JMIR Formative Research最新文献

{"title":"Safe@Campus Virtual Reality Training for Campus Shooting Preparedness: Prototype Development and Usability Study.","authors":"Jingzhen Yang, Hannah P Schneider, Krista K Wheeler, Lindsay Sullivan, Jason Wheeler, Brandon Abbott, David C Schwebel","doi":"10.2196/89471","DOIUrl":"10.2196/89471","url":null,"abstract":"<p><strong>Background: </strong>Campus shootings, though infrequent, result in significant loss of life, psychological trauma, and disruption to university communities. Traditional preparedness programs developed for K-12 settings do not translate well to university environments. Virtual reality (VR) offers an immersive and engaging method to enhance situational awareness and decision-making during high-stress events.</p><p><strong>Objective: </strong>This study aimed to develop the Safe@Campus prototype, a theory-informed, stakeholder-engaged VR-based prototype designed to prepare university students to recognize and respond to campus shooting threats, and to evaluate its initial usability and feasibility among undergraduate students.</p><p><strong>Methods: </strong>We followed a 2-phase, user-centered design process. Phase I (stakeholder-informed feasibility assessment and prototype refinement): through interviews with campus safety experts, firearm safety practitioners, school safety specialists, and students, we identified key content, scenario requirements, and implementation considerations. A 360-degree video-based VR prototype depicting an active shooter incident in a university classroom was developed using Unity3D, incorporating branching decision points aligned with the \"run, hide, or fight\" framework. Expert and user feedback guided iterative refinements. Phase II (student usability and acceptability testing): 2 focus groups with undergraduates at The Ohio State University (N=17) viewed a VR scenario and then participated in guided discussions about prior training experiences, the acceptability of VR, and recommendations for improvement. Transcripts were analyzed using constant comparative methods in ATLAS.ti (version 25).</p><p><strong>Results: </strong>The first focus group comprised 8 students (n=5, 63% female; n=3, 38% White, n=4, 50% Asian/Asian American), and the second comprised 9 students (n=6, 67% female; n=6, 67% White). Across both groups, 82% (14/17) reported participating in active shooter drills during K-12 schooling, yet many felt these experiences did not adequately prepare them for the complexity of university environments. The following four major themes emerged: (1) prior experience with active shooter drills: K-12 drills varied widely in realism and left students uncertain about appropriate actions in university settings; (2) need for university-specific training: participants noted substantial gaps in preparedness and expressed strong support for required, standardized training; (3) perceived usefulness of VR: students found VR highly engaging, realistic, and effective for reinforcing situational awareness and decision-making; and (4) recommendations for prototype improvement: students suggested increasing interactivity, adding time-pressured decisions, expanding scenarios to diverse campus spaces, and integrating the program into required university activities such as orientation.</p><p><strong>Conclusions: </stro","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e89471"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815593","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":"Impact of Prescribed and Self-Selected Music Interventions on Stress, Sleep, Heart Rate Variability, and Brain Connectivity in Surgeons Using 7-Tesla Functional Magnetic Resonance Imaging and Wearable Actigraphy: Multimodal Feasibility Randomized Controlled Trial.","authors":"Mei Rui, Anthony Brandt, Linda Moore, Enshuo Hsu, Christof Karmonik, Aparajitha Verma, Miguel Valdivia Y Alvarado, Jefferson Todd Frazier, Atiya Dhala","doi":"10.2196/84899","DOIUrl":"https://doi.org/10.2196/84899","url":null,"abstract":"<p><strong>Background: </strong>Stress, sleep deprivation, and burnout are significant safety risks for acute care surgeons, negatively impacting performance, well-being, and clinical outcomes.</p><p><strong>Objective: </strong>This pilot randomized controlled trial aimed to measure neurophysiological effects of prescribed music (PM) and self-selected music (SSM) on surgeon stress, burnout, and neurophysiological responses using a multimodal protocol that integrated functional magnetic resonance imaging (fMRI), wearable biosensor monitoring, and psychological self-assessments.</p><p><strong>Methods: </strong>Full-time attending surgeons at a quaternary care hospital were invited to participate in a 3-armed trial (1:1:1 block allocation). Intervention groups were instructed to listen to 30 minutes (minimum 15 minutes) of either PM or SSM daily at bedtime for 6 weeks, reflecting real-world conditions. PM comprised original compositions based on elements promoting perceived relaxation from a prior study. The control arm avoided music in the 30 minutes before bed. Allocation was concealed from the recruiting investigator; the fMRI technicians, the statistician, and lead investigators were blinded until analyses were completed. Functional connectivity patterns were measured using fMRI at baseline and 6 weeks while participants listened to simulated intensive care unit noise, PM, and SSM. Secondary outcomes included continuous actigraphy for sleep quality and self-reported anxiety, sleep quality, and burnout using validated scales (State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, and Maslach Burnout Inventory).</p><p><strong>Results: </strong>A total of 22 surgeons were assessed; demands of fMRI and data collection schedule led 3 to decline and 2 (allocated to PM) not to finish baseline measures; 6 PM, 5 SSM, and 6 controls received allocated intervention; 2 PM participants were withdrawn for nonadherence and missing follow-up data and 1 control missed follow-up collection due to scheduling (final analysis set after missing data: PM: n=4, SSM: n=5, control: n=5). One control participant experienced transient vertigo in fMRI. Trends in fMRI data indicated that both intervention groups experienced less negative emotional arousal and anxiety, with physical tension reduced in the PM group. The PM group exhibited reduced stress response in the frontal lobes when exposed to intensive care unit alarms, suggesting diminished attentional response to the high-stress auditory environment, compared to control. However, lack of statistical significance and baseline variability entail cautious interpretation. Observations of sleep quality were mixed, and no statistically significant differences in stress surveys were observed.</p><p><strong>Conclusions: </strong>Both music interventions trended toward positive changes in neurophysiological responses, suggesting potential benefits in reducing surgeon stress. However, due to the small sample, mixed or no","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e84899"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815468","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":"Involving Health Care Professionals in the Human-Centered Design of a Digital Platform for Work-Focused Health Care: Lessons From a Mixed Methods Study.","authors":"Nina Zipfel, Marije Hagendijk, Ersen Colkesen, Marijke Melles, Sylvia J van der Burg-Vermeulen","doi":"10.2196/83212","DOIUrl":"10.2196/83212","url":null,"abstract":"<p><strong>Background: </strong>Effective collaboration throughout the full cycle of care is essential for value-based health care. In the Netherlands, occupational health care and curative health care traditionally operate as 2 separate sectors. As a consequence, effective communication and robust collaboration between professionals working in these sectors are lacking. Digital collaborative care platforms (ie, digital systems that facilitate communication and collaboration between health care professionals) are recognized as a promising solution to address the fragmentation of work-focused health care (health care that supports people on long-term sick leave in staying at or returning to work). A human-centered design (HCD) approach can help ensure that such platforms align with professionals' needs by involving them throughout the design process.</p><p><strong>Objective: </strong>This study examines the experiences of (work-focused) health care professionals, including occupational physicians, insurance physicians, medical specialists, and general practitioners, during the design phase of a real-world HCD process for developing a digital platform to support collaborative care. The study specifically focused on understanding how these professionals perceive this collaborative approach.</p><p><strong>Methods: </strong>A mixed method study design was employed, combining observations of 17 design sessions with semistructured interviews with health care professionals as intended users of the platform. Observational data captured session dynamics, while interview data provided deeper insights into professionals' experiences with the participatory HCD approach.</p><p><strong>Results: </strong>Health care professionals were generally motivated to contribute, driven by professional interest, social encouragement, or a desire to improve practice. They valued the open and informal atmosphere of the design sessions and described their role as actively sharing practical experiences and identifying bottlenecks in current practice. Participants emphasized the importance of clear goals, good preparation, and iterative involvement for meaningful engagement. Barriers identified included limited session time, constraints of virtual interaction, and uncertainty about the commercial context of the platform. Some professionals felt unsure about the relevance of their input or experienced limited interaction, especially when the session's purpose was unclear. Others noted that the use of a mock-up platform as a conversational foundation, familiarity with similar system interfaces, and well-guided, structured discussions facilitated their input. Positive experiences included a sense of impact through involvement in the design process, note-taking as part of active user engagement, and a safe environment for open and constructive feedback. Participants recommended a clearer explanation of the platform's broader aims in advance, enhanced participant preparation, and op","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e83212"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716619","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":"Community Health Worker Feedback on an mHealth Intervention for Hypertension in Rural Guatemala: Mixed Methods Formative Study.","authors":"Alvaro Bermudez-Cañete, Pablo Nuñez-Perez, Sean Duffy, Alejandro Chavez, Ian Stanley Arthur, Rafael Tun, Yoselin Letona Lopez, Celina Perez, Taryn McGinn Valley","doi":"10.2196/75471","DOIUrl":"https://doi.org/10.2196/75471","url":null,"abstract":"<p><strong>Background: </strong>Hypertension remains a leading global health challenge, particularly in low- and middle-income countries (LMICs), where limited health care infrastructure and resources restrict effective management. Community health workers (CHWs) are critical in delivering care in these settings, and when equipped with mobile health (mHealth) apps, they can greatly enhance chronic disease management. Involving CHWs in the design and development at all stages is essential for the success of such programs. However, relatively little research discusses CHW feedback on mHealth interventions.</p><p><strong>Objective: </strong>This study aims to evaluate CHW feedback on a hypertension program using a novel tablet-based mHealth tool designed for CHW hypertension diagnosis and management in rural Guatemala.</p><p><strong>Methods: </strong>We conducted a mixed-methods analysis as part of a pilot study in San Lucas Tolimán, Guatemala, involving 6 CHWs over a 6-month period. Quantitative data were collected using the System Usability Scale and Likert-scale surveys before and after study completion. Qualitative data were gathered through written surveys and focus group interviews conducted in Spanish by bilingual team members. These methods assessed the app's ease of use, workflow integration, and cultural appropriateness. CHWs provided detailed perspectives on technical challenges, training adequacy, and patient engagement, which guided iterative refinements to both the mHealth app and the hypertension management program.</p><p><strong>Results: </strong>The mHealth app was generally well-received. Average System Usability Scale scores exceeded 70, surpassing established usability thresholds. Likert scale data revealed CHWs found the app to be useful and easy to use, but identified training protocols as areas for improvement. Qualitative analysis of focus groups and written surveys revealed 3 dominant themes. First, CHWs identified practical short-term needs, including slower and more comprehensive training sessions, simplified medication dosing regimens to reduce pill burden, and streamlined survey questions to shorten patient visit times. Second, CHWs raised larger structural concerns, including retention challenges related to financial compensation and misalignment between required clinical data collection and the cultural appropriateness of certain app questions. Third, CHWs highlighted program benefits, including improved patient care and hypertension management, empowerment through educational tools, and increased pride and community trust associated with the program.</p><p><strong>Conclusions: </strong>Our findings suggest that iteratively integrating user feedback into the development of mHealth interventions is key to improve usability, cultural appropriateness, and overall effectiveness of chronic disease management in resource-constrained settings. Due to the small number of CHW participants, as well as a reliance on self-reported","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e75471"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815257","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":"Preliminary Usability Assessment of a Rule-Based Digital Self-Monitoring Platform for Patients With Brain Tumors Toward Digital Early Warning Systems: Pilot Feasibility Study.","authors":"Yourack Lee, HyeongGuk Son, Joonho Byun","doi":"10.2196/87928","DOIUrl":"10.2196/87928","url":null,"abstract":"<p><strong>Background: </strong>Postoperative follow-up after brain tumor surgery is typically limited to intermittent clinic visits, leaving subtle neurological or general deterioration between visits underrecognized. Digital self-monitoring platforms may help fill this gap, but evidence in neuro-oncology is scarce, particularly regarding how patient-reported symptom trajectories can feed into future data-driven early warning systems.</p><p><strong>Objective: </strong>This study aimed to evaluate the feasibility, use patterns, and preliminary usability of a smartphone or web-based self-monitoring system for patients after brain tumor surgery and to explore simple rule-based digital alerts as a first step toward an advanced digital early warning framework.</p><p><strong>Methods: </strong>We conducted a single-center prospective pilot study including adults discharged after brain tumor surgery who had access to a smartphone and could use a web app. Participants completed brief symptom surveys consisting of 51 binary items across 7 symptom domains, with an automatically calculated daily total score and score history visualization. Feasibility was assessed by enrollment, retention, submission counts, and submission rates. A total of 4 interpretable alert rules based on current score, short-term worsening, new-onset symptom combinations, and persistence across domains were evaluated using each patient's last 3 submissions as the analytic unit. Clinical deterioration was defined a priori as objective decline in performance status, new neurological deficit, radiologic progression, or clinically significant laboratory changes. Rule performance metrics and bootstrap CIs were computed. Usability and acceptability were evaluated using the System Usability Scale and additional adherence-related items.</p><p><strong>Results: </strong>Of 64 enrolled patients, 30 (47%) with ≥3 submissions formed the analysis cohort (median age 57, IQR 47.2-64.5 years; n=12.9, 43% malignant tumors); 6 (20%) experienced clinical deterioration during follow-up. Patients contributed a median of 8.5 submissions (mean 19.03, SD 30.12) at 1.7 surveys per week on average, indicating sustained but heterogeneous engagement. The best-performing rule, based on net short-term score increase, achieved an area under the receiver operating characteristic of 0.88, with sensitivity 0.83, specificity 0.92, and accuracy 0.90 on the last-window dataset, outperforming rules based solely on current score or multidomain persistence. Among 23 app users who completed the System Usability Scale, the mean score was 84.0, reflecting high perceived usability; higher-frequency users reported stronger perceived usefulness and habit-driven use.</p><p><strong>Conclusions: </strong>This pilot study demonstrates that a smartphone or web-based self-monitoring platform for patients with brain tumor is feasible and well accepted and that simple, transparent rules applied to longitudinal symptom scores show potentia","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e87928"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716662","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 iGET Living, a Digital Graded Exposure Intervention for Youth With Chronic Pain: Multiphase User-Centered Design and Pilot Study.","authors":"Lauren E Harrison, Sarah N Webster, Ellison S Choate, Dylan Mayanja, Nicole Jehl, Beth D Darnall, Jennifer N Stinson, Marianne Bonnert, Maria Lalouni, Rikard K Wicksell, Laura E Simons","doi":"10.2196/89206","DOIUrl":"https://doi.org/10.2196/89206","url":null,"abstract":"<p><strong>Background: </strong>Pediatric chronic pain affects up to one-third of youth and is associated with significant disruptions in social, emotional, and behavioral functioning. Although behavioral treatments are effective, access remains limited due to geographic, financial, and systemic barriers. Digital behavioral health interventions offer a promising solution, but many lack user-centered design, iterative refinement, and implementation-informed development strategies that support usability and scalability.</p><p><strong>Objective: </strong>This study aimed to develop and iteratively refine iGET Living, a digital graded exposure intervention for youth with chronic pain, using a combined user-centered and implementation-informed framework, and to evaluate its preliminary acceptability, feasibility, and user-perceived success.</p><p><strong>Methods: </strong>Guided by the Consolidated Framework for Implementation Research (CFIR) and the mHealth (mobile health) Agile Development and Lifecycle model, intervention development proceeded through 3 phases. Phase 0 translated an evidence-based in-person graded exposure treatment (GET Living) into an initial digital prototype. Phase 1 involved iterative user-centered refinement across 3 cycles of qualitative development sessions with youth with chronic pain (n=15), incorporating think-aloud usability testing, Likert-rated feedback, and rapid qualitative analysis mapped to CFIR constructs to guide real-time modifications to content, design, and functionality. Phase 2 piloted the refined intervention with a new sample of youth (n=38, n=30 completers) recruited from a tertiary pediatric pain clinic to evaluate feasibility, acceptability, treatment credibility and expectancy, and user-perceived functional improvements. Quantitative outcomes were summarized descriptively, and qualitative exit interview data were analyzed using rapid qualitative analysis.</p><p><strong>Results: </strong>Across development cycles, youth feedback informed substantive refinements to the intervention, including reducing text density, incorporating animated educational videos, enhancing interactive features, and improving navigation and layout. These changes resulted in progressive improvements in clarity, satisfaction, and acceptability across prototypes. In the Phase 2 pilot study, participants reported moderate-to-high treatment credibility (mean of 19.71 out of 30) and expectancy (mean of 17.96 out of 30), as well as high satisfaction (mean of 46.12 out of 60). Acceptability ratings across domains of the Theoretical Framework of Acceptability were favorable. Qualitative exit interviews highlighted the interventions' perceived role in helping youth re-engage in valued activities.</p><p><strong>Conclusions: </strong>Using a combined CFIR and agile development approach, iGET Living emerged as a feasible, acceptable, engaging digital graded exposure intervention for youth with chronic pain. These findings highlight the val","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e89206"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716578","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":"Experiences From an Internet-Delivered Treatment Program for Individuals With Obesity: Pilot Study.","authors":"Agneta Anderzen-Carlsson, Annika Imhagen, Stefan Jansson, Marije Galavazi, Jan Karlsson","doi":"10.2196/79853","DOIUrl":"https://doi.org/10.2196/79853","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of obesity is a global health challenge, as obesity is associated with various comorbidities, reduced quality of life, and increased mortality. Providing effective treatment to improve health and quality of life for people with obesity is a major health care concern. Internet-delivered treatment (IDT) is an alternative treatment that increases patient accessibility and reachability; however, pilot testing is required before such interventions are evaluated in full-scale studies or implemented.</p><p><strong>Objective: </strong>This study aims to investigate the feasibility and user-friendliness of an IDT program for obesity (IDT-O); to evaluate body weight, dietary habits, physical activity, psychosocial functioning, and experiences of treatment in those who completed the 6-month treatment; and to investigate the dropouts' experiences of the treatment.</p><p><strong>Methods: </strong>A prospective 1-year observational approach, evaluated through a multimethod research design, was adopted. Inclusion criteria were age 18 years and older, BMI of ≥30 kg/m2, or BMI of 28-29.9 kg/m2 with obesity-related comorbidity. Participants were offered a 6-month therapist-assisted IDT-O program providing evidence-based obesity treatment, behavioral and lifestyle support, and strategies to address weight stigma. BMI, participants' dietary habits, self-reported physical activity, psychosocial functioning, experiences of treatment effects, and treatment satisfaction were measured before treatment and after 6 and 12 months. Dropouts were followed up through qualitative interviews.</p><p><strong>Results: </strong>A total of 20 participants (17 females and 3 male; mean age 44.2, SD 16.4 years) started the IDT-O program, and 35% (7/20) completed all 12 modules. Ten (8 females) out of 13 dropouts were interviewed. Both quantitative and qualitative findings showed that participants were generally satisfied with the content and design of the intervention. Those who completed the IDT-O lost some weight (mean 2.0%, 95% CI -1.09 to 5.13), reported improved dietary habits (effect size [ES] 0.25, 95% CI -0.51 to 1.00), increased physical activity (ES 0.93, 95% CI -0.08 to 1.87), and improved psychosocial functioning (distress: ES 0.43, 95% CI 0.-0.37 to 1.19; avoidance: ES 0.67, 95% CI -0.18 to 1.48), 6 months after completing the treatment. The qualitative analysis of the interviews revealed \"The programme was OK, but it does not suit everyone\" as the main theme. The main themes were based on the 3 subthemes: \"It wasn't for me,\" \"There were good things,\" and \"There are things to improve.\"</p><p><strong>Conclusions: </strong>The findings indicate that the IDT-O holds potential as a treatment for people with obesity, although one limitation is that only 35% (7/20) of the participants completed the pilot program. Improvements in lifestyle habits and psychosocial functioning were observed in those who completed the IDT-O, but these fi","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e79853"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716603","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 Influencing Factors of Medication Adherence Among Chinese Patients With Alzheimer Disease: Delphi Study Informing Future Artificial Intelligence-Supported Interventions.","authors":"Xinyue Zhang, Rafiq Elmansy","doi":"10.2196/89508","DOIUrl":"https://doi.org/10.2196/89508","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer disease (AD) affects cognition, treatment adherence, family connections, and health care resource allocation. Most patients with AD have low adherence to medication therapy due to the limitations associated with cognitive impairment. Therefore, increasing the involvement of patients and their family members in medication management is important to improve treatment outcomes and reduce the burden of care.</p><p><strong>Objective: </strong>This study explores the potential application of artificial intelligence (AI) in medication management for Chinese patients with early- to mid-stage AD focusing on enhancing medication adherence. The study first predicts and evaluates key factors through an online Delphi study, which provides a basis for their subsequent incorporation into the AI model as input variables to enable prediction of medication-taking behaviors. Since AI research in medication management for this population is still undeveloped, this paper further explores the multiple potentials of AI from a theoretical view, including drug dosage optimization, multidrug interaction detection, and family education support. It will provide a preliminary direction and theoretical basis for the development of an intelligent medication management system in the future.</p><p><strong>Methods: </strong>The exploratory online Delphi study with no modification predicted the key factors influencing medication adherence. Based on the results, the study confirmed the potential of AI to improve adherence. Participation by 12 experts in 3 rounds systematically assessed the core elements influencing patients' adherence to their medication.</p><p><strong>Results: </strong>Family care, social support, environmental factors, emotional support, and patient behaviors were identified as the primary factors influencing medication adherence among Chinese patients with AD. These factors were validated and ranked through iterative Delphi rounds, with family care and social support receiving the highest importance scores. The Wilcoxon signed-rank test indicated no significant difference between rounds (P=.06), supporting the stability of the consensus. These findings establish a foundational set of variables for AI systems that predict and enhance medication adherence.</p><p><strong>Conclusions: </strong>This study highlights the critical factors affecting medication adherence by Chinese patients with AD. It was designed as an exploratory online Delphi study to identify and prioritize key influencing factors, rather than to validate a specific AI-based system, and the findings provide a theoretical foundation for future AI-informed interventions. The results also indicate theoretical potential roles for AI in supporting medication management, such as optimizing drug dosage, detecting multidrug interactions, and enhancing family education.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e89508"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772144","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 Survey of Primary Care Clinician Experiences With Electronic Health Record-Based Clinical Decision Support to Improve HIV Pre-Exposure Prophylaxis Prescribing.","authors":"Afiba Manza-A Agovi, Caitlin T Thompson, Wentao Li, Jennifer Allard, Nicole Lee, Esther Fasanmi, Rohit P Ojha","doi":"10.2196/89638","DOIUrl":"10.2196/89638","url":null,"abstract":"<p><strong>Unlabelled: </strong>A survey of primary care clinicians suggests that a clinical decision support tool to support sexual risk assessment and prescribing of HIV pre-exposure prophylaxis was appropriate and useful for identifying at-risk patients, but uptake was hindered by workflow and usability barriers, which underscores the importance of postimplementation clinician feedback to improve the use of clinical decision support tools.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e89638"},"PeriodicalIF":2.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698816","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":"Cross-sectional research: Application of an Artificial Intelligence-Based Pediatric Early Warning Score in the Pediatric Emergency Department.","authors":"Wanhua Xie, Xuan Shi, Meiqing Peng","doi":"10.2196/89306","DOIUrl":"https://doi.org/10.2196/89306","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There are a large number of pediatric emergency patients. Due to the fact that the children cannot describe their own conditions, there is a shortage of nursing staff, it is extremely important to identify the early warning signs of the children's conditions as early as possible. The current targeted care needs to be improved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to investigate the application of an artificial intelligence-based pediatric early warning score (PEWS) in the pediatric emergency observation unit, analyze the relationship between PEWS and disease severity , and assess its impact on length of hospital stay and hospitalization costs after admission, so as to provide references for targeted nursing care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a retrospective study. A total of 1,233 pediatric patients admitted via the pediatric emergency department of a tertiary specialty hospital in Guangzhou from September 2023 to March 2024 were included. The patients were divided according to the status of the activation of the early-warning group (PEWS score ≥ 1) vs. not triggered [score 0]) during emergency observation. Length of stay and hospitalization costs were compared between the early warning group and the non-early warning group.The differences between groups were performed with the Mann-Whitney U test. We did the multivariable logistic regression to discuss the association of resource utilization metrics and the status of AI-PEWS, adjusted by age, sex and disease category (respiratory, neurological, hematologic).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 1,233 patients, 597 (48.4%) triggered the AI-PEWS (mean score 2.44 ± 1.41), and 636 (51.6%) did not. In the early warning group, 68 children were transferred to the intensive care unit, with a mean PEWS of 3.32 ± 1.73. Compared with the non-early warning group, the early warning group had a longer hospital stay (z = -5.180, P &lt; 0.001) and higher hospitalization costs (z = -6.500, P &lt; 0.001), and the differences between groups were statistically significant (P &lt; 0.001). Among the top three admission categories-respiratory, neurological, and hematologic diseases-children in the PEWS early warning group had significantly longer hospital stays and higher hospitalization costs, with statistically significant differences between groups (P &lt; 0.01). The β coefficient for length of hospital stay was 0.053 (SE=0.010), Waldχ²=5.533, OR=1.055 (95% CI: 1.035-1.075); while the β coefficient for hospitalization costs was 0.001 (SE=0.000), Waldχ²=6.075, OR=1.001 (95% CI: 1.001-1.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Compared with the non-early-warning group, the early-warning group had significantly longer hospital stays and higher hospitalization costs; similar patterns were observed within respiratory, neurological, and hematologic disease categories. It shows differences between children who triggered the warning and children who did not, providing a refe","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698793","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}