JMIR Formative Research

BACKGROUND: Epidemiological trends in the US have shown an increase in HIV cases among young sexual minority men (YSMM). Utilizing mHealth, which refers to health services and information delivered or enhanced through the Internet and related technologies, is a crucial strategy to address HIV disparities. However, despite its potential, the practical implementation of mHealth remains limited. Additionally, it is important to consider that young individuals may become accustomed, distracted, or lose interest in these applications, highlighting the need for regular updates and monitoring of relevant content...

BACKGROUND: There is significant heterogeneity in disease progression among hospitalized COVID-19 patients. The pathogenesis of SARS-CoV-2 infection is attributed to a complex interplay between virus and host immune response that in some patients unpredictably and rapidly leads to "hyperinflammation" associated with increased risk of mortality. Early identification of patients at risk of progression to hyperinflammation may help inform timely therapeutic decisions and lead to improved outcomes...

BACKGROUND: Gen Z and young Millennials (ages 18-35) are unique in that they either have no memory of or were born shortly after the internet "explosion." They are constantly online, face significant challenges with their mental health (depressive symptoms, anxiety, stress) and sleep, and are frequent users of digital wellness apps. Gen Z and young Millennials also uniquely identify with and practice spirituality, which has been linked to better mental health and sleep in adult populations...

BACKGROUND: Gastrointestinal symptoms (GISs) are highly prevalent worldwide caused by a combination of biopsychosocial factors. Given the complex nature coupled with ineffective communication of diagnosis by physicians, patients with intimate GISs often feel stigmatized which in turn can inhibit their ability to express their thoughts and feelings adequately and lead to either over or underreport of their symptoms. And selective service seeking for and reporting of GISs have direct bearing on the stage of disease at presentation, and consequently, on the overall prognosis...

BACKGROUND: mHealth systems have been deployed widely in Lower- and Middle-Income countries (LMICs) for health system strengthening, requiring considerable resource allocation. However, most solutions have not achieved scale or sustainability. Poor usability and failure to address perceived needs are among the principal reasons mHealth systems fail to achieve acceptance and adoption by healthcare workers. A human-centered design approach to improve mHealth system use requires an exploration of users' perceptions of mHealth systems including the environmental, user-related, and technological aspects of a system...

BACKGROUND: In the first year of the COVID-19 pandemic, studies reported delays in healthcare utilization due to safety concerns. Delays in care may result in increased morbidity and mortality from otherwise treatable conditions. Telehealth provides a safe alternative for patients to receive care when other circumstances make in-person care unavailable or unsafe, but information on patient experiences is limited. Understanding which people are more or less likely to use telehealth and their experiences can help tailor outreach efforts to maximize the impact of telehealth...

BACKGROUND: Effective COVID-19 vaccines have been available since early 2021 yet many Americans refuse or delayed uptake. As of mid-2022, still around 30% of US adults remain unvaccinated against COVID-19. The majority (81%) of these unvaccinated adults say they will "definitely not" be getting the COVID-19 vaccine. Understanding the determinants of COVID-19 vaccine uptake is critical to reducing death and illness from the virus, as well as to inform future vaccine efforts, such as the more recent bivalent (omicron) booster...

Parkinson disease (PD) is a complex neurodegenerative disorder that afflicts over 10 million people worldwide, resulting in debilitating motor and cognitive impairment. In the United States alone (with approximately 1 million cases), the economic burden for treating and caring for persons with PD exceeds US $50 billion and myriad therapeutic approaches are under development, including both symptomatic- and disease-modifying agents. The challenges presented in addressing PD are compounded by observations that numerous, statistically distinct patient phenotypes present with a wide variety of motor and nonmotor symptomatic profiles, varying responses to current standard-of-care symptom-alleviating medications (L-DOPA and dopaminergic agonists), and different disease trajectories...

BACKGROUND: Mental illness is a pervasive worldwide public health issue. Residentially vulnerable populations, such as those living in rural medically underserved areas (MUAs) or mental health provider shortage areas (MHPSAs), face unique access barriers to mental health care. Despite the growth of digital mental health interventions using relational agent technology, little is known about their use patterns, efficacy, and favorability among residentially vulnerable populations. OBJECTIVE: This study aimed to explore differences in app use, therapeutic alliance, mental health outcomes, and satisfaction across residential subgroups (metropolitan, nonmetropolitan, or rural), MUAs (yes or no), and MHPSAs (yes or no) among users of a smartphone-based, digital mental health intervention, Woebot LIFE (WB-LIFE)...

BACKGROUND: SMS text messages are affordable, scalable, and effective smoking cessation interventions. However, there is little research on SMS text message interventions specifically designed to support people who smoke to quit by switching to vaping. OBJECTIVE: Over 3 phases, with vapers and smokers, we codeveloped and coproduced a mobile phone SMS text message program. The coproduction paradigm allowed us to collaborate with researchers and the community to develop a more relevant, acceptable, and equitable SMS text message program...

BACKGROUND: Spouses and significant others (SSOs) of public safety personnel (PSP) are affected by the risks and requirements of these occupations. Internet-delivered cognitive behavioral therapy (ICBT) provides a convenient and accessible treatment format that can be tailored to the needs of SSOs of PSP. OBJECTIVE: This study aimed to assess the initial use and client perceptions (eg, likes, helpfulness, and areas for improvement) of a self-guided, transdiagnostic ICBT course designed for Canadian SSOs of PSP and identify opportunities to further tailor ICBT for this group...

BACKGROUND: Mobile health (mHealth) interventions among adolescents and young adults (AYAs) are increasingly available in African low- and middle-income countries (LMICs). For example, the unstructured supplementary service data (USSD) could be used to verify HIV self-testing (HIVST) among AYAs with poor bandwidth. OBJECTIVE: The aim of this study is to describe the creation of an USSD platform and determine its feasibility and usability to promote the verification of HIVST results among AYAs in Nigeria...

BACKGROUND: The COVID-19 pandemic has presented significant challenges to health care systems, particularly impacting the older population due to their vulnerability and increased susceptibility to severe complications. Many of the most vulnerable individuals rely on informal caregivers, who play a vital role in enabling them to continue living in their homes. However, social isolation and limited access to health services during the pandemic have made caregiving more difficult. In response, massive open online courses (MOOCs) have emerged as a training and support solution for caregivers...

BACKGROUND: COVID-19 had a considerable impact on mortality, but its effect on behaviors associated with social media remains unclear. As travel decreased due to lockdowns during the pandemic, selfie-related mortality may have decreased, as fewer individuals were taking smartphone photographs in risky locations. OBJECTIVE: In this study, we examined the effect of the COVID-19 pandemic on trends in selfie-related mortality. METHODS: We identified fatal selfie-related injuries reported in web-based news reports worldwide between March 2014 and April 2021, including the deaths of individuals attempting a selfie photograph or anyone else present during the incident...

BACKGROUND: Social media (SM) has gained importance in the health care sector as a means of communication and a source of information for physicians and patients. However, the scope of professional SM use by orthopedic and trauma surgeons remains largely unknown. OBJECTIVE: This study presents an overview of professional SM use among orthopedic and trauma surgeons in Germany in terms of the platforms used, frequency of use, and SM content management. METHODS: We developed a web-based questionnaire with 33 variables and 2 separate sections based on a review of current literature...

BACKGROUND: Stress, anxiety, and depression are major mental health concerns worldwide. A wide variety of digital mental health interventions have demonstrated efficacy in improving one's mental health status, and digital interventions that involve some form of human involvement have been shown to demonstrate greater efficacy than self-guided digital interventions. Studies demonstrating the efficacy of digital mental health interventions within the Asian region are scarce. OBJECTIVE: This study aimed to investigate the potential efficacy of the digital mental health intervention, ThoughtFullChat, which consists of one-on-one, asynchronous, text-based coaching with certified mental health professionals and self-guided tools, in improving self-reported symptoms of depression, anxiety, and stress...

BACKGROUND: The emerging field of epidemiological criminology studies the intersection between public health and justice systems. To increase the value of and reduce waste in research activities in this area, it is important to perform transparent research priority setting considering the needs of research beneficiaries and end users along with a systematic assessment of the existing research activities to address gaps and harness opportunities. OBJECTIVE: In this study, we aimed to examine published research outputs in epidemiological criminology to assess gaps between published outputs and current research priorities identified by prison stakeholders...

BACKGROUND: The COVID-19 pandemic accelerated the adoption of telehealth services for remote mental health care provision. Although studies indicate that telehealth can enhance the efficiency of service delivery and might be favored or even preferred by certain clients, its use varied after the pandemic. Once the pandemic-related restrictions eased, some regions curtailed their telehealth offerings, whereas others sustained them. Understanding the factors that influenced these decisions can offer valuable insights for evidence-based decision-making concerning the future of telehealth in mental health services...

BACKGROUND: Transmasculine people are at risk for HIV; yet few HIV prevention interventions have been developed for this population. We adapted an existing HIV prevention smartphone app for cisgender men who have sex with men to meet the sexual health needs of transmasculine people. OBJECTIVE: This study aims to assess the acceptability of the adapted app, Transpire, among transmasculine people living in Atlanta, Georgia, and Washington, DC, via in-depth interviews of participants in a pilot feasibility trial...

BACKGROUND: Machine learning (ML)-driven clinical decision support (CDS) continues to draw wide interest and investment as a means of improving care quality and value, despite mixed real-world implementation outcomes. OBJECTIVE: This study aimed to explore the factors that influence the integration of a peripheral arterial disease (PAD) identification algorithm to implement timely guideline-based care. METHODS: A total of 12 semistructured interviews were conducted with individuals from 3 stakeholder groups during the first 4 weeks of integration of an ML-driven CDS...