Journal of Medical Internet Research最新文献

{"title":"Empowering Capabilities of People With Chronic Conditions Supported by Digital Health Technologies: Scoping Review.","authors":"Messaline Fomo, Liyousew G Borga, Thomas Abel, Philip S Santangelo, Sara Riggare, Jochen Klucken, Ivana Paccoud","doi":"10.2196/68458","DOIUrl":"10.2196/68458","url":null,"abstract":"<p><strong>Background: </strong>Patient empowerment is widely recognized for improving health outcomes, increasing patient satisfaction, and enhancing the overall effectiveness of health care. Digital health technologies (DHTs) contribute to this empowerment by keeping patients informed, involved, and engaged in their own health. However, more evidence is needed to better understand which aspects of empowerment patients value when using DHTs and how DHTs can support these values.</p><p><strong>Objective: </strong>Drawing on Sen's capability approach, this paper conceptualizes patient empowerment in digital health by defining distinct capabilities, resources, and conversion factors that contribute to patient empowerment through DHTs.</p><p><strong>Methods: </strong>We based our scoping review on the methodology recommended by the Joanna Briggs Institute Manual for evidence synthesis and an a priori registered protocol. Papers were included if they focused on patient empowerment in relation to DHTs among patients with chronic diseases (cardiovascular diseases, diabetes, cancer, chronic respiratory diseases, and neurodegenerative diseases), with particular emphasis on the patient perspective. PubMed, Scopus, and Web of Science were searched for evidence published from January 2013 to April 2024. Data were extracted and thematically analyzed via a multidisciplinary workshop to identify empowerment components relevant to the capability framework, such as capabilities, DHTs as resources, and conversion factors.</p><p><strong>Results: </strong>Our analysis identified 3 core capabilities to achieve patient empowerment supported by DHTs: health information and knowledge management, self-management, and emotional and social support. DHTs as resources supported these capabilities through distinct functional components, including informing patients, communication with the health care team, monitoring, behavior change interventions, individualized feedback, or peer support, each contributing to a varying degree. Conversion factors such as demographic and socioeconomic status, digital literacy, disease status, perceived value of DHTs, sociocultural values and norms, doctor-patient relationship, connectivity, and cost influenced the development of empowering capabilities resulting from using DHTs.</p><p><strong>Conclusions: </strong>While the capabilities related to patient empowerment in DHTs were clearly distinguishable, our analysis revealed a notable interconnectedness among these components. Our conceptualization of patient empowerment serves as a valuable resource for researchers seeking to understand or assess patient empowerment via DHTs. It also provides guidance for DHT developers, helping them design DHTs that enhance valued capabilities and account for the conversion factors and ultimately promote patient empowerment across diverse population groups.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e68458"},"PeriodicalIF":5.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Quality of Life in Patients With Hypothyroidism Using a Scientific Yoga Module: Randomized Controlled Trial.","authors":"Savithri Nilkantham, Amit Singh, Vijaya Majumdar, Harini K N, Snigdha Atmakur","doi":"10.2196/54078","DOIUrl":"10.2196/54078","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The impact of hypothyroidism on quality of life is extensively documented, highlighting its substantial physical, psychological, and social burden. Yoga has demonstrated promising therapeutic benefits in improving hypothyroidism outcomes. Leveraging telehealth's growth, this study used a rigorously designed scientific yoga module specifically tailored for digital delivery for patients with hypothyroidism undergoing levothyroxine treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to assess the impact of a 6-month tele-yoga intervention in patients with hypothyroidism by comparing outcomes between those receiving levothyroxine combined with tele-yoga and those receiving only levothyroxine treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-blinded, 2-arm, parallel-group randomized controlled trial was conducted for 6 months (April 1, 2022-September 30, 2022) with 134 clinically diagnosed patients with hypothyroidism recruited from the Arogyadhama Holistic Health Home registry (2013-2021). Participants were randomized to either a yoga intervention group or a waitlist control group with 67 in each group and assessed at 3 time points (before, in the middle of, and after the intervention) for primary and secondary outcomes. The 36-Item Short Form Health Survey for health-related quality of life was used as a primary measure, whereas secondary measures included thyroid profile, BMI, blood pressure, the Fatigue Assessment Scale, the Perceived Stress Scale, and the Gita Inventory of Personality. Clinical data were collected via online questionnaires, and laboratory data (thyroid profile blood pressure and anthropometric measurements) were obtained in person using standardized instruments. A generalized linear model with repeated-measure ANOVA was used to evaluate both within- and between-group effects. In addition, in the yoga intervention group, performance was assessed using a yoga performance assessment scale, and satisfaction was measured through a structured feedback survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The intervention showed highly significant effects across all domains of the primary outcome measure (P&lt;.001), with the most notable effects on mental health (F&lt;sub&gt;2, 118&lt;/sub&gt;=425.88; η&lt;sup&gt;2&lt;/sup&gt;=0.88), energy and vitality (F&lt;sub&gt;2, 118&lt;/sub&gt;=371.73; η&lt;sup&gt;2&lt;/sup&gt;=0.86), and role limitations-emotional (F&lt;sub&gt;2, 118&lt;/sub&gt;=335.45; η&lt;sup&gt;2&lt;/sup&gt;=0.85). Secondary measures also showed significant improvements (P&lt;.001), except for thyroxine (P&lt;.014). Average yoga performance assessment scores increased significantly from 65.08 (SD 10.97) to 88.62 (SD 11.18; P&lt;.001), indicating that most participants could easily perform the practices. Overall, 95% (64/67) of the participants in the yoga intervention group expressed high satisfaction with the tele-yoga intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This clinical trial is the first to demonstrate the benefits of a digitally delivered scientific yoga module ","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e54078"},"PeriodicalIF":5.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Rigour in Online Health Surveys Through the Reduction of Fraudulent Data.","authors":"Wen Zhi Ng, Sundarimaa Erdembileg, Jean Cj Liu, Joseph D Tucker, Rayner Kay Jin Tan","doi":"10.2196/68092","DOIUrl":"https://doi.org/10.2196/68092","url":null,"abstract":"<p><strong>Unstructured: </strong>Online surveys have become a key tool of modern health research, offering a fast, cost-effective, and convenient means of data collection. It enables researchers to access diverse populations, such as those underrepresented in traditional studies, and facilitates the collection of stigmatized or sensitive behaviours through greater anonymity. However, the ease of participation also introduces significant challenges, particularly around data integrity and rigour. As fraudulent responses - whether from bots, repeat responders, or individuals misrepresenting themselves - become more sophisticated and pervasive, ensuring the rigour of online surveys has never been more crucial. This article provides a comprehensive synthesis of practical strategies that help to increase the rigour of online surveys through the detection and removal of fraudulent data. Drawing on recent literature and case studies, we outline several options that address the full research cycle from pre-data collection strategies to post-data collection validation. We emphasize the integration of automated screening techniques (e.g. CAPTCHAs, honeypot questions) and attention checks (e.g. trap questions) for purposeful survey design. Robust recruitment procedures (e.g. concealed eligibility criteria, two-stage screening) and a proper incentive or compensation structure can also help to deter fraudulent participation. We examine the merits and limitations of different sampling methodologies, including river sampling, online panels, and crowdsourcing platforms, offering guidance on how to select samples based on specific research objectives. Post-data collection, we discuss meta-data based techniques to detect fraudulent data (e.g. duplicate email or IP addresses, response time analysis), alongside methods to better screen for low quality responses (e.g. inconsistent response patterns, improbable qualitative responses). The escalating sophistication of fraud tactics, particularly with the growth of Artificial Intelligence, demands that researchers continuously adapt and stay vigilant. We propose the use of dynamic protocols, combining multiple strategies into a multi-pronged approach that can better filter for fraudulent data and evolve depending on the type of responses received across the data-collection process. However, there is still significant room for strategies to develop, and it should be a key focus for upcoming research. As online surveys become increasingly integral to health research, investing in robust strategies to screen for fraudulent data and increasing the rigour of studies is key to upholding scientific integrity.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The State of Remote Patient Monitoring for Chronic Disease Management in the United States.","authors":"Margaret M Paul, Nandita Khera, Praneetha R Elugunti, Kevin C Ruff, Musab S Hommos, Leslie F Thomas, Vivek Nagaraja, Ashley L Garrett, Mari Pantoja-Smith, Nathan L Delafield, Blanca C Lizaola-Mayo, Molly M Kresin, Mahesh Seetharam, Sandhya R Nagarakanti, Manreet Kaur","doi":"10.2196/70422","DOIUrl":"10.2196/70422","url":null,"abstract":"<p><p>Remote patient monitoring (RPM) increased exponentially during the COVID-19 pandemic. RPM programs commonly incorporate tools to capture and transmit health-relevant data from the home to the clinical space to augment the clinical decision-making process of health care providers. Given the potential to improve patient health outcomes, health care systems around the world are actively engaged in fashioning, implementing, and exploring the outcomes of various RPM program models. However, new challenges to health care systems include increasing RPM program enrollment, optimizing condition-specific RPM programs to best address the needs of specific patient groups, integrating new RPM-derived data streams into existing IT infrastructure, overcoming limited availability of desired remote monitoring technologies, and quantifying the health outcomes produced by RPM use. Herein, we identify stakeholders for RPM in the United States, summarize the landscape of RPM tools available for chronic disease management, discuss the current regulatory environment, delve into the benefits and challenges of integrating these tools into clinical practice, summarize aspects of coverage and reimbursement, and examine the knowledge and policy gaps regarding sustained use of RPM in clinical practice, along with associated opportunities.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e70422"},"PeriodicalIF":5.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Remote Network Technology Supervised Exercise Program Combined With Drug Treatment for Fibromyalgia: Randomized, Single-Blind, Controlled Trial.","authors":"Cuomaoji Zhang, Peijun Zhang, Yuanmeng Zhao, Yuntao Liu, Yun Hu, Zihan Zhu, Hong Xiao","doi":"10.2196/71624","DOIUrl":"10.2196/71624","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fibromyalgia (FM) is a chronic musculoskeletal pain disorder that is seldom reported in China. Recent studies have focused on nondrug treatments, particularly physical therapy, as an alternative to treatments using medication. With the rise of smartphones and mobile communication, mobile health technology has become a significant area of study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to explore whether using remote network applications to supervise patient exercise, in combination with medication, can improve FM pain. It builds on previous research that focuses on drug treatments and offers insights into individualized exercise therapy for FM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt; The study used a prospective, randomized controlled design with 80 participants, who were divided into 2 groups: supervised and unsupervised. Both groups received a drug regimen: oral pregabalin (75-150 mg twice daily) and duloxetine (30-60 mg once daily). The supervised group followed exercise routines with guidance from web-based rehabilitation therapist via a remote network application, while the unsupervised group exercised without supervision. The study was blinded to the participants. Primary outcomes were pain levels over the past 24 hours as measured by the Brief Pain Inventory (BPI). Secondary outcomes included pain relief, sleep improvement, quality of life, and adverse event occurrences. Observations were made at the start of treatment (T0), 1 month after treatment (T1), and 3 months after treatment (T3).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We recruited 80 participants, evenly divided into 2 groups, from August 2022 to December 2023 at West China Hospital of Sichuan University. Comparisons of the 2 groups were performed using analysis of variance and Bonferroni post hoc analyses (SPSS version 25 for Windows, P&lt;.05 considered as significant). Compared with T0, the Widespread Pain Index (WPI), symptom severity score (SSS), and BPI (pain on average, least pain in past 24 h, pain right now) scores of the 2 groups of patients with fibromyalgia at T1 were significantly lower. Compared with T0, the WPI, SSS, BPI (pain on average, worst pain in past 24 h, least pain in past 24 h, pain right now), and Fibromyalgia Impact Questionnaire scores of the 2 groups of patients at T3 were significantly lower. The WPI, SSS, BPI (pain on average, worst pain in past 24 h, pain right now), and Pittsburgh Sleep Quality Index scores of the 2 groups at T3 were significantly lower than at T1. However, the significance of some of the data did not exist after Bonferroni correction. The changes in scores from T0 to T1 (T1-T0), from T0 to T3 (T3-T0), and from T1 to T3 (T3-T1) in the supervised group were all less statistically significant compared to the unsupervised group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The study showed that exercise combined with drug therapy can significantly improve the prognosis of FM, including pain relief, better sleep, and bet","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e71624"},"PeriodicalIF":5.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incentives and Trust Are the Main Drivers of Recruiting Participants in 6 African Countries via Web-Based Environments: A Vignette Survey Experiment.","authors":"Henning Silber, Björn Rohr, Jan Priebe","doi":"10.2196/68472","DOIUrl":"10.2196/68472","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In-person health surveys and biomarker collections (eg, blood testing) provide crucial data to monitor and investigate progress on health outcomes in sub-Saharan Africa. Bearing in mind that administrative sampling frames are often outdated and financial resources can be limited, it is of substantial policy importance to better understand whether recruitment of individuals for in-person health data collection efforts can be accomplished via web-based environments such as social media sites. Yet, there is little methodological research on (1) the feasibility of recruitment through web-based environments and (2) the factors that drive in-person survey participation rates in sub-Saharan Africa countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to share our experimental results on the recruitment of individuals from sub-Saharan Africa for participation in in-person, health-related surveys and biomarker collections via Facebook ads and to provide recommendations for future data collections and research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a preregistered 2×4×4 vignette experiment to investigate people's willingness to participate in in-person health surveys and blood tests. The experiment was part of a web survey (n≈10,600) of individuals recruited via Facebook advertisements that we conducted in early 2023 in 6 sub-Saharan Africa countries (Ghana, Kenya, Nigeria, South Africa, Tanzania, and Uganda). Based on the theories of contextual integrity, economic participation, and social exchange, three factors were varied: (1) the topic (HIV or diabetes), (2) the incentive (US $0, US $2 cash, US $2 voucher, and US $2 lottery), and (3) the sponsor (nongovernmental organization, statistical office, health ministry, or local university).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, we found that a majority of survey participants are willing to participate in in-person health surveys and provide biomarkers (vignette means range between 5.54 and 6.09 on a 1 to 7 scale). First, providing a financial incentive significantly increased the likelihood of being willing to participate (b=.180, .188, and .200; all P&lt;.001). Second, individuals with high levels of trust in nongovernmental organizations or the health ministry were more likely to be willing to participate (b=.086 and .048; both P&lt;.001). In contrast, 2 factors (topic and sponsor) showed mainly non-significant effects (b=.010, P=.63; b=.041, P=.18; b=.042, P=.19; b=.063, P=.05). Other factors that were related to an increase in willingness to participate included fertility levels (having children), risk-taking, having an illness (HIV, diabetes), better general health, social trust, trust in science, survey enjoyment, survey value, and cognitive skills.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Together, the study's results suggest that using a web-based environment for recruiting health research participants in sub-Saharan Africa can be a viable option and emphasize t","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e68472"},"PeriodicalIF":5.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Stakeholders' Perceptions of Using Digital Health Technologies to Improve the Conservative Treatment of Adolescent Idiopathic Scoliosis: Qualitative Study.","authors":"Kamila Sykorova, Anna Mathew, Nenad Pavel, Parisa Gazerani, Trust Saidi, Marianne Bakke Johnsen, June Ullevoldsæter Lystad, Helen Bull, Mette Fløystad Kvammen, Hong-Gu He, Julia Jacoby, Minna Pikkarainen","doi":"10.2196/69089","DOIUrl":"10.2196/69089","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adolescent idiopathic scoliosis (AIS) affects 2%-3% of adolescents, with conservative treatments like bracing and physiotherapeutic scoliosis-specific exercises (PSSEs) recommended for mild to moderate cases. However, patient compliance with these treatments is often low. Digital tools, including smartphone apps and web applications, offer capabilities such as spinal curvature monitoring, remote consultation, and reduction of health care professionals' workload. These tools may also enhance adherence by increasing motivation and providing real-time feedback, which can be particularly beneficial for patients struggling with brace discomfort or self-esteem concerns. Despite these potential benefits, research remains limited on how digital health technologies can specifically enhance conservative AIS treatment and improve patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore the perspectives of multiple stakeholders, including patients, caregivers, and health care providers, on using digital health technologies to improve AIS treatment adherence and outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This qualitative research study was conducted in Norway and included 17 participants (1 medical doctor, 2 physiotherapists, 8 patients, 4 family caregivers, and 2 IT specialists). The study adhered to Norwegian regulations. After approval from authorities and approval of the study protocol, patients were recruited through the Norwegian Spine and Back Pain Organization. A portion of the sample was recruited through direct communication from one of the researchers. After obtaining written informed consent from all participants, 5 focus group interviews were conducted between April and June 2023. Data were transcribed, translated, and analyzed using a content analysis approach, with findings reviewed by 2 independent researchers for validation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The content analysis revealed four key themes: (1) AIS-specific education and information, (2) psychosocial support for patients with AIS and community connection, (3) health care communication and access, and (4) treatment adherence to AIS and gamification. Participants highlighted the need for accessible, adolescent-friendly, and multilingual education on AIS; digital platforms for peer support; improved remote communication with health care providers; and gamification elements tailored to AIS challenges (eg, brace compliance tracking, avatar customization for self-expression, and real-time exercise feedback).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Key findings highlighted the need for accessible information, peer support, and better communication with health care providers, with gamification enhancing treatment adherence. The findings of this study show the potential of digital health technologies in AIS management through fostering accessible information, peer support, and improved communication with health care providers. Customized ga","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e69089"},"PeriodicalIF":5.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a Multilingual AI Care Agent to Reduce Disparities in Colorectal Cancer Screening for Higher Fecal Immunochemical Test Adoption Among Spanish-Speaking Patients: Retrospective Analysis.","authors":"Meenesh Bhimani, R Hal Baker, Markel Sanz Ausin, Gerald Meixiong, Rae Lasko, Mariska Raglow-Defranco, Alex Miller, Subhabrata Mukherjee, Saad Godil, Anderson Cook, Jonathan D Agnew, Ashish Atreja","doi":"10.2196/71211","DOIUrl":"10.2196/71211","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) screening rates remain disproportionately low among Hispanic and Latino populations compared to non-Hispanic White populations. While artificial intelligence (AI) shows promise in health care delivery, concerns exist that AI-based interventions may disadvantage non-English-speaking populations due to biases in development and deployment.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a multilingual AI care agent in engaging Spanish-speaking patients for CRC screening compared to that with English-speaking patients.</p><p><strong>Methods: </strong>This retrospective analysis examined an AI-powered outreach initiative at WellSpan Health in Pennsylvania and Maryland during September 2024. The study included 1878 patients (517 Spanish-speaking, 1361 English-speaking) eligible for CRC screening who lacked active web-based health profiles. A multilingual AI conversational agent conducted personalized telephone calls in the patient's preferred language to provide education about CRC screening and facilitate fecal immunochemical test (FIT) kit requests. The primary outcome was the FIT test opt-in rate, with secondary outcomes including connect rates and call duration. Statistical analysis included descriptive statistics, bivariate comparisons, and multivariate logistic regression.</p><p><strong>Results: </strong>Spanish-speaking patients demonstrated significantly higher engagement across all measures than English-speaking patients with respect to FIT test opt-in rates (18.2% vs 7.1%, P<.001), connect rates (69.6% vs 53.0%, P<.001), and call duration (6.05 vs 4.03 minutes, P<.001). Demographically, Spanish-speaking patients were younger (mean age 57 vs 61 years, P<.001) and more likely to be female (49.1% vs 38.4%, P<.001). In multivariate analysis, Spanish language preference remained an independent predictor of FIT test opt-in (adjusted odds ratio 2.012, 95% CI 1.340-3.019; P<.001) after controlling for demographic factors and call duration.</p><p><strong>Conclusions: </strong>AI-powered outreach achieved significantly higher engagement among Spanish-speaking patients, challenging the assumption that technological interventions inherently disadvantage non-English-speaking populations. The 2.6-fold higher FIT test opt-in rate among Spanish-speaking patients represents a notable departure from historical patterns of health care disparities. These findings suggest that language-concordant AI interactions may help address longstanding disparities in preventive care access. Study limitations include its single health care system setting, short duration, and lack of follow-up data on completed screenings. Future research should assess long-term adherence and whether higher engagement translates to improved clinical outcomes.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e71211"},"PeriodicalIF":5.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Language Models Could Revolutionize Health Care, but Technical Hurdles May Limit Their Applications.","authors":"Diva Beltramin, Cédric Bousquet, Théophile Tiffet","doi":"10.2196/71618","DOIUrl":"10.2196/71618","url":null,"abstract":"","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e71618"},"PeriodicalIF":5.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Information and Communication Technology-Based Cognitive Behavioral Therapy Using the Smart Sleep App on Insomnia in Older Adults: Randomized Controlled Trial.","authors":"ChanHee Kim, Yeonhee Lee, Seung-Gul Kang, Seon-Heui Lee","doi":"10.2196/67751","DOIUrl":"10.2196/67751","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is a common sleep disorder, especially among older adults, with a significant impact on the quality of life (QoL) and is associated with various comorbidities. Traditional pharmacotherapy for insomnia is often unsuitable for older adults because of potential drug interactions and side effects, making nonpharmacological interventions such as cognitive behavioral therapy for insomnia (CBT-I) more appropriate. However, delivering CBT-I in a traditional face-to-face setting poses challenges including accessibility and adherence, particularly for older adults.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of an information and communication technology (ICT)-based CBT-I program, \"Smart Sleep,\" specifically designed to improve insomnia among community-dwelling older persons.</p><p><strong>Methods: </strong>A single-blind randomized controlled trial was conducted with 59 older participants from Incheon, South Korea. Participants were divided into an intervention group, which used the Smart Sleep mobile app, and a control group. The intervention group received 8 weeks of non-face-to-face CBT-I through the app, which included sleep diaries, relaxation exercises, and real-time consultations. Outcomes were measured at baseline, week 4, and week 8, with a focus on insomnia severity, sleep quality, sleep efficiency, dysfunctional beliefs about sleep, depression, and QoL.</p><p><strong>Results: </strong>The intervention group showed significant improvements in insomnia severity, sleep quality, sleep efficiency, and dysfunctional beliefs about sleep compared to the control group. However, there was no significant difference in the QoL between the 2 groups (F_2,114=0.998, P=.37). Participation rates in the Smart Sleep program were high, with a 94% completion rate for sleep diary tasks and 100% participation in real-time consultations. In addition, subgroup analysis based on sleep medication use showed significant improvements in insomnia severity for both medicated and nonmedicated participants.</p><p><strong>Conclusions: </strong>The ICT-based CBT-I program \"Smart Sleep\" effectively improved sleep-related outcomes among older participants, demonstrating the potential of non-face-to-face interventions in managing insomnia in this population. The program is user-friendly, and ICT-based coaching contributed to high engagement. To ensure broader access for older adults, distribution through community welfare or public health centers is recommended.</p><p><strong>Trial registration: </strong>Clinical Research Information Service KCT0007287; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=23344.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"27 ","pages":"e67751"},"PeriodicalIF":5.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}