Interactive Journal of Medical Research最新文献

{"title":"Trust Barriers and Vulnerabilities in Older Adults' Telemedicine Adoption: Scoping Review.","authors":"Wanqing Wang, Xin Ma, Matthew Ting Chi Liu, Angela Chang","doi":"10.2196/84818","DOIUrl":"10.2196/84818","url":null,"abstract":"<p><strong>Background: </strong>Aging populations worldwide face increasing health care demands, particularly for chronic disease management. While telemedicine offers a viable solution to enhance health care access, significant trust-related barriers hinder its adoption among older adults, warranting a scoping synthesis of available evidence.</p><p><strong>Objective: </strong>This scoping review aims to map the available evidence on trust barriers experienced by older adults in telemedicine, identify underlying vulnerability domains, and chart the evidence base for design and policy recommendations.</p><p><strong>Methods: </strong>We conducted a scoping review in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, analyzing literature from PubMed, Web of Science, and Scopus. Thematic analysis was applied to synthesize findings from 30 included studies.</p><p><strong>Results: </strong>Four primary trust barriers were identified: technophobia and technical difficulties, privacy and data security concerns, negative emotional and social impacts, and a strong preference for in-person care. These barriers mapped onto 4 vulnerability domains: limited telemedicine literacy (particularly low eHealth self-efficacy), declining health status (including sensory and cognitive impairments), psychological and cognitive factors (such as anxiety about losing autonomy), and inadequate social support systems. The review also underscored how rapid technological change amplifies these challenges for older adults.</p><p><strong>Conclusions: </strong>Effective telemedicine implementation for older adults requires multipronged interventions, including age-appropriate interface design, targeted digital literacy training, robust privacy protections, and personalized support systems. These approaches address both technological and psychosocial barriers, potentially increasing engagement while mitigating vulnerabilities. Future research should assess the effectiveness of these interventions across diverse older populations.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"15 ","pages":"e84818"},"PeriodicalIF":3.3,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450414","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":"Healthcare Analytics Challenges: A Three-Pillar Framework Connecting Analytics Maturity, Workforce Agility, and Technical Enablement.","authors":"Samuel Thomas Harrold","doi":"10.2196/96541","DOIUrl":"10.2196/96541","url":null,"abstract":"<p><strong>Unstructured: </strong>Healthcare organizations face a \"Triple Threat\" of low analytics maturity, high workforce instability, and semantic technical barriers that together produce a crisis of \"Institutional Amnesia.\" Leadership turnover, workforce shortages, and widespread intent to leave among informatics specialists systematically erase the tacit knowledge required to navigate complex clinical data schemas, trapping organizations in a cycle where knowledge loss outpaces knowledge capture. Viewed through Nonaka's SECI (Socialization, Externalization, Combination, Internalization) model of knowledge creation, the root cause is a \"Socialization Failure\": high turnover fractures the social networks required for mentorship, rendering the traditional apprenticeship model of informatics unsustainable. To address this failure, we employ a Design Science Research (DSR) approach, synthesizing evidence from healthcare informatics, knowledge management, and natural language processing to develop a socio-technical framework: Human-in-the-Loop Knowledge Governance (HITL-KG). HITL-KG is designed to shift the locus of organizational knowledge from volatile human memory to durable semantic artifacts called \"Validated Query Triples,\" each comprising a natural language intent, executable SQL, and rationale metadata. By embedding knowledge capture into the daily query workflow, the framework aims to convert ephemeral analytics into permanent institutional assets. The accompanying Three-Pillar Assessment Rubric enables organizations to identify compounding vulnerabilities across analytics maturity, workforce agility, and technical enablement. The \"Validator Paradox\" (who validates the AI when experts leave?) is addressed by reframing validation through Lean \"Standard Work\": each validated query establishes the current known standard rather than eternal truth, functioning as a \"knowledge ratchet\" that prevents regression. Decoupling analytical capability from individual tenure lets analytics maturity advance even as the workforce evolves. This paper proposes and theoretically motivates the framework; empirical validation is deferred to a companion study.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Landscape, Evidence, Gaps, and Opportunities in Digital Mental Health Interventions for Older Adults: Scoping Review.","authors":"Leyi Zhou, Xinyi Zuo, Joonyoung Cho, Chuxuan Zheng, Shengyi Jing, Xiaoling Xiang","doi":"10.2196/92542","DOIUrl":"10.2196/92542","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mental health conditions, including depression, anxiety, and psychological distress, are prevalent among the aging population and affect their health, functioning, and quality of life. Access to proper and high-quality mental health treatment is necessary; however, mental health treatment and care remain underused due to stigma, workforce shortages, cost, and mobility limitations. Digital mental health interventions (DMHIs) are emerging as a promising strategy to improve the accessibility and effectiveness of mental health services for older adults, but older adults have historically been underrepresented in DMHI development and evaluation. Additionally, the effectiveness of different types of DMHIs and how age-centered design approaches influence outcomes remain underexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This scoping review mapped and synthesized evidence on DMHIs focused on adults aged 50 years and older and identified gaps in the evidence base related to study design, age-related adaptations, and clinical outcomes. Specifically, we examined (1) the technologies and therapeutic approaches used, (2) the outcomes and effectiveness of DMHIs, and (3) age-centered adaptations and their outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This scoping review searched for studies focusing on DMHIs for older adults across PubMed, PsycINFO, Scopus, Ageline, and Web of Science that were published from 2000 to February 2025. Eligible studies evaluated or described the design of DMHIs targeting mental health conditions among adults aged 50 years or older. Two rounds of independent screening and data extraction were conducted by multiple reviewers. Extracted data included study design, sample characteristics, intervention features, technologies used, age-related adaptations, and clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventy-two studies met the inclusion criteria, of which 36 were randomized controlled trials and 54 reported clinical outcomes. Web-based cognitive behavioral therapy was the most commonly used approach, followed by games, virtual reality, mobile apps, chatbots, and robots. Fifty-four studies reported positive clinical outcomes, most commonly reductions in depression, anxiety, or psychological distress. However, only one-third of the studies incorporated age-centered design adaptations or co-design approaches, such as simplified interfaces, larger fonts, age-relevant content, or participatory development with older adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Among studies reporting positive clinical outcomes, DMHIs can reduce depression, anxiety, and psychological distress. However, with only half of the included studies using randomized controlled trial designs, the overall evidence base remains moderate. In addition, age-adaptive design remains underdeveloped. Future research should strengthen trial designs and systematically examine how usability and age-centered adaptations influence DMHI effectivenes","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"15 ","pages":"e92542"},"PeriodicalIF":3.3,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392327","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":"Determining the Relationship Between People's Explicit and Implicit Preferences for Gender-Inclusive Sexual and Reproductive Health Content: Randomized Controlled Trial.","authors":"Elizabeth R Boskey, Jessica D Kant, Ariel K Berman, Frances W Grimstad","doi":"10.2196/85868","DOIUrl":"10.2196/85868","url":null,"abstract":"<p><strong>Background: </strong>Inclusive health education content has been shown to increase acceptability and accessibility for lesbian, gay, bisexual, transgender, queer, intersex, and asexual, as well as other sexual and gender minority (LGBTQ+) individuals. However, there has been some backlash among general audiences, with claims that such inclusive content is \"woke\" or otherwise problematic.</p><p><strong>Objective: </strong>The goal of this study was to test whether individuals across the political spectrum notice when sexual and reproductive health content is written with inclusive language in order to demonstrate the acceptability of inclusive content to a broader audience.</p><p><strong>Methods: </strong>This study included 454 adults assigned female at birth from the United States, one-third of whom identified as LGBTQ+, reviewed 2 sets of reproductive health educational handouts designed for adolescents, with 1 gender-inclusive and 1 gender-specific version in each set, randomized in order. Individuals were asked to rate each document and state a preference within each pair (implicit preference). They were then debriefed on the study's purpose and asked if they had an explicit preference for gender-specific or gender-inclusive content.</p><p><strong>Results: </strong>Preferences for explicit content tended toward gender-specific content: always gender-specific (n=184, 40.5%), sometimes gender-specific (n=59, 13%), no preference (n=131, 28.8%), sometimes gender-inclusive (n=39, 8.6%), and always gender-inclusive (n=41, 9%). However, most people (n=273, 59%) did not notice differences between the first pair of documents they viewed or rate them differently (mean difference -0.19, SD 2.17, range -10 to 12). Furthermore, the majority of individuals who had a stated preference for gender-specific health education documents did not choose the gender-specific document as their preferred version for either the first (n=45, 24%) or second pair of documents (n=69, 38%). Individuals who preferred content to always be gender-inclusive were significantly more likely to choose the concordant version of their document (n=20, 49% for the first pair; n=24, 58% for the second pair). A total of 58% (n=262) of the participants stated they did not notice the study design until the debrief.</p><p><strong>Conclusions: </strong>Most participants did not notice when sexual and reproductive health educational content had been made gender-inclusive-even when they had an explicit preference for gender-specific content. This suggests that when inclusive language is not directly called to readers' attention, inclusive sexual and reproductive health content is broadly acceptable to individuals across a range of political beliefs. The use of inclusive language may therefore be a means of increasing the accessibility and applicability of educational materials to diverse recipients, including LGBTQ+ individuals.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"15 ","pages":"e85868"},"PeriodicalIF":3.3,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303948","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":"Generosity as a Scientific Method: Building Knowledge and Community in a Competitive World.","authors":"Bruno B Andrade","doi":"10.2196/84933","DOIUrl":"10.2196/84933","url":null,"abstract":"<p><strong>Unlabelled: </strong>Generosity can function as a scientific method-a disciplined stance that aligns curiosity with openness, credit-sharing, and stewardship of data, specimens, and ideas. Rather than a soft add-on, generosity structures how questions are framed, teams are built, and results are disseminated, thereby improving rigor, reproducibility, and impact. This viewpoint article advances a conceptual and operational framework for \"generosity in science,\" aimed at researchers, institutions, and funders seeking alternatives to competition-driven models of knowledge production. I examine generosity as practice at the levels of people, collectives, and institutions and argue that persistent global challenges in health demand pro-collaborative architectures. Seen this way, generosity is not mere altruism; it is part of the epistemic engine that turns uncertainty into shared knowledge while distributing opportunity and recognition more fairly. I define core principles of generous research and organize them across three domains: research design, governance, and evaluation. The paper draws on illustrative examples and relevant literature to situate generosity within ongoing debates on open science, team science, and research assessment reform. I outline practical principles for embedding generosity into research design, governance, and evaluation and discuss how these principles can counter vanity metrics and short-term incentives. I conclude that embedding generosity in the infrastructure of science enables better questions, faster learning, and greater public value.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"15 ","pages":"e84933"},"PeriodicalIF":3.3,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279852","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":"Barriers and Facilitators to Physician-Patient Communication in Chinese Tertiary Hospitals From the Perspectives of Hospital-Based Physicians and Patient Relations Coordinators: Qualitative Study.","authors":"Zengping Shi, Qinqin Jiang, Xincheng Wang, Hongli Yan, Yi Xia, Lushaobo Shi, Dong Wang","doi":"10.2196/87947","DOIUrl":"10.2196/87947","url":null,"abstract":"<p><strong>Background: </strong>Effective physician-patient communication is essential for building trust and sustaining positive relationships, yet becomes increasingly challenging in China's tertiary hospitals, where physicians face heavy workloads.</p><p><strong>Objective: </strong>This study explored the barriers and facilitators of physician-patient communication by synthesizing perspectives from Chinese hospital-based physicians and patient relations coordinators.</p><p><strong>Methods: </strong>A qualitative study using semistructured interviews was conducted with 17 participants (11 physicians and 6 patient relations coordinators) from tertiary hospitals in China (April-July 2025). Data were analyzed using thematic analysis following Braun and Clarke's framework.</p><p><strong>Results: </strong>Barriers and facilitators of physician-patient communication were organized into a multilevel framework comprising patient-level, physician-level, and system-level factors. Patient-level barriers included individual background differences, inadequate expression and limited health literacy, and psycho-emotional states with expectation misalignment, whereas facilitators included effective expectation management, good health literacy and communication readiness, and trust in physicians with shared decision-making. Physician-level barriers involved communication style deficiencies, empathy gaps, and time pressure constraints; facilitators included active listening and patient-centeredness, empathy and emotional support, and clear explanations with cultural adaptability. At the system level, barriers included hospital environment and medical visit settings, legal and policy deficiencies, insufficient communication training, and media-driven distrust with digitally mediated information challenges, while facilitators included institutional support and security assurance, educational training and policy promotion, process optimization and patient health education, and artificial intelligence-assisted baseline knowledge.</p><p><strong>Conclusions: </strong>Physician-patient communication is influenced by multiple factors, necessitating comprehensive intervention measures: enhancing patient education, improving physician communication skills, and strengthening organizational support systems. Notably, special attention should be directed toward addressing the unique challenges posed by digital technologies while concurrently leveraging the opportunities they present to optimize communication outcomes.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"15 ","pages":"e87947"},"PeriodicalIF":3.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220658","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":"Enhancing Transparency, Auditability, and Reproducibility of Deduplication in Systematic Reviews: A Tutorial for the Rayyan Method and Systematic Auto Resolver Feature.","authors":"Mimi Kim, Amin M Shanaa, Hossam Hammady, Mohammad Aboelnour, Robert Ayan","doi":"10.2196/94317","DOIUrl":"10.2196/94317","url":null,"abstract":"<p><strong>Unstructured: </strong>Deduplication across search results is one of the earliest and most critical steps in the systematic review methodological process; yet, existing solutions often lack the transparency, auditability, and reproducibility required by rigorous systematic review standards. Many automated deduplication tools introduce bias through opaque, non-configurable algorithmic decisions, while also potentially removing relevant references through false positive identification. We provide a tutorial on the Rayyan Method, including the Systematic Auto Resolver feature for the de-duplication process. This Method is defined by an enhanced deduplication approach that combines a high-sensitivity duplicate detection with user-controlled resolution criteria. Systematic Auto Resolver enables research teams to define, apply, and document their own deduplication standards rather than relying on predetermined automated decisions. Users apply deduplication criteria, iteratively reviewing results after each pass, maintaining complete control over methodological decisions. The Rayyan Method addresses critical limitations in current deduplication approaches by supporting methodological rigor through user-controlled resolution, while enhancing efficiency, transparency, and reproducibility. By empowering research teams to define their own deduplication criteria, this approach supports and aligns with the prescribed methodologically rigorous systematic review process. The Method provides a citable framework for researchers to comprehensively document their deduplication methodology.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of the Core Competencies Required in Endodontics for Undergraduate Students in Syrian Dental Schools by Using a Modified Delphi Technique: Prospective Exploratory Survey Study.","authors":"Muhammad Salameh, Mayssoon Dashash, Issam Jamous","doi":"10.2196/83799","DOIUrl":"10.2196/83799","url":null,"abstract":"<p><strong>Background: </strong>There is a worldwide movement toward competency-based medical education to equip dental students with essential competencies required to meet health care needs. In Syria, dental faculties currently lack a formal competency-based curriculum for endodontics at the undergraduate level. Moreover, the quality of root canal treatment performed by general dentists is frequently described as inadequate or substandard.</p><p><strong>Objective: </strong>This study aimed to develop a national consensus on the required competencies for undergraduate endodontics in Syria in order to establish a foundation for a standardized national curriculum, which can guide educators in adopting best practices in both dental education and clinical endodontics.</p><p><strong>Methods: </strong>This study was conducted at Syrian Virtual University between April and June 2025. A modified Delphi technique was used to determine endodontic competencies. Initially, a group of 5 Syrian endodontic consultants identified preliminary competencies. In the first round, 53 experts evaluated these competencies by using a 5-point Likert scale. Based on these results, a second round was conducted with 38 experts. Competencies with a weighted average above 4.20 were considered essential. Data analysis was performed using IBM SPSS package 27, and survey reliability was measured by Cronbach α.</p><p><strong>Results: </strong>Following the final Delphi round, a set of 31 competencies was established, comprising 9 knowledge, 13 skills, and 9 attitudes competencies. Cronbach α was more than 0.9 in the first and second round. The standard deviation across all questionnaires was low (≤0.85). The standard error was also minimal (≤0.12).</p><p><strong>Conclusions: </strong>This study identified a set of core endodontic competencies for the undergraduate level in Syria. These competencies are intended to support students in acquiring the required knowledge, skills, and attitudes, and assisting policymakers in implementing competency-based medical education within Syria and similar contexts.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"15 ","pages":"e83799"},"PeriodicalIF":3.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206929","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 Interventions Addressing Cognitive and Psychological Symptoms in Long COVID: Scoping Review of Multicomponent Approaches.","authors":"Sandra León-Herrera, Marta Sánchez-Castro, Ana Luisa Neves, Mª Pilar Rodríguez-Pérez, Vinicius Jobim Fischer, Djenna Hutmacher, Reham Aldakhil, Marina Vaillancourt de Dios, Vinicius Anjos de Almeida, Bárbara Oliván-Blázquez, Rosa Magallón-Botaya, Charles Benoy, Raquel Gómez-Bravo","doi":"10.2196/80616","DOIUrl":"10.2196/80616","url":null,"abstract":"<p><strong>Background: </strong>Long COVID, or postacute COVID-19 syndrome, presents with persistent cognitive and psychological symptoms such as brain fog, anxiety, depression, and fatigue, significantly impacting quality of life and daily functioning. Digital health interventions offer a scalable, accessible solution to bridge care gaps, especially where conventional neuropsychological support is limited. However, evidence regarding their effectiveness for neuropsychiatric symptoms in long COVID remains fragmented.</p><p><strong>Objective: </strong>This scoping review aimed to systematically identify and map the existing evidence on digital interventions targeting cognitive and psychological symptoms in individuals with long COVID. The review also sought to categorize intervention types, assess reported outcomes, and identify methodological gaps to inform future clinical and research priorities.</p><p><strong>Methods: </strong>The review followed the Arksey and O'Malley framework and adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Comprehensive searches were conducted in 4 databases (PubMed, Scopus, Web of Science, and ScienceDirect) from December 2024 to February 2025. Eligible studies included peer-reviewed and gray literature published in English or Spanish since 2020. Studies were screened and selected based on predefined inclusion and exclusion criteria. Data were extracted using a standardized charting form and synthesized narratively, with thematic grouping by intervention type.</p><p><strong>Results: </strong>Of 888 records identified, 25 (2.82%) were included. Intervention types encompassed telehealth platforms, mobile health apps, virtual reality, online cognitive and psychological therapies, game-based cognitive training, neuromodulation (transcranial direct current stimulation), and multicomponent programs. Most studies reported improvements in psychological well-being, emotional regulation, and cognitive domains such as attention and memory. However, findings varied, with some interventions showing no significant cognitive gains or sustained effects. Common limitations included small sample sizes, lack of control groups, heterogeneity in outcomes and intervention protocols, and short follow-up durations. The underrepresentation of older adults and underserved populations was also noted.</p><p><strong>Conclusions: </strong>Digital interventions show promise for addressing cognitive and psychological symptoms in long COVID, particularly when delivered as multicomponent programs. Nonetheless, the evidence base remains preliminary. Future research should prioritize high-quality randomized trials with standardized outcome measures, long-term follow-up, and diverse participant samples. Addressing barriers related to digital literacy and access will be essential to ensure equity and real-world effectiveness.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"15 ","pages":"e80616"},"PeriodicalIF":3.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206879","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":"COVID-19 Rebound in Nirmatrelvir Plus Ritonavir Treatment and Control Groups: Prospective Cohort Study.","authors":"Jacqueline K Kueper, Kalyani Kottilil, Giorgio Quer, Danielle C Chiang, Emily G Spencer, Jyothi Purushotham, Edward Ramos, Leila Roumani, Kristian G Andersen, Eric J Topol, Jay A Pandit, Michael J Mina","doi":"10.2196/80263","DOIUrl":"10.2196/80263","url":null,"abstract":"<p><strong>Background: </strong>Observation of COVID-19 rebound after nirmatrelvir plus ritonavir (NPR) has driven important questions surrounding one of the only direct-acting antiviral treatments for COVID-19.</p><p><strong>Objective: </strong>The objective of this study was to examine the epidemiology of COVID-19 rebound among COVID-19-positive outpatients in the United States who independently decided whether or not to take NPR.</p><p><strong>Methods: </strong>This prospective, decentralized observational cohort study was conducted from August 2022 through December 2023 and included frequent proctored COVID-19 rapid antigen tests and self-report symptom surveys for 15 days. The primary outcome was the incidence of viral and symptom rebound. Secondary outcomes included time to initial viral and symptom clearance, rebound probability among patients who cleared by day 15, and symptom frequency.</p><p><strong>Results: </strong>Of 917 consenting participants, 669 (73%) were eligible for inclusion in the analysis (n=443, 66% in the NPR group; n=226, 34% in the control group). The mean age was 46.1 (SD 12.9) years, 62.6% (n=419) of participants were female, and 49.2% (n=329) had at least one preexisting condition. Overall, 15-day cumulative incidence was higher in the NPR group than the control group for both viral (70/443, 15.8% vs 12/226, 5.3%) and symptom (73/443, 16.5% vs 19/226, 8.4%) rebound. Time to initial viral and symptom clearance was similar between groups, and among those who experienced clearance by day 15, the probability of viral rebound (NPR: 19.1%, 95% CI 15.1%-24.0% vs control: 7%, 95% CI 4.0%-12.6%; P<.001) and symptom rebound (NPR: 47.7%, 95% CI 36.1%-60.8% vs control: 16.9%, 95% CI 10.9%-25.7%; P<.001) was higher in the NPR group than the control group.</p><p><strong>Conclusions: </strong>This study demonstrates that while COVID-19 rebound occurs in both NPR-treated and untreated outpatients, the incidence is higher in the NPR group.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"15 ","pages":"e80263"},"PeriodicalIF":3.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151309","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}