JMIR Formative Research最新文献

{"title":"Zoom-Delivered Empowered Relief for Chronic Pain: Observational Longitudinal Pilot Study Exploring Feasibility and Pain-Related Outcomes in Patients on Long-Term Opioids.","authors":"Karlyn A Edwards, Troy C Dildine, Dokyoung S You, Ashley M Herrick, Beth D Darnall, Sean C Mackey, Maisa S Ziadni","doi":"10.2196/68292","DOIUrl":"10.2196/68292","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic pain on long-term opioid therapy often face barriers to accessing effective nonpharmacological treatments, including the burden of multiple sessions, lack of trained clinicians, and travel time. Empowered Relief (ER), a 2-hour, single-session pain relief skills class, can improve pain and quality of life among patients with chronic pain when delivered in person or virtually.</p><p><strong>Objective: </strong>This study examined the impact of Zoom-delivered ER among people with chronic pain on long-term opioid therapy. We assessed (1) the feasibility and acceptability of Zoom-delivered ER; (2) changes in pain and opioid use outcomes at 3 and 6 months after treatment; and (3) daily associations among pain, opioid dose, and the Pain Catastrophizing Scale (PCS) before and after treatment.</p><p><strong>Methods: </strong>During the early COVID-19 pandemic, we conducted an uncontrolled pilot study of a Zoom-delivered ER among 60 adults (n=45, 76% female participants; n=52, 88% White participants) experiencing chronic pain who were receiving daily prescribed opioids (≥10 morphine-equivalent daily dose). Participants completed assessments at enrollment, before class, after class, 3 months after treatment, and 6 months after treatment. Furthermore, participants completed 2 daily assessment periods (spanning 14 consecutive days) before and after the class. We used a multilevel modeling approach to examine (1) the raw changes in PCS, average pain intensity, pain interference, and self-reported opioid dose at 3 and 6 months after treatment and (2) daily-level changes in average pain intensity and opioid dose before and after the class.</p><p><strong>Results: </strong>Of the 60 participants enrolled, 41 (68%) attended the class and 24 (59% of the 41 class attendees) reported satisfaction with the Zoom-delivered class. PCS score was significantly reduced at 3 months (β=-3.49, P=.01; Cohen d=0.35) and 6 months after treatment (β=-3.61, P=.01; Cohen d=0.37), and pain intensity was significantly reduced at 3 months (β=-0.56, P=.01; Cohen d=0.39) compared to enrollment. There were no significant reductions in pain interference or opioid dose. Across daily assessments, higher daily pain catastrophizing was associated with worse daily pain (β=.42, P<.001) and higher self-reported opioid use (β=3.14, P<.001); daily pain intensity significantly reduced after the class (β=-.50, P<.001). People taking prescribed opioids as needed trended toward decreasing their daily opioid use after the class (β=-9.31, P=.02), although this result did not survive correction for multiplicity.</p><p><strong>Conclusions: </strong>Improvements to future Zoom-delivered ER iterations are needed to improve feasibility and acceptability among people with chronic pain and daily prescribed opioid use. Despite this, findings show a promising preliminary impact of the intervention on pain outcomes. A larger randomized controlled trial of Zoom-d","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e68292"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604979","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":"Telemedicine Prescribing by US Mental Health Care Providers: National Cross-Sectional Survey.","authors":"Mollie R Cummins, Julia Ivanova, Hiral Soni, Zoe Robbins, Brian E Bunnell, Esteban López, Brandon M Welch","doi":"10.2196/63251","DOIUrl":"10.2196/63251","url":null,"abstract":"<p><strong>Background: </strong>In the postpandemic era, telemedicine continues to enable mental health care access for many people, especially persons living in areas with mental health care provider shortages. However, as lawmakers consider long-term telemedicine policy decisions, some question the safety and appropriateness of prescribing via telemedicine, and whether there should be requirements for in-person evaluation, especially for controlled substances.</p><p><strong>Objective: </strong>Our objective was to assess US telemental health care provider perceptions of comfort and perceived safety in prescribing medications, including controlled substances, via telemedicine.</p><p><strong>Methods: </strong>We conducted a web-based, cross-sectional survey of US telemental health care providers who prescribe via telemedicine, using nonprobability, availability sampling of a national telehealth research panel from February 13 to April 28, 2024. We used descriptive statistics, visualization, and thematic analysis to analyze results. We assessed differences in response distribution by health care provider licensure type (physician vs nonphysician) and specialty (psychiatry vs nonpsychiatry) using the Mann-Whitney U test.</p><p><strong>Results: </strong>A total of 115 screened and eligible panelists completed the survey. Overall, participants indicated high levels of comfort with prescribing via telemedicine, with 84% (102/115) of health care providers indicating they strongly agree with the statement indicating comfort in prescribing medications via telemedicine. However, participants indicated less comfort in prescribing if they have never seen a patient in person, or if the patient is located out-of-state. Most participants indicated they can safely prescribe controlled substances via telemedicine, without having previously provided care to a patient in person. However, 14.8% (17/115) to 19.1% (30/115) of health care providers (by schedule) felt that they could rarely or never safely prescribe controlled substances. There were some differences in perception of comfort and safety by licensure and specialty. Among controlled substance schedules, participants indicated the least perceived safety with schedule IV medications, and the most safety with schedule II and III medications.</p><p><strong>Conclusions: </strong>These health care providers were highly comfortable prescribing both scheduled and unscheduled medications via telemedicine. Comfort and perceived safety with telemedicine prescribing varied somewhat by licensure type (physician vs nonphysician) and specialty (psychiatry vs nonpsychiatry). Perceived safety varied moderately for scheduled medications (controlled substances), especially for schedule IV and V medications. Participants indicated use of adaptive strategies to prescribe safely depending upon the clinical context. In ongoing efforts, we are analyzing additional survey results and conducting qualitative research related to tele","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63251"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604975","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":"Evaluation of the MyFertiCoach Lifestyle App for Subfertile Couples: Single-Center Evaluation of Augmented Standard Care.","authors":"Jesper Smeenk, Ellen Smit, Marc Jacobs, Ilse van Rooij","doi":"10.2196/64239","DOIUrl":"10.2196/64239","url":null,"abstract":"<p><strong>Background: </strong>Many couples undergoing fertility treatment face multiple lifestyle risk factors that lower their chances of achieving pregnancy. The MyFertiCoach (MFC) app was designed as an integrated lifestyle program featuring modules on healthy weight management, nutrition, exercise, quitting smoking, reducing alcohol and drug use, and managing stress. We hypothesized that supplementing standard care with the MFC app would improve lifestyle outcomes.</p><p><strong>Objective: </strong>This study aims to assess the impact of the MFC app on changing multiple lifestyle habits in women seeking fertility treatment. The primary outcome is the change in the total risk score (TRS) at 3- and six-month follow-ups. The TRS is calculated for each individual as the sum of all risk scores per behavior (eg, vegetable/fruit/folic acid intake, smoking, and alcohol use) at 3 and 6 months. A higher TRS indicates unhealthier nutrition and lifestyle habits and a lower likelihood of achieving pregnancy. The secondary endpoints include changes in BMI, activity score, preconception dietary risk score, distress score (eg, perceived burden), smoking habits, alcohol intake, and program adherence.</p><p><strong>Methods: </strong>This retrospective, observational, single-center evaluation included patients between January 1, 2022, and December 31, 2023. Subfertile female patients aged 18-43 years and their partners, who were referred to a gynecologist, were invited to participate in online lifestyle coaching via the MFC app. The gynecologist selected relevant lifestyle modules based on the results of integrated screening questionnaires. We used (hierarchical) linear mixed models (LMMs) to estimate changes in outcomes. For missing data patterns deemed missing not at random, joint modeling was applied. Statistical significance was set at P≤.05, with methods in place to maintain the same false-positive rate.</p><p><strong>Results: </strong>A total of 1805 patients were invited to participate in the evaluation, with an average of 737 (40.83%) completing the screening questionnaire at baseline. For the TRS, 798 (44.21%) patients were included at baseline, of whom 517 (64.8%) involved their partner. On average, 282 of 744 (37.9%) patients submitted at least one follow-up questionnaire. Patients rated the app above average (n=137, median score of 7 on a 1-10 scale) on days 7 and 14. The TRS decreased by an average of 1.5 points (P<.001) at T3 and T6 compared with baseline, a clinically meaningful improvement. All secondary outcomes showed statistically significant positive changes for patients who used a relevant lifestyle module (P<.001). Most improvements were achieved by 3 months and remained significant at 6 months (P<.001), except for alcohol intake (P<.53). These findings were consistent across both LMMs and joint models.</p><p><strong>Conclusions: </strong>Our evaluation of a mobile health app integrated into standard care demonstrates immediate and clini","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64239"},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597004","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":"Predictors of the Intention to Stop Using Smart Devices at Bedtime Among University Students in Saudi Arabia: Cross-Sectional Survey.","authors":"Manal Almalki","doi":"10.2196/67223","DOIUrl":"10.2196/67223","url":null,"abstract":"<p><strong>Background: </strong>The widespread use of smart devices, particularly among university students, has raised concerns about their impact on sleep quality. Bedtime usage of smart devices is associated with sleep disruptions and poor sleep quality.</p><p><strong>Objective: </strong>This study aimed to explore the behavioral and perceptual factors influencing university students' intention to stop using smart devices at bedtime in Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in June 2024 and distributed via social media platforms to university students (aged ≥18 years). The questionnaire collected data on demographics, smart device usage habits, perceived negative effects on sleep, and physical sleep disturbances. The Pittsburgh Sleep Quality Index was used to assess sleep quality. Path analysis was performed to evaluate relationships between the outcome variables, intended to stop using smart device usage, and 3 latent variables: sleep quality smartphone usage, sleep quality perceived negative effects, and sleep quality during the past month. Model fit was assessed using chi-square, comparative fit index, and root mean square error of approximation.</p><p><strong>Results: </strong>Of the 774 participants, 90.43% (700/774) reported using their smart devices every night and 72.48% (561/774) believed bedtime device use negatively affected them the next morning. The most frequently reported next-morning symptoms were fatigue or drowsiness (480/774, 62.01%). Common purposes for bedtime device use were staying in touch with friends or family (432/774, 55.81%), entertainment (355/774, 45.86%), and filling up spare time (345/774, 44.57%). Overall, 58.26% (451/774) expressed an intention to stop bedtime device use within the next 3 months. Path analysis demonstrated that frequent nightly use (path coefficient=0.36) and after-lights-off usage (0.49) were positively associated with the intention to stop, whereas spending ≥3 hours on devices (-0.35) and engaging in multiple activities (-0.18) had negative associations. The strongest predictors of the intention to stop were perceived negative effects on next-morning well-being (0.71) and difficulty breathing comfortably during sleep (0.64). Model fit was excellent (comparative fit index=0.845 and root mean square error of approximation=0.039).</p><p><strong>Conclusions: </strong>Perceived negative effects on sleep quality and physical sleep disturbances are strong predictors of the intention to stop using smart devices at bedtime among university students in Saudi Arabia. Interventions aimed at improving sleep hygiene should focus on raising awareness about the impact of smart device use on well-being and addressing behaviors such as late-night usage and heavy screen time. Public health strategies should target both psychological and physiological aspects of bedtime smart device use to improve sleep quality in this population.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67223"},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585803","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":"Medical Misinformation in AI-Assisted Self-Diagnosis: Development of a Method (EvalPrompt) for Analyzing Large Language Models.","authors":"Troy Zada, Natalie Tam, Francois Barnard, Marlize Van Sittert, Venkat Bhat, Sirisha Rambhatla","doi":"10.2196/66207","DOIUrl":"10.2196/66207","url":null,"abstract":"<p><strong>Background: </strong>Rapid integration of large language models (LLMs) in health care is sparking global discussion about their potential to revolutionize health care quality and accessibility. At a time when improving health care quality and access remains a critical concern for countries worldwide, the ability of these models to pass medical examinations is often cited as a reason to use them for medical training and diagnosis. However, the impact of their inevitable use as a self-diagnostic tool and their role in spreading health care misinformation has not been evaluated.</p><p><strong>Objective: </strong>This study aims to assess the effectiveness of LLMs, particularly ChatGPT, from the perspective of an individual self-diagnosing to better understand the clarity, correctness, and robustness of the models.</p><p><strong>Methods: </strong>We propose the comprehensive testing methodology evaluation of LLM prompts (EvalPrompt). This evaluation methodology uses multiple-choice medical licensing examination questions to evaluate LLM responses. Experiment 1 prompts ChatGPT with open-ended questions to mimic real-world self-diagnosis use cases, and experiment 2 performs sentence dropout on the correct responses from experiment 1 to mimic self-diagnosis with missing information. Humans then assess the responses returned by ChatGPT for both experiments to evaluate the clarity, correctness, and robustness of ChatGPT.</p><p><strong>Results: </strong>In experiment 1, we found that ChatGPT-4.0 was deemed correct for 31% (29/94) of the questions by both nonexperts and experts, with only 34% (32/94) agreement between the 2 groups. Similarly, in experiment 2, which assessed robustness, 61% (92/152) of the responses continued to be categorized as correct by all assessors. As a result, in comparison to a passing threshold of 60%, ChatGPT-4.0 is considered incorrect and unclear, though robust. This indicates that sole reliance on ChatGPT-4.0 for self-diagnosis could increase the risk of individuals being misinformed.</p><p><strong>Conclusions: </strong>The results highlight the modest capabilities of LLMs, as their responses are often unclear and inaccurate. Any medical advice provided by LLMs should be cautiously approached due to the significant risk of misinformation. However, evidence suggests that LLMs are steadily improving and could potentially play a role in health care systems in the future. To address the issue of medical misinformation, there is a pressing need for the development of a comprehensive self-diagnosis dataset. This dataset could enhance the reliability of LLMs in medical applications by featuring more realistic prompt styles with minimal information across a broader range of medical fields.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66207"},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597006","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":"Testing and Iterative Improvement of the CEN ISO/TS 82304-2 Health App Quality Assessment: Pilot Interrater Reliability Study.","authors":"Anna-Lena Frey, Diana Matei, Ben Phillips, Adam McCabe, Rachel Fuller, Begoña Laibarra, Laura Alonso, Victor de la Hoz, Carme Pratdepadua Bufill, Berta Llebot Casajuana, Giuseppe D'Avenio, Pier Angelo Sottile, Laura Melania Rocchi, Matteo Errera, Yasmine Laaissaoui, Michael Cardinal, Menno Kok, Petra Hoogendoorn","doi":"10.2196/64565","DOIUrl":"10.2196/64565","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;With the increasing use of health apps and ongoing concerns regarding their safety, effectiveness, and data privacy, numerous health app quality assessment frameworks have emerged. However, assessment initiatives experience difficulties scaling, and there is currently no comprehensive, consistent, internationally recognized assessment framework. Therefore, health apps often need to undergo several quality evaluations to enter different markets, leading to duplication of work. The CEN ISO/TS 82304‑2 health app assessment seeks to address this issue, aiming to provide an internationally accepted quality evaluation through a network of assessment organizations located in different countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop and evolve the draft CEN ISO/TS 82304-2 assessment handbook and developer guidance by testing them across organizations in several countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Assessment organizations from 5 countries were engaged to evaluate 24 health apps using the evolving CEN ISO/TS 82304-2 assessment across 3 evaluation rounds. The information submitted by a given health app developer was evaluated by 2 assessment organizations, and interrater reliability was examined. In addition, app developers and assessors were asked to report how much time they spent on information collation or evaluation and to rate the clarity of the developer guidance or assessor handbook, respectively. The collected data were used to iteratively improve the handbook and guidance between rounds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The interrater reliability between assessment organizations improved from round 1 to round 2 and stayed relatively stable between rounds 2 and 3, with 80% (55/69) of assessment questions demonstrating moderate or better (Gwet AC1&gt;0.41) agreement in round 3. The median time required by developers to prepare the assessment information was 8 hours and 59 minutes (IQR 5.7-27.1 hours) in round 3, whereas assessors reported a median evaluation time of 8 hours and 46 minutes (IQR 7.1-11.0 hours). The draft guidance and handbook were generally perceived as clear, with a median round-3 clarity rating of 1.73 (IQR 1.64-1.90) for developers and 1.78 (IQR 1.71-1.89) for assessors (0=\"very unclear\", 1=\"somewhat unclear\", and 2=\"completely clear\").&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;To our knowledge, this is the first study to examine the consistency of health app evaluations across organizations located in different countries. Given that the CEN ISO/TS 82304-2 guidance and handbook are still under development, the interrater reliability findings observed at this early stage are promising, and this study provided valuable information for further refinement of the assessment. This study marks an important first step toward establishing the CEN ISO/TS 82304-2 assessment as a consistent, cross-national health app evaluation. It is envisioned that the assessment will ultimately help avo","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64565"},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597010","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":"Development of a Voice-Activated Virtual Assistant to Improve Insomnia Among Young Adult Cancer Survivors: Mixed Methods Feasibility and Acceptability Study.","authors":"Hunter Groninger, Hannah Arem, Lylian Ayangma, Lisa Gong, Eric Zhou, Daniel Greenberg","doi":"10.2196/64869","DOIUrl":"10.2196/64869","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Up to 75% of young adult cancer survivors (YACS) experience chronic insomnia, negatively affecting physical and emotional health and overall quality of life. Cognitive behavioral therapy for insomnia (CBT-I) is a gold-standard intervention to address insomnia. To improve CBT-I access and treatment adherence, screen-based digital CBT-I platforms have been developed. However, even with these digital products, widespread uptake of CBT-I remains limited, and new strategies for CBT-I delivery are warranted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objective of this study is to understand how YACS experience insomnia and how they might incorporate technology-delivered CBT-I into a daily routine and test the feasibility and acceptability of a novel screen-free voice-activated virtual assistant-delivered CBT-I prototype.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eligible participants-ages 18-39, living with a history of cancer (any type, any stage), self-reporting on average less sleep than National Sleep Foundation recommendations, and English-speaking-were recruited from a major urban cancer center, 2 regional oncology clinics, and 2 cancer survivorship support groups. We conducted 4 focus groups to understand the YACS experience of insomnia, their routine use of technology at home, particularly voice-activated virtual assistants such as Amazon Alexa, and input on how CBT-I might be delivered at home through a smart speaker system. We developed a prototype device to deliver key elements of CBT-I at home along with circadian lighting and monitoring of post-bedtime device use, collected YACS user perspectives on this prototype, and then conducted a single-arm feasibility and acceptability study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 26 YACS (6-7 participants per group) experiencing insomnia participated in focus groups to share experiences of insomnia during cancer survivorship and to provide input regarding a CBT-I prototype. Common triggers of insomnia included worry about disease management and progression, disease-related pain and other symptoms, choices regarding personal device use, and worry about the impact of poor sleep on daily functioning. In total, 12 participants completed device prototype testing, engaging with the prototype 94% of the assigned times (twice daily for 14 days; meeting predetermined feasibility cutoff of engagement ≥70% of assigned times) and rating the prototype with an overall mean score of 5.43 on the Satisfaction subscale of the Usability, Satisfaction, and Ease of Use scale (range 4.42-7; exceeding the predetermined cutoff score for acceptability of 5.0). All participants completing the study reported they would be interested in using the prototype again and would recommend it to someone else with insomnia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;YACS were highly engaged with our voice-activated virtual assistant-delivered CBT-I prototype and found it acceptable to use. Following final device developme","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64869"},"PeriodicalIF":2.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597001","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":"FRAILSURVEY-an mHealth App for Self-Assessment of Frailty Based on the Portuguese Version of the Groningen Frailty Indicator: Validation and Reliability Study.","authors":"Luis Midao, Mafalda Duarte, Rute Sampaio, Marta Almada, Cláudia Camila Dias, Constança Paúl, Elísio Costa","doi":"10.2196/51975","DOIUrl":"10.2196/51975","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Portugal is facing the challenge of population ageing, with a notable increase in the proportion of older individuals. This has positioned the country among those in Europe with a high prevalence of frailty. Frailty, a geriatric syndrome characterized by diminished physiological reserve and heightened vulnerability to stressors, imposes a substantial burden on public health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study seeks to address two primary objectives: (1) translation and psychometric evaluation of the European Portuguese version of the Groningen Frailty Indicator (GFI); and (2) development and evaluation of the FRAILSURVEY app, a novel assessment tool for frailty based on the GFI. By achieving these objectives, the study aims to enhance the accuracy and reliability of frailty assessment in the Portuguese context, ultimately contributing to improved health care outcomes for older individuals in the region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;To accomplish the objectives of the study, a comprehensive research methodology was used. The study comprised 2 major phases: the initial translation and validation of the GFI into European Portuguese and the development of the FRAILSURVEY app. Following this, an extensive examination of the app's validity and reliability was conducted compared with the conventional paper version of the GFI. A randomized repeated crossover design was used to ensure rigorous evaluation of both assessment methods, using both the paper form of the GFI and the smartphone-based app FRAILSURVEY.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The findings of the study revealed promising outcomes in line with the research objectives. The meticulous translation process yielded a final version of the GFI with robust psychometric properties, ensuring clarity and comprehensibility for participants. The study included 522 participants, predominantly women (367/522, 70.3%), with a mean age of 73.7 (SD 6.7) years. Psychometric evaluation of the European Portuguese GFI in paper form demonstrates good reliability (internal consistency: Cronbach a value of 0.759; temporal stability: intraclass correlation coefficient=0.974) and construct validity (revealing a 4D structure explaining 56% of variance). Evaluation of the app-based European Portuguese GFI indicates good reliability (interinstrument reliability: Cohen k=0.790; temporal stability: intraclass correlation coefficient=0.800) and concurrent validity (r=0.694; P&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Both the smartphone-based app and the paper version of the GFI were feasible and acceptable for use. The findings supported that FRAILSURVEY exhibited comparable validity and reliability to its paper counterpart. FRAILSURVEY uses a standardized and validated assessment tool, offering objective and consistent measurements while eliminating subjective biases, enhancing accuracy, and ensuring reliability. This app holds promising potential for aiding health care professi","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e51975"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575833","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":"HUMAn, a Real-Time Evolutive Patient Model for Major Incident Simulation: Development and Validation Study.","authors":"Maxence Laurent, Arnaud Jaccard, Laurent Suppan, Elio Erriquez, Xavier Good, Eric Golay, Dominique Jaccard, Mélanie Suppan","doi":"10.2196/66201","DOIUrl":"10.2196/66201","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Major incidents correspond to any situation where the location, number, severity, or type of casualties requires extraordinary resources. Major incident management must be efficient to save as many lives as possible. As any paramedic or emergency medical technician may unexpectedly have to respond to major incidents, regular training is mandatory. Those trainings usually include simulations. The vast majority of major incident simulations are limited by the fact that simulated patients do not evolve during the simulation, regardless of the time elapsed and treatment decisions. Therefore, most simulations fail to incorporate the critical temporal effect of decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop and validate a simplified mathematical model of physiology, capable of plausibly simulating the real-time evolution of several injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A modified version of the user-centered design framework, including a relevance, development, and validation phase, was used to define the development process of the physiological model. A 12-member design and development team was established, including prehospital physicians, paramedics, and computer scientists. To determine whether the developed model was clinically realistic, 15 experienced professionals working in the prehospital field participated in the validation phase. They were asked to rate clinical and physiological parameters according to a 5-point Likert scale ranging from 1 (impossible) to 5 (absolutely realistic).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The design and development team led to the development of the HUMAn model (Human is an Uncomplicated Model of Anatomy). During the relevance phase, the team defined the needed features of the model: clinically realistic, able to compute the evolution of prehospital vital signs, yet simple enough to allow real-time computation for several simulated patients on regular computers or tablets. During the development phase, iterations led to the development of a heart-lung-brain interaction model coupled to functional blocks representing the main anatomical body parts. During the validation phase, the evolution of nine simulated patients presenting pathologies devised to test the different systems and their interactions was assessed. Overall, clinical parameters of all patients had a median rating of 5 (absolutely realistic; IQR 4-5). Most (n=52, 96%) individual clinical parameters had a median rating of 5, the remainder (n=2, 4%) being rated 4. Overall physiological parameters of all patients had a median rating of 5 (absolutely realistic; IQR 3-5). The majority of individual physiological parameters (n=43, 79%) had a median rating of 5, with (n=9, 17%) rated 4, and only (n=2 ,4%) rated 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A simplified model of trauma patient evolution was successfully created and deemed clinically realistic by experienced clinicians. This model shoul","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66201"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572869","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":"\"Your Life, Your Health: Tips and Information for Health and Well-Being\": Development of a World Health Organization Digital Resource to Support Universal Access to Trustworthy Health Information.","authors":"Danielle M Muscat, Rachael Hinton, Shyama Kuruvilla, Don Nutbeam","doi":"10.2196/57881","DOIUrl":"10.2196/57881","url":null,"abstract":"<p><strong>Background: </strong>Access to trustworthy, understandable, and actionable health information is a key determinant of health and is an essential component of universal health coverage and primary health care. The World Health Organization has developed a new digital resource for the general public to improve health and well-being across different life phases and to support people in caring for themselves, their families, and their communities. The goal was to make trustworthy health information accessible, understandable, and actionable for the general public in a digital format and at the global scale.</p><p><strong>Objective: </strong>The aim of this paper was to describe the multistage approach and methodology used to develop the resource Your life, your health: Tips and information for health and well-being (hereafter, Your life, your health).</p><p><strong>Methods: </strong>A 5-step process was used to develop Your life, your health, including (1) reviewing and synthesizing existing World Health Organization technical guidance, member state health and health literacy plans, and international human rights frameworks to identify priority messages; (2) developing messages and graphics that are accessible, understandable, and actionable for the public using health literacy principles; (3) engaging with experts and stakeholders to refine messages and message delivery; (4) presenting priority content in an accessible digital format; and (5) adapting the resource based on feedback and new evidences.</p><p><strong>Results: </strong>The Your life, your health online resource adopts a life-course approach to organize health information based on priority actions and rights that support peoples' health and well-being across different life stages and specific health topics. The resource promotes health literacy by offering advice on asking questions to health workers, making informed decisions about personal and family health, and effectively using digital media to obtain reliable health information. Additionally, it reflects the ambitions of the Sustainable Development Goals by providing essential information on the social determinants of health and clarifies the distinct roles of individuals, frontline workers, governments, and the media in promoting and protecting health.</p><p><strong>Conclusions: </strong>Making health information available-including to the public-is an essential step in strengthening the global health information system. The development process for the Your life, your health online resource outlined in this article offers a structured approach to translate technical health guidelines into accessible, understandable, and actionable health information for the general public.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e57881"},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572863","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}