JMIR Human Factors最新文献

{"title":"User Perspectives on Conversational Agents for Preventive Alcohol Self-Help: Qualitative Exploratory Study.","authors":"Marissa De Vries, Melissa Begeman, Marloes Derksen, Anna Goudriaan, Matthijs Blankers","doi":"10.2196/86752","DOIUrl":"10.2196/86752","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use remains a major public health concern, and although preventive alcohol self-help interventions aim to support individuals in need of indicated prevention, they continue to face challenges related to low engagement and high attrition. Chatbots, also known as conversational agents (CAs), powered by artificial intelligence, may enhance engagement by offering personalized guidance and 24/7 availability. Yet, user perspectives on CAs in preventive alcohol self-help care remain largely unexplored.</p><p><strong>Objective: </strong>This paper aimed to gain insight into the diverse factors shaping the adoption of CAs in preventive alcohol self-help by qualitatively exploring users' expectations and concerns, complemented by descriptive questionnaire data on perceived usefulness, intention to use, comfort, and trust.</p><p><strong>Methods: </strong>This qualitative, exploratory study with a small purposive sample (N=12) included adults recruited from a Dutch digital alcohol self-help intervention and a client advisory board. Data were collected during an online focus group (n=8, 66.7%), 4 semistructured interviews (n=4, 33.3%), and a brief questionnaire administered to all participants in March 2025 and April 2025. The qualitative data were analyzed inductively using thematic analysis.</p><p><strong>Results: </strong>Qualitative findings showed that participants appreciated the 24/7 availability, practical guidance, and nonjudgmental stance of CAs but doubted their capacity for genuine empathy and authenticity. Participants emphasized that the conversational tone was important: CAs should be supportive without being overly agreeable and should be confrontational once trust is established. Concerns about undue influence arose occasionally, while privacy was viewed by 1 (8.3%) participant as a major issue. Descriptive questionnaire results showed that 11 (92%) participants had prior experience with CAs, whereas only 6 (50%) had experience with digital health interventions. Most participants considered CAs potentially useful for reducing alcohol use, yet few expressed strong intentions to use one themselves. Comfort and trust ratings were largely neutral, reflecting a cautious but generally open attitude toward CA use.</p><p><strong>Conclusions: </strong>CAs appear to hold promise as complementary tools for preventive alcohol self-help, although they are not perceived as replacements for human contact. Future design efforts should emphasize personalized interactions; an appropriate conversational tone, supportive yet not overly agreeable; and transparent communication about data use to enhance engagement and acceptance. The findings are descriptive and are not intended to be broadly generalizable.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e86752"},"PeriodicalIF":3.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Blended Physical Activity Intervention for Office Employees Using Intervention Mapping: Intervention Development Study.","authors":"Yan Sun, Alison Yt Ou, Tony Lei Shi, Yang Gao, Martin S Hagger, Zhennan Xiong, Xiang-Yan Chen, Shirley Sm Fong, Linda L D Zhong, Yao Jie Xie, Julien S Baker","doi":"10.2196/87328","DOIUrl":"10.2196/87328","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Insufficient engagement in moderate to vigorous physical activity (MVPA) is a significant risk factor for major noncommunicable diseases, including cardiovascular diseases (eg, coronary heart disease and stroke), type 2 diabetes, and several cancers. Physical inactivity accounts for an estimated 3.2 million deaths annually. Office employees, due to their sedentary and desk-based work patterns, are particularly vulnerable to low MVPA levels, which negatively affect health and work productivity. The COVID-19 pandemic exacerbated these issues, further reducing MVPA levels due to lockdowns and work-from-home policies. Although numerous interventions have aimed to promote MVPA, many lack theoretical grounding, stakeholder involvement, or systematic development frameworks. A theory- and evidence-informed approach is warranted to target modifiable determinants and mechanisms, improve coherence and replicability, and enhance effectiveness and scalability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to design an evidence-based blended intervention to improve MVPA, health, and productivity among office employees, guided by the intervention mapping (IM) framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following the first 4 steps of the IM framework, we developed a 12-week blended intervention and created a website named \"Smartly Active for Health and Life.\" Step 1 involved a needs assessment through a literature review and focus group discussions (n=12 office employees) to identify barriers, facilitators, and determinants of MVPA. Step 2 defined intervention outcomes, performance objectives, and change objectives based on the social ecological model. Step 3 integrated theory- and evidence-based behavior change techniques with delivery methods, resulting in a 3-group randomized controlled trial design: (1) a blended intervention group (web-based sessions and e-workshops), (2) a web-only intervention group, and (3) an active control group. Step 4 developed and refined intervention materials and protocols through a pilot study (n=18). Key behavior change techniques included problem-solving, goal setting, self-monitoring, and habit formation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The pilot study demonstrated the intervention's acceptability, feasibility, and adaptability. Participants reported increased motivation, improved knowledge of MVPA benefits, and greater confidence in goal setting and self-regulation. Feedback led to refinements such as improved website navigation and interactive content. The intervention is expected to enhance MVPA levels, health, and work productivity by addressing both motivational and volitional phases of behavior change while supporting habitual behaviors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The IM framework offered a systematic and iterative approach for developing a blended MVPA intervention tailored to the needs of office employees. This study highlights the importance of theory-driven and stakeholder","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e87328"},"PeriodicalIF":3.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449720","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":"Evaluation of the Feasibility and Acceptability of Perfect Fit, a Virtual Coach-Based mHealth Intervention for Smoking Cessation and Physical Activity in Adults: Mixed Methods Study.","authors":"Milon H M van Vliet, Eline Meijer, Nele Albers, Kristell M Penfornis, Walter Baccinelli, Bouke L Scheltinga, Roxy A van Eersel, Niels H Chavannes, Anke Versluis","doi":"10.2196/83456","DOIUrl":"10.2196/83456","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mobile health (mHealth) interventions with virtual coaches offer scalable and potentially cost-effective solutions for health behavior change. However, these interventions commonly present challenges, such as limited personalization and insufficient grounding in evidence-based strategies. Perfect Fit (PF; Perfect Fit consortium), a personalized mHealth intervention with a text-based virtual coach, supports adults in quitting smoking and becoming more physically active. By combining innovative techniques, including sensor technology, end user involvement, and evidence-based strategies, PF aims to address common challenges faced by mHealth interventions, including those with virtual coaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The study primarily investigated the feasibility and acceptability of PF. The secondary aim was to explore associations between sociodemographic, smoking-, and physical activity-related characteristics and the feasibility and acceptability outcomes. The third aim was to evaluate the feasibility of conducting the research study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-arm, pre-post, mixed methods study was conducted in the Netherlands with 100 adults who smoked. The intervention lasted approximately 16 weeks. Data were collected at baseline, during the intervention, and postintervention (4 months). Quantitative data included usage data and self-report questionnaires on feasibility, acceptability, and baseline characteristics. Qualitative data were gathered through postintervention semistructured interviews. Analyses included descriptive and inferential analyses, as well as the framework approach for the qualitative data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;PF usage varied considerably across participants (n=87). The mean satisfaction rating was 2.79 (SD 0.73; scale range 1-4), and perceived usability had a median score of 67.50 (range 12.50-87.50; scoring range 0-100), indicating OK-to-good usability. The mean virtual coach acceptance rating was -0.27 (SD 1.30; scale range -3 to 3; n=77). Higher PF usage was associated with greater satisfaction, usability, and coach acceptance (all P≤.004). Frequent connection issues with the smartwatch were a disruptive factor. Qualitative findings (n=12) provided in-depth insights into PF's feasibility and acceptability, encompassing both positive and negative experiences. For instance, some participants valued the virtual coach for its anonymity, low-threshold access, and the sense of control it offered, while others preferred a human coach for greater accountability. Suggested improvements included more varied content and enhanced adaptability of the coach to users' input and personal situations. Exploratory analyses suggested that high PF users were older than moderate (P=.01) and low PF users (P=.05). Importantly, PF was perceived as similarly feasible and acceptable across socioeconomic groups (P&gt;.05), aligning with one of the project's goals. Finally, researc","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e83456"},"PeriodicalIF":3.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449717","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 Patients' Experiences in a Blended Transdiagnostic Group Treatment: Qualitative Study.","authors":"Noelia Jiménez-Orenga, Alba Fadrique-Jiménez, Azucena García-Palacios, Jorge Osma, Amanda Díaz-García, Juana Bretón-López","doi":"10.2196/86016","DOIUrl":"10.2196/86016","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Emotional disorders (EDs) are the most prevalent mental disorders worldwide. Health services face significant difficulties in attending to the high demand and applying evidence-based psychological treatments. Combining the transdiagnostic approach with the group and blended formats could help the accessibility of treatment for ED. It is important to assess the feasibility and acceptability of new interventions from a qualitative perspective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore the experiences and opinions of patients with ED who have received transdiagnostic cognitive behavioral therapy treatment in a group and blended format.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two subsamples of participants were included: those who completed the intervention (n=18) and those who did not (n=4). The completers' subsample participated in focus groups, which were transcribed verbatim and subsequently analyzed using a consensus qualitative research methodology. The noncompleters subsample completed a brief online questionnaire. Key themes identified by 2 independent researchers were described and used as complementary to focus group findings. Results were reported following the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After analyzing the focus group interviews using the consensus qualitative research method, 8 domains (or topic areas) were identified, namely experience with the online platform, configuration of the blended intervention, therapeutic content, experience with the group sessions via videoconference, role of the therapists, overall assessment of the blended treatment, elements that help maintain adherence, and suggestions for improvement. Overall, participants reported benefits from this type of intervention, expressed satisfaction with the treatment, and highlighted the perceived improvement and usefulness of what they learned. They also noted the good usability of the platform and the possibility of establishing a good therapeutic alliance in this format. Participants also pointed out unfavorable aspects and offered suggestions on possible areas for improvement. For noncompleters, various reasons for dropping out were identified: lack of treatment efficacy, intervention-related stress, difficulty in applying learned strategies, low involvement, lack of motivation, time constraints, or need for different types of help. Strategies to enhance adherence to treatment were also identified, such as changes in the format and configuration of the sessions, allowing more time to discuss individual problems or reducing the number of homework assignments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These qualitative results support the feasibility, acceptability, and clinical utility of a blended group transdiagnostic intervention for the treatment of ED. This novel format could be a scalable and well-valued option within mental health services, althou","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e86016"},"PeriodicalIF":3.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399671","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":"A Mobile App (Tpro) for Symptom Management in Patients With Deep Vein Thrombosis Based on Patient-Reported Outcomes: Design and Development Using an Iterative Convergent Mixed Methods Approach.","authors":"Qiaodan Lu, Yafei Liu, Manna Shao, Lei Wang","doi":"10.2196/92738","DOIUrl":"10.2196/92738","url":null,"abstract":"<p><strong>Background: </strong>Deep vein thrombosis (DVT) is a significant global health issue, often associated with a high symptom burden and reduced quality of life, especially after discharge. Traditional symptom management models are typically passive, clinician-centered, and lack real-time monitoring and feedback, which can lead to delayed interventions and poor patient engagement. While mobile health (mHealth) interventions offer a promising alternative, they require rigorous usability testing to ensure both efficacy and adoption.</p><p><strong>Objective: </strong>This study aimed to design and develop Tpro (developed by the Department of Vascular Surgery, Peking Union Medical College Hospital), a patient-reported outcome (PRO)-based mobile app for patients with DVT. Using an iterative convergent mixed methods design, the app seeks to enable proactive symptom monitoring, health education, clinician-patient interaction, and peer support, thereby optimizing its usability, functionality, and alignment with patient needs.</p><p><strong>Methods: </strong>The development followed an iterative convergent mixed methods design, comprising predevelopment and iterative optimization phases. Initial functions were informed by qualitative interviews with 14 patients with DVT. Over 4 iterative cycles, qualitative feedback and quantitative usability data (including task completion rates and User Interface Usability Questionnaire [UIUQ] scores) were concurrently collected, analyzed, and integrated via joint displays to guide refinements in content, interface, and system architecture until usability benchmarks were met.</p><p><strong>Results: </strong>The final Tpro app encompasses 4 core modules, including gamified symptom reporting, multimodal health education, clinician-patient communication, and a peer support community. Iterative testing identified and resolved key usability issues. The final prototype demonstrated high usability, achieving an excellent UIUQ score (mean 89, SD 13) and a task completion rate of 92% (12/13), indicating high user acceptance and operational reliability.</p><p><strong>Conclusions: </strong>Applying the iterative convergent mixed methods approach enabled the systematic and user-centered development of Tpro. This methodology effectively integrated diverse stakeholder feedback into a functional and engaging patient-reported outcome-based app, ready for subsequent efficacy trials. This approach offers a replicable model for developing digital health tools in complex clinical contexts.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e92738"},"PeriodicalIF":3.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382393","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 Intervention Mapping to Codevelop Orchid, a Digital Tool for Reproductive Life Planning: Development and Feasibility Study.","authors":"Catherine Stewart, Helen Carr, Maitri Shila Tursini, Alice Howe, Jennifer Hall","doi":"10.2196/87650","DOIUrl":"10.2196/87650","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Most people make no health or lifestyle changes before pregnancy, missing a key opportunity to improve outcomes. Consequently, nearly half of UK pregnancies are unplanned, disproportionately affecting underserved groups and widening health inequalities. Digital health interventions (DHIs) offer promise but require systematic, theory-driven development to ensure effectiveness and real-world applicability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to use Intervention Mapping to codevelop and pilot Orchid, a novel DHI designed to support people of reproductive age to understand their pregnancy preferences and develop a reproductive life plan (RLP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used Intervention Mapping steps 1-4 to guide the systematic, theory-informed codevelopment of Orchid. A multidisciplinary planning group and codevelopment group of 21 members of the public contributed throughout. At step 1, previous research and a scoping review of existing RLPs informed the program goals and logic model of the problem. During step 2, we identified performance objectives and behavioral determinants to specify practical strategies for each target behavior. At step 3, we applied the Capability, Opportunity, Motivation-Behavior (COM-B) model and relevant behavior change techniques to guide intervention design. Finally, at step 4, Orchid was co-designed as a website and mobile app providing users with a pregnancy preference group and prediction of pregnancy, a dynamic RLP, tailored evidence-based information, and optional goal-setting features to support behavior change. Orchid was piloted between January and May 2025 to explore its feasibility and acceptability in health care settings. Interviews with users, nonusers, and health care professionals were conducted and quantitative data from users were collected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;These findings indicate that implementation was feasible, and health care professionals found it acceptable to recommend Orchid to patients, though noted barriers including time constraints and competing priorities. Overall, 153 people signed up to Orchid; 68% (72/106) of eligible users received a pregnancy preference group and 27% (32/119) of eligible users completed a full RLP. Users were positive about Orchid, appreciating its content and design, noting that Orchid contained a wealth of information about reproductive health presented in an easy-to-understand manner. They valued the autonomy, convenience, and privacy afforded by the digital format, and found it acceptable to be recommended Orchid within a health care setting. Orchid uptake was lower than anticipated, and use was limited; this was partly expected given the short pilot period, but feedback also suggested targeted recruitment and navigation improvements could enhance uptake and engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Orchid is the first co-designed DHI to support reproductive health across the life course.","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e87650"},"PeriodicalIF":3.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377110","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":"Monitoring Health Status: Development and Preliminary Validation of a Personal Health Index Using the International Classification of Functioning, Disability and Health.","authors":"Ilkka Rautiainen, Lauri Parviainen, Veera Jakoaho, Sami Äyrämö, Jukka-Pekka Kauppi","doi":"10.2196/84802","DOIUrl":"10.2196/84802","url":null,"abstract":"<p><strong>Background: </strong>Effective health monitoring is essential for personalized care and comprehensive health assessment. Personal health indices and profiles offer a concise summary of an individual's overall health, supporting both clinical decision-making and self-management. However, global standardization remains challenging due to diverse practices and data formats across countries.</p><p><strong>Objective: </strong>This study aimed to present a novel model for computing a personal health index and health profile using the International Classification of Functioning, Disability and Health (ICF) framework. The model was designed to handle incomplete and heterogeneous datasets and aimed to provide standardized, interpretable health metrics.</p><p><strong>Methods: </strong>We developed a recursive algorithm that calculates the health index based on the hierarchical structure of the ICF, using all available measurements. The model incorporates time decay and linkage reliability to weight input data. Preliminary validation was conducted on data from 505 individuals, using statistical correlation analyses with self-assessed health measures (EuroQol Visual Analogue Scale and pain ratings), and a sensitivity analysis was performed to assess model robustness.</p><p><strong>Results: </strong>The computed health index showed moderate positive correlations with EuroQol Visual Analogue Scale scores (all P<.001) and negative correlations with maximum pain trajectories, supporting its validity. Sensitivity analysis confirmed predictable behavior in response to input changes, and the model demonstrated resilience to missing data.</p><p><strong>Conclusions: </strong>The proposed model offers a flexible and scientifically grounded approach to computing personal health indices and profiles within the ICF framework. It enables the integration of diverse health data sources and supports the visual representation for clinical and personal use. This model has potential applications in health monitoring, rehabilitation planning, and machine learning-based health informatics.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e84802"},"PeriodicalIF":3.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377128","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":"Evaluating the Viability of Virtual Reality for Children's Food Choice Research: Comparative Mixed Methods Study.","authors":"Deepti Aggarwal, Thuong Hoang, Sze-Yen Tan, Mohammadreza Mohebbi, Catherine G Russell","doi":"10.2196/88476","DOIUrl":"10.2196/88476","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality (VR) systems offer promising potential as a controlled platform to investigate human behaviors specifically related to food choices. Yet, little is known about its viability for conducting food choice studies with children, thus limiting the development of public health research.</p><p><strong>Objective: </strong>This study aimed to investigate the viability of VR technology for understanding children's food choices, focusing specifically on perceptual differences between VR and real-life (RL) settings. We examined how children perceive and interact with food portion sizes and container sizes in VR as compared with an equivalent RL scenario.</p><p><strong>Methods: </strong>A within-subject, mixed methods study was conducted with 437 children aged 5-12 years at a science museum. Participants engaged in a standardized food selection task for a simulated breakfast scenario, choosing portions of cereal and milk in 2 conditions: a head-mounted VR environment and a corresponding RL physical setup. Children's food selection behaviors were quantitatively compared across 3 independent variables: condition (VR vs RL), food healthiness (healthy vs unhealthy options), and container size (small, medium, and large). Qualitative and quantitative data were collected via postsession questionnaires assessing presence, embodiment, and simulator sickness, alongside detailed interaction logs from the VR environment. Data analysis used statistical comparisons and thematic analysis.</p><p><strong>Results: </strong>The findings revealed both behavioral consistency and significant perceptual differences between the VR and RL conditions. A behavioral similarity was identified, as children served significantly larger portions of unhealthy food compared with healthy food in both conditions. Crucially, a difference was observed in size perception: children struggled to accurately match the size of bowls and glasses between the VR and RL conditions. Furthermore, while children reported low feelings of presence and embodiment within the VR scenario, they demonstrated a high degree of control and engagement in the virtual task.</p><p><strong>Conclusions: </strong>Our findings suggest that current state-of-the-art VR technology presents limitations in its viability for conducting food choice studies with children, particularly concerning accurate size and volume perception. Based on the findings, we provide 4 practical recommendations to guide the future development of immersive food environments, thereby supporting more reliable and ecologically valid food choice research with young populations.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e88476"},"PeriodicalIF":3.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370106","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-Based Ecological Momentary Assessment to Monitor Opioid Use and Overdose Among People Who Use Opioids: Prospective Observational Feasibility Study.","authors":"Kamal Gautam, Kiran Paudel, Jeffrey A Wickersham, Antoine Khati, Anushka Thapa, Sandesh Bhusal, Md Safaet Hossain Sujan, Sherry Pagoto, Toan Ha, Roman Shrestha","doi":"10.2196/95655","DOIUrl":"10.2196/95655","url":null,"abstract":"<p><strong>Background: </strong>Opioids account for 76% of drug overdose deaths in the United States, with nearly 80,000 opioid overdose deaths annually. The risk of overdose is dynamic and influenced by rapidly changing behaviors and contexts that are not well captured by retrospective or infrequent assessments. Ecological momentary assessment (EMA) allows repeated near real-time reporting of behaviors and experiences in natural settings.</p><p><strong>Objective: </strong>This study evaluated the feasibility and acceptability of smartphone-based EMA among people who use opioids to monitor opioid use, overdose experiences, and naloxone access.</p><p><strong>Methods: </strong>Participants were recruited through the New Haven Syringe Services Program in New Haven, Connecticut, and completed fixed-time, twice-daily EMA prompts for 30 days using a smartphone app. EMA measures assessed behaviors and experiences occurring within the previous 12 hours, including opioid craving, plans to use drugs, opioid use, overdose experiences, and naloxone access. Feasibility was assessed through recruitment, retention, and EMA completion rates, as well as the reporting of drug use-related behaviors. Acceptability was evaluated using exit surveys assessing ease of use, burden, and privacy, as well as qualitative interviews.</p><p><strong>Results: </strong>Of the 13 screened individuals, 10 were enrolled and completed the baseline assessment. A total of 9 (90%) participants completed EMA and responded to 411 prompts, with an overall compliance rate of a mean of 85.0% (SD 8.7%). Compliance was similar across morning (84.2%, SD 13.1%) and evening (85.8%, SD 11.2%) prompts. Participants reported opioid cravings (274 reports), plans to use illicit drugs (252 reports), and opioid use (411 reports) during the study period. Two participants reported overdose events (5 reports) and were carrying naloxone during each overdose event. Acceptability ratings were high: all participants reported that EMA prompts were easy to understand and private, and most did not find them burdensome. Qualitative feedback further highlighted the ease of use, integration into daily routines, and increased self-awareness, although some participants reported emotional discomfort when reflecting on their substance use.</p><p><strong>Conclusions: </strong>Smartphone-based EMA was feasible and acceptable among people who use opioids recruited through a syringe service program. EMA may support the monitoring of opioid use, overdose experiences, and naloxone access, and it may inform future digital health interventions aimed at reducing harm, including overdose risk, among people who use opioids.</p>","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e95655"},"PeriodicalIF":3.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354033","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":"Risk Factors for Noninitiation and Dropout in Blended Therapy in Inpatient Psychiatric Patients: Retrospective Cohort Study.","authors":"Nikita Gupta, Fabian Gardin, Thomas Berger, Wolfram Kawohl","doi":"10.2196/85816","DOIUrl":"10.2196/85816","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Blended therapy (BT) combines digital applications with face-to-face treatment and has become an increasingly important component of psychiatric care. Evidence indicates that BT can achieve outcomes comparable to or even superior to those of traditional face-to-face therapy. Despite certain advantages, routine implementation of BT remains challenging, and clinical practice suggests that while some inpatients engage with BT, many either discontinue early or do not initiate its use at all. To better understand these patterns, this multicentric, retrospective observational study investigates factors associated with noninitiation and dropout among inpatients who are offered BT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this study, data from 278 inpatients were analyzed to examine the influence of sociodemographic variables, comorbidities, and symptom severity on the uptake and continued use of BT. The objective was to identify predictors of noninitiation and dropout.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Multivariable logistic regression models were conducted to identify significant predictors of noninitiation and dropout among inpatients using the transdiagnostic, cognitive behavioral therapy-based electronic mental health platform Minddistrict, which offers modules targeting psychoeducation, cognitive restructuring, and behavioral activation. Data were collected from 2 psychiatric hospitals between January 2020 and May 2024. The sample consisted predominantly of patients diagnosed with depression (182/278, 65.7%) and posttraumatic stress disorder (61/278, 21.9%), alongside various comorbid conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The findings indicate distinct patterns of association for noninitiation and dropout. Of the 278 patients, only 5 (1.8%) completed all the assigned modules, and one-third of the patients never initiated the platform at all. Specifically, increasing age was linked to a lower risk of noninitiation (odds ratio [per year age difference] 0.98, 95% CI 0.96-1.00; P=.01), while the presence of a comorbid anxiety disorder was associated with a reduced risk of dropout (odds ratio 0.23, 95% CI 0.08-0.66; P=.007). Several variables showed no association with either noninitiation or dropout across all analyses, including sex, overall symptom severity, and certain comorbidities such as personality disorders and depression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this preselected inpatient sample, uptake of BT was very limited. Older age was associated with lower noninitiation, and comorbid anxiety disorders were associated with a lower likelihood of dropout. These findings may help inform future prospective studies on how BT can be introduced and supported more effectively in inpatient psychiatric care. As access to BT was granted selectively by therapists, the results should be interpreted as predictors of engagement within a selected sample rather than general predictors of BT uptake among all psychiatric inpati","PeriodicalId":36351,"journal":{"name":"JMIR Human Factors","volume":"13 ","pages":"e85816"},"PeriodicalIF":3.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354048","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}