JMIR Formative Research最新文献

{"title":"A Digital Psychosocial Service (Sui App) for Arabic-Speaking Refugees in Switzerland: Development and Cultural-Contextual Adaptation Using a User-Centered and Participatory Approach.","authors":"Rilana Tanja Stoeckli, Thomas Berger, Monia Aebersold, Viktoria Zoellner, Farhad Haji, Muriel Hunziker, Beatriz Jesus Ferreira, Michel Hosmann, Sebastian Burchert, Jessica Wabiszczewicz, Christine Knaevelsrud, Eva Heim","doi":"10.2196/59905","DOIUrl":"10.2196/59905","url":null,"abstract":"<p><strong>Background: </strong>Upon arriving in host countries, forcibly displaced people face psychological, cultural, as well as sociostructural challenges. Access to mental health and psychosocial support (MHPSS) remains limited, affecting both refugees and host country structures. Digital services offer promise in addressing these challenges, given their potential for scalability and accessibility. Despite the increasing use of digital MHPSS, cultural and contextual adaptation remains insufficiently documented, requiring systematic documentation.</p><p><strong>Objective: </strong>This study aims (1) to assess the psychosocial needs of newly arrived refugees in Switzerland and identify potential digital support solutions and (2) to participatorily develop and culturally adapt the Sui app to address those needs for Arabic-speaking refugees.</p><p><strong>Methods: </strong>We used a 2-phase adaptation process, structured using the RECAPT (Reporting Cultural Adaptation in Psychological Trials) framework to ensure systematic documentation. The preparation phase (2019-2021) included a desk review, needs assessment interviews, and conceptualization discussions. The development phase (2021-2022) included iterative development loops with a user advisory board (UAB) and a beta test, followed by final adjustments.</p><p><strong>Results: </strong>The desk review provided 5 key insights guiding development: mental health stigma, health literacy, sociostructural aspects, adherence to digital interventions, and task-shifting approaches. Findings from the needs assessment with 22 asylum care interviewees, 2 intercultural interpreters, and 4 target group interviewees confirmed the importance of integrating sociostructural and psychological factors. Through conceptualization discussions with a consultancy agency and 4 UAB (n=9) meetings, the scope of the Sui app was drafted: 9 relevant, everyday life topics (eg, asylum process, housing, and work), 5 psychological topics (eg, stress, sleep, and emotion regulation), and 1 peer-guided chat support feature. A multilevel translation process, involving 5 Arabic speakers from different countries, ensured linguistic accessibility. This allowed the UAB to focus on surface, content, and delivery during 19 development loops. The app's content was delivered in various formats, including text, illustrations, video testimonies, and audio exercises. The beta test revealed high acceptability, with most users engaging with the app several times a week. However, technical challenges such as slow loading times hindered the full exploration of the features. Participants valued the peer support function, highlighting the importance of faster response times and personalized messages. Based on the beta test, technical and content refinements were made to prepare the app for a future quantitative evaluation.</p><p><strong>Conclusions: </strong>Through engagement with stakeholders and adherence to the RECAPT framework, we carefully c","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e59905"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080673","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 Generative Artificial Intelligence Implementation Impacts in Social and Health Care Language Translation: Mixed Methods Case Study.","authors":"Miia Martikainen, Kari Smolander, Johan Sanmark, Enni Sanmark","doi":"10.2196/73658","DOIUrl":"10.2196/73658","url":null,"abstract":"<p><strong>Background: </strong>Generative artificial intelligence (GAI) is expected to enhance the productivity of the public social and health care sector while maintaining, at minimum, current standards of quality and user experience. However, empirical evidence on GAI impacts in practical, real-life settings remains limited.</p><p><strong>Objective: </strong>This study investigates productivity, machine translation quality, and user experience impacts of the GPT-4 language model in an in-house language translation services team of a large well-being services county in Finland.</p><p><strong>Methods: </strong>A mixed methods study was conducted with 4 in-house translators between March and June 2024. Quantitative data of 908 translation segments were collected in real-life conditions using the computer-assisted language translation software Trados (RWS) to assess productivity differences between machine and human translation. Quality was measured using 4 automatic metrics (human-targeted translation edit rate, Bilingual Evaluation Understudy, Metric for Evaluation of Translation With Explicit Ordering, and Character n-gram F-score) applied to 1373 GAI-human segment pairs. User experience was investigated through 5 semistructured interviews, including the team supervisor.</p><p><strong>Results: </strong>The findings indicate that, on average, postediting machine translation is 14% faster than translating texts from scratch (2.75 vs 2.40 characters per second, P=.03), and up to 37% faster when the number of segments is equalized across translators. However, productivity varied notably between individuals, with improvements ranging from -2% to 102%. Regarding translation quality, 11% (141/1261) of Finnish-Swedish and 16% (18/112) of Finnish-English GAI outputs were accepted without edits. Average human-targeted translation edit rate scores were 55 (Swedish) and 46 (English), indicating that approximately half of the words required editing. Bilingual Evaluation Understudy scores averaged 43 for Swedish and 38 for English, suggesting good translation quality. Metric for Evaluation of Translation With Explicit Ordering and Character n-gram F-scores reached 63 and 68 for Swedish and 59 and 57 for English, respectively. All metrics have been converted to an equivalent scale from 0 to 100, with 100 reflecting a perfect match. Interviewed translators expressed mixed reviews on productivity gains but generally perceived value in using GAI, especially for repetitive, generic content. Identified challenges included inconsistent or incorrect terminology, lack of document-level context, and limited system customization.</p><p><strong>Conclusions: </strong>Based on this case study, GPT-4-based GAI shows measurable potential to enhance translation productivity and quality within an in-house translation team in the public social and health care sector. However, its effectiveness appears to be influenced by factors, such as translator postediting skills, workflo","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e73658"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080743","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":"Previsit Preparation for Shared Decision-Making in Lung Cancer Screening in Primary Care Using a Paper Decision Aid and an Automated Text Messaging Program: Quasi-Experimental Pilot Study.","authors":"Mayuko Ito Fukunaga, Renda Soylemez Wiener, Shaun Toomey, Joann Wagner, Qiming Shi, Kavitha Balakrishnan, Alexandra Nguyen, Dan Nguyen, M Diane McKee, Alexander A Bankier, Rajani S Sadasivam, Sybil L Crawford, Paul Kj Han, Thomas K Houston, Kathleen M Mazor","doi":"10.2196/69044","DOIUrl":"10.2196/69044","url":null,"abstract":"<p><strong>Background: </strong>Patient-provider discussions and shared decision-making (SDM) are essential for tailoring lung cancer screening (LCS) decisions to individual patients. However, the implementation of SDM in primary care settings is challenging. Innovative approaches are needed to reach and prepare patients eligible for LCS for SDM in primary care settings and increase LCS uptake.</p><p><strong>Objective: </strong>We piloted previsit preparation comparing 2 strategies: a paper decision aid (DA; DA group) and an enhanced comparator strategy consisting of the paper DA plus an automated text message program (DA+TM group) designed to promote patient-provider LCS discussions. We explored feasibility and gathered preliminary data on its potential effects on LCS discussions, decision-making, and LCS uptake in primary care settings.</p><p><strong>Methods: </strong>In a sequential quasi-experimental pilot study, we recruited patients who were eligible for LCS in a single academic health care system. Prior to an upcoming visit, participants in both groups received a paper-based DA by mail. In the DA+TM group, participants also received a series of automated text messages to help them prepare for their LCS discussions. We monitored participant recruitment and retention, as well as patient engagement in DA and text messages. In exploratory analyses, we assessed patient-provider discussion of LCS, SDM, patient knowledge, decision conflict at baseline and in follow-up telephone surveys, and LCS completion measured by electronic health records.</p><p><strong>Results: </strong>We enrolled and included 48 participants (DA group=19 and DA+TM group=29) in the final analysis. Participants were predominantly White, with a median age of 61.0 (IQR, 57.0-65.0), and 58% (28/48) of them were female. Engagement was high in both groups. LCS knowledge significantly improved in the DA+TM group (4.5 baseline vs 6.0 follow-up; P=.003), while there was no change in the DA group (5.0 baseline vs 5.0 follow-up, P=.23). Median LCS knowledge change from baseline to follow-up was 0.5 (IQR -1.0 to 2.5) in the DA group and 1.5 (IQR 0-3.0) in the DA+TM group (P=.24). Decision conflict in both groups significantly decreased (DA group: 37.5 baseline vs 0 follow-up, P<.001; DA+TM group: 50.0 baseline vs 20.0 follow-up, P=.003). The median SDM process score (a measure of SDM) was 3.0 (IQR 1.5-4.0) in the DA group and 2.0 (IQR 1.0-3.0) in the DA+TM group (P=.11). The LCS completion rates were 5% (1/19) in the DA group and 31% (9/29) in the DA+TM group at 3 months (P=.07), and 26% (5/19) in the DA group and 34% (10/29) in the DA+TM group at 6 months (P=.75).</p><p><strong>Conclusions: </strong>Previsit preparation was feasible in primary care settings. An enhanced, text message-based strategy has the potential to reach and engage broader LCS-eligible populations and prepare patients for LCS discussions with their primary care providers, which may ultimately improve informed deci","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e69044"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080746","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 Web-Based Intervention to Support Primary Health Care Professionals in Digital Health Measurement: User-Centered Participatory Approach.","authors":"Kristel Meijers, Esther Bols, Emmylou Beekman, Rachel Slangen, Peter Alexander van de Hoef, Darcy Ummels, Rik Crutzen","doi":"10.2196/72331","DOIUrl":"10.2196/72331","url":null,"abstract":"<p><strong>Background: </strong>Digital health measurement offers opportunities to address several primary health care challenges, but health care professionals encounter significant implementation barriers. Therefore, resources need to be developed to facilitate the integration of digital health measurement into daily practice.</p><p><strong>Objective: </strong>We aim to identify the most appropriate format and content for an intervention to support primary health care professionals in adopting digital health measurement. In addition, we describe and reflect on the development process.</p><p><strong>Methods: </strong>We used a participatory action research approach as well as user-centered design principles. A total of 19 primary health care professionals from 4 disciplines-physical therapy, occupational therapy, speech and language therapy, and general practitioner practice assistance-participated in intervention development as end users. External experts were consulted to broaden perspectives. Data were collected across 3 iterative stages (concept, design, and testing and trials) between January 2022 and December 2023 during cocreative meetings, individual interviews, focus group discussions, usability testing, and prototype use in daily practice. Data were analyzed using content analysis and descriptive statistics.</p><p><strong>Results: </strong>A web-based, stepwise intervention combining theoretical information, practical aids, examples, and experiences proved most suitable. Key features were concise content, intuitive and attractive graphic design, and flexible navigation and functionalities. Iterative improvements led to an increase in usability ratings from \"okay\" to \"good to excellent.\"</p><p><strong>Conclusions: </strong>Different health care disciplines benefit from similar support strategies; yet, this requires a careful balancing of intervention design and content. Combining participatory action research and user-centered design principles was useful to tailor the intervention to end users' daily routines. The described development process offers a replicable framework for creating support strategies for digital health measurement in various health care settings.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e72331"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075313","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":"Use of and Attitudes Toward Technology Among Young People Living With HIV in San Francisco: Cross-Sectional Study.","authors":"Sean Arayasirikul, Caitlin Turner, Dillon Trujillo, Jarett Maycott","doi":"10.2196/81845","DOIUrl":"10.2196/81845","url":null,"abstract":"<p><p>Digital technology is an important tool for engaging and delivering care to and for young people living with HIV. This research letter examines how 120 out-of-care young people living with HIV in San Francisco use digital technology, the attitudes they have toward technology, and the anxiety they feel about being without technology. Our findings emphasize the importance of being aware of the unintended consequences of digital health interventions.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e81845"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064510","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":"Factors Influencing the Use of Online Symptom Checkers in the United Kingdom: Cross-Sectional Study.","authors":"Austen El-Osta, Eva Riboli-Sasco, Mahmoud Al Ammouri, Sami Altalib, Ana Luisa Neves, Azeem Majeed, Benedict Hayhoe","doi":"10.2196/65314","DOIUrl":"10.2196/65314","url":null,"abstract":"<p><strong>Background: </strong>The National Health Service (NHS) faces increasing strain. Concurrently, demand for health information, consumer empowerment, and health awareness continues to grow. These trends, coupled with the ubiquity of smartphones and internet access, are positioning online symptom checkers (OSCs) as promising tools for preliminary diagnosis and triage. While there is increasing data on the demographics, motivations, and perspectives of current and potential users of OSCs globally, no study has yet quantified or ranked the various factors associated with the use of OSCs in the United Kingdom.</p><p><strong>Objective: </strong>This study aimed to assess key trends and user perceptions on the usability and effectiveness of OSC in the United Kingdom. We also sought to identify concerns related to the privacy, security, and accuracy of OSCs and to quantify the weight of these various factors on the use of OSCs.</p><p><strong>Methods: </strong>A cross-sectional survey of UK adults was conducted using an electronic questionnaire. A convenience sample was recruited between February and March 2024 through web-based platforms and personal networks. The survey included questions on awareness, use, perceptions, and concerns regarding OSCs, as well as respondents' demographics. Responses were pseudo-anonymized and analyzed using univariable and multivariable logistic regression models to assess relationships between demographic factors; perceived usability, reliability, and risks; and OSC use.</p><p><strong>Results: </strong>The survey collected responses from 634 participants. The majority (543/634, 85.7%) had used OSCs, primarily the NHS 111 service (498/634, 78.6%). Younger age (<46 years old), being female (adjusted odds ratio [aOR] 1.79, 95% CI 1.05-3.06), and having children (aOR 3.19, 95% CI 1.56-6.51) were associated with higher odds of using OSCs. Key motivations for using OSCs included understanding symptoms (501/634, 79.0%) and determining the need for medical care (491/634, 77.4%). Key concerns negatively impacting use related to privacy (aOR 0.58, 95% CI 0.35-0.97) and fear of replacing traditional, face-to-face consultations (aOR 0.47, 95% CI 0.26-0.87). The most important factor found to affect the decision to use OSCs was the perceived ease of use (aOR 8.17, 95% CI 4.25-15.71), followed by the perceived helpfulness in decision-making (aOR 2.96, 95% CI 1.62-5.42), and respondents' trust in their diagnostic accuracy (aOR 2.24, 95% CI 1.32-3.79).</p><p><strong>Conclusions: </strong>OSCs are widely used in the United Kingdom, particularly the NHS 111 service, driven primarily by ease of use and perceived helpfulness in decision support. However, privacy and security concerns, as well as fears of OSCs replacing traditional consultations, pose significant barriers. Addressing these concerns is crucial for enhancing user trust and maximizing the benefits of OSCs in supporting self-care and improving health care efficiency.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e65314"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069582","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":"Typology and Ethical Considerations of Digital Health Promotion Tools for Youth in Sub-Saharan Africa: Review of Examples From Ghana, Kenya, and South Africa.","authors":"Agata Ferretti, Shannon Hubbs, Richard Mawutor Dzikunu, Keymanthri Moodley, Frederick Murunga Wekesah, Jonty Wright, Effy Vayena","doi":"10.2196/54472","DOIUrl":"10.2196/54472","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Digital technologies for health promotion have proliferated over the past decade, with uptake increasing steadily among young people, including those in low- and middle-income countries (LMICs). Youth increasingly rely on digital tools for health information, and the early influence of this digital technology can have an impact throughout the lifespan. While there is a growing body of literature on the opportunities and challenges of digital health promotion (DHP) for young people, a gap remains in research that closely examines the characteristics of digital health strategies developed specifically for youth in LMICs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this paper, we investigate and compare selected examples of DHP tools from 3 countries in Sub-Saharan Africa, namely Ghana, Kenya, and South Africa. Our aim is to create a multidimensional descriptive typology of DHP tools developed specifically to promote the health of adolescents and young adults in these countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;To select the tools, we conducted systematic internet-based searches using relevant keywords, incorporating the expertise of local professionals to ensure a thorough search. Included solutions originated from one of the 3 countries of focus and could take any number of forms such as apps, websites, chatbots, or social media initiatives. We thereafter deductively created a typology describing selected features of each tool, including the health area of focus, key stakeholders, type of service, and ethical values explicitly referenced within the tool. While such high-level features of interest were selected based on the existing literature in the field, the detailed descriptive categories were identified through an inductive analysis of the tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 31 DHP tools were identified. Sexual and reproductive health was the most common health area of focus for DHP services, which were primarily funded and supported by local non-governmental organizations, foundations, and international organizations. The assessed tools were predominantly web-based and social media-based, with the overarching goal and core value of expanding health knowledge and offering access to health promotion services to young people.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;With sustained investment, DHP can improve the health of young people while relieving pressure on health care services. The areas of mental health, as well as substance use prevention and nutrition, stand out with clear potential for health gains through investment in DHP. Addressing ethical concerns such as privacy, transparency, equity, and inclusiveness is essential to the safety, usefulness, and fairness of DHP. To achieve the greatest benefit, local youth perspectives and priorities should be included in DHP development. Local initiatives have the potential to be the most agile, flexible, and relevant for the target audience of young people, with","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e54472"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080800","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":"TruVox Web-Based Software for Vocal Pitch Training in Transgender Women: Development and Single-Session Evaluations.","authors":"Sam R Weese, Mary E Wilkens, Om Jadhav, Xiangyi Wang, Ansh Bhanushali, Tyler DiLoreto, Reyna Kozel, Renee L Gustin, Tara McAllister, Victoria Sue McKenna, Vesna Dominika Novak","doi":"10.2196/73841","DOIUrl":"10.2196/73841","url":null,"abstract":"<p><strong>Background: </strong>Transgender people often experience distress due to a mismatch between their gender and the way their voice is perceived (eg, transgender women with low pitch), which significantly reduces their mental health and quality of life. This is especially a problem for transfeminine people and can be reduced with gender-affirming voice training (GAVT), but such training is often inaccessible due to factors such as price and geographical constraints.</p><p><strong>Objective: </strong>We aim to improve the limited availability of GAVT by developing and testing a free web-based software platform (named TruVox; University of Cincinnati) that would combine real-time feedback about the user's voice with structured vocal pitch exercises for transfeminine people.</p><p><strong>Methods: </strong>The current publicly accessible TruVox prototype focuses on vocal pitch training with 5 structured exercises that provide real-time pitch visualizations as well as supporting videos and text. It was tested in 2 evaluation stages: initial remote usability evaluations and a later single-session in-person evaluation with 21 transfeminine participants under the supervision of 2 researchers. In remote evaluations, participants reported bugs and usability issues that were iteratively addressed. In the in-person evaluation, participants tested the final software prototype and filled out the System Usability Scale, then performed 10 repetitions of different exercises to gauge performance improvement with practice. They also filled out the Intrinsic Motivation Inventory for each exercise.</p><p><strong>Results: </strong>The System Usability Scale score had a mean of 79.8 (SD 12.8) on a 100-point scale, Intrinsic Motivation Inventory scores were high (eg, interest/enjoyment over 11/14), and exercise performance significantly improved in all but 1 exercise (P values ranging from below .001 to .095). As qualitative feedback, participants requested to be able to use the software without much preparation and suggested several desirable future features, such as performance tracking and goal-setting.</p><p><strong>Conclusions: </strong>While the pitch training module should not be considered a complete GAVT package, TruVox represents a promising foundation for further GAVT software because it was perceived as usable and motivating and allowed participants to improve their exercise performance. To our knowledge, TruVox is the first GAVT software that combines real-time voice visualization with structured exercises, and this study represents the first quantitative human subjects evaluation of GAVT software. In the future, TruVox will be expanded with additional modules such as resonance training, then tested in longer-term trials.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e73841"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069501","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":"Personality-Driven Variations in Fitness App Affordance Actualization Among Adults: Quantitative Survey Study.","authors":"Moayad Alshawmar, Bengisu Tulu, E Vance Wilson, Adrienne Hall-Phillips","doi":"10.2196/72691","DOIUrl":"10.2196/72691","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fitness apps aim to advance individuals' health and wellness by encouraging consistent healthy habits. Despite their widespread use, sustaining user engagement remains a challenge. Research studies on fitness apps have identified app affordances as one of the key factors that influence user engagement. Some affordances, such as exercise guidance and activity status updates, are shown to support users in achieving their health goals if the users actualize them. However, these affordances need to be actualized by the users to seize these benefits. While identifying these app affordances can deepen our insight into user-app interactions, the impact of personality traits on the actualization of these affordances remains underexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to examine the influence of personality traits on the actualization of fitness app affordances.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Building on affordance actualization theory and the Big Five personality framework, we hypothesized about certain personality traits influencing the actualization of certain app affordances. We tested these hypotheses using a survey of adult Fitbit app (Google LLC) users (N=442). We used validated measures from the literature to assess these variables. We analyzed the survey data using covariance-based structural equation modeling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our findings reveal distinct affordance actualization patterns based on users' personality traits. Users with the conscientious personality trait primarily actualize the updating affordance (β=0.136, P=.01), while the influence of the conscientious trait on actualization of rewards (β=-0.154, P=.06), competing (β=-0.118, P=.18), comparing (β=-0.084, P=.33), reminding (β=-0.060, P=.44), or guidance (β=-0.006, P=.95) affordances was not significant. The openness to experience trait showed a significant positive effect on actualization of updating affordances (β=0.227, P=.001), but did not significantly influence actualization of searching (β=-0.172, P=.11), watching others (β=-0.077, P=.50), or guidance (β=-0.005, P=.96) affordances. Users with the agreeableness trait actualized comparison (β=0.213, P=.02), guidance (β=0.259, P=.003), and encouragement (β=0.244, P=.01) affordances, while the effect of the agreeableness trait on actualization of watching others was not significant (β=0.143, P=.13). Extravert users actualized recognition (β=0.191, P&lt;.001), self-presentation (β=0.165, P=.002), and watching others (β=0.167, P=.003) affordances, but did not actualize updating affordances (β=0.001, P=.98). Finally, a lower emotional stability trait did not significantly influence any of the hypothesized affordances, with nonsignificant effects on guidance (β=-0.083, P=.30), reminding (β=-0.093, P=.21), and updates (β=-0.036, P=.49).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study shows that certain personality traits are associated with the actualization of specifi","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e72691"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053534","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":"Semaglutide and Tirzepatide in a Remote Weight Management Program: 12-Month Retrospective Observational Study.","authors":"Rebecca Richards, William Lunt, Michael Whitman, Giulia Spaltro, Rachel Hall","doi":"10.2196/81912","DOIUrl":"10.2196/81912","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Obesity affects &gt;890 million adults worldwide, and traditional lifestyle interventions often lack long-term success. While glucagonlike peptide-1 receptor agonists (GLP-1RAs) have shown strong weight loss outcomes, access to specialist care is limited by cost and capacity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated the effectiveness, feasibility, acceptability, and potential cost-effectiveness of a 12-month remote GLP-1RA-supported weight management program, comparing outcomes between tirzepatide and semaglutide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective analysis included 339 participants (n=278, 82% women) who completed a 12-month remote weight management program using either tirzepatide (n=209, 61.7%) or semaglutide (n=130, 38.3%) between February and June 2024. The program combined medication, app-based behavioral support, coaching from registered dietitians and nutritionists, and clinical oversight. It featured 5 phases with evidence-based behavior change techniques, monthly monitoring, and safety protocols. Primary outcomes were mean weight change and proportions achieving ≥10% and ≥15% weight loss. Secondary outcomes included behavior changes, side effects, acceptability, feasibility, and estimated cost-effectiveness compared to National Health Service care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Mean weight change at 12 months was -22.9 kg (-22.1% of baseline weight, SD 8%; P&lt;.001) in the tirzepatide cohort and -18.1 kg (-17.1% of baseline weight, SD 8.1%; P&lt;.001) in the semaglutide cohort. Achievement of ≥10% weight loss occurred in 95.2% (199/209) of participants using tirzepatide and 83.1% (108/130) of participants using semaglutide, whereas ≥15% weight loss was achieved by 83.7% (175/209) and 56.2% (73/130) of the participants, respectively. The proportion of inactive participants (no weekly exercise) decreased substantially in both cohorts (tirzepatide: 31/209, 14.8% to 14/209, 6.7%; semaglutide: 29/130, 22.3% to 7/130, 5.4%; P&lt;.001). Side effects decreased significantly over the 12-month period, with participants who reported no side effects increasing from 41.6% (87/209) to 60.3% (126/209; P&lt;.001) in the tirzepatide cohort and from 53.8% (70/130) to 67.7% (88/130) in the semaglutide cohort (P=.02), whereas common initial side effects, including constipation, nausea, and fatigue, showed significant reductions (P&lt;.001). Economic modeling suggested a 60% to 70% cost saving compared to specialist weight management services and a 10% to 60% cost saving compared to primary care in the National Health Service.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This real-world evaluation demonstrates that remotely delivered, GLP-1RA-supported weight management programs can achieve weight loss outcomes that align closely with clinical trial results while potentially reducing health care costs by 10% to 70% compared to traditional UK services. Both the tirzepatide and semaglutide cohorts exceeded clinically sign","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":"e81912"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954964","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}