JMIR Formative Research最新文献

{"title":"A Proposed mHealth Intervention to Address Patient Barriers to Colposcopy Attendance: Qualitative Interview Study of Clinic Staff and Patient Perspectives.","authors":"Jennifer R Hemler, Rachel B Wagner, Brittany Sullivan, Myneka Macenat, Erin K Tagai, Jazmarie L Vega, Enrique Hernandez, Suzanne M Miller, Kuang-Yi Wen, Charletta A Ayers, Mark H Einstein, Shawna V Hudson, Racquel E Kohler","doi":"10.2196/55043","DOIUrl":"10.2196/55043","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer disparities persist among minoritized women due to infrequent screening and poor follow-up. Structural and psychosocial barriers to following up with colposcopy are problematic for minoritized women. Evidence-based interventions using patient navigation and tailored telephone counseling, including the Tailored Communication for Cervical Cancer Risk (TC3), have modestly improved colposcopy attendance. However, the efficacious TC3 intervention is human resource-intense and could have greater reach if adapted for mobile health, which increases convenience and access to health information.</p><p><strong>Objective: </strong>This study aimed to describe feedback from clinic staff members involved in colposcopy processes and patients referred for colposcopy regarding adaptions to the TC3 phone-based intervention to text messaging, which addresses barriers among those referred for colposcopy after abnormal screening results.</p><p><strong>Methods: </strong>Semistructured depth qualitative interviews were conducted over Zoom [Zoom Communications, Inc] or telephone with a purposive sample of 22 clinic staff members (including clinicians and support staff members) and 34 patients referred for colposcopy from 3 academic obstetrics and gynecology (OB-GYN) clinics that serve predominantly low-income, minoritized patients in different urban locations in New Jersey and Pennsylvania. Participants were asked about colposcopy attendance barriers and perspectives on a proposed text message intervention to provide tailored education and support in the time between abnormal cervical screening and colposcopy. The analytic team discussed interviews, wrote summaries, and consensus-coded transcripts, analyzing output for emergent findings and crystallizing themes.</p><p><strong>Results: </strong>Clinic staff members and patients had mixed feelings about a text-only intervention. They overwhelmingly perceived a need to provide patients with appointment reminders and information about abnormal cervical screening results and colposcopy purpose and procedure. Both groups also thought messages emphasizing that human papillomavirus is common and cervical cancer can be prevented with follow-up could enhance attendance. However, some had concerns about the privacy of text messages and text fatigue. Both groups thought that talking to clinic staff members was needed in certain instances; they proposed connecting patients experiencing complex psychosocial or structural barriers to staff members for additional information, psychological support, and help with scheduling around work and finding childcare and transportation solutions. They also identified inadequate scheduling and reminder systems as barriers. From this feedback, we revised our text message content and intervention design, adding a health coaching component to support patients with complex barriers and concerns.</p><p><strong>Conclusions: </strong>Clinic staff members an","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e55043"},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978552","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":"Acceptance, Safety, and Effect Sizes in Online Dialectical Behavior Therapy for Borderline Personality Disorder: Interventional Pilot Study.","authors":"Ruben Vonderlin, Tali Boritz, Carola Claus, Büsra Senyüz, Saskia Mahalingam, Rachel Tennenhouse, Stefanie Lis, Christian Schmahl, Jürgen Margraf, Tobias Teismann, Nikolaus Kleindienst, Shelley McMain, Martin Bohus","doi":"10.2196/66181","DOIUrl":"10.2196/66181","url":null,"abstract":"<p><strong>Background: </strong>The potential of telehealth psychotherapy (ie, the online delivery of treatment via a video web-based platform) is gaining increased attention. However, there is skepticism about its acceptance, safety, and efficacy for patients with high emotional and behavioral dysregulation.</p><p><strong>Objective: </strong>This study aims to provide initial effect size estimates of symptom change from pre- to post treatment, and the acceptance and safety of telehealth dialectical behavior therapy (DBT) for individuals diagnosed with borderline personality disorder (BPD).</p><p><strong>Methods: </strong>A total of 39 individuals meeting the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) criteria for BPD received 1 year of outpatient telehealth DBT at 3 sites in Germany and Canada. Effect size estimates were assessed using pre-post measures of BPD symptoms, dissociation, and quality of life. Safety was evaluated by analyzing suicide attempts and self-harm. Additionally, acceptance and feasibility, satisfaction with treatment, useability of the telehealth format, and the quality of the therapeutic alliance were assessed from both therapists' and patients' perspectives. All analyses were conducted on both the intention-to-treat (ITT) and according-to-protocol (ATP) samples.</p><p><strong>Results: </strong>Analyses showed significant and large pre-post effect sizes for BPD symptoms (d=1.13 in the ITT sample and d=1.44 in the ATP sample; P<.001) and for quality of life (d=0.65 in the ITT sample and d=1.24 in the ATP sample). Dissociative symptoms showed small to nonsignificant reductions. Self-harm behaviors decreased significantly from 80% to 28% of all patients showing at least 1 self-harm behavior in the last 10 weeks (risk ratio 0.35). A high dropout rate of 38% was observed. One low-lethality suicide attempt was reported. Acceptance, feasibility, and satisfaction measures were high, although therapists reported only moderate useability of the telehealth format.</p><p><strong>Conclusions: </strong>Telehealth DBT for BPD showed large pre-post effect sizes for BPD symptoms and quality of life. While the telehealth format appeared feasible and well-accepted, the dropout rate was relatively high. Future research should compare the efficacy of telehealth DBT with in-person formats in randomized controlled trials. Overall, telehealth DBT might offer a potentially effective alternative treatment option, enhancing treatment accessibility. However, strategies for decreasing drop-out should be considered.</p><p><strong>Trial registration: </strong>German Clinical Trials Register DRKS00027824; https://drks.de/search/en/trial/DRKS00027824.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66181"},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983641","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":"Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey Study.","authors":"Keigo Inagaki, Daisuke Tsuriya, Takuya Hashimoto, Katsumasa Nakamura","doi":"10.2196/62772","DOIUrl":"10.2196/62772","url":null,"abstract":"<p><strong>Background: </strong>One method for noninvasive and simple urinary microalbumin testing is urine test strips. However, when visually assessing urine test strips, accurate assessment may be difficult due to environmental influences-such as lighting color and intensity-and the physical and psychological influences of the assessor. These complicate the formation of an objective assessment.</p><p><strong>Objectives: </strong>This study developed an \"automated urine test strip colorimetric program\" (hereinafter referred to as \"this program\") to objectively assess urine test strips. Using this program may allow urine tests to be conducted at home. In this study, urine samples from hospitalized or outpatient patients were randomly obtained, and the reliability of this program was verified by comparing the agreement rate between this program and an automatic urine analyzer (US-3500 [Eiken Chemical Co, Ltd] and LABOSPECT 006 [Hitachi High-Tech Co, Ltd]). Furthermore, the sensitivity and specificity of the urine albumin test were investigated, and its applicability to screening for microalbuminuria was verified.</p><p><strong>Methods: </strong>A urine test strip was placed in a photography box with constant light intensity and color temperature conditions. The image taken with a smartphone camera on top of the photography box was judged by this program. This program used Accelerated KAZE to perform image-matching processing to reduce the effect of misalignment during photography. It also calculated and judged the item with the smallest color difference between the color chart and the urine test strip using the CIEDE2000 color difference formula. The agreement rate of the results of this program was investigated using the results of an automatic urine analyzer as the gold standard.</p><p><strong>Results: </strong>Compared with the judgments of an automatic urine analyzer, the average agreement rate for 12 items (protein, glucose, urobilinogen, bilirubin, ketone bodies, specific gravity, occult blood, pH, white blood cells, nitrite, creatinine, and albumin) was 78.6%. Furthermore, the average agreement rate of the 12 items within ±1 rank was 95.4%. The results showed a sensitivity of 100% and a specificity of 58.6% in determining albumin in urine, which is important for determining the stage of diabetic nephropathy. Finally, the area under the curve (0.907) derived from the receiver operating characteristic curve was satisfactory.</p><p><strong>Conclusions: </strong>The program developed by the authors can determine urine test strips without requiring calibration in a certain shooting environment. If this program can be used at home to perform urinary microalbumin tests, the early detection and treatment of diabetic nephropathy may prevent the condition from becoming severe.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e62772"},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983666","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 the General Acceptability and User Experience of a Digital Therapeutic for Cognitive Training in a Singaporean Older Adult Population: Qualitative Study.","authors":"Siong Peng Kwek, Qiao Ying Leong, V Vien Lee, Ni Yin Lau, Smrithi Vijayakumar, Wei Ying Ng, Bina Rai, Marlena Natalia Raczkowska, Christopher L Asplund, Alexandria Remus, Dean Ho","doi":"10.2196/63568","DOIUrl":"10.2196/63568","url":null,"abstract":"<p><strong>Background: </strong>Singapore's large aging population poses significant challenges for the health care system in managing cognitive decline, underscoring the importance of identifying and implementing effective interventions. Cognitive training delivered remotely as a digital therapeutic (DTx) may serve as a scalable and accessible approach to overcoming these challenges. While previous studies indicate the potential of cognitive training as a promising solution for managing cognitive decline, understanding the attitudes and experiences of older adults toward using such DTx platforms remains relatively unexplored.</p><p><strong>Objective: </strong>This study aimed to characterize the general acceptability and user experience of CURATE.DTx, a multitasking-based DTx platform that challenges the cognitive domains of attention, problem-solving, and executive function in the Singaporean older adult population.</p><p><strong>Methods: </strong>A total of 15 older adult participants (mean age 66.1, SD 3.5 years) were recruited for a 90-minute in-person session. This session included a 30-minute playtest of CURATE.DTx, followed by a 60-minute semistructured interview to understand their overall attitudes, experience, motivation, and views of the intervention. Interviews were audio-recorded and transcribed verbatim, then analyzed using an inductive approach. Thematic analysis was used to identify emerging patterns and insights.</p><p><strong>Results: </strong>A total of 3 main themes, and their respective subthemes, emerged from the interviews: comprehension, with subthemes of instruction and task comprehension; acceptability, with subthemes of tablet usability, engagement and enjoyment, and attitude and perceived benefits; and facilitators to adoption, with subthemes of framing and aesthetics, motivation recommendations and the role of medical professionals. Our findings revealed that participants encountered some challenges with understanding certain elements of CURATE.DTx. Nevertheless, they were still highly engaged with it, finding the challenge to be enjoyable. Participants also showed a strong awareness of the importance of cognitive training and expressed a keen interest in using CURATE.DTx for this purpose, especially if recommended by medical professionals.</p><p><strong>Conclusions: </strong>Given the positive engagement and feedback obtained from Singaporean older adults on CURATE.DTx, this study can serve as a basis for future platform iterations and strategies that should be considered during implementation. Future studies should continue implementing an iterative codesign approach to ensure the broader applicability and effectiveness of interventions tailored to this demographic.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63568"},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978565","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 and Beta Validation of an mHealth-Based Hearing Screener (SRESHT) for Young Children in Resource-Limited Countries: Pilot Validation Study.","authors":"Vidya Ramkumar, Deepashree Joshi B, Anil Prabhakar, James W Hall, Ramya Vaidyanath","doi":"10.2196/53460","DOIUrl":"10.2196/53460","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The prevalence of hearing loss in infants in India varies between 4 and 5 per 1000. Objective-based otoacoustic emissions and auditory brainstem response have been used in high-income countries for establishing early hearing screening and intervention programs. Nevertheless, the use of objective screening tests in low- and middle-income countries (LMICs) such as India is not feasible. Mobile health (mHealth) solutions have been demonstrated to be a viable option for hearing screening in LMICs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to develop and beta-validate an affordable hearing screener for children younger than 6 years of age to identify moderately severe or higher degrees of hearing loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In phase 1, a mHealth-based hearing screener (SRESHT) was developed using a single board computer with wireless commercial headphones and speakers as transducers, which were calibrated according to the standard procedure. Three subjective hearing screening modules were conceptualized and developed for different age groups: (1) behavioral observation audiometry-screening for infants aged from 0 to 1 year; (2) speech spectrum awareness task-screening for children 1 to 3 years old; and (3) speech recognition task-screening for children 3 to 6 years old. Different auditory stimuli for the screening modules were generated and suitability was assessed: (1) noisemakers, animal sounds, and environmental sounds for infants (birth to 1 year old); (2) animal sounds and nonsense syllables for children (1 to 3 years old); and (3) eighteen picturable spondee words for children (3 to 6 years old). In phase 2, the SRESHT screener was beta-validated in children aged below 6 years to establish the agreement between SRESHT modules and the gold-standard procedure in identifying moderately severe and higher degrees of hearing loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Off-the-shelf commercial speakers and headphones were selected and calibrated. On comparison of stimuli for behavioral observation audiometry on 15 children, Noisemaker stimuli were found suitable based on the average minimum response levels. On comparison of different stimuli for speech spectrum awareness task on 15 children, animal sounds were found to be suitable. On familiarity check of 18 spondee words for speech recognition task among 20 children, 12 spondee words had the eligibility cutoff (85%) and a presentation level of 5 dB SL (re-pure tone threshold) was sufficient to achieve 80% psychometric function. In phase 2, a total of 55 children aged 0 to 6 years (31 normal hearing and 24 hearing impairment) underwent SRESHT screening for beta validation. Cohen κ indicated that the overall SRESHT screener had a very good agreement (κ=0.82) with gold-standard audiometric screening for identifying moderately severe and higher degrees of hearing loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The development and beta validation of the SRESHT screener","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e53460"},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978556","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 Preventive Intravenous Amiodarone on Reperfusion Ventricular Fibrillation in Patients With Left Ventricular Hypertrophy Undergoing Open-Heart Surgery: Randomized Controlled Clinical Trial.","authors":"Chan-Juan Gong, Xiao-Kai Zhou, Zhen-Feng Zhang, Yin Fang","doi":"10.2196/64586","DOIUrl":"10.2196/64586","url":null,"abstract":"<p><strong>Background: </strong>Ventricular fibrillation (VF) is a vicious arrhythmia usually generated after removal of the aortic cross-clamp (ACC) in patients undergoing open-heart surgery, which could damage cardiomyocytes, especially in patients with left ventricular hypertrophy (LVH). Amiodarone has the prominent properties of converting VF and restoring sinus rhythm. However, few studies concentrated on the effect of amiodarone before ACC release on reducing VF in patients with LVH.</p><p><strong>Objective: </strong>The study was designed to explore the effectiveness of prophylactic intravenous amiodarone in reducing VF after the release of the ACC in patients with LVH.</p><p><strong>Methods: </strong>A total of 54 patients with LVH scheduled for open-heart surgery were enrolled and randomly divided (1:1) into 2 groups-group A (amiodarone group) and group P (placebo-controlled group). Thirty minutes before removal of the ACC, the trial drugs were administered intravenously. In group A, 150 mg of amiodarone was pumped in 15 minutes. In group P, the same volume of normal saline was pumped in 15 minutes. The primary outcome was the incidence of VF 10 minutes after removal of the ACC.</p><p><strong>Results: </strong>The incidence of VF was lower in group A than in group P (30% vs 70%, P=.003). The duration of VF, the number of defibrillations, and the defibrillation energy were also lower in group A than in group P (P<.001, P=.002, and P=.002, respectively). After the end of cardiopulmonary bypass, the heart rate and mean arterial pressure were lower in group A, and the mean pulmonary arterial pressure and the dose of vasoactive drugs were higher than those in group P (P<.001, P<.001, P=.04, and P=.02, respectively). However, there were no significant differences in the use of vasoactive-inotropic agents and hemodynamic status between the 2 groups before the end of surgery.</p><p><strong>Conclusions: </strong>In patients with LVH who undergo open-heart surgery, amiodarone can be safely used to reduce the incidence of VF, the duration of VF, the frequency of defibrillation, and the energy of defibrillation after ACC removal.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64586"},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978573","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":"Identification of Behavioral, Clinical, and Psychological Antecedents of Acute Stimulant Poisoning: Development and Implementation of a Mixed Methods Psychological Autopsy Study.","authors":"Marley Antolin Muñiz, Vanessa M McMahan, Xochitl Luna Marti, Sarah Brennan, Sophia Tavasieff, Luke N Rodda, James Knoll, Phillip O Coffin","doi":"10.2196/64873","DOIUrl":"https://doi.org/10.2196/64873","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing fatal stimulant poisoning in the United States, little is understood about the mechanism of death. The psychological autopsy (PA) has long been used to distinguish the manner of death in equivocal cases, including opioid overdose, but has not been used to explicitly explore stimulant mortality.</p><p><strong>Objective: </strong>We aimed to develop and implement a large PA study to identify antecedents of fatal stimulant poisoning, seeking to maximize data gathering and ethical interactions during the collateral interviews.</p><p><strong>Methods: </strong>We ascertained death records from the California Electronic Death Reporting System (CA-EDRS) and the San Francisco Office of the County Medical Examiner (OCME) from June 2022 through December 2023. We selected deaths determined to be due to acute poisoning from cocaine or methamphetamine, which occurred 3-12 months prior and were not attributed to suicide or homicide. We identified 31 stimulant-fentanyl and 70 stimulant-no-opioid decedents. We sought 2 informants for each decedent, who were able to describe the decedent across their life course. Informants were at least 18 years of age, communicated with the decedent within the year before death, and were aware that the decedent had been using substances during that year. Upon completion of at least one informant interview conducted by staff with bachelor's or master's degrees, we collected OCME, medical record, and substance use disorder treatment data for the decedent. Planned analyses include least absolute shrinkage and selection operator regressions of quantitative data and thematic analyses of qualitative data.</p><p><strong>Results: </strong>We identified and interviewed at least one informant (N=141) for each decedent (N=101). Based on feedback during recruitment, we adapted language to improve rapport, including changing the term \"accidental death\" to \"premature death,\" offering condolences, and providing content warnings. As expected, family members were able to provide more data about the decedent's childhood and adolescence, and nonfamily informants provided more data regarding events proximal to death. We found that the interviews were stressful for both the interviewee and interviewer, especially when participants thought the study was intrusive or experienced significant grief during the interviews.</p><p><strong>Conclusions: </strong>In developing and implementing PA research on fatal stimulant poisoning, we noted the importance of recruitment language regarding cause of death and condolences with collateral informants. Compassion and respect were critical to facilitate the interview process and maintain an ethical framework. We discuss several barriers to success and lessons learned while conducting PA interviews, as well as recommendations for future PA studies.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e64873"},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005723","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":"Healthy Kai (Food) Checker Web-Based Tool to Support Healthy Food Policy Implementation: Development and Usability Study.","authors":"Magda Rosin, Cliona Ni Mhurchu, Elaine Umali, Sally Mackay","doi":"10.2196/60447","DOIUrl":"10.2196/60447","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Public health programs and policies can positively influence food environments. In 2016, a voluntary National Healthy Food and Drink Policy was released in New Zealand to improve the healthiness of food and drinks for hospital staff and visitors. However, no resources were developed to support policy implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to design, develop, and test a new web-based tool to support food providers implementing the National Healthy Food and Drink Policy in New Zealand.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Double Diamond model, a structured framework with 4 design phases, was used to design and develop a web-based tool. Findings from our previous research, such as (1) systematic review of barriers and facilitators to workplace healthy food policy implementation; (2) scoping review of current tools and resources available in New Zealand, Australia, and Canada; (3) interviews with food providers and public health nutrition professionals; and (4) food and drink availability audit results in New Zealand hospitals were used in the \"Discover\" (understanding of current gaps) and \"Define\" (prioritizing functions and features) phases. Subsequent phases focused on generating ideas, creating prototypes, and testing a new web-based tool using Figma, a prototyping tool. During the \"Develop\" phase, project stakeholders (11 public health nutrition professionals) provided feedback on the basic content outline of the initial low-fidelity prototype. In the final \"Deliver\" phase, a high-fidelity prototype resembling the appearance and functionality of the final tool was tested with 3 end users (public health nutrition professionals) through interactive interviews, and user suggestions were incorporated to improve the tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A new digital tool, Healthy Kai (Food) Checker-a searchable database of packaged food and drink products that classifies items according to the Policy's nutritional criteria-was identified as a key tool to support Policy implementation. Of 18 potential functions and features, 11 were prioritized by the study team, including basic and advanced searches for products, sorting list options, the ability to compile a list of selected products, a means to report products missing from the database, and ability to use on different devices. Feedback from interview participants was that the tool was easy to use, was logical to navigate, and had an appealing color scheme. Suggested visual and usability improvements included ensuring that images represented the diverse New Zealand population, reducing unnecessary clickable elements, adding information about the free registration option, and including more frequently asked questions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Comprehensive research informed the development of a new digital tool to support implementation of the National Healthy Food and Drink Policy. Testing with end users identified features that ","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60447"},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978570","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":"Unified Mobile App for Streamlining Verbal Autopsy and Cause of Death Assignment in India: Design and Development Study.","authors":"Harleen Kaur, Stuti Tripathi, Manjeet Singh Chalga, Sudhir K Benara, Amit Dhiman, Shefali Gupta, Saritha Nair, Geetha Menon, B K Gulati, Sandeep Sharma, Saurabh Sharma","doi":"10.2196/59937","DOIUrl":"10.2196/59937","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Verbal autopsy (VA) has been a crucial tool in ascertaining population-level cause of death (COD) estimates, specifically in countries where medical certification of COD is relatively limited. The World Health Organization has released an updated instrument (Verbal Autopsy Instrument 2022) that supports electronic data collection methods along with analytical software for assigning COD. This questionnaire encompasses the primary signs and symptoms associated with prevalent diseases across all age groups. Traditional methods have primarily involved paper-based questionnaires and physician-coded approaches for COD assignment, which is time-consuming and resource-intensive. Although computer-coded algorithms have advanced the COD assignment process, data collection in densely populated countries like India remains a logistical challenge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop an Android-based mobile app specifically tailored for streamlining VA data collection by leveraging the existing Indian public health workforce. The app has been designed to integrate real-time data collection by frontline health workers and seamless data transmission and digital reporting of COD by physicians. This process aimed to enhance the efficiency and accuracy of COD assignment through VA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The app was developed using Android Studio, the primary integrated development environment for developing Android apps using Java. The front-end interface was developed using XML, while SQLite and MySQL were employed to streamline complete data storage on the local and server databases, respectively. The communication between the app and the server was facilitated through a PHP application programming interface to synchronize data from the local to the server database. The complete prototype was specifically built to reduce manual intervention and automate VA data collection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The app was developed to align with the current Indian public health system for district-level COD estimation. By leveraging this mobile app, the average duration required for VA data collection to ascertainment of COD, which typically ranges from 6 to 8 months, is expected to decrease by approximately 80%, reducing it to about 1-2 months. Based on annual caseload projections, the smallest administrative public health unit, health and wellness centers, is anticipated to handle 35-40 VA cases annually, while medical officers at primary health centers are projected to manage 150-200 physician-certified VAs each year. The app's data collection and transmission efficiency were further improved based on feedback from user and subject area experts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The development of a unified mobile app could streamline the VA process, enabling the generation of accurate national and subnational COD estimates. This mobile app can be further piloted and scaled to different regions to","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e59937"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023024","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":"Analysis of Social Performance and Action Units During Social Skills Training: Focus Group Study of Adults With Autism Spectrum Disorder and Schizophrenia.","authors":"Hiroki Tanaka, Kana Miyamoto, Jennifer Hamet Bagnou, Elise Prigent, Céline Clavel, Jean-Claude Martin, Satoshi Nakamura","doi":"10.2196/59261","DOIUrl":"10.2196/59261","url":null,"abstract":"<p><strong>Background: </strong>Social communication is a crucial factor influencing human social life. Quantifying the degree of difficulty faced in social communication is necessary for understanding developmental and neurological disorders and for creating systems used in automatic symptom screening and assistive methods such as social skills training (SST). SST by a human trainer is a well-established method. Previous SST used a modified roleplay test to evaluate human social communication skills. However, there are no widely accepted evaluation criteria or social behavioral markers to quantify social performance during SST.</p><p><strong>Objective: </strong>This paper has 2 objectives. First, we propose applying the Social Performance Rating Scale (SPRS) to SST data to measure social communication skills. We constructed a Japanese version of the SPRS already developed in English and French. Second, we attempt to quantify action units during SST for people with autism spectrum disorder (ASD) or schizophrenia.</p><p><strong>Methods: </strong>We used videos of interactions between trainers, adults with ASD (n=16) or schizophrenia (n=15), and control participants (n=19) during SST sessions. Two raters applied the proposed scale to annotate the collected data. We investigated the differences between roleplay tasks and participant groups (ASD, schizophrenia, and control). Furthermore, the intensity of action units on the OpenFace toolkit was measured in terms of mean and SD during SST roleplaying.</p><p><strong>Results: </strong>We found significantly greater gaze scores in adults with ASD than in adults with schizophrenia. Differences were also found between the ratings of different tasks in the adults with schizophrenia and the control participants. Action units numbered AU06 and AU12 were significantly deactivated in people with schizophrenia compared with the control group. Moreover, AU02 was significantly activated in people with ASD compared with the other groups.</p><p><strong>Conclusions: </strong>The results suggest that the SPRS can be a useful tool for assessing social communication skills in different cultures and different pathologies when used with the modified roleplay test. Furthermore, facial expressions could provide effective social and behavioral markers to characterize psychometric properties. Possible future directions include using the SPRS for assessing social behavior during interaction with a digital agent.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e59261"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970977","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}