JMIR Formative Research最新文献

{"title":"Identifying Themes for an Initial Beta Version of a Mobile Health App for Latino and Native Hawaiian/Pacific Islander Communities: Co-Design and Community-Based Participatory Research in a Code to Community Study.","authors":"Christina K Holub, Amy L Barrera, Rosalva Romero Gonzalez, Diane Hoang, Luna Prieto, Samuelu Fesili, Tiana Smith, Harleen Kaur, Cassandra Surban, Michael Markidis, Tana Lepule, Konane Martinez","doi":"10.2196/76178","DOIUrl":"10.2196/76178","url":null,"abstract":"<p><p>Through a co-design and community-based participatory approach with Latino and Native Hawaiian/Pacific Islander communities, we identified key themes for an initial beta version of a mobile health app, including priorities regarding mental health, access to resources, and chronic disease prevention. Social and cultural connectedness and generational approaches emerged as important strategies for successful intervention design and long-term adoption.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":" ","pages":"e76178"},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159204","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":"Improving Suicidal Ideation Detection in Social Media Posts: Topic Modeling and Synthetic Data Augmentation Approach.","authors":"Hamideh Ghanadian, Isar Nejadgholi, Hussein Al Osman","doi":"10.2196/63272","DOIUrl":"10.2196/63272","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In an era dominated by social media conversations, it is pivotal to comprehend how suicide, a critical public health issue, is discussed online. Discussions around suicide often highlight a range of topics, such as mental health challenges, relationship conflicts, and financial distress. However, certain sensitive issues, like those affecting marginalized communities, may be underrepresented in these discussions. This underrepresentation is a critical issue to investigate because it is mainly associated with underserved demographics (eg, racial and sexual minorities), and models trained on such data will underperform on such topics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objective of this study was to bridge the gap between established psychology literature on suicidal ideation and social media data by analyzing the topics discussed online. Additionally, by generating synthetic data, we aimed to ensure that datasets used for training classifiers have high coverage of critical risk factors to address and adequately represent underrepresented or misrepresented topics. This approach enhances both the quality and diversity of the data used for detecting suicidal ideation in social media conversations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We first performed unsupervised topic modeling to analyze suicide-related data from social media and identify the most frequently discussed topics within the dataset. Next, we conducted a scoping review of established psychology literature to identify core risk factors associated with suicide. Using these identified risk factors, we then performed guided topic modeling on the social media dataset to evaluate the presence and coverage of these factors. After identifying topic biases and gaps in the dataset, we explored the use of generative large language models to create topic-diverse synthetic data for augmentation. Finally, the synthetic dataset was evaluated for readability, complexity, topic diversity, and utility in training machine learning classifiers compared to real-world datasets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our study found that several critical suicide-related topics, particularly those concerning marginalized communities and racism, were significantly underrepresented in the real-world social media data. The introduction of synthetic data, generated using GPT-3.5 Turbo, and the augmented dataset improved topic diversity. The synthetic dataset showed levels of readability and complexity comparable to those of real data. Furthermore, the incorporation of the augmented dataset in fine-tuning classifiers enhanced their ability to detect suicidal ideation, with the F&lt;sub&gt;1&lt;/sub&gt;-score improving from 0.87 to 0.91 on the University of Maryland Reddit Suicidality Dataset test subset and from 0.70 to 0.90 on the synthetic test subset, demonstrating its utility in improving model accuracy for suicidal narrative detection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our results demonstrate that","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63272"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274877","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":"Using Ecological Momentary Assessment to Assess Family Functioning in Spanish-Speaking Parent and Adolescent Dyads: Daily Questionnaire Study.","authors":"Alejandra Fernandez, Savannah Bernal, Lana Kim, Subodh Potla","doi":"10.2196/60073","DOIUrl":"10.2196/60073","url":null,"abstract":"<p><strong>Background: </strong>Family functioning is associated with several adolescent health outcomes, and many family-based interventions (FBIs) exist to improve family functioning. However, most FBIs assess family functioning retrospectively at baseline and post intervention, thereby overlooking the daily fluctuations in family functioning throughout the intervention. Ecological momentary assessment (EMA) is a method involving a high frequency of assessments and has been underused to assess family functioning across parent and adolescent dyads. Further, limited research exists on the use of EMA in bilingual populations.</p><p><strong>Objective: </strong>The purpose of this study was to assess an EMA protocol's feasibility and acceptability and to analyze within-person and between-person variance in family functioning reports in a sample of primarily Spanish-speaking parent and adolescent dyads.</p><p><strong>Methods: </strong>Participants completed a baseline assessment (including demographics and family functioning assessment), a 7-day protocol with a once-daily family assessment questionnaire using an EMA app, and an acceptability questionnaire at the conclusion of the study.</p><p><strong>Results: </strong>We recruited 7 mothers (mean age 37.29, SD 3.82 years) and 8 adolescents (n=7, 88% females; mean age 11.86, SD 1.07 years) who identified themselves as Hispanic/Latinx. The participants showed overall satisfaction with the EMA protocol. The daily assessments were completed relatively quickly (mean 3 minutes and 16 seconds, SD 11 minutes and 5 seconds) after the prompt notification was received, and the response rate across the daily assessments was 90% (87/97). The reported family functioning was relatively high across both adolescents (mean 4.57) and parents (mean 4.59). The variance across adolescents (SD 0.459) was larger than that within their individual reports of family functioning (SD 0.122). Alternatively, the variance across parents was smaller (SD 0.132) than that reported among parents' individual reports of family functioning (SD 0.286). Our findings highlight the heterogeneity between adolescent and parent responses. Finally, the visual inspection of data underscored the individualized patterns and reported differences in the family functioning reports across parents and adolescents.</p><p><strong>Conclusions: </strong>Our findings emphasize the value of EMA in studying family (eg, adolescent-caregiver) behaviors. EMA's ability to capture immediate experiences presents a nuanced picture of daily interactions and offers suggestions for practice when using the EMA methodology in populations such as the one included in this study (ie, primarily Spanish-speaking parent-adolescent dyads).</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e60073"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274880","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":"Impacts of the Mindfulness Meditation Mobile App Calm on Undergraduate Students' Sleep and Emotional State: Pilot Randomized Controlled Trial.","authors":"Tovan Lew, Natnaiel M Dubale, Erik Doose, Alex Adenuga, Holly E Bates, Sarah L West","doi":"10.2196/66131","DOIUrl":"10.2196/66131","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Undergraduate students frequently experience negative emotional states and sleep quality, which is believed to have worsened following the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study piloted the use of a popular mobile mindfulness app (Calm) as a potential intervention to improve state depression, anxiety, stress, and sleep quality in undergraduate students attending a Canadian university, following the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Undergraduate students were randomly assigned to a control or treatment group and completed a series of 3 questionnaires to evaluate baseline state emotional health (Depression Anxiety Stress Scale 42-Item Version [DASS-42], Perceived Stress Scale 10-Item Version [PSS-10], and Pittsburgh Sleep Quality Index). Treatment group participants were instructed to engage with the fully-automated Calm app's sleep section for 30 days: 20 minutes daily, 5 days a week, along with an additional 30 minutes of interaction with other app sections each week, resulting in a goal of 130 minutes per week. The control participants were instructed to continue with everyday life and refrain from the use of mindfulness-based apps for 30 days. Following the 30-day treatment period, all participants repeated the 3 questionnaires. The impact of the treatment on all outcomes was examined using linear mixed model analyses. Independent samples t tests were used to determine if psychosocial health or sleep scores differed between baseline and follow-up and if differences in such scores were present between the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 80 students met the inclusion criteria and were randomly assigned to the control (n=40) or treatment (n=40) group. One control participant was lost to follow-up and 3 treatment participants discontinued engaging with the Calm app. Both control (n=39) and treatment (n=37) groups began with similar demographic, emotional state, and sleep characteristics. Treatment participants engaged with the Calm app's sleep section for an average of 234 minutes per week; however, 54% (20/37) met the minimum prescribed interaction time across all 4 weeks. Following the 30-day treatment period, compared to the control group, the treatment group's state anxiety (mean 14, SD 7.4 vs mean 12, SD 7.8; P=.002), state stress (DASS-42: mean 20, SD 8.8 vs mean 15, SD 8.5; P&lt;.001; PSS-10: mean 22, SD 5.9 vs mean 19, SD 5.9; P=.02), and sleep quality (mean 7.7, SD 2.7 vs mean 6.4, SD 3.5; P&lt;.001) improved. Posttreatment, state stress and perceived stress severity was lower in the treatment versus control group (DASS-42: P=.02; PSS-10: P=.03, respectively).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These pilot findings indicate that a mindfulness app may be an effective tool for reducing state anxiety and stress, as well as enhancing sleep quality among undergraduate university students. A larger, randomized controlled trial should confirm these findings.&lt;","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66131"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Individually Tailored Internet-Based Cognitive Behavioral Therapy During the COVID-19 Pandemic: Qualitative Interview Study.","authors":"Victoria Aminoff, Matilda Baltius, Emelie Lundström, Matilda Berg, Gerhard Andersson, Mikael Ludvigsson","doi":"10.2196/66908","DOIUrl":"10.2196/66908","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, both physical and psychological health were at risk. Internet-based cognitive behavioral therapy (ICBT) is a psychological treatment alternative that does not inherently increase the risk of virus transmission because face-to-face interactions are not required. ICBT has been found to be effective for a variety of mental health problems, both before and during the COVID-19 pandemic. Although the experiences of undergoing ICBT have been investigated in previous studies, the specific experiences of participating in ICBT during the COVID-19 pandemic have been less examined.</p><p><strong>Objective: </strong>This qualitative study aimed to investigate the experiences of participants undergoing individually tailored ICBT with weekly therapist support during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We approached trial participants who had received ICBT for psychological symptoms related to the COVID-19 pandemic during the summer of 2020. A strategic sample, based on the number of log-ins to the treatment platform, among other factors, was selected in an effort to achieve the highest possible variation. Semistructured telephone interviews were conducted 4 to 6 months after treatment completion, depending on whether the participant was initially assigned to the treatment or control group. Data were transcribed and then analyzed based on thematic analysis.</p><p><strong>Results: </strong>A total of 16 participants aged between 23 and 78 years were interviewed. Four main themes and 10 subthemes were derived from the thematic analysis: (1) functions of the treatment (initiating and motivating, perspective widening), (2) treatment equals work (experience of the treatment as demanding, going from text to action, posttreatment engagement, participant agency), (3) changes experienced (changes in relation to the COVID-19 pandemic, other changes not related to the COVID-19 pandemic), and (4) wishing for something else (individually tailored, contact with the therapist).</p><p><strong>Conclusions: </strong>The results closely align with those of previous qualitative studies on experiences of ICBT. Participants expressed appreciation of the treatment's content and format. Suggestions and wishes for changes were also expressed in the interviews. However, a unique finding was that participants described experiencing changes in well-being related to the COVID-19 pandemic. At the same time, there were also reports of changes in other symptoms not related to the pandemic. Further studies are needed on the experiences of participants who drop out of ICBT and the type of therapist contact they prefer.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66908"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274904","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":"Smartphone Ecological Momentary Assessment and Wearable Activity Tracking in Pediatric Depression: Cohort Study.","authors":"Jimena Unzueta Saavedra, Emma A Deaso, Margot Austin, Laura Cadavid, Rachel Kraff, Emma E M Knowles","doi":"10.2196/66187","DOIUrl":"10.2196/66187","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adolescent depression is a significant public health concern. The presentation of depressive symptoms varies widely among individuals, fluctuating in intensity over time. Ecological momentary assessment (EMA) offers a unique advantage by enhancing ecological validity and reducing recall bias, allowing for a more accurate and nuanced understanding of major depressive disorder (MDD) symptoms. This methodology provides valuable insights into the fluctuating nature of depression, which could inform more personalized and timely interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to (1) evaluate the feasibility of collecting smartphone-based EMA data alongside activity and sleep tracking in adolescents with depression; (2) investigate the severity and variability of mood symptoms reported over time; and (3) explore the relationship between mood, activity, and sleep.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty-six participants (23 with MDD, 13 unaffected controls; 75% [n=27] female, mean age 19.50 y) completed twice-daily EMA check-ins over 2 weeks, complemented by continuous activity and sleep monitoring using FitBit Charge 3 devices. The study examined feasibility, usability of the EMA app, symptom severity and variability, and relationships between mood, activity, and sleep. We applied linear mixed-effects regression to the data to examine relationships between variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants completed a total of 923 unique check-ins (mean check-ins per participant=25.60). Overall compliance rates were high (91.57%), indicating the approach is highly feasible. MDD participants demonstrated greater symptom severity and variability over time compared with controls (β=34.48, P&lt;.001). Individuals with MDD exhibited greater diurnal variation (β=-2.54, P&lt;.001) with worse mood in the morning and worse mood than anxiety scores over time (β=-6.93, P&lt;.001). Life stress was a significant predictor of more severe EMA scores (β=24.50, P&lt;.001). MDD cases exhibited more inconsistent sleep patterns (β=32.14, P&lt;.001), shorter total sleep times (β=-94.38, P&lt;.001), and a higher frequency of naps (β=14.05, P&lt;.001). MDD cases took fewer steps per day (mean 5828.64, SD 6188.85) than controls (mean 7088.47, SD 5378.18) over the course of the study, but this difference was not significant (P=.33), and activity levels were not significantly predictive of EMA score (P=.75).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates the feasibility of integrating smartphone-based EMA with wearable activity tracking in adolescents with depression. High compliance rates support the practicality of this approach, while EMA data provide valuable insights into the dynamic nature of depressive symptoms, particularly in relation to sleep and life stress. Future studies should validate these findings in larger, more diverse samples. Clinically, EMA and wearable tracking may enhance routine assessments and inform personal","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e66187"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274879","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":"Feasibility and Usability of a Web-Based Peer Support Network for Care Partners of People With Serious Illness (ConnectShareCare): Observational Study.","authors":"Aricca D Van Citters, Megan M Holthoff, Colleen Young, Sarah M Eck, Amelia M Cullinan, Stephanie Carney, Elizabeth A O'Donnell, Joel R King, Malavika Govindan, David Gustafson, Stephanie C Tomlin, Anne B Holmes, Ann D Bradley, Brant J Oliver, Matthew M Wilson, Eugene C Nelson, Amber E Barnato, Kathryn B Kirkland","doi":"10.2196/70206","DOIUrl":"10.2196/70206","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;While it can be rewarding to provide care for a person with serious illness, care partners are often unprepared to manage and cope with the physical and emotional stresses that arise with disease progression and bereavement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to evaluate membership enrollment, engagement, and experiences within a web-based peer support network for active and bereaved care partners of people with serious illness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a formative evaluation of the ConnectShareCare peer-to-peer web-based support network, which targeted care partners of people with serious illness residing in the northeastern United States. Recruitment methods included marketing postcards, flyers, listserv messages, and referrals from community stakeholders, peers, and clinicians. Enrollment occurred through a self-guided, web-based process. Study participants included members enrolled in ConnectShareCare between April 2021 and June 2023. We used the network's analytics dashboard (eg, registration, usage, and notification logs) to evaluate membership enrollment and engagement in discussions. We used surveys of a subset of members to assess experiences, including satisfaction, ability to find meaning by supporting others, and value and opportunities for improvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over 2 years, the network enrolled 250 members, with an average of 9 new members per month. Among 193 members providing information, most (58%, n=112) identified as active care partners, 17% (n=33) identified as bereaved care partners, and 27% (n=52) chose not to specify their role. Two-thirds of the 250 members did not post, 20% (n=50) posted 1-10 times, 6% (n=14) posted 11-25 times, 6% (n=15) posted 26-100 times, and 3% (n=7) posted more than 100 times. On average, 19 members posted per month resulting in 166 member posts per month. Moderators (1 community manager, 2 volunteer mentors, and 2 project team members) supported members with an average of 111 posts/month. In total, 187 discussion topics were created, including 42% (n=78) started by members and 58% (n=109) started by moderators. Seventy-eight discussion topics had 10 or more posts associated with them. The most frequent discussion topics focused on \"check-ins\" and \"sources of joy and hope.\" Among 18 care partner members who completed a research survey, 69% (11/16) reported connecting with at least 1 person and 62% (10/16) reported that ConnectShareCare helped them find meaning and purpose by supporting others. Most reported satisfaction with support (12/16, 75%) and information (14/16, 88%) through the network. Although most noted that ConnectShareCare was easy to use (10/17, 59%), respondents were less likely to easily find the information they were seeking (6/16, 38%). Survey respondents found value in peer connection and support and identified opportunities to improve navigation of resources and engagement of members.&lt;/p&gt;&lt;p&gt;&lt;stron","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e70206"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274905","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":"Relationship of Hair Cortisol Concentration With Perceived and Somatic Stress Indices: Cross-Sectional Pilot Study.","authors":"Sharon H Bergquist, Danyang Wang, Brad Pearce, Alicia K Smith, Allison Hankus, David L Roberts, Miranda A Moore","doi":"10.2196/63811","DOIUrl":"10.2196/63811","url":null,"abstract":"<p><strong>Background: </strong>Hair cortisol is an emerging biomarker of chronic stress. However, the psychological and physiological aspects of chronic stress that are reflected in hair cortisol concentration (HCC) have not been fully determined. Since physiological responses to stress do not always align with how stress is perceived, we conducted this study to evaluate whether HCC correlates with neuroendocrine stress indicators or stress perceptions.</p><p><strong>Objective: </strong>This study aimed to evaluate whether subjective (Perceived Stress Scale and Connor-Davidson Resilience Scale) and objective (plasma cortisol/dehydroepiandrosterone-sulfate [DHEA-S] and cortisol/high-sensitivity C-reactive protein) determinants of stress and resilience correlate with HCC.</p><p><strong>Methods: </strong>In this cross-sectional pilot validity study, scatter plots and Spearman correlation coefficients were used to measure the direction and magnitude of the relationship between stress and resilience measures among 51 predominantly male participants. In a subset (n=24), we performed a step-wise regression modeling approach to isolate the association of perceived and somatic stress on hair cortisol.</p><p><strong>Results: </strong>Bivariate correlations showed a weak inverse association of HCC with Perceived Stress Scale (Spearman correlation ρ=-0.14, P=.52) and a stronger positive association with somatic neuroendocrine stress indices cortisol/DHEA-S (ρ=0.24, P=.25) and cortisol/high-sensitivity C-reactive protein (ρ=0.21, P=.35). In linear regression models, HCC showed the strongest association with cortisol/DHEA-S (r2=0.10, P=.13, 1.01β 1.01, 95% CI 0.99-1.01). This relationship remained when age, gender, hair washing frequency, hair dye or bleach use, diabetes mellitus, obesity, cardiovascular disease, anxiety, medication use, and endocrine disorders were considered.</p><p><strong>Conclusions: </strong>Our results do not indicate a statistically significant association (at the P<.05 threshold) between HCC and stress perception or somatic measures of neuroendocrine response.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e63811"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274878","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":"Feasibility of an Electronic Patient-Reported Outcome System in People Living With HIV: Retrospective Analysis of a Mobile App-Based Pilot Study.","authors":"Yusuke Yoshino, Yoshitaka Kimura, Yoshitaka Wakabayashi, Takatoshi Kitazawa","doi":"10.2196/71493","DOIUrl":"10.2196/71493","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Advances in antiretroviral therapy have transformed HIV into a manageable chronic condition, allowing people living with HIV to live longer. However, with aging, people living with HIV face increased risks of lifestyle-related diseases and unaddressed psychosocial issues, including stigma, discrimination, and mental health concerns. Patient-reported outcomes are essential tools in person-centered care and have demonstrated clinical utility in oncology and rheumatology; yet remains underutilized in infectious disease settings. Recently, the European AIDS Clinical Society has recommended electronic patient-reported outcome (ePRO) systems to support HIV care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the feasibility and clinical utility of a smartphone-based ePRO system specifically developed for people living with HIV in Japan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective study was conducted among people living with HIV who attended the HIV outpatient clinic at Teikyo University Hospital between July and September 2022. Participants who consented to use the ePRO system installed a smartphone app and completed the HIV symptom index prior to their clinic visit. Physicians reviewed the responses during consultations; following the visits, patients completed a usability survey addressing clarity, response time, satisfaction, communication quality, and intention for future use. Medical records were reviewed to determine any new symptoms, findings, or medical actions that had not been documented in the previous two years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 27 people living with HIV (median age, 46 years; 100% male) used the ePRO app, and 25 (93%) completed the postuse questionnaire. Of these, 19/25 (76%) completed the Symptom Index within 5 minutes, while one participant required more than 15 minutes. Regarding usability, 76% (n=19) reported being satisfied or very satisfied, and 76% (n=19) found the system useful in improving communication with their provider. Additionally, 76% (n=19) expressed willingness to use the system again, while 5 (20%) participants indicated interest only if improvements were made. Medical record analysis revealed that 17/27 patients (63%) had new clinical information documented, including mental health symptoms (n=7, 26%), skin problems (n=7, 26%), and new diagnoses or treatment changes in 6 (22%) cases. Over 40% (n=11) of patients reported issues such as anxiety, insomnia, dermatological symptoms, or concerns related to body image.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot study demonstrated that a smartphone-based ePRO system for people living with HIV is feasible and well-accepted in real-world clinical practice. It facilitated early detection of psychosocial and physical issues that may otherwise be overlooked in routine care and improved patient-provider communication. These findings support the integration of ePRO systems into HIV care and underscore th","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e71493"},"PeriodicalIF":2.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266290","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":"mindLAMPVis as a Co-Designed Clinician-Facing Data Visualization Portal to Integrate Clinical Observations From Digital Phenotyping in Schizophrenia: User-Centered Design Process and Pilot Implementation.","authors":"Karthik Sama, Jaya Sreevalsan-Nair, Soumya Choudhary, Srilakshmi Nagendra, Preethi V Reddy, Asher Cohen, Urvakhsh Meherwan Mehta, John Torous","doi":"10.2196/70073","DOIUrl":"10.2196/70073","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The potential of digital mental health to transform care delivery in low- and middle-income countries is well established. However, there remains the need to clinically and organically adapt current tools to local needs. This paper explores the process of creating a novel data visualization system for a digital mental health app and outlines the necessary steps in the process. This work demonstrates co-design involving collaboration between teams across geographies and disciplines based on clinicians' requirements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to co-design a visualization dashboard app for clinicians through a design study with a multidisciplinary team consisting of clinicians in Boston and Bangalore, mindLAMP software developers in Boston, and computer scientists with visualization expertise in Bangalore. The app is designed to visualize derivatives of both active and passive data of patients with schizophrenia to support the research contexts of digital psychiatry clinics in India.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The mindLAMP app, already used in many countries today, is adapted to offer a new clinician-facing data visualization portal, mindLAMPVis. The novel web-based portal is designed to improve clinical integration for use in India. After building the new portal, the insights from this new portal are corroborated with known clinical observations of relapse using comparative visualization. The data were taken from the mindLAMP app and processed using multivariate analysis and dimensionality reduction to make it easy and manageable for clinicians to analyze. These techniques are integrated in mindLAMPVis, thus making it a locally co-designed, developed, and deployed tool. A feasibility study of the pilot implementation of the app was completed through a domain expert study with clinician-driven case studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;To assess the system, we preloaded data from 24 patients with schizophrenia, including those with relapses. Through case examples focusing on relapse risk prediction in schizophrenia, mindLAMPVis is used to identify different visualization methods to compare different analytical results for each patient. In partnership with clinicians for co-designing the app, we explored the feasibility of a comparative visualization tool for discovering patterns across different time stamps for a single patient or any patterns across patients related to the relapse episode. As an example of reverse translation, mindLAMPVis offers new features that complement the original features of mindLAMP, highlighting the mutual benefit of software adaptation and collaborative design.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;mindLAMPVis is a tailored tool designed for use in India, but it can aid in identifying and comparing behavioral patterns that may indicate clinical risk for patients in any country. mindLAMPVis offers an example of how, through technical design, feedback, and real-w","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e70073"},"PeriodicalIF":2.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266291","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}