed thematically.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;CARE-PAC was implemented across 5 UK clinical sites with 26 participants (13 patient-carer dyads). No significant changes were observed in patients' total QoL scores; however, significant improvements were seen in the \"overall QoL\" and \"social\" domains, alongside a significant decline in the \"physical\" domain. Carers showed no significant changes across total or domain-specific QoL scores. Usability was rated highly by patients (mean 87.9, SD 12.4) and carers (mean 94.7, SD 3.8), indicating an excellent user experience. Health care professionals (HCPs) reported lower usability scores (mean 63.6, SD 15.6), falling below average but above the threshold for poor usability. Thematic analysis of qualitative data gathered via catch-up calls (all patient-carer dyads), in-depth interviews (2 patients-2 carers), and 4 focus groups/1 interview (12 HCPs) identified 4 key themes: impact on care experiences, reflections and satisfaction, implementation challenges, and future directions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;CARE-PAC is a usable, feasible, and acceptable remote monitoring and support system for patients in the last year of life, their carers, and HCPs. It enables real-time identification of needs and has shown positive impacts on the QoL of both patients and carers. These findings support the need f","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e69394"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131009","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":"Implementation, Challenges, and Outlook of an Intergenerational, Layperson-led, Health Coaching Program (HealthStart): A Pilot Case Study.","authors":"Xiaoting Huang, Ka Shing Yow, Audrey Shu Ting Kwan, Jin Ye Yeo, Haikel A Lim, Jie Xin Lim, Meng Han Lim, Lynn Pei Zhen Teo, Nerice Heng Wen Ngiam, Si Qi Lim, Kharuna Jaichandra, Kai Wen Aaron Tang, Angeline Jie-Yin Tey, Lian Leng Low, Kennedy Yao Yi Ng","doi":"10.2196/76592","DOIUrl":"10.2196/76592","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As rapidly aging populations become a worldwide phenomenon, early detection and prompt management of chronic disease become essential to support healthy aging. Community-based health screenings, a key component of this strategy, often struggle with poor follow-up rates, limiting their long-term impact. Given the untapped potential of youth volunteers and the urgent need for a scalable approach to improve continuity of care post health screenings, we developed HealthStart: a structured, theory-based program that empowers these older adults to take greater ownership of their health and their chronic conditions with the support of youth community health volunteers (CHVs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to describe the development, implementation, and early outcomes of HealthStart-an intergenerational, layperson-led health coaching program-and summarize operational lessons to guide similar models in Asian communities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;HealthStart adopted an intergenerational service-learning approach modeled on a self-determination theory-based layperson-led health coaching framework. Each HealthStart team consisted of 1 health care volunteer (HCV) and 4 youth CHVs. All volunteers underwent blended training and were assessed for layperson-led health coaching readiness. Between September 2022 and June 2023 in Singapore, youth CHVs empowered adult participants aged 40 years and older after their health screening to (1) learn about their chronic diseases, (2) learn at least one digital health app, (3) enroll with a primary care provider, and (4) set a lifestyle goal (based on the Specific, Measurable, Achievable, Realistic/Relevant, and Time-bound [SMART] framework for goal setting) and achieve it. We used an implementation-focused case study design using descriptive statistics and volunteer-participant feedback to evaluate feasibility and outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 236 eligible individuals, 192 enrolled. Participants had a mean age of 67 (SD 9.6) years; 52.1% (n=100) of participants were female, with a majority of Chinese ethnicity, having completed primary or secondary school education, residing in self-owned flats, and living in 3-room public housing. Follow-up rate with primary care increased from 42.7% (82/148) preprogram to 84.5% (125/148) postprogram (χ21=43; P&lt;.001). In total, 58 HCVs were recruited, comprising 26 nurses and 6 doctors, with the remainder as allied health professionals. A total of 33 were trained and deployed. The mean age of HCVs was 37 years old, and 24 (72.7%) were female. Furthermore, 149 youth CHVs were recruited, 138 trained, and 102 deployed. The mean age of the youth CHVs who were deployed was 24 years, and 75 (73.5%) were female. Reflections included the importance of volunteer competency and selection criteria, tiering of participant intervention, tapping on community assets, adoption of a social prescription framework, importance of al","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e76592"},"PeriodicalIF":2.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124906","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}