JMIR Formative Research最新文献

{"title":"Automated Detection of Neurodevelopmental Disorders Using Face-to-Face Mobile Technology Among Typically Developing Greek Children: Randomized Controlled Trial.","authors":"Eugenia I Toki, Victoria Zakopoulou, Giorgos Tatsis, Jenny Pange","doi":"10.2196/53465","DOIUrl":"10.2196/53465","url":null,"abstract":"<p><strong>Background: </strong>Neurodevelopmental disorders (NDs) are characterized by heterogeneity, complexity, and interactions among multiple domains with long-lasting effects in adulthood. Early and accurate identification of children at risk for NDs is crucial for timely intervention, yet many cases remain undiagnosed, leading to missed opportunities for effective interventions. Digital tools can help clinicians assist and identify NDs. The concept of using serious games to enhance health care has gained attention among a growing group of scientists, entrepreneurs, and clinicians.</p><p><strong>Objective: </strong>This study aims to explore the core principles of automated mobile detection of NDs in typically developing Greek children, using a serious game developed within the SmartSpeech project, designed to evaluate multiple developmental domains through principal component analysis (PCA).</p><p><strong>Methods: </strong>A total of 229 typically developing children aged 4 to 12 years participated in the study. The recruitment process involved open calls through public and private health and educational institutions across Greece. Parents were thoroughly informed about the study's objectives and procedures, and written consent was obtained. Children engaged under the clinician's face-to-face supervision with the serious game \"Apsou,\" which assesses 18 developmental domains, including speech, language, psychomotor, cognitive, psychoemotional, and hearing abilities. Data from the children's interactions were analyzed using PCA to identify key components and underlying principles of ND detection.</p><p><strong>Results: </strong>A sample of 229 typically developing preschoolers and early school-aged children played the Apsou mobile serious game for automated detection of NDs. Performing a PCA, the findings identified 5 main components accounting for about 80% of the data variability that potentially have significant prognostic implications for a safe diagnosis of NDs. Varimax rotation explained 61.44% of the total variance. The results underscore key theoretical principles crucial for the automated detection of NDs. These principles encompass communication skills, speech and language development, vocal processing, cognitive skills and sensory functions, and visual-spatial skills. These components align with the theoretical principles of child development and provide a robust framework for automated ND detection.</p><p><strong>Conclusions: </strong>The study highlights the feasibility and effectiveness of using serious games for early ND detection in children. The identified principal components offer valuable insights into critical developmental domains, paving the way for the development of advanced machine learning applications to support highly accurate predictions and classifications for automated screening, diagnosis, prognosis, or intervention planning in ND clinical decision-making. Future research should focus on validating these find","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406412","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":"Leveraging Chatbots to Combat Health Misinformation for Older Adults: Participatory Design Study.","authors":"Wei Peng, Hee Rin Lee, Sue Lim","doi":"10.2196/60712","DOIUrl":"10.2196/60712","url":null,"abstract":"<p><strong>Background: </strong>Older adults, a population particularly susceptible to misinformation, may experience attempts at health-related scams or defrauding, and they may unknowingly spread misinformation. Previous research has investigated managing misinformation through media literacy education or supporting users by fact-checking information and cautioning for potential misinformation content, yet studies focusing on older adults are limited. Chatbots have the potential to educate and support older adults in misinformation management. However, many studies focusing on designing technology for older adults use the needs-based approach and consider aging as a deficit, leading to issues in technology adoption. Instead, we adopted the asset-based approach, inviting older adults to be active collaborators in envisioning how intelligent technologies can enhance their misinformation management practices.</p><p><strong>Objective: </strong>This study aims to understand how older adults may use chatbots' capabilities for misinformation management.</p><p><strong>Methods: </strong>We conducted 5 participatory design workshops with a total of 17 older adult participants to ideate ways in which chatbots can help them manage misinformation. The workshops included 3 stages: developing scenarios reflecting older adults' encounters with misinformation in their lives, understanding existing chatbot platforms, and envisioning how chatbots can help intervene in the scenarios from stage 1.</p><p><strong>Results: </strong>We found that issues with older adults' misinformation management arose more from interpersonal relationships than individuals' ability to detect misinformation in pieces of information. This finding underscored the importance of chatbots to act as mediators that facilitate communication and help resolve conflict. In addition, participants emphasized the importance of autonomy. They desired chatbots to teach them to navigate the information landscape and come to conclusions about misinformation on their own. Finally, we found that older adults' distrust in IT companies and governments' ability to regulate the IT industry affected their trust in chatbots. Thus, chatbot designers should consider using well-trusted sources and practicing transparency to increase older adults' trust in the chatbot-based tools. Overall, our results highlight the need for chatbot-based misinformation tools to go beyond fact checking.</p><p><strong>Conclusions: </strong>This study provides insights for how chatbots can be designed as part of technological systems for misinformation management among older adults. Our study underscores the importance of inviting older adults to be active co-designers of chatbot-based interventions.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Patient Portal Uses and Needs: Cross-Sectional Study in a State Fair Setting.","authors":"Sripriya Rajamani, Robin Austin, Chelsea Richwine, Malin Britt-Lalich, Madhur Thakur, Yasmin Odowa, Ratchada Jantraporn, Jenna Marquard","doi":"10.2196/64085","DOIUrl":"10.2196/64085","url":null,"abstract":"<p><p>This study identified 22 features that are used and the needs for desired features/data in patient portals that enable online access to medical records. Data collected at a Midwestern state fair indicates that while most participants used patient portals, use and desirability of specific features varied widely. Identified needs for enhanced data access, portal functionality, and usability can be used to inform effective patient portal design.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406415","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":"Seasonal and Weekly Patterns of Korean Adolescents' Web Search Activity on Insomnia: Retrospective Study.","authors":"Kwangyeol Baek, Jake Jeong, Hyun-Woo Kim, Dong-Hyeon Shin, Jiyoung Kim, Gha-Hyun Lee, Jae Wook Cho","doi":"10.2196/52977","DOIUrl":"10.2196/52977","url":null,"abstract":"<p><strong>Background: </strong>Sleep deprivation in adolescents is a common but serious public health issue. Adolescents often have a progressive circadian delay and suffer from insufficient sleep during weekdays due to the school schedule. Temporal patterns in internet search activity data can provide relevant information for understanding the characteristic sleep problems of the adolescent population.</p><p><strong>Objective: </strong>We aimed to reveal whether adolescents exhibit distinct temporal seasonal and weekly patterns in internet search activity on insomnia compared to adults.</p><p><strong>Methods: </strong>We hypothesized that adolescents exhibit larger variations in the internet search volume for insomnia, particularly in association with the school schedule (e.g., academic vacations and weekends). We extracted the daily search volume for insomnia in South Korean adolescents (13-18 years old), adults (19-59 years old), and young adults (19-24 years old) during the years 2016-2019 using NAVER DataLab, the most popular search engine in South Korea. The daily search volume data for each group were normalized with the annual median of each group. The time series of the search volume was decomposed into slow fluctuation (over a year) and fast fluctuation (within a week) using fast Fourier transform. Next, we compared the normalized search volume across months in a year (slow fluctuation) and days in a week (fast fluctuation).</p><p><strong>Results: </strong>In the annual trend, 2-way ANOVA revealed a significant (group) × (month) interaction (P<.001). Adolescents exhibited much greater seasonal variations across a year than the adult population (coefficient of variation=0.483 for adolescents vs 0.131 for adults). The search volume for insomnia in adolescents was notably higher in January, February, and August, which are academic vacation periods in South Korea (P<.001). In the weekly pattern, 2-way ANOVA revealed a significant (group) × (day) interaction (P<.001). Adolescents showed a considerably increased search volume on Sunday and Monday (P<.001) compared to adults. In contrast, young adults demonstrated seasonal and weekly patterns similar to adults.</p><p><strong>Conclusions: </strong>Adolescents demonstrate distinctive seasonal and weekly patterns in internet searches on insomnia (ie, increased search in vacation months and weekend-weekday transitions), which are closely associated with the school schedule. Adolescents' sleep concerns might be potentially affected by the disrupted daily routine and the delayed sleep phase during vacations and weekends. As we demonstrated, comparing various age groups in infodemiology and infoveillance data might be helpful in identifying distinctive features in vulnerable age groups.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287778","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":"Decision Support Tool to Improve Decision-Making for HIV Pre-Exposure Prophylaxis (PrEP): Development Process and Alpha Testing.","authors":"Wale Ajiboye, Abban Yusuf, Cheryl Pedersen, Rebecca Brown, Kristaps Dzonsons, LaRon Nelson","doi":"10.2196/57348","DOIUrl":"10.2196/57348","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;African, Caribbean, and Black (Black) communities in Canada are disproportionately affected by the HIV epidemic. Pre-exposure prophylaxis (PrEP) is a highly effective option for the prevention of HIV. However, the use of PrEP for HIV prevention among eligible Black clients in Canada remains far below the thresholds necessary to achieve the goal of zero new HIV infections. In a recent study in Toronto, PrEP-eligible Black clients were found to have decisional conflict and unmet decisional needs, which affected the quality of their decision-making process regarding the initiation and adherence to PrEP. There is evidence that decision support tools (DSTs) can improve the quality of a decision, the quality of the decision-making process, the implementation or continuation of the chosen option, and the appropriate use of health services. Despite these benefits, there is currently no DST for PrEP-eligible Black clients being asked to consider PrEP for HIV prevention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Our study aimed to develop a DST to improve PrEP decision-making for Black clients and to evaluate the tool's acceptability and usability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We developed and evaluated the PrEP DST for Black patients using the 7-step process outlined in the Ottawa Decision Support Group Guideline for the development and evaluation of DST. To facilitate the implementation of the Ottawa Decision Support Group guideline, we assembled a multidisciplinary team of primary health care providers, researchers, community members with lived experiences, and digital content designers to serve as the steering committee. First, we assessed patients' and primary health care providers' views on decisional support needs, after which we determined the content, design, and distribution plan for the DST. Subsequently, we conducted evidence synthesis, reviews, and appraisal before developing the PrEP DST prototype. The final tool was reviewed by steering committee members for completeness before acceptability and usability testing with potential Black clients and PrEP providers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The web-based DST yielded 27 pages divided into 6 distinct sections. The six sections include (1) an introduction of the DST, (2) clarify your decision, (3) knowledge, (4) a value clarification exercise, (5) support system, and (6) next steps. Both Black clients and PrEP providers reported ease of task performance, general satisfaction, and usefulness of the tool to support decision-making for Black clients. Feedback on usability centered on the need to add a user guide to increase usability. All feedback was incorporated into the final tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A PrEP DST for Black clients developed using a systematic process and a multidisciplinary steering committee was acceptable and usable by both Black clients and PrEP providers. Further study (eg, randomized controlled trials) may be needed to evaluate t","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406413","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":"Increasing Colorectal Cancer Screening Among Black Men in Virginia: Development of an mHealth Intervention.","authors":"Maria D Thomson, Guleer H Shahab, Chelsey A Cooper-McGill, Vanessa B Sheppard, Sherrick S Hill, Michael Preston, Larry Keen Ii","doi":"10.2196/50028","DOIUrl":"10.2196/50028","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the United States, colorectal cancer (CRC) is the third leading cause of cancer death among Black men. Compared to men of all other races or ethnicities, Black men have the lowest rates of CRC screening participation, which contributes to later-stage diagnoses and greater mortality. Despite CRC screening being a critical component of early detection and increased survival, few interventions have been tailored for Black men.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to report on the multistep process used to translate formative research including prior experiences implementing a national CRC education program, community advisory, and preliminary survey results into a culturally tailored mobile health (mHealth) intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A theoretically and empirically informed translational science public health intervention was developed using the Behavioral Design Thinking approach. Data to inform how content should be tailored were collected from the empirical literature and a community advisory board of Black men (n=7) and reinforced by the preliminary results of 98 survey respondents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A community advisory board identified changes for delivery that were private, self-paced, and easily accessible and content that addressed medical mistrust, access delays for referrals and appointments, lack of local information, misinformation, and the role of families. Empirical literature and survey results identified the need for local health clinic involvement as critical to screening uptake, leading to a partnership with local Federally Qualified Health Centers to connect participants directly to clinical care. Men surveyed (n=98) who live or work in the study area were an average of 59 (SD 7.9) years old and held high levels of mistrust of health care institutions. In the last 12 months, 25% (24/98) of them did not see a doctor and 16.3% (16/98) of them did not have a regular doctor. Regarding CRC, 27% (26/98) and 38% (37/98) of them had never had a colonoscopy or blood stool test, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Working with a third-party developer, a prototype mHealth app that is downloadable, optimized for iPhone and Android users, and uses familiar sharing, video, and text messaging modalities was created. Guided by our results, we created 4 short videos (1:30-2 min) including a survivor vignette, animated videos about CRC and the type of screening tests, and a message from a community clinic partner. Men also receive tailored feedback and direct navigation to local Federally Qualified Health Center partners including via school-based family clinics. These content and delivery elements of the mHealth intervention were the direct result of the multipronged, theoretically informed approach to translate an existing but generalized CRC knowledge-based intervention into a digital, self-paced, tailored intervention with links to local community cl","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Pediatric Experiences With Symptomatic Varicoceles: Mixed Methods Study of an Online Varicocele Community.","authors":"Grace E Sollender, Tommy Jiang, Ilana Finkelshtein, Vadim Osadchiy, Michael H Zheng, Jesse N Mills, Jennifer S Singer, Sriram V Eleswarapu","doi":"10.2196/50141","DOIUrl":"10.2196/50141","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Varicoceles affect up to 30% of postpubertal adolescent males. Studying this population remains difficult due to this topic's sensitive nature. Using the popularity of social media in this cohort and natural language processing (NLP) techniques, our aim was to identify perceptions of adolescent males on an internet varicocele forum to inform how physicians may better evaluate and counsel this pediatric population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to characterize themes of discussion and specific concerns expressed by adolescents using a mixed methods approach involving quantitative NLP and qualitative annotation of an online varicocele community.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We extracted posts from the Reddit community \"r/varicocele\" (5100 members) with criteria of discussant age ≤21 years and word count &gt;20. We used qualitative thematic analysis and the validated constant comparative method, as well as an NLP technique called the meaning extraction method with principal component analysis (MEM/PCA), to identify discussion themes. Two investigators independently interrogated 150 randomly selected posts to further characterize content based on NLP-identified themes and calculated the Kaiser-Meyer-Olkin (KMO) statistic and the Bartlett test. Both quantitative and qualitative approaches were then compared to identify key themes of discussion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1103 posts met eligibility criteria from July 2015 to June 2022. Among the 150 randomly selected posts, MEM/PCA and qualitative thematic analysis separately revealed key themes: an overview of varicocele (40/150, 27%), management (29/150, 19%), postprocedural experience (28/150, 19%), seeking community (26/150, 17%) and second opinions after visiting a physician (27/150, 18%). Quantitative analysis also identified \"hypogonadism\" and \"semen analysis\" as concerns when discussing their condition. The KMO statistic was &gt;0.60 and the Bartlett test was &lt;0.01, indicating the appropriateness of MEM/PCA. The mean age was 17.5 (SD 2.2; range 14-21) years, and there were trends toward higher-grade (40/45, 89% had a grade of ≥2) and left-sided varicoceles. Urologists were the topic of over 50% (53/82) of discussions among discussants, and varicocelectomy remained the intervention receiving the most interest. A total of 60% (90/150) of discussants described symptomatic varicoceles, with 62 of 90 reporting pain, 24 of 90 reporting hypogonadism symptoms, and 45 of 90 reporting aesthetics as the primary concern.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We applied a mixed methods approach to identify uncensored concerns of adolescents with varicoceles. Both qualitative and quantitative approaches identified that adolescents often turned to social media as an adjunct to doctors' visits and to seek peer support. This population prioritized symptom control, with an emphasis on pain, aesthetics, sexual function, and hypogonadism. These data highlight","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Marijuana Documentation Practices in Patient Electronic Health Records: A Retrospective Observational Study Using Smart Data Elements and Chart Review.","authors":"Donielle Beiler, Aanya Chopra, Christina Gregor, Lorraine D Tusing, Apoorva M Pradhan, Katrina M Romagnoli, Chadd K Kraus, Brian J Piper, Eric A Wright, Vanessa Troiani","doi":"10.2196/65957","DOIUrl":"https://doi.org/10.2196/65957","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Medical Marijuana (MMJ) is available in Pennsylvania (PA) and participation in the state-regulated program requires a patient to register and receive certification by an approved physician. There is currently no integration of MMJ certification data in PA into health records that would allow for clinicians to rapidly identify patients that are using MMJ, as there are with other scheduled drugs. This absence of a formal data sharing structure necessitates tools that aid in consistent documentation practices to enable comprehensive patient care. Customized smart data elements (SDEs) were made available to clinicians at an integrated health system, Geisinger, following MMJ legalization in PA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this project was to examine and contextualize the use of MMJ SDEs in the Geisinger population. We accomplished this goal by developing a systematic chart review protocol, with the goal of creating a tool that resulted in consistent human data extraction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We developed a chart review protocol for extracting MMJ-related information. The protocol was developed between August to December of 2022 and focused on a patient group that received one of several MMJ SDEs between 1/25/2019 and 5/26/2022. Characteristics were first identified on a small pilot sample of patients (n=5), which were then iteratively reviewed to optimize for consistency. Following the pilot, two reviewers were assigned 200 patient charts, selected randomly from the larger cohort, with a third reviewer examining a subsample (n=30) to determine reliability. We then summarized the clinician-level and patient-level features from 156 charts with a table-format SDE that best captured MMJ information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We found the chart review protocol was feasible for those with minimal medical background to complete, with high inter-rater reliability (Kappa = .966 (P&lt;.001), 95% CI (.954 - .978)). MMJ certification was largely documented by nurses and medical assistants (88.5%) and typically within primary care settings (68.6%). The SDE has six pre-set field prompts with heterogeneous documentation completion rates, including certifying conditions (93.6%), product (92.9%), authorized dispensary (87.8%), active ingredient (83.3%), certifying provider (61.5%), and dosage (30.8%). We found pre-set fields were overall well-recorded (76.6% across all fields). Primary diagnostic codes recorded at documentation encounters varied, with the most frequent being routine exams and testing (21.8%), musculoskeletal/nervous conditions (13.5%), and signs and symptoms not classified elsewhere (13.5%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This method of chart review yields high quality data extraction that can serve as a model for other health record inquiries. Our evaluation showed relatively high completeness of SDE fields, primarily by clinical staff responsible for rooming patients. Additiona","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465938","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":"Integrating Real-Time Air Quality Monitoring, Ecological Momentary Assessment, and Spirometry to Evaluate Asthma Symptoms: Usability Study.","authors":"Barbara Polivka, Kathryn Krueger, Olivia Bimbi, Luz Huntington-Moskos, Sharmilee Nyenhuis, Emily Cramer, Kamal Eldeirawi","doi":"10.2196/60147","DOIUrl":"10.2196/60147","url":null,"abstract":"<p><strong>Background: </strong>Individuals are exposed to a variety of indoor residential toxins including volatile organic compounds and particulates. In adults with asthma, such exposures are associated with asthma symptoms, asthma exacerbations, and decreased lung function. However, data on these exposures and asthma-related outcomes are generally collected at different times and not in real time. The integration of multiple platforms to collect real-time data on environmental exposure, asthma symptoms, and lung function has rarely been explored.</p><p><strong>Objective: </strong>This paper describes how adults with asthma perceive the acceptability and usability of three integrated devices: (1) residential indoor air quality monitor, (2) ecological momentary assessment (EMA) surveys delivered via a smartphone app, and (3) home spirometry, over 14 days.</p><p><strong>Methods: </strong>Participants (N=40) with uncontrolled asthma were mailed the Awair Omni indoor air quality monitor, ZEPHYRx home spirometer, and detailed instructions required for the in-home monitoring. The air quality monitor, spirometer, and EMA app were set up and tested during a videoconference or phone orientation with a research team member. Midway through the 14-day data collection period, participants completed an interview about the acceptability of the study devices or apps, instructional materials provided, and the setup process. At the end of the 14-day data collection period, participants completed a modified System Usability Scale. A random sample of 20 participants also completed a phone interview regarding the acceptability of the study and the impact of the study on their asthma.</p><p><strong>Results: </strong>Participants ranged in age from 26 to 77 (mean 45, SD 13.5) years and were primarily female (n=36, 90%), White (n=26, 67%), college graduates (n=25, 66%), and residing in a single-family home (n=30, 75%). Most indicated that the air quality monitor (n=23, 58%), the EMA (n=20, 50%), and the spirometer (n=17, 43%) were easy to set up and use. Challenges with the EMA included repetitive surveys, surveys arriving during the night, and technical issues. While the home spirometer was identified as a plausible means to evaluate lung function in real time, the interpretation of the readings was unclear, and several participants reported side effects from home spirometer use. Overall, the acceptability of the study and the System Usability Scale scores were high.</p><p><strong>Conclusions: </strong>The study devices were highly acceptable and usable. Participant feedback was instrumental in identifying technical challenges that should be addressed in future studies.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400265","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":"Design of a Temporally Augmented Text Messaging Bot to Improve Adolescents' Physical Activity and Engagement: Proof-of-Concept Study.","authors":"Adrian Ortega, Christopher C Cushing","doi":"10.2196/60171","DOIUrl":"10.2196/60171","url":null,"abstract":"<p><strong>Background: </strong>Digital interventions hold promise for improving physical activity in adolescents. However, a lack of empirical decision points (eg, timing of intervention prompts) is an evidence gap in the optimization of digital physical activity interventions.</p><p><strong>Objective: </strong>The study examined the feasibility and acceptability, as well as the technical and functional reliability, of and participant engagement with a digital intervention that aligned its decision points to occur during times when adolescents typically exercise. This study also explored the impact of the intervention on adolescents' moderate to vigorous physical activity (MVPA) levels. Consistent with the Obesity-Related Behavioral Interventions Trials (ORBIT) model, the primary goal of the study was to identify opportunities to refine the intervention for preparation for future trials.</p><p><strong>Methods: </strong>Ten adolescents completed a 7-day baseline monitoring period and Temporally Augmented Goal Setting (TAGS), a 20-day digital physical activity intervention that included a midday self-monitoring message that occurred when adolescents typically start to exercise (3 PM). Participants wore an accelerometer to measure their MVPA during the intervention. Participants completed questionnaires about the acceptability of the platform. Rates of recruitment and attrition (feasibility), user and technological errors (reliability), and engagement (average number of text message responses to the midday self-monitoring message) were calculated. The investigation team performed multilevel models to explore the effect of TAGS on MVPA levels from preintervention to intervention. In addition, as exploratory analyses, participants were matched to adolescents who previously completed a similar intervention, Network Underwritten Dynamic Goals Engine (NUDGE), without the midday self-monitoring message, to explore differences in MVPA between interventions.</p><p><strong>Results: </strong>The TAGS intervention was mostly feasible, acceptable, and technically and functionally reliable. Adolescents showed adequate levels of engagement. Preintervention to intervention changes in MVPA were small (approximately a 2-minute change). Exploratory analyses revealed no greater benefit of TAGS on MVPA compared with NUDGE.</p><p><strong>Conclusions: </strong>TAGS shows promise for future trials with additional refinements given its feasibility, acceptability, technical and functional reliability, participants' rates of engagement, and the relative MVPA improvements. Opportunities to strengthen TAGS include reducing the burden of wearing devices and incorporating of other strategies at the 3 PM decision point. Further optimization of TAGS will inform the design of a Just-in-Time Adaptive Intervention for adolescent physical activity and prepare the intervention for more rigorous testing.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400263","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}