JMIR Formative Research最新文献

{"title":"Using Statistical Time-Series Forecasting to Predict the Resting Heart Rate From Wearable Device Data: Case Report.","authors":"Ying-Ju Chen, Chia-Yu Liu, Ya-Han Chang, Huh-Tswen Eric Lin, Tsang-Hai Huang","doi":"10.2196/91216","DOIUrl":"10.2196/91216","url":null,"abstract":"<p><strong>Background: </strong>For endurance athletes, resting heart rate (RHR) is a well-known indicator of training load, physiological status, and readiness for upcoming training. Predicting the following day's RHR would enable athletes and coaches to optimize training plans and make timely load adjustments.</p><p><strong>Objective: </strong>The aim of this study was to develop a statistical time-series forecasting model for RHR.</p><p><strong>Methods: </strong>Daily heart rate (HR) data (624 valid observations) collected from the personal wearable device of a single endurance runner (n=1) were used to establish a statistical time-series RHR forecasting model. This model was built using an autoregressive integrated moving average (ARIMA) model from the sktime package. The research framework evaluates wearable RHR forecasting models across 3 distinct phases. Phase 1 compared a naive persistence baseline against 4 dynamic seasonal autoregressive integrated moving average (SARIMA) models (using 1-day and 7-day rolling forecasts, with and without exogenous features) on a 75-25 train-test split. Phase 2 conducted a leave-one-feature-out ablation analysis on the top-performing model from phase 1. Finally, phase 3 assessed real-world \"cold-start\" viability by training a streamlined SARIMA model on the first 21 days of data.</p><p><strong>Results: </strong>In phase 1, the baseline naive forecaster yielded a mean absolute error (MAE) of 2.404. The SARIMA model using a 1-day rolling forecast with exogenous features and a chronological 75-25 split achieved an MAE of 1.712. An ablation analysis in phase 2 revealed that previous-day RHR and trimmed average active HR were the primary predictive drivers. Consequently, in phase 3, the streamlined SARIMA model, trained on just 21 days of initial data and using only the previous-day RHR and trimmed average active HR as 2 training features, demonstrated performance comparable to that of the full-history model.</p><p><strong>Conclusions: </strong>In the current case study, we preliminarily verified that a continuously updated SARIMA model trained on sufficient features can forecast future RHR in a single runner. Further study with a larger number of participants and the inclusion of more exogenous features will be needed to verify the framework's applicability.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e91216"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Professionals' Context-Specific Trust in AI-Based Screening for Autism Spectrum Disorder: Cross-Sectional Survey Study.","authors":"Yoshimasa Ohmoto, Kazunori Terada, Ryoichiro Iwanaga, Hirokazu Kumazaki","doi":"10.2196/98367","DOIUrl":"10.2196/98367","url":null,"abstract":"<p><strong>Background: </strong>In clinical settings, clinicians' context-specific trust in AI is associated with individual factors. This is particularly relevant in autism spectrum disorder (ASD) screening, where diagnostic criteria are complex, heterogeneous, and inherently uncertain. Although some AI systems demonstrate high sensitivity, clinicians are not always convinced of their utility. Therefore, examining potential biases in context-specific trust and achieving well-calibrated trust are critical.</p><p><strong>Objective: </strong>This study aimed to examine the individual factors associated with professionals' context-specific trust in AI-assisted ASD screening systems.</p><p><strong>Methods: </strong>Fifty-five professionals involved in ASD assessment participated in the study. We used an AI-based ASD screening method based on a geometric shape-drawing task that assesses children's motor function and has demonstrated high sensitivity for identifying children with ASD. Expert clinicians selected 2 ambiguous screening scenarios for evaluation. Participants made independent judgments while considering the AI output and rated their context-specific trust in each decision on a 7-point Likert scale. A linear mixed model (LMM) examined the associations between context-specific trust in AI decisions and participant characteristics while accounting for the nested data structure.</p><p><strong>Results: </strong>LMM analysis revealed significant between-participant variability in context-specific trust. Years of professional experience (<i>t</i>_46.3=-2.20; <i>P</i>=.03) and the length of education required to obtain professional credentials (<i>t</i>_47.6=-2.67; <i>P</i>=.01) were significantly and negatively associated with context-specific trust in AI-based screening. Dispositional trust in AI was significantly and positively associated with context-specific trust (<i>t</i>_46.1=2.78; <i>P</i>=.008). Confidence in participants' own assessments was significantly and positively associated with context-specific trust (<i>t</i>_91.0=5.67; <i>P</i><.001).</p><p><strong>Conclusions: </strong>Our findings suggest that more experienced clinicians tend to exhibit greater skepticism toward AI, consistent with observations in other medical fields such as oncology. To support the effective integration of AI into clinical practice, professional education should include training on AI principles and strategies for appropriate human-AI collaboration. Future studies with larger and more diverse samples, multimodal assessment approaches, and real-world clinical settings are needed to validate these findings and inform the implementation of AI-assisted ASD screening.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e98367"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061085","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":"Routine Online Psychological Therapy in an Insurance-Based Care Setting: Retrospective Service Evaluation of Real-World Outcomes.","authors":"Tobias Opsahl, Mikkel Meinert, Emil Brødsgaard","doi":"10.2196/101074","DOIUrl":"10.2196/101074","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Depression, anxiety, and stress-related difficulties represent a major global health burden. Online psychological therapy has emerged as a promising approach to increasing access to care, yet evidence from routine, real-world clinical settings, particularly for services delivered without standardized treatment protocols, remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to describe symptom change and patient-reported satisfaction associated with routine online psychological therapy delivered within an insurance-based care setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective observational service evaluation was conducted using deidentified routine care data. Clients aged 15 years and older who initiated online psychological therapy and completed baseline and end-of-treatment assessments on all 3 outcome measures were included. Symptoms of depression, anxiety, and perceived stress were measured using the 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalized Anxiety Disorder (GAD-7), and 10-item Perceived Stress Scale (PSS-10), respectively. Changes in symptoms were examined using paired sample t tests, within-sample effect sizes (Cohen d and Cohen d&lt;sub&gt;z&lt;/sub&gt; with 95% CIs), and reliable change indices. Robustness was assessed with therapist-clustered mixed models and attrition sensitivity analyses. A ≥50% reduction in symptom scores was reported as a descriptive response criterion. Patient satisfaction was assessed with single-item ratings at the end-of-treatment assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1221 clients were included. Clients completed a mean of 4.7 (SD 1.67) therapy sessions over an average treatment duration of 62.7 (SD 40.4) days. Significant reductions with large within-sample effect sizes were observed for depression (Cohen d=1.25, 95% CI 1.17-1.32), anxiety (Cohen d=1.49, 95% CI 1.41-1.57), and perceived stress (Cohen d=1.46, 95% CI 1.38-1.54). A ≥50% symptom reduction was observed in 60.7% (741/1220) of clients for depression, 67.5% (824/1221) for anxiety, and 30.8% (376/1221) for perceived stress. At the end-of-treatment assessment, 80.7% (985/1221) scored below the clinical cutoff for depression (PHQ-9&lt;10) and 79.2% (967/1221) for anxiety (GAD-7&lt;8). Reliable improvement was observed in 56% (688/1221) to 65% (794/1221) of clients, with deterioration below 2% on all measures. Mean patient-reported satisfaction scores ranged from 8.55 (SD 1.71) to 8.96 (SD 1.45) on a 10-point scale, and mean recommendation likelihood was 8.61 (SD 1.88). Therapist-level intraclass correlation coefficients were ≤0.029; effect sizes were 1.27-1.50 under inverse-probability weighting and 0.41-0.50 under zero-change imputation for baseline-screened clients without end-of-treatment assessments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Routine online psychological therapy delivered within an insurance-based care setting was associated with substantial pre-post symptom reductions,","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e101074"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061147","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 Usability and Quality of a Mobile App-Based Intervention for Personalized Exercises in Individuals With Spinal Cord Injury: Convergent Parallel Mixed Methods Study.","authors":"Sara Nataletti, Anushua Banerjee, Sara Prokup, Arun Jayaraman, Alex W K Wong","doi":"10.2196/84316","DOIUrl":"10.2196/84316","url":null,"abstract":"<p><strong>Background: </strong>Mobile health technologies offer scalable opportunities to support home-based exercise programs. However, most commercially available apps are not tailored to individuals with spinal cord injury (SCI) and have rarely been evaluated for usability and implementation outcomes in this population.</p><p><strong>Objective: </strong>This study aims to assess the acceptability, appropriateness, feasibility, and quality of a mobile app-based intervention designed to support exercise adherence in individuals with SCI.</p><p><strong>Methods: </strong>We conducted a convergent parallel mixed methods study using quantitative data from standardized measures and qualitative feedback from focus groups. Twelve individuals with SCI (mean age 50.5, SD 17 years; n=6, 50% male; n=8, 67% White; n=6, 50% with thoracic injuries; n=6, 50% ambulators) engaged in a customized exercise regimen using the app for 2 weeks. Acceptability, appropriateness, and feasibility of this mobile intervention were assessed using the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. The objective and subjective qualities, and the perceived impact, of the app-based intervention were evaluated using the User Version of the Mobile Application Rating Scale.</p><p><strong>Results: </strong>Using a cutoff score of >4 out of 5, 67% (8/12) of participants rated the app-based intervention as highly acceptable and feasible, and 50% (6/12) rated it as highly appropriate. The objective quality of the app was rated 3.57 out of 5 on the User Version of the Mobile Application Rating Scale. At the scale level, information received the highest score (mean 4.10, SD 0.52), with functionality (mean 3.51, SD 0.66) and aesthetics (mean 3.50, SD 0.70) closely following. Engagement scored lowest (mean 3.18, SD 0.72). The app's subjective quality averaged 3.27 (SD 0.88), and its perceived impact on exercise adherence was rated 3.79 (SD 0.92). Qualitative feedback indicated that customization, access to professional support, and SCI-specific exercises were positive features. Areas for improvement included bug fixes and enhanced features to boost engagement.</p><p><strong>Conclusions: </strong>The smartphone-based intervention demonstrates adequate acceptability and feasibility, along with high information quality and favorable usability, for supporting exercise adherence in individuals with SCI. Improvements in engagement features are recommended to enhance sustainable implementation.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e84316"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060934","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":"Remote Vital Sign Monitoring in Acutely Unwell Hospital at Home Patients: Nonrandomized Feasibility Study.","authors":"Rachel C Greer, Cristian Roman, Mayue Shi, Benn Gooch, Bethany K Lawson, Christopher Biggs, Clare Edwards, Sarah Vollam, Peter Watkinson, Lionel Tarassenko, Andrew Farmer, Daniel Lasserson","doi":"10.2196/84233","DOIUrl":"10.2196/84233","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Remote vital sign monitoring of acute hospital at home (aHAH) patients is recommended in policy without clear guidance on implementation. While such monitoring has the potential to improve patient care, there is limited evidence for its feasibility and acceptability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the feasibility and acceptability of using a remote, community-based monitoring system using a vital sign wearable patch and pulse oximeter in aHAH patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this nonrandomized feasibility study, we recruited patients from an aHAH service in Oxford, United Kingdom, between January and October 2024. Eligible patients were aged 18 years and older with an acute illness (lower respiratory tract infection, cellulitis, urinary tract infection, systemic evidence of acute infection, acute kidney injury, or heart failure with acute fluid overload) requiring aHAH care. Pregnant women and those with contraindications to monitoring were excluded. Participants were asked to wear a chest patch to estimate their heart rate and respiratory rate (passive monitoring), and to intermittently check their oxygen saturations, blood pressure, and temperature (active monitoring). Participants were asked to complete a Technology Acceptance Questionnaire. All aHAH patients were screened. Recruitment was nonconsecutive due to the availability of the research team. Participants were monitored for 7 days or until discharge from the aHAH service, whichever was shorter. Fixed time windows were used to assess real-time vital sign data coverage during each participant's monitoring period. The primary outcomes were the proportion of 4-hour monitoring windows with a recorded heart rate and 12-hour daytime windows with a recorded oxygen saturation level. Time-series analyses and descriptive statistics were used for quantitative data. Content analysis was used to analyze the open-ended comments in the questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 29 participants were recruited and 3 immediately withdrew from the study. Participants were monitored for 4.8 (IQR 2.9-6.2) days on average. Overall, 89% (600/674) of the 4-hour monitoring windows had a heart rate and 75.4% (508/674) had a respiratory rate recorded in real-time. For the 12-hour daytime windows, 58.1% (75/129) had an oxygen saturation, 54.3% (70/129) had a blood pressure, and 51.2% (66/129) had a temperature recorded. Data coverage was higher for passive monitoring compared to active monitoring. Most participants who had capacity found the combined monitoring system easy to use and thought it was useful for their health care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Remote monitoring of vital signs in aHAH patients is feasible. Good data coverage was achieved for the passive monitoring, which did not require specific actions by the participants or their caregivers. Further work is required to ascertain which patients would benefi","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e84233"},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061103","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":"Digital Health Information Use, Trust, and Language-Related Disparities in Health Literacy in South Tyrol, Italy: Cross-Sectional Survey Study.","authors":"Dietmar Ausserhofer, Verena Barbieri, Stefano Lombardo, Timon Gärtner, Klaus Eisendle, Giuliano Piccoliori, Adolf Engl, Christian Josef Wiedermann","doi":"10.2196/80934","DOIUrl":"10.2196/80934","url":null,"abstract":"<p><strong>Background: </strong>Health literacy (HL) is a crucial determinant of population health; however, disparities persist in multilingual settings. In South Tyrol, Italy, where German- and Italian-speaking populations coexist within a unified health care system, HL disparities may reflect differences in language, culture, and digital engagement.</p><p><strong>Objective: </strong>This study investigated whether the usage of digital health information mediates the relationship between language group and HL and examined informational trust and other sociodemographic factors as covariates of HL.</p><p><strong>Methods: </strong>Data were obtained from a population-based survey conducted in South Tyrol, Italy. The analytical sample comprised 1500 participants with adequate responses to the 16-item Health Literacy Survey European Union Questionnaire (HLS-EU-Q16) instrument and an identified language group. Mediation analysis was performed using PROCESS Model 4 (5000 bootstrap samples), with use of digital health information as the mediator, language group as the predictor, and HL as the outcome. Covariates included age, sex, education, self-rated health, trust in professional information sources, and trust in health information on the internet.</p><p><strong>Results: </strong>Italian-speaking participants showed significantly higher HL scores (mean 12.54, SD 3.31 vs mean 11.56, SD 3.48 on a 0-16 scale; <i>P</i><.001) and reported more frequent digital health information use (<i>P</i>=.003) compared with German-speaking participants. Digital health information use was weakly positively correlated with HL in bivariate analyses (<i>r</i>=0.11). In the fully adjusted mediation model, the indirect effect of language group on HL through digital health information use was not significant (<i>B</i>=0.018, 95% bootstrap CI -0.035 to 0.074; partially standardized effect=0.005), whereas the direct effect of language group remained robust (<i>B</i>=0.96; <i>P</i><.001). Trust in professional health information (<i>B</i>=0.39; <i>P</i><.001) and trust in health information on the internet (<i>B</i>=0.61; <i>P</i><.001) were both positively associated with HL.</p><p><strong>Conclusions: </strong>Although digital engagement and online trust are related to HL, they do not explain the persistent language-based disparities in HL observed in South Tyrol. Public health strategies should prioritize strengthening critical appraisal skills, fostering trust in professional health information sources, and improving digital access to effectively address HL inequalities in multilingual populations.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e80934"},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13607262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038760","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":"Patient Experiences With a Symptom Monitoring and Self-Referral Program for Specialty Palliative Care After Lung Cancer Diagnosis: Qualitative Study.","authors":"Julia L Agne, Alice A Gaughan, Laura J Rush, Jennifer L Eramo, Anneliese Sinclair, Madison M Grogan, Jessica S Merlin, Jack Stevens, Robert M Cronin, Tasleem J Padamsee, Carolyn J Presley, Ann Scheck McAlearney","doi":"10.2196/95948","DOIUrl":"10.2196/95948","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Palliative care improves patients' health-related quality of life (HRQoL) by delivering specialty-level management for cancer symptoms. Digital symptom monitoring programs (SMPs) improve patients' HRQoL through early symptom identification during cancer care. Through complementary approaches, SMPs and palliative care align with symptom management theory by linking the patient-reported symptom experience with clinician recommendations for symptom management to improve health outcomes for patients with serious illness. While both SMPs and palliative care reduce health care use and improve survival through detection and treatment of cancer symptoms, few studies have attempted to integrate palliative care into SMPs for cancer symptom management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to assess patients' perspectives about the feasibility and acceptability of an SMP with a prompted palliative care self-referral option (Symptom Monitoring Program Linked to Electronic Referrals [SyMPLER]) via a mobile health (mHealth) app during lung cancer treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a single-institution qualitative study of patients newly diagnosed with lung cancer who were enrolled in a single-arm feasibility pilot of an mHealth app that facilitates on-demand reporting of cancer-related symptoms and prompts patients to self-refer to palliative care for symptom management. Interview participants were purposively sampled based on high (≥3 uses) vs low (0-2 uses) engagement with the app during the first 3 months of access to the SMP. Questions focused on program feasibility and acceptability as well as perceptions of the 5 components of the SMP intervention (introduction to palliative care, reminders, symptom reporting, palliative care self-referral, and oncology team callback). Interviews were conducted from May 2024 to May 2025 by telephone, recorded, transcribed, and analyzed using thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 31 patients were interviewed; 21 had high and 10 had low app engagement. Participants were mostly White (n=29, 93.5%), female (n=21, 67.7%), and aged 60 years or older (n=19, 61.3%). In high and low engagement groups, participants voiced willingness and ability to report symptoms through the app and self-refer to palliative care if needed for symptom management. Feasibility barriers differed by group, with high-engagement participants noting forgetting to use the app for symptom reporting, while low-engagement participants cited low symptom burden, technology concerns, and time constraints as reasons for limited use of the SMP. Participants described uncertainty about when or why to request palliative care as a major barrier to self-referral.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Participants' perspectives on the feasibility and acceptability of SyMPLER differed by their level of engagement with the SMP app. Participants in both groups voiced acceptance of the opti","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e95948"},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038823","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":"Standardized Manual-Based Smoking Cessation Treatment in Patients With Comorbid Mental Disorders: Qualitative Interview Study.","authors":"Johanna Bück, Esra Sünkel, Alla Machulska, Marie Neubert, Tim Klucken","doi":"10.2196/97001","DOIUrl":"10.2196/97001","url":null,"abstract":"<p><strong>Background: </strong>Smoking prevalence is disproportionately high among individuals with mental disorders, who also show reduced cessation success, suggesting that current cessation interventions may not fully address their specific needs. A barrier to smoking cessation is the fear that quitting may worsen mental health, yet little is known about how individuals with mental disorders experience guideline-conform cessation treatments, which may address such concerns.</p><p><strong>Objective: </strong>This qualitative study explored the perspectives of smoking individuals with comorbid mental disorders who participated in a standardized, manual-based, cognitive behavioral smoking cessation program to identify targets for optimizing guideline-conform interventions for this population, spanning treatment engagement, perceived challenges, and facilitators within this context.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with 11 participants representing diverse cessation trajectories (sustained abstinence, relapse, and no quit attempt) 6 months after treatment completion. Data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three overarching themes were identified. First, participants described smoking cessation as a multidimensional, processual experience extending beyond behavioral change to encompass psychological and social dimensions, characterized by nonlinearity, adaptive meaning-making, and improvements in self-efficacy despite transient strain during early abstinence. Second, smoking was experienced as a functionally embedded practice serving affective, habitual, and social functions, with motivation emerging as dynamic and relationally sustained rather than stable. Third, treatment engagement was shaped by motivational states and contextual circumstances, with participants offering favorable evaluations of the structured intervention alongside recommendations for greater individualization and flexibility. Notably, mental health-related concerns about cessation largely persisted despite predominantly positive or neutral mental health outcomes, a pattern consistent with cognitive immunization processes.</p><p><strong>Conclusions: </strong>Guideline-conform smoking cessation treatment appears feasible and largely well-received by individuals with comorbid mental disorders. The findings highlight the need for targeted psychoeducation to address persistent misconceptions about the mental health risks of cessation, as well as individualized, context-sensitive treatment adaptations, including greater flexibility in session structure, motivational support beyond the active treatment phase, and explicit attention to the social and functional embeddedness of smoking, to improve cessation outcomes in this high-risk population.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e97001"},"PeriodicalIF":2.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030700","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 a Virtual Mindfulness-Based Stress Reduction Intervention for Individuals With Chronic Pain: Pilot Randomized Controlled Trial.","authors":"Shashank Ghai, Sabrina Cavallo, Mathieu-Joël Gervais, Diana Zidarov","doi":"10.2196/98632","DOIUrl":"10.2196/98632","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic pain (CP) is a complex and prevalent public health condition that significantly impacts physical functioning, psychological well-being, and quality of life. Traditional biomedical treatments often provide limited relief, highlighting the need for integrative approaches. Biopsychosocial interventions, such as mindfulness-based stress reduction (MBSR), have shown promise in improving pain-related outcomes by targeting cognitive, emotional, and behavioral processes associated with CP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This pilot randomized controlled trial (RCT) evaluated the feasibility and preliminary effects of a virtual MBSR intervention for individuals with CP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a single-blinded, randomized, pilot trial of 61 participants with CP randomly assigned to either an 8-week virtual MBSR program or a no-intervention control group. Participants were aware of their allocation; the data analyst remained blinded throughout the study; and the outcome assessor was blinded at baseline, although blinding could not be reliably maintained at subsequent assessments. The primary outcome was feasibility, assessed through recruitment, retention, and adherence rates. Secondary outcomes, examined on an exploratory basis, included pain disability, CP acceptance, pain catastrophizing, pain self-efficacy, health-related quality of life (HRQoL; PROMIS-29 [Patient-Reported Outcomes Measurement Information System-29] and PROMIS-10 [Patient-Reported Outcomes Measurement Information System-10]), and global rating of change.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Recruitment (23.5%), retention (60.7%), and adherence (63.3%) rates were below the prespecified thresholds of 30%, 80%, and 80%, respectively, indicating that modifications to the current design are required before proceeding to a definitive trial. As this pilot trial was not powered to test intervention effectiveness, the following clinical outcomes are reported as exploratory and hypothesis-generating. A significant group-by-assessment period interaction was observed for pain disability, PROMIS-10 (physical health and global health), and PROMIS-29 (participation in social activities). No significant interactions were observed for pain catastrophizing, pain self-efficacy, or CP acceptance. On the Global Rating of Change scale, MBSR participants reported greater improvement in pain self-efficacy than the no-intervention control group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot study did not meet its feasibility targets, highlighting the need to refine recruitment, retention, and intervention delivery procedures before conducting a future trial. Preliminary exploratory analyses suggested improvements in pain disability and several HRQoL subdomains in the MBSR group compared with the control group, but these findings should be interpreted cautiously given the underpowered sample and the exploratory nature of these analyses. These results pr","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e98632"},"PeriodicalIF":2.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030683","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":"Neuropsychological Assessment Using Portable Automated Rapid Testing in Cognitively Healthy Older Adults: Test-Retest Reliability Study.","authors":"Quentin Coppola, Lakshmi Kannan, Audrey Carrillo, Susanne M Jaeggi, Aaron R Seitz","doi":"10.2196/90646","DOIUrl":"10.2196/90646","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Remote, scalable cognitive assessment could improve detection and longitudinal monitoring of age-related cognitive change, but few studies have validated comprehensive digital neuropsychological batteries administered entirely at home.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate the feasibility, acceptability, and short-term test-retest reliability of a remotely delivered digital neuropsychological battery (portable automated rapid testing [PART]) in cognitively healthy older adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We screened 82 English-speaking, cognitively healthy older adults aged 50 to 85 years and mailed configured tablets to participants. Researchers remotely administered a battery of neuropsychological assessments spanning language fluency (Boston Naming Test, verbal fluency: letter \"F,\" supermarket items, and animals), memory (verbal paired associates, word list recall, and logical memory recall), praxis memory (clock drawing and constructional praxis [CP]), and executive functioning (trail making test [TMT]) using the PART app twice, approximately 1 month apart. Task comfortability was summarized with a comfort index based on participants' self-reports after completing each task. Reliability analyses included paired t tests to detect group-level shifts in performance, Pearson correlations for short-term stability, and Bland-Altman limits of agreement (LoA) to quantify bias and within-person variability. Performance across all tasks was also compared to comparative samples from large normative studies using equivalent paper-and-pencil versions of these tasks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 72 participants completed the first time point (T1), 64 completed the second time point (T2), and the analytic sample comprised a total of 63 participants. Overall comfort was high across sessions (mean comfort index was 88% at T1 and 84% at T2). Memory and executive function measures showed moderate test-retest correlations (r=0.39-0.73), while clock drawing and CP showed low or nonsignificant associations, likely due to ceiling effects. Paired tests indicated small but significant practice effects for verbal paired associates (t&lt;sub&gt;62&lt;/sub&gt;=-3.10; P=.003) and word list (t&lt;sub&gt;57&lt;/sub&gt;=-2.50; P=.02), with substantial practice effects for logical memory (story A: t&lt;sub&gt;56&lt;/sub&gt;=-2.95; P=.005) and TMT part A (t&lt;sub&gt;50&lt;/sub&gt;=-3.97; P&lt;.001) and part B (t&lt;sub&gt;42&lt;/sub&gt;=-2.05; P=.05). Bland-Altman analyses revealed minimal mean bias for many tasks but notably wide LoA for TMT (part A: LoA=-44.7 to 29.2 seconds; part B: LoA=-78.1 to 57.9 seconds). Importantly, in descriptive comparisons, our sample generally overlapped within ±1 SD of the medians in comparative paper-and-pencil normative samples.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;PART was well tolerated among healthy older adults and reproduces group-level normative patterns with moderate short-term reliability for several conventional measures.","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e90646"},"PeriodicalIF":2.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030706","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}