JMIR Formative Research最新文献

{"title":"Feasibility, User Acceptance, and Outcomes of Using a Cancer Prehabilitation App for Exercise: Pilot Cohort Study.","authors":"Fuquan Zhang, Deepali Bang, Christine Alejandro Visperas, Mon Hnin Tun, San San Tay","doi":"10.2196/64427","DOIUrl":"10.2196/64427","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of cancer prehabilitation programs is supported by international reviews and meta-analyses. Technology has been deployed in cancer prehabilitation to address challenges such as access or limited resources. This study evaluated the feasibility, user acceptance, safety, and program outcomes of a newly developed mobile app for cancer prehabilitation. The app integrates with Singapore's existing health care mobile app, Health Buddy, and provides instructional videos for prescribed exercises.</p><p><strong>Objective: </strong>The objectives of this study were to investigate the feasibility, user experience, safety, and outcomes of a mobile app for cancer prehabilitation within a hospital-associated, home-based, multimodal cancer prehabilitation program.</p><p><strong>Methods: </strong>This retrospective study analyzed the records of patients enrolled in the cancer prehabilitation program from September 1, 2022, to March 30, 2023. Patients who participated in the prehabilitation program (n=63) were categorized into 2 groups: those prescribed the app (n=41) and those who were not (n=22). There was further subgroup analysis of those who were prescribed: app users (n=25) versus those who were non-app users (n=16). Demographics, Fried Frailty Phenotype, prehabilitation duration, app use, and functional outcome measures (6-minute walk test [6MWT], 30-second sit-to-stand test [STS], timed up and go test [TUG], and Hospital Anxiety and Depression Scale [HADS]) were collected. Compliance was determined by the completion of prescribed exercises and the accuracy of executing these exercises, with a high compliance rate considered to be at 80% or more. Baseline characteristics and preoperative outcomes were compared between the groups. User satisfaction was assessed through surveys among app users (n=25).</p><p><strong>Results: </strong>Among 63 patients, 41 (65.1%) patients were prescribed the app, of which 22 (34.9%) patients were users. No significant differences in preoperative functional improvements were observed between app users and nonusers (6MWT: P=.60; STS: P=.81; TUG: P=.53; HADS: P=.36), or between those prescribed and not prescribed the app (6MWT: P=.94; STS: P=.26; TUG: P=.39; HADS: P=.62). However, high compliance rates (80%) were observed among app users. Patient satisfaction with the app was high (>90%), with positive feedback on ease of use and technical reliability. Baseline measures revealed significantly lower functional scores and higher mean frailty scores in the nonprescribed group.</p><p><strong>Conclusions: </strong>This preliminary study demonstrates the acceptability, feasibility, and safety of Singapore's first smartphone app for exercise prescription in cancer prehabilitation. Lower baseline functional outcome measures and a higher mean frailty score in the unprescribed group have implications for the selection process and patient participation. Further studies should include strategies t","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64427"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052231","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":"Developing a Machine Learning-Based Automated Patient Engagement Estimator for Telehealth: Algorithm Development and Validation Study.","authors":"Pooja Guhan, Naman Awasthi, Kathryn McDonald, Kristin Bussell, Gloria Reeves, Dinesh Manocha, Aniket Bera","doi":"10.2196/46390","DOIUrl":"10.2196/46390","url":null,"abstract":"<p><strong>Background: </strong>Patient engagement is a critical but challenging public health priority in behavioral health care. During telehealth sessions, health care providers need to rely predominantly on verbal strategies rather than typical nonverbal cues to effectively engage patients. Hence, the typical patient engagement behaviors are now different, and health care provider training on telehealth patient engagement is unavailable or quite limited. Therefore, we explore the application of machine learning for estimating patient engagement. This can assist psychotherapists in the development of a therapeutic relationship with the patient and enhance patient engagement in the treatment of mental health conditions during tele-mental health sessions.</p><p><strong>Objective: </strong>This study aimed to examine the ability of machine learning models to estimate patient engagement levels during a tele-mental health session and understand whether the machine learning approach could support therapeutic engagement between the client and psychotherapist.</p><p><strong>Methods: </strong>We proposed a multimodal learning-based approach. We uniquely leveraged latent vectors corresponding to affective and cognitive features frequently used in psychology literature to understand a person's level of engagement. Given the labeled data constraints that exist in health care, we explored a semisupervised learning solution. To support the development of similar technologies for telehealth, we also plan to release a dataset called Multimodal Engagement Detection in Clinical Analysis (MEDICA). This dataset includes 1229 video clips, each lasting 3 seconds. In addition, we present experiments conducted on this dataset, along with real-world tests that demonstrate the effectiveness of our method.</p><p><strong>Results: </strong>Our algorithm reports a 40% improvement in root mean square error over state-of-the-art methods for engagement estimation. In our real-world tests on 438 video clips from psychotherapy sessions with 20 patients, in comparison to prior methods, positive correlations were observed between psychotherapists' Working Alliance Inventory scores and our mean and median engagement level estimates. This indicates the potential of the proposed model to present patient engagement estimations that align well with the engagement measures used by psychotherapists.</p><p><strong>Conclusions: </strong>Patient engagement has been identified as being important to improve therapeutic alliance. However, limited research has been conducted to measure this in a telehealth setting, where the therapist lacks conventional cues to make a confident assessment. The algorithm developed is an attempt to model person-oriented engagement modeling theories within machine learning frameworks to estimate the level of engagement of the patient accurately and reliably in telehealth. The results are encouraging and emphasize the value of combining psychology and machine lear","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e46390"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005717","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":"Insights From Diverse Perspectives on Social Media Messages to Inform Young Adults With Cancer About Clinical Trials: Focus Group Study.","authors":"Melissa P Beauchemin, Desiree Walker, Allison Rosen, Maria Frazer, Meital Eisenberger, Rhea K Khurana, Edward Bentlyewski, Victoria Fedorko, Corey H Basch, Grace C Hillyer","doi":"10.2196/64265","DOIUrl":"10.2196/64265","url":null,"abstract":"<p><strong>Background: </strong>Low rates of adolescent and young adult (YA; aged 15-39 y) clinical trial enrollment (CTE), particularly among underserved groups, have resulted in a lack of standardized cancer treatments and follow-up guidelines for this group that may limit improvement in cancer treatments and survival outcomes for YAs.</p><p><strong>Objective: </strong>To understand and address unique barriers to CTE, we conducted focus groups to learn about informational, financial, and psychosocial needs of YAs surrounding CTE and identify strategies to address these barriers.</p><p><strong>Methods: </strong>We conducted 5 focus groups in 2023 among a diverse sample of YA patients from across the United States. An interview guide was developed collaboratively with YA advocates. Specifically, informational needs, financial concerns, and psychosocial issues were explored, and participants were probed to suggest strategies, especially those that leverage technology, to address these barriers. Sessions were audio recorded, transcribed, and coded using direct content analysis. Findings were synthesized through consensus discussions.</p><p><strong>Results: </strong>We confirmed the previously proposed thematic barriers regarding YA CTE and identified 9 subthemes: awareness, lack of clear and accessible CTE information, fear of the unknown, assumptions about costs, insurance coverage, navigating financial responsibilities, clinical trial discussions, clinical trial misconceptions, and desire for a support network. Throughout, YAs mentioned needs that might be addressed through informational outreach leveraging digital technology, the internet, and social media.</p><p><strong>Conclusions: </strong>This study expands knowledge of YA perceived barriers to CTE. These findings suggest that leveraging digital technology to disseminate reliable information to address needs may be an effective strategy to improve clinical trial participation in the YA population.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64265"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046907","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 Mobile Health Intervention to Support Collaborative Decision-Making in Mental Health Care: Development and Usability.","authors":"Kristin Lie Romm, Mari Skoge, Elizabeth Ann Barrett, Lars-Christian Berentzen, Dagfinn Bergsager, Pål Fugelli, Thomas Bjella, Erlend Strand Gardsjord, Kristine Kling, Sindre Hembre Kruse, Kari Jorunn Kværner, Ingrid Melle, Erlend Mork, Henrik Myhre Ihler, Eline Borger Rognli, Carmen Simonsen, Tor Gunnar Værnes, Sofie Ragnhild Aminoff","doi":"10.2196/57614","DOIUrl":"10.2196/57614","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Shared decision-making between clinicians and service users is crucial in mental health care. One significant barrier to achieving this goal is the lack of user-centered services. Integrating digital tools into mental health services holds promise for addressing some of these challenges. However, the implementation of digital tools, such as mobile apps, remains limited, and attrition rates for mental health apps are typically high. Design thinking can support the development of tools tailored to the needs of service users and clinicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to develop and beta test a digital tool designed for individuals with severe mental disorders or substance use disorders to facilitate shared decision-making on treatment goals and strategies within mental health services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used a user-centered design approach to develop iTandem, an app facilitating collaborative treatment between service users and clinicians. Through qualitative interviews and workshops, we engaged 6 service users with severe mental disorders or substance use disorders, 6 clinicians, and 1 relative to identify and design relevant app modules. A beta test of iTandem was conducted to refine the app and plan for a pilot trial in a clinical setting. After 6 weeks of app use, 5 clinicians and 4 service users were interviewed to provide feedback on the concept, implementation, and technical issues. Safety and ethical considerations were thoroughly discussed and addressed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;To avoid overload for the service users, we applied a pragmatic take on module content and size. Thus, iTandem includes the following 8 modules, primarily based on the needs of service users and clinicians: Sleep (sleep diary), Medication (intake and side effects), Recovery (measures, including well-being and personal recovery, and exercises, including good things and personal strengths), Mood (mood diary and report of daily feelings), Psychosis (level of positive symptoms and their consequences and level of negative symptoms), Activity (goal setting and progress), Substance use (weekly use, potential triggers or strategies used to abstain), and Feedback on therapy (of individual sessions and overall rating of the past week). For the beta testing, service users and clinicians collaborated in choosing 2-3 modules in iTandem to work with during treatment sessions. The testing showed that the app was well received by service users, and that facilitation for implementation is crucial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;iTandem and similar apps have the potential to enhance treatment outcomes by facilitating shared decision-making and tailoring treatment to the needs of service users. However, successful implementation requires thorough testing, iterative development, and evaluations of both utility and treatment effects. There is a critical need to focus on how technology integrates into cli","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e57614"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005691","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":"Sexual and Gender Minority Adolescents' Preferences for HIV Pre-Exposure Prophylaxis Social Marketing Campaigns: Qualitative Preimplementation Study.","authors":"Kathryn Macapagal, Juan Pablo Zapata, Junye Ma, Jacob D Gordon, Christopher Owens, Silvia Valadez-Tapia, Peter Cummings, Nathan Walter, Jim Pickett","doi":"10.2196/60398","DOIUrl":"https://doi.org/10.2196/60398","url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender minority (SGM) adolescents in the United States are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical HIV prevention method, but its awareness and uptake among SGM adolescents are low. There are no adolescent-centered PrEP social marketing campaigns in the United States that have the potential to increase awareness and interest in PrEP.</p><p><strong>Objective: </strong>To address this gap, this qualitative study aims to examine SGM adolescents' needs and preferences regarding adolescent-centered PrEP social marketing campaigns.</p><p><strong>Methods: </strong>SGM adolescents from Chicago and its surrounding areas participated in web-based asynchronous focus groups from February to May 2021. Questions elicited their preferences for content, design, and delivery of SGM adolescent-centered PrEP campaigns. We used rapid qualitative data analysis and organized the findings around key components of social marketing, known as the 4 Ps: product, price, place, and promotion.</p><p><strong>Results: </strong>Participants (N=56) were aged 14 to 19 years (mean 18.16, SD 1.22 y), and 64% (36/56) of them identified as a racial or ethnic minority. Among the 56 participants, 70% (n=39) were aware of PrEP; however, 95% (n=53) did not know that PrEP could be prescribed to those aged under 18 years. Adolescents expressed a need for PrEP campaign messaging that provides simple, accurate, and easily accessible information (eg, what is PrEP, for whom PrEP is indicated, and where and how to access PrEP). For product and price, SGM adolescents wanted a campaign to address barriers to, costs of, and how to access PrEP and desired to know about other adolescents' PrEP experiences to improve campaign relatability. For place and promotion, participants preferred digital campaigns on social media to reduce the possibility of embarrassment and stigma and increase the accessibility of health content.</p><p><strong>Conclusions: </strong>These findings lay the groundwork for designing adolescent-centered educational PrEP campaigns that prioritize both user preferences in PrEP marketing design and strategies to overcome common barriers to PrEP awareness.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60398"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recruitment Challenges and Strategies in a Technology-Based Intervention for Dementia Caregivers: Descriptive Study.","authors":"Eunjung Ko, Ye Gao, Peng Wang, Lahiru Wijayasingha, Kathy D Wright, Kristina C Gordon, Hongning Wang, John A Stankovic, Karen M Rose","doi":"10.2196/59291","DOIUrl":"10.2196/59291","url":null,"abstract":"<p><strong>Background: </strong>Researchers have encountered challenges in recruiting unpaid caregivers of people living with Alzheimer disease and related dementias for intervention studies. However, little is known about the reasons for nonparticipation in in-home smart health interventions in community-based settings.</p><p><strong>Objective: </strong>This study aimed to (1) assess recruitment rates in a smart health technology intervention for caregivers of people living with Alzheimer disease and related dementias and reasons for nonparticipation among them and (2) discuss lessons learned from recruitment challenges and strategies to improve recruitment.</p><p><strong>Methods: </strong>The smart health intervention was a 4-month, single-arm trial designed to evaluate an in-home, technology-based intervention that monitors stressful moments for caregiving dyads through acoustic signals and to provide the caregivers with real-time stress management strategies. The recruitment involved two main methods: on-site engagement by a recruiter from a memory clinic and social media advertising. Caregivers were screened for eligibility by phone between January 2021 and September 2023. The recruitment rates, reasons for nonparticipation, and participant demographics were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Of 201 caregivers contacted, 11 were enrolled in this study. Eighty-two caregivers did not return the screening call, and others did not participate due to privacy concerns (n=30), lack of interest (n=29), and burdensome study procedures (n=26). Our recruitment strategies included addressing privacy concerns, visualizing collected data through a dashboard, boosting social media presence, increasing the recruitment budget, updating advertisements, and preparing and deploying additional study devices.</p><p><strong>Conclusions: </strong>This study highlighted barriers to participation in the smart health intervention. Despite several recruitment strategies, enrollment rates remained below expectations. These findings underscore the need for future research to explore alternative methods for increasing the recruitment of informal dementia caregivers in technology-based intervention studies.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e59291"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046941","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":"Informal Caregivers Connecting on the Web: Content Analysis of Posts on Discussion Forums.","authors":"Michelle L Foster, Chinenye Egwuonwu, Erin Vernon, Mohammad Alarifi, M Courtney Hughes","doi":"10.2196/64757","DOIUrl":"10.2196/64757","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;About 53 million adults in the United States offer informal care to family and friends with disease or disability. Such care has an estimated economic value of US $600 million. Most informal caregivers are not paid nor trained in caregiving, with many experiencing higher-than-average levels of stress and depression and lower levels of physical health. Some informal caregivers participate in web-based forums related to their caregiving role.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore how informal caregivers use easy-to-access caregiving web-based forums, including the types of information they share and seek from others. It also aimed to gain insights into the informal caregiver experience from the content these informal caregivers posted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study population consisted of participants who posted on 5 web-based forums for informal caregivers between February and April 2024. Researchers extracted the first 6 responses to the first 20 questions and comments to appear posted by the informal caregivers in each of the 5 forums, removing any individually identifying information. We used a codebook thematic analysis approach to examine the data with Dedoose (SocioCultural Research Consultants). Researchers independently read all posts and coded the data. The author group discussed the codes, reiteratively refined them, and identified themes within the data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The data consisted of 100 initial posts and 600 responses. Over half of the initial posts included specific questions, with the remaining initial posts sharing experiences or reflections. Posts ranged in length from a sentence to more than 500 words. Domains identified included handling interpersonal challenges, navigating complicated systems, gathering tactical coping strategies, managing emotions, and connecting with others in similar situations. Negative interpersonal interactions were mentioned 123 times, with 77 posts describing challenging situations with extended family. Posters inquired about accessing resources, with health care and health insurance included 51 times, while legal and financial concerns were addressed 124 times. Caregiving challenges were mentioned hundreds of times, including discussion of hygiene (n=18), nutrition (n=21), and desire for a caregiving break (n=47). Posters expressed emotion in their comments 180 times, which included 32 mentions of guilt and 26 mentions of positive emotion. The importance of web-based group support was mentioned 301 times.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Informal caregivers play an essential role in society. Many experience multifaceted challenges related to their caregiving role, and some turn to the internet for community. Accessing web-based discussion forums is a low-barrier method for informal caregivers to connect with others who may be experiencing similar emotions and challenges. Gaining a greater understanding of the ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64757"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mindfulness-Based App Intervention for Pregnant Women: Qualitative Evaluation of a Prototype Using Multiple Case Studies.","authors":"Silvia Rizzi, Maria Chiara Pavesi, Alessia Moser, Francesca Paolazzi, Michele Marchesoni, Stefania Poggianella, Erik Gadotti, Stefano Forti","doi":"10.2196/58265","DOIUrl":"10.2196/58265","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pregnancy is a complex period characterized by significant transformations. How a woman adapts to these changes can affect her quality of life and psychological well-being. Recently developed digital solutions have assumed a crucial role in supporting the psychological well-being of pregnant women. However, these tools have mainly been developed for women who already present clinically relevant psychological symptoms or mental disorders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop a mindfulness-based well-being intervention for all pregnant women that can be delivered electronically and guided by an online assistant with wide reach and dissemination. This paper aimed to describe a prototype technology-based mindfulness intervention's design and development process for pregnant women, including the exploration phase, intervention content development, and iterative software development (including design, development, and formative evaluation of paper and low-fidelity prototypes).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Design and development processes were iterative and performed in close collaboration with key stakeholders (N=15), domain experts including mindfulness experts (n=2), communication experts (n=2), and psychologists (n=3), and target users including pregnant women (n=2), mothers with young children (n=2), and midwives (n=4). User-centered and service design methods, such as interviews and usability testing, were included to ensure user involvement in each phase. Domain experts evaluated a paper prototype, while target users evaluated a low-fidelity prototype. Intervention content was developed by psychologists and mindfulness experts based on the Mindfulness-Based Childbirth and Parenting program and adjusted to an electronic format through multiple iterations with stakeholders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;An 8-session intervention in a prototype electronic format using text, audio, video, and images was designed. In general, the prototypes were evaluated positively by the users involved. The questionnaires showed that domain experts, for instance, positively evaluated chatbot-related aspects such as empathy and comprehensibility of the terms used and rated the mindfulness traces present as supportive and functional. The target users found the content interesting and clear. However, both parties regarded the listening as not fully active. In addition, the interviews made it possible to pick up useful suggestions in order to refine the intervention. Domain experts suggested incorporating auditory components alongside textual content or substituting text entirely with auditory or audiovisual formats. Debate surrounded the inclusion of background music in mindfulness exercises, with opinions divided on its potential to either distract or aid in engagement. The target users proposed to supplement the app with some face-to-face meetings at crucial moments of the course, such as the beginning and","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":"e58265"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768956","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":"Sentiments of Individuals with Interstitial Cystitis/Bladder Pain Syndrome Toward Pentosan Polysulfate Sodium: Infodemiology Study.","authors":"Yulin Hswen, Qiuyuan Qin, Pressley Smith, Alison Swierczynski, Stuart Bauer, Erika Ladson, Amanda Leigh Garrett, Catherine A Brownstein","doi":"10.2196/54209","DOIUrl":"10.2196/54209","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Interstitial cystitis/bladder pain syndrome (IC/BPS) is a multifactorial, chronic syndrome involving urinary frequency, urgency, and bladder discomfort. These IC/BPS symptoms can significantly impact individuals' quality of life, affecting their mental, physical, sexual, and financial well-being. Individuals sometimes rely on peer-to-peer support to understand the disease and find methods of alleviating symptoms. The only US Food and Drug Administration-approved medication to treat IC/BPS is pentosan polysulfate sodium (PPS). However, ocular pigmentary maculopathy has been described in some individuals, with greater severity associated with prolonged PPS exposure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;While prior research has separately assessed the benefits and side effects of PPS, this study sought to identify (1) sentiments of individuals with IC/BPS toward PPS and (2) topics discussed by individuals with IC/BPS in conjunction with PPS through use of an internet peer-to-peer forum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were collected from Inspire-an anonymous web-based health community where individuals gather by condition to find support and information. Sentiment analysis and percentages of negative, positive, and neutral sentiment for PPS discussions encompassing each topic was conducted using VADER (Valence Aware Dictionary for Sentiment Reasoning). Topic modeling was conducted using latent Dirichlet allocation. Words with the highest probability were ranked to categorize each topic, and authors manually investigated and labeled discussions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 354 forum posts related to PPS. Topic modeling with latent Dirichlet allocation revealed 5 topic categories: \"ineffectiveness or discontinued use,\" \"alternative treatments,\" \"personal treatment suggestions based on experience,\" \"severe side effects,\" and \"risk of long-term use.\" Topics related to \"severe side effects\" and \"risk of long-term use\" garnered less discussion, with the former also having the lowest positive sentiment (4.28, 14.29%). The topic \"ineffectiveness or discontinued use\" was most frequently discussed. This topic also had the highest percentage of negative posts (52/152, 34.21%). However, the average compound score was within the neutral compound score range (-0.094, SD 0.625). In addition, forum data highlighted individuals' acknowledgment of the efficacy of PPS in improving their quality of life, with statements such as \"saved my sanity\" being representative. The overall compound individuals' sentiment toward PPS was -0.083, split across 32.49% (115/354) negative, 22.03% (78/354) positive, and 45.48% (161/354) neutral sentiment categories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The overall authentic sentiment toward PPS is broad but balances to neutral. This neutral sentiment suggests that while some individuals express concerns about the side effects and long-term risks associated with PPS, others appreciate its po","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e54209"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046943","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":"Assessing the Current Limitations of Large Language Models in Advancing Health Care Education.","authors":"JaeYong Kim, Bathri Narayan Vajravelu","doi":"10.2196/51319","DOIUrl":"10.2196/51319","url":null,"abstract":"<p><strong>Unlabelled: </strong>The integration of large language models (LLMs), as seen with the generative pretrained transformers series, into health care education and clinical management represents a transformative potential. The practical use of current LLMs in health care sparks great anticipation for new avenues, yet its embracement also elicits considerable concerns that necessitate careful deliberation. This study aims to evaluate the application of state-of-the-art LLMs in health care education, highlighting the following shortcomings as areas requiring significant and urgent improvements: (1) threats to academic integrity, (2) dissemination of misinformation and risks of automation bias, (3) challenges with information completeness and consistency, (4) inequity of access, (5) risks of algorithmic bias, (6) exhibition of moral instability, (7) technological limitations in plugin tools, and (8) lack of regulatory oversight in addressing legal and ethical challenges. Future research should focus on strategically addressing the persistent challenges of LLMs highlighted in this paper, opening the door for effective measures that can improve their application in health care education.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e51319"},"PeriodicalIF":2.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}