JMIR Publications

Real-world effectiveness, safety, immunogenicity and cost effectiveness of the IXCHIQ® chikungunya vaccine: an ambispective cohort #Study in La Réunion, CHIK RE VAC #Study, DGOS N° ECTZ347081 Date Submitted: Mar 5, 2026. Open Peer Review Period: Mar 6, 2026 - May 1, 2026.

Reminder>> Real-world effectiveness, safety, immunogenicity and cost effectiveness of the IXCHIQ® chikungunya vaccine: an ambispective cohort #Study in La Réunion, CHIK RE VAC #Study, DGOS N° ECTZ347081 (preprint) #openscience #PeerReviewMe #PlanP

Family-Centered WeChat Mini-Program for Adolescent Sugar Intake Control: Theory-Driven Development and Consensus-Based Design (preprint) #openscience #PeerReviewMe #PlanP

Real-World Validation of Arkangel AI, a Conversational Agent for Real-Time Evidence-Based #Medical Question Answering: #RCT #ClinicalTrial Date Submitted: Feb 17, 2026. Open Peer Review Period: Mar 11, 2026 - May 6, 2026.

Real-World Validation of Arkangel AI, a Conversational Agent for Real-Time Evidence-Based #Medical Question Answering: #RCT #ClinicalTrial (preprint) #openscience #PeerReviewMe #PlanP

Patterns of Online #Health Information Behavior among Newly Diagnosed Breast #Cancer #Patients in a Southern Chinese City: A Grounded Theory #Study Date Submitted: Mar 8, 2026. Open Peer Review Period: Mar 11, 2026 - May 6, 2026.

Patterns of Online #Health Information Behavior among Newly Diagnosed Breast #Cancer #Patients in a Southern Chinese City: A Grounded Theory #Study (preprint) #openscience #PeerReviewMe #PlanP

Reminder>> A Large Language Model-Based Behavioral Activation Chatbot for Young People with #Depression: Mixed-Methods Evaluation Using Artificial Users and Clinical Experts (preprint) #openscience #PeerReviewMe #PlanP

Humanoid Robot–Assisted Support for Health Care in Older Adults: Systematic Scoping Review Background: Humanoid robots offer a promising solution to the growing burden of care for older adults. However, existing evidence on their applications for general aging populations remains fragmented and lacks systematic synthesis. Objective: This scoping review aimed to examine the literature on humanoid robot–assisted support for health care in older adults and identify gaps in the literature to guide future research. Methods: The methodological framework by Arksey and O’Malley was used to conduct this scoping review. We conducted a comprehensive search in 8 databases, including IEEE Xplore Digital Library, CINAHL, Cochrane Library, EMBASE, PubMed, Scopus, Web of Science, and OpenGrey Repository, covering literature published up to April 30, 2025. The reference lists of key texts were examined, and citation chaining was conducted. Two independent reviewers examined all full articles for fitness with the eligibility criteria and extracted data elements. The study findings were then summarized, coded, and analyzed using the PAGER (Patterns, Advances, Gaps, Evidence for practice, and Research recommendations) framework. Results: A total of 32,477 articles were retrieved, 59 of which were included in this review. The majority (49/59, 83%) were conducted in real-world settings. Methodologically, 34 studies (34/59, 58%) had small sample sizes (n≤25), with study designs comprising 26 quantitative (26/59, 44%), 22 mixed method (22/59, 37%), and 11 qualitative (11/59, 19%) approaches. Participant characteristics revealed female predominance (>50%) in 32 studies (32/59, 54%), while 27 studies (27/59, 46%) included participants with cognitive impairment. Through PAGER framework analysis, we identified 4 key patterns: (1) effects, perceptions, and experiences of humanoid robots; (2) preferences, expectations, and facilitators for humanoid robots; (3) implementation barriers and challenges; and (4) determinants of user experiences and outcomes. Conclusions: This scoping review demonstrates the promising yet methodologically constrained potential of humanoid robots in health care for older adults while highlighting key challenges in their practical implementation. Successful integration will require addressing technical limitations, user acceptance barriers, and systemic adoption challenges.

New in JMIR Aging: Humanoid Robot–Assisted Support for Health Care in Older Adults: Systematic Scoping Review #HumanoidRobots #HealthCare #AgingPopulation #ElderCare #RobotAssistance

Patient Perceptions of Blockchain-Based Health Information Exchange: User-Centered Design Study (mentions @jmirpub)

JMIR Publications Teams Up with University of Turku for Unlimited Open Access Publishing (mentions @jmirpub)

Grok Imagine Prompt Guide: 10 Proven Prompt Patterns to Boost Image Generation Results (mentions @jmirpub)

Longitudinal mental health data collected via the Corona Health smartphone app during COVID-19 (mentions @jmirpub)

Effects of Internet-Based Dementia Risk Reduction Education on Risk and Protective Factor ... (mentions @jmirpub)

eHealth Literacy and Type 2 Diabetes Prevention Among At-Risk Populations (mentions @jmirpub)

Longitudinal Effects of a Smartphone Game (Tumaini) for HIV - XSL•FO (mentions @jmirpub)

#feasibility and Preliminary Efficacy of Empowered Relief in Patients With Chronic Pain Taking Methadone or Buprenorphine: Single-Arm National Pilot Study Background: Approximately 45% of individuals taking methadone or buprenorphine have chronic pain. These medications are commonly prescribed for chronic pain or opioid use disorder (OUD). To optimize pain management as well as reduce opioid-related symptoms (eg, craving) and risks (misuse and overdose), there is a critical need for a brief, effective, and accessible pain skills intervention for this population. Objective: This single-arm study aimed to examine the #feasibility and preliminary efficacy of online Empowered Relief (ER), a 1-session pain relief skills class, for individuals with chronic pain taking methadone or buprenorphine for chronic pain or OUD. Methods: A priori #feasibility criteria were defined as at least 75% of enrolled participants attending the ER class and the mean satisfaction rating of at least 8 on a 0‐10 scale. Participants were recruited nationally across the United States. Out of the 69 enrolled participants, 55 attended the ER class. Self-report measures were collected at baseline, immediately post class, and at follow-up points of 2 weeks and months 1‐3. Additionally, qualitative interviews were conducted in a small sample (n=14) to obtain in-depth participant feedback. Among the class attendees, 51 participants (27/51, 52.9% female; mean age 48.6, SD 12.2, range 28‐71 years) completed at least one follow-up survey, and treatment outcomes were analyzed using repeated measures ANOVA, with missing data imputed using linear regression. This analytic sample consisted of 24 participants taking methadone and 27 participants taking buprenorphine; 43.1% (22/51) endorsed at least≥2 OUD symptoms within the past 12 months, meeting the ( [Fifth Edition]) diagnostic criteria for current OUD. Results: #feasibility was achieved with 79.7% (55/74) attendance and mean 8.6 (SD 2) ratings of treatment appraisal and satisfaction. Qualitative feedback demonstrated high acceptability of the class content and delivery, with suggestions for refinements. Repeated-measures ANOVAs and FDR-corrected post hoc tests revealed significant reductions at 1 month post-ER class (primary endpoint) in pain intensity (Cohen =0.71), pain bothersomeness (Cohen =0.54), and pain interference (Cohen =0.61). At 3 months post-ER class, efficacy was maintained for pain intensity, pain bothersomeness, and pain interference (Cohen =0.28, 0.44, and 0.48, respectively). No significant time effects were observed for pain catastrophizing, sleep disturbance, physical function, fatigue, depression, anxiety, social isolation, and opioid craving. Conclusions: This study is the first to test ER in patients taking methadone or buprenorphine for pain or OUD. Findings showed #feasibility, acceptability, and preliminary evidence of treatment efficacy. Participant feedback will inform future study designs. These findings support a randomized trial to fully evaluate the efficacy and scalability of ER in this population. Trial Registration: ClinicalTrials.gov NCT05057988; https://clinicaltrials.gov/study/NCT05057988 International Registered Report Identifier (IRRID): RR2-10.2196/53784

JMIR Formative Res: #feasibility and Preliminary Efficacy of Empowered Relief in Patients With Chronic Pain Taking Methadone or Buprenorphine: Single-Arm National Pilot Study #ChronicPain #PainManagement #OpioidCrisis #EmpoweredRelief #Methadone

Clinical Efficacy Evaluation of Tuina Combined Medicated Oil in the Treatment of Nonspecific Low Back Pain: #Protocol for a #RCT #ClinicalTrial Background: Nonspecific low back pain (NSLBP) is a significant global public health concern that affects the health and well-being of individuals across different age groups, limiting their daily activities and reducing their quality of life. As Tuina (Chinese therapeutic massage) therapy and medicated oil are widely used in China, it is necessary to design a randomized clinical trial to assess the effectiveness of Tuina combined medicated oil (TNO) in treating NSLBP. Objective: This #Study aims to evaluate the efficacy and safety of Tuina therapy combined with medicated oil in treating NSLBP. Methods: One hundred participants will be enrolled and randomly allocated to either a TNO group (n=50) or a Tuina combined water group (n=50). Treatment will last for 4 weeks, with sessions 3 times a week, followed by a 4-week follow-up. The visual analog scale score is the primary outcome; secondary outcomes include the evaluation of treatment Japanese Orthopaedic Association scores, infrared thermography, muscle tension tests, and tenderness scores. All adverse reactions will be recorded. Results: The trial commenced in June 2023 and is expected to conclude in September 2025. In June 2025, key preliminary steps were completed, and the ethical review and clinical trial registration were concluded. Recruitment is proceeding as planned, with 100 participants enrolled to date. Data collection is underway, while formal data analysis has not yet commenced. Conclusions: The project’s purpose is to evaluate the effectiveness of TNO in alleviating pain and improving lumbar function in patients with NSLBP. Trial Registration: ChiCTR ChiCTR2300076144; https://www.chictr.org.cn/hvshowproject.html?id=247247 International Registered Report Identifier (IRRID): DERR1-10.2196/81887

JMIR Res Protocols: Clinical Efficacy Evaluation of Tuina Combined Medicated Oil in the Treatment of Nonspecific Low Back Pain: #Protocol for a #RCT #ClinicalTrial

International Clinical Practice Guidelines on Traditional Chinese Medicine Therapy for Dysmenorrhea: Development #Protocol Background: Traditional Chinese medicine (TCM) functions according to the concepts of “holism” and treatment based on syndrome differentiation, and it has achieved good clinical results in treating patients with dysmenorrhea, which is a common gynecological disorder. However, there are currently no international clinical practice guidelines involving TCM therapies for dysmenorrhea. This #Study aims to establish a #Protocol for the development of such guidelines. Objective: This #Protocol will provide a road map for the development of the first international clinical practice guidelines on TCM therapy for dysmenorrhea. Methods: The guidelines will be developed with reference to the and the . They will be developed in accordance with the Appraisal of Guidelines for #Research and Evaluation II and the World Health Organization guideline handbook and will make recommendations based on systematic reviews. We have established a guideline working group and will formulate clinical questions using the participants, interventions, comparisons, outcomes, and #Study design framework. The recommendations will be developed through evidence retrieval, synthesis, and the Delphi method. We will consider the preferences and values of patients, as well as the costs and the pros and cons of interventions. Results: This work was supported by the National Key R&D Program of China (grant 2019YFC1712000) in 2019. The writing group for guidelines was formed in January 2021. The literature search and screening process began in May 2022. So far, the literature search and 2 rounds of the Delphi method have been completed. The #Protocol will provide a road map for the development of the first international clinical practice guidelines on TCM therapy for dysmenorrhea. Conclusions: The guideline will be developed in accordance with this #Protocol, which may provide support and evidence for TCM treatment in patients with dysmenorrhea. There is currently a need for clinical practice guidelines in TCM for the treatment of dysmenorrhea. International Registered Report Identifier (IRRID): DERR1-10.2196/77423

JMIR Res Protocols: International Clinical Practice Guidelines on Traditional Chinese Medicine Therapy for Dysmenorrhea: Development #Protocol

Effectiveness of Inactivated #COVID19 #coronavirus #Vaccination Against #COVID19 #coronavirus–Related Hospitalization and Severe Outcomes in Adults ≥80 Years During Omicron Circulation in Beijing, China: Retrospective Cohort Study Background: A large wave of #COVID19 #coronavirus caused by SARS-CoV-2 #COVID19 #coronavirus Omicron subvariants began in Beijing in early December 2022. Objective: This study aimed to evaluate the #COVID19 #coronavirus #Vaccine effectiveness (VE) in mitigating the risk of #COVID19 #coronavirus–related hospitalization during the #Epidemic. Methods: We conducted a retrospective cohort study linking regional health care data and #Vaccination registry routinely collected in Beijing. All electronic medical records on #COVID19 #coronavirus–related hospital discharges of older inpatients aged ≥80 years during November 2022 and February 2023 were included. Poisson regressions were used to estimate incidence risk ratio of #COVID19 #coronavirus–related hospitalization, severe or critical cases, and in-hospital death compared with un#Vaccinated groups, adjusting for gender and age. VE was calculated as 1 minus incidence risk ratio×100%. Results: A total of 53,789 individuals aged ≥80 years were included, 28,423 (52.84%) were male, 45,270 (84.16%) were aged 80‐89 years, and 8519 (15.84%) were aged ≥90 years. Overall, 30,531 (56.76%) were in the #Vaccine group, with 4524 (8.41%) of the total participants receiving partial #Vaccination, 20.91% completing the primary series, and 14,761 (27.44%) receiving one booster. Additionally, 23,258 (43.24%) were in the un#Vaccinated group. Of the 53,789 hospitalized individuals, 17,916 (33.31%) had a #COVID19 #coronavirus diagnosis, 3535 (6.57%) had #COVID19 #coronavirus–related hospitalization, 961 (1.79%) were #COVID19 #coronavirus severe or critical cases, and 4130 (7.68%) had in-hospital death. The analysis revealed that the VE of booster #Vaccination in preventing #COVID19 #coronavirus–related hospital, severe or critical #COVID19 #coronavirus, and in-hospital death was 63.5% (95% CI 59.8%‐66.9%), 66.9% (95% CI 60.1%‐72.6%) and 79.4% (95% CI 77%‐81.5%), the VE of primary series 56% (95% CI 51.4%‐60.2%), 66.8% (95% CI 59%‐73%) and 66.4% (95% CI 63%‐69.5%). Conclusions: The first booster #Vaccination was associated with significantly reduced the risk of #COVID19 #coronavirus–related severe outcomes in older inpatients aged ≥80 years during the Omicron-dominant period. Considering the potential selection bias and unmeasured confounders, these estimates may reflect both the VE and the better baseline health status of the #Vaccinated older individuals.

JMIR Public Health: Effectiveness of Inactivated #COVID19 #coronavirus #Vaccination Against #COVID19 #coronavirus–Related Hospitalization and Severe Outcomes in Adults ≥80 Years During Omicron Circulation in Beijing, China: Retrospective Cohort Study

A Supportive Group Intervention for Caregivers to Patients Diagnosed With Glioblastoma: #Protocol for the SUGRI #Study Background: Caregivers to a person diagnosed with a glioblastoma often face significant responsibilities, balancing the demands of care with the complexities of the disease and treatment trajectory, while also coping with concerns and uncertainty of the future. Caregivers report unmet needs of information and support throughout the patient’s disease and treatment trajectory, and they may benefit from targeted supportive care interventions. Objective: The aim of this #Study is to develop, test, and evaluate the feasibility of a supportive group intervention among caregivers to patients diagnosed with a glioblastoma. Methods: The #Study consists of 3 phases with ongoing patient and public involvement (PPI). In the first phase, a systematic review will be carried out exploring the outcome of supportive group interventions for caregivers to patients diagnosed with a primary brain tumor. In the second phase, the design and development of the intervention will be conducted in cooperation with a panel of caregivers using PPI process. The third phase will include the feasibility and evaluation of the intervention. The #Study will be guided by the British Medical #Research Council’s framework for developing complex interventions. The feasibility of the intervention will be tested in reference to relevant parameters. Quantitative data in terms of questionnaires will be analyzed using descriptive statistics, and qualitative evaluation interviews will be analyzed using thematic analysis. Results: A national panel of caregivers (N=10) has been established, and the final design of the intervention is currently developed through an ongoing PPI process. A total of 3 hospitals in Denmark have committed to participating in the recruitment for the feasibility #Study. Recruitment began in April 2025, and the SUGRI (Supportive Group Intervention for caregivers to patients diagnosed with a glioblastoma) intervention will undergo a feasibility assessment in a multicenter #Study starting in August 2025, with the final evaluation planned for April 2026. Conclusions: This #Study is expected to provide necessary insights to guide caregiver initiatives, ultimately improving support for caregivers within the neuro-oncology field. A supportive group intervention offered to the caregivers has the potential to address specific caregiver needs and strengthen their supportive network. Providing caregivers with support may enhance their perceived support, strengthen family functioning, and provide them with strategies to manage caregiving challenges, ultimately benefiting both caregivers and patients. Trial Registration: ClinicalTrials.gov NCT06869577; https://clinicaltrials.gov/#Study/NCT06869577

JMIR Res Protocols: A Supportive Group Intervention for Caregivers to Patients Diagnosed With Glioblastoma: #Protocol for the SUGRI #Study

Prevalence and Factors Associated With Acute Stress Disorder Among Adults Ever Infected With #COVID19 #coronavirus During the Ending Phase of the Pandemic in 7 Chinese Cities: Cross-Sectional Study Background: Acute stress disorder (ASD) among people ever infected with #COVID19 #coronavirus is prevalent and may lead to posttraumatic stress disorder. Soon after China relaxed their #COVID19 #coronavirus control measures in November 2022 or December 2022, the infection rate surged rapidly, creating huge uncertainty and stressful situations. Little is known about situations regarding ASD at the ending phase of the pandemic. Objective: The study aimed to investigate the potential of personal cognitive or emotional factors and environmental factors of ASD. Methods: A cross-sectional study was conducted among 5545 people ever infected with #COVID19 #coronavirus aged 18‐60 years from December 27, 2022, to January 9, 2023, living in 7 cities of China. The 5-item Chinese version of the Primary Care PTSD Screen was used to assess ASD. Multiple logistic regression analyses were performed to identify factors of ASD. Results: The prevalence of ASD was 21.2% (1174/5545). Adjusted for the background variables, significant personal risk factors (#COVID19 #coronavirus infection severity, cognitions including perceived high reinfection risk and perceived weak acquired natural immunity, and emotions including worry about the long-term physical harms and panic about infection of older or younger family members), and significant environmental risk factors (difficulties in getting information and medical supplies, having un#Vaccinated older or younger family members, and having significant others with severe #COVID19 #coronavirus symptoms) were identified. Conclusions: The prevalence of ASD among people ever infected with #COVID19 #coronavirus was noticeable. It is warranted to identify those at high risk of developing ASD and provide them with care and early interventions to prevent deterioration. Such programs may consider targeting the modifiable risk factors found in this study.

JMIR Public Health: Prevalence and Factors Associated With Acute Stress Disorder Among Adults Ever Infected With #COVID19 #coronavirus During the Ending Phase of the Pandemic in 7 Chinese Cities: Cross-Sectional Study

Data-Driven Phenotyping Reveals Nonuniform Association Between Age and Mortality After Aortic Surgery: Retrospective Cohort Study of UK Biobank Data Background: Life expectancy and age are frequently considered factors to assess perioperative and postoperative mortality risks in patients affected by aortic pathologies, which can affect the decision whether to suggest invasive treatment. Objective: This study aims to investigate the association between age and all-cause mortality after invasive aortic treatment. Methods: Unsupervised clustering (k-means) using data from the UK Biobank was conducted for patients with aortic pathologies ( [ICD-10] group I71) receiving endovascular or open surgical treatment. Clustering variables encompassed demographic and clinical parameters. Survival analyses (postoperative survival time in days to all-cause death) between clusters and cluster-derived age groups were conducted. Results: The study included 1801 individuals undergoing surgical or endovascular repair for aortic aneurysms. Unsupervised cluster analysis identified distinct groups primarily based on age, both in models using 2 or 3 clusters. Clusters with older patients at surgery exhibited lower postoperative survival, with perioperative mortality disproportionately affecting these groups. While age was significantly associated with postoperative mortality overall (hazard ratio 1.07, 95% CI 1.05‐1.08), this association diminished in older clusters after excluding perioperative deaths, a trend confirmed in analyses adjusted for relevant confounders. Conclusions: Unsupervised cluster analysis revealed age as the primary factor distinguishing patient groups undergoing invasive treatment for aortic pathologies. However, age at surgery appears to have different consequences in certain age brackets, indicating a complex nonuniform relationship.

New in JMIR Aging: Data-Driven Phenotyping Reveals Nonuniform Association Between Age and Mortality After Aortic Surgery: Retrospective Cohort Study of UK Biobank Data #DataDriven #AorticSurgery #MortalityRisk #AgeAndHealth #UKBiobank

Using Semiautomated WhatsApp Messages for Daily Stress Measurements: Integrated #usability and #feasibility Study Background: Stress is a key determinant of health outcomes and may influence work performance. Questionnaire-based assessments of stress are typically broad and retrospective. Daily stress measurements via smartphones offer more granular, real-time data but have adherence issues. Using an already established communication medium (WhatsApp) and a more conversational style assessment might improve adherence and help collect more detailed insights into (work) stress, underlying stressors, and countering energy sources. Objective: This study focuses on the #usability and #feasibility of semiautomated voice- and text-messages (with and without emojis) via WhatsApp as a method to collect daily data on experienced work stress, stressors, and energy sources. Methods: A sample of 210 workers was recruited via social media and participated in a 10-workday diary study using semiautomated WhatsApp messages to rate daily stress, stressors, and energy sources. Questions (with and without emojis) were presented by a chatbot as text messages with clickable buttons (multiple-choice questions; MC) or with instructions to answer with either a voice or a text message. The study used an experimental design with 4 groups: (1) week 1 voice, week 2 text/MC with emojis; (2) week 1 voice, week 2 text/MC without emojis; (3) week 1 text/MC, week 2 voice with emojis; (4) week 1 text/MC, week 2 voice without emojis. Pre- and poststudy web-based questionnaires assessed demographics, familiarity with voice messages, and #usability, including participants’ preference for research studies. Open answers were coded using artificial intelligence (#AI), and the number of stressors or energy sources was compared across the 3 collection methods (MC, voice, and text messages) to determine if the amount and quality of information collected differ per method within participants. Results: A total of 158 workers completed at least 80% of scheduled conversations. The sample was predominantly women(170/210, 81%), highly educated (173/210, 82%), and a slight majority worked part-time (109/210, 52%). Mean adherence to the daily schedule was very high (mean of 95%). The postquestionnaire revealed a strong preference for MC and text over voice messages, mostly due to ease and convenience in a variety of situations. The number of stressors per week was approximately 3 times higher in the MC-condition than in the voice condition, even though average stress levels per week did not differ significantly within participants. The number of energy sources was comparable between open answers in the voice and text conditions, but voice messages consisted of more words. Conclusions: Collecting (work) stress data via semiautomatic WhatsApp messages is a feasible method with low effort for participants. #usability ratings indicated a strong preference among participants for MC and text messages over voice messages. Future research should explore #usability in more diverse samples and in direct comparison to traditional assessment methods.

JMIR Formative Res: Using Semiautomated WhatsApp Messages for Daily Stress Measurements: Integrated #usability and #feasibility Study #StressManagement #MentalHealth #Wellbeing #WorkplaceWellness #WhatsApp

AI-Enhanced Conversational Agents for Personalized Asthma Support in People With Asthma: Factors for Engagement, Value, and Efficacy in a Cross-Sectional Survey Study Background: Asthma-related deaths in the United Kingdom are the highest in Europe, and only 30% of patients access basic care. There is a need for alternative approaches to reaching people with asthma to provide health education, self-management support, and better bridges to care. Objective: This study aimed to examine patients’ interest in using a chatbot for asthma and to identify factors that influence engagement. Automated conversational agents (specifically, mobile chatbots) present opportunities for providing alternative and individually tailored access to health education, self-management support, and risk self-assessment. But would patients engage with a chatbot, and what factors influence engagement? Methods: We present results from a patient survey (N=1257) developed by a team of asthma clinicians, patients, and technology developers, conducted to identify optimal factors for efficacy, value, and engagement with an asthma chatbot. Results: Results indicate that most adults with asthma (53%) are interested in using a chatbot. The patients most likely to do so are those who believe their asthma is more serious and are less confident in their self-management. Results also indicate enthusiasm for 24/7 access, personalization, and for WhatsApp (Meta) as the preferred access method (compared to app, voice assistant, SMS text messaging, or website). Conclusions: Obstacles to uptake include security and privacy concerns and skepticism of technological capabilities. We present detailed findings and consolidate these into 7 recommendations for developers to optimize the efficacy of chatbot-based health support.

JMIR HumanFactors: AI-Enhanced Conversational Agents for Personalized Asthma Support in People With Asthma: Factors for Engagement, Value, and Efficacy in a Cross-Sectional Survey Study

The #heartHealth Program: A Mixed Methods Study of a Community-Based Text Messaging Support Program for Patients With #cardiovascular Disease From 2020 to 2024 Background: The #heartHealth program is a 6-month SMS text messaging–based support program offered to patients with a recent #cardiovascular hospitalization or recent #cardiovascular clinic visit in Western Sydney, Australia. Its customized content focuses on #cardiovascular risk factors, lifestyle, treatments, and general #heart health information. Objective: This study aimed to evaluate the implementation of the #heartHealth program. Methods: A mixed methods study was conducted assessing program reach, effectiveness, implementation, and maintenance using program data, participant feedback surveys, and staff focus group discussions. Consecutive adult patients who had attended #cardiology clinics or had been discharged from #cardiology hospitalization at Westmead Hospital, between April 2020 and April 2024, were included in the analysis. Content analysis was used to interpret the qualitative data. Results: A total of 23,095 patients were invited, 8804 (38.1%) enrolled into the program, and 7964 out of 8804 (90.5%) completed the 6-month duration. Participants enrolled in the #heartHealth program had a mean age of 58.6 years, 60.3% (5302/8788) were male, and 62.4% (5382/8624) were recruited from an outpatient clinic setting. A total of 851,058 SMS text messages were sent, with 99.41% (846,009/851,058) delivered successfully. A total of 3533 out of 7964 (44.4% of program completers) participants completed the postintervention survey, and 4 #heartHealth staff members participated in a focus group discussion. Among the participants who completed the survey, 60.5% (2137/3533) reported that the program improved the healthiness of their diet, 53.6% (1894/3533) reported improved physical activity levels, and 56.1% (1982/3533) reported that it helped remind them to take their medications. Content analysis of participant feedback identified that the program was effective in prompting participants to change their diet, providing emotional support, reminding them of the importance of behavior change, improving their confidence in managing their health, and keeping participants focused. Key barriers included limited personalization, language options, and SMS text messaging scheduling flexibility. Recommended adaptations focused on enhancing personalization, greater engagement by local clinical teams, and expanding program dissemination. Conclusions: The program had a broad reach, translated to improved patient-reported health behaviors, and provided participants with needed support at low cost and low resource requirements. This analysis highlights the successful implementation and scalability of the #heartHealth program and provides key learnings for health systems that are looking to implement similar programs in the future.

New in JMIR Cardio: The #heartHealth Program: A Mixed Methods Study of a Community-Based Text Messaging Support Program for Patients With #cardiovascular Disease From 2020 to 2024

Enhancing Adherence to Home-Based Expiratory Muscle Strength Training in Parkinson Disease: Randomized Controlled Trial of an mHealth Intervention Background: Aspiration pneumonia is a leading cause of death in Parkinson disease (PD). Expiratory muscle strength training (EMST) is a promising intervention for respiratory and swallowing dysfunction. However, long-term EMST adherence is frequently poor in PD. Objective: This study aims to determine whether mobile health (mHealth)–assisted EMST with the app (Czech Technical University) improves long-term adherence and physiological outcomes versus conventional EMST among participants at risk for nonadherence. Methods: In this single-center, parallel, phase 2 randomized controlled trial, 75 individuals with PD were randomized 1:1 to conventional EMST (control; n=38) or the same protocol enhanced with the app (experimental; n=37), using a simple computer-generated randomization sequence. The is an mHealth app that provides real-time performance monitoring, direct visual feedback, and longitudinal progress tracking. All participants completed 8 weeks of semisupervised intensive EMST with biweekly in-person reassessments, followed by 16 weeks of unsupervised maintenance training. The primary outcome was adherence during weeks 8 to 24 among participants at risk for nonadherence, defined a priori at week 8 as Self-Efficacy for Home Exercise Program Scale (SEHEPS) less than 59. Because risk status was determined at week 8 and all participants subsequently entered the unsupervised phase, individuals not classified as at-risk were not excluded. Their data from week 8 onward were reported alongside the at-risk group. Secondary outcomes were changes in maximum expiratory pressure and SEHEPS. Results: No study-related adverse events occurred. Groups were well matched at baseline (control vs experimental: mean disease duration 7.0 (SD 5.7) vs 7.3 SD 4.7) y; mean Hoehn-Yahr 1.97 (SD 0.6) vs 2.0 (SD 0.5)). The mixed-effects model showed no significant 3-way interaction (group×interval×SEHEPS risk; =.14). At week 24, the at-risk category for the nonadherence cohort comprised 34 participants (control, n=17; experimental, n=17). In this at-risk cohort, the experimental group demonstrated a smaller decline in adherence during weeks 8 to 24 than controls (=496.9, 95% CI 130.7‐863.3; =.008), completing 1073 (95% CI 643‐1502) expiratory maneuvers versus 525 (95% CI 358‐692). Maximum expiratory pressure increased in both groups from weeks 0 to 24, with larger gains in the experimental group (+43.1, 95% CI 32.4‐53.8 cmHO) than in controls (+22.8, 95% CI 13.8‐31.8 cmHO; =.006; Cohen =0.74). SEHEPS improved after intensive training in both groups, but only the experimental group exceeded the 12-point minimal detectable change at the 95% confidence limit. Conclusions: This is the first randomized controlled trial to integrate mHealth with EMST. Unlike prior studies in the EMST field, we focused on sustaining long-term exercise adherence. -assisted EMST resulted in higher long-term adherence and greater gains in expiratory muscle strength than conventional EMST. In real-world PD care, assessing self-efficacy after the supervised EMST phase may help identify individuals who would benefit from digital support, making mHealth-assisted EMST a practical approach for maintaining exercise adherence. Trial Registration: ClinicalTrials.gov NCT05728099; https://clinicaltrials.gov/study/NCT05728099

Enhancing Adherence to Home-Based Expiratory Muscle Strength Training in Parkinson Disease: Randomized Controlled Trial of an mHealth Intervention

Patient Perceptions of Blockchain-Based Health Information Exchange: User-Centered Design Study Background: Blockchain-based health information exchange (HIE) has received increased attention in health care research and practice over the last years. It enables the sharing of patient information across healthcare organizations, provides higher levels of data confidentiality and security, and reduces time and costs in collaborative medical decision-making. To make informed decisions on the implementation of blockchain-based HIE in practice and to fully understand the implications of its use for patient care, it is important to gain insights into patient perceptions of and interactions with blockchain-based HIE. Objective: This study aimed to assess patient perceptions of a blockchain-based HIE mobile app to inform its iterative development. Methods: We used a mixed methods user-centered design in 3 phases to iteratively assess patient perceptions of blockchain-based HIE: (1) structured questionnaires collecting patient requirements for blockchain-based HIE, (2) semistructured interviews evaluating mobile app mock-ups, and (3) a survey with blockchain-based HIE scenarios related to their patient care using the technology acceptance model, System Usability Scale, and open feedback. Both the semistructured interviews and the survey were conducted in a clinical setting with patients with cancer undergoing treatment at a major university hospital in Germany. As an exemplary case, we deem patients with cancer as well-positioned to evaluate a blockchain-based HIE mobile app since their treatment requires extensive coordination and data sharing across health care providers. Results: Our findings support that patients have a high intention to use the blockchain-based functions that enable them to define, track, and revoke access to their health data per health care facility and service provider. Patients rated the 4 key functionalities (connection with providers, document sharing, a health diary, and a health care service provider search) as both useful and easy to use. The overall System Usability Scale of the blockchain-based HIE mobile app improved over the 3 phases up to 77.34, showing a good overall usability. The open feedback showed that patients’ perceived usefulness of a blockchain-based HIE mobile app is especially influenced by 3 factors: the acceleration of the process of data sharing, patient-centered access control, and alignment with the respective health care settings. Moreover, patients’ perceived ease of use of a blockchain-based HIE mobile app is impacted by 3 additional factors: the intuitiveness of the interaction, an aesthetic and functional design, and individual differences such as age or literacy with document management systems. Conclusions: The evaluation demonstrates that patients are inclined to use blockchain-based HIE to manage their health data, as it empowers them to control which health care providers or individuals can access their information. To foster the use of a blockchain-based HIE mobile app, the app should allow patients to effortlessly establish connections with health care providers, offer an overview of all patient data, and enable patients to share medical documents individually via the app.

Patient Perceptions of Blockchain-Based Health Information Exchange: User-Centered Design Study

Correction: A Supervised Explainable Machine Learning Model for Perioperative Neurocognitive Disorder in Liver-Transplantation Patients and External Validation on the Medical Information Mart for Intensive Care IV Database: Retrospective Study

Feasibility and User Experience of Immersive #VirtualReality #VR–Based Rehabilitation in Patients With Stroke: Single-Arm Pretest-Posttest Pilot Study Background: Immersive #VirtualReality #VR (VR) is promising in stroke rehabilitation; it is believed to promote motivation and intervention adherence among patients. However, existing work often lacks a structured assessment of user experience over a longer period of time. Objective: This study aimed to assess the feasibility, user experience, and preliminary effectiveness of a VR-based rehabilitation program designed for patients with stroke to train upper limb and cognitive functions. Methods: Thirty-two chronic (n=19, 59%) or postacute (n=13, 41%) patients with stroke (mean age 60, SD 11 years) were enrolled. All participants performed 4 weeks of training, performing exercises in the #Virtual Supermarket for Stroke (VSS). The VSS is an ecological VR-based application allowing customization of difficulty to make the task of “doing the shopping” more challenging throughout the sessions. Subjective outcomes were assessed after the first and last sessions. Clinical scales were administered at baseline and at the end of the treatment. Results: Of 32 participants, 31 (97%) completed the training. Flow (median 4.56, IQR 3.94-4.72; 5-point scale), sense of presence (Spatial Presence: median 3.44, IQR 12.85-3.85; Engagement: median 3.79, IQR 3.26-4.191; Naturalness: median 3.60, IQR 3.20-4.40; all 5-point scales), and affective state-related variables (Positive and Negative Affect Schedule; Positive Affect: median 4.60, IQR 4.00-5.00; Negative Affect: median 1, IQR 1.00-1.00) were satisfactory after the first session. Perceived ease of use was rated as very high (median 6.75, IQR 6.00-7.00; 7-point scale). No severe symptoms of cybersickness were recorded (Simulator Sickness Questionnaire [SSQ-TS]: median 11.22, IQR 0-20.57). At the end of the intervention, no significant differences were recorded in any subjective variable. Regarding clinical outcomes, significant improvements were recorded in balance (Berg Balance Scale pre: median 30, IQR 14.00-45.75; post: median 33.5, IQR 17.00-47.00; =.02), upper limb motor functions (Motricity Index pre: median 45, IQR 15.25-69.00; post: median 46, IQR 32.00-77.00; =.02; Box and Block pre: median 0, IQR 0-11.5; post: median 0, IQR 0-28; =.005), and functional mobility (Time Up and Go pre: median 18, IQR 13.25-34.50; post: median 14, IQR 9.00-26.00; =.005). No significant differences were recorded for general cognitive abilities (Mini-Mental State Examination pre: median 27, IQR 25-28; post: median 28, IQR 26-29), spasticity, and pain (visual analog scale pre: median 0, IQR 0-3.5; post: median 0, IQR 0-2). Conclusions: The study showed the preliminary feasibility of a rehabilitation program using the VSS. It addressed the essential topic of assessing VR-based rehabilitation user experience throughout the entire training period, shedding light on the features that can contribute to an optimal psychological experience. Clinical outcomes suggested that the VSS promoted neuroplasticity and that the recorded improvements could translate into meaningful functional gains in daily activities. Further studies with larger samples and patients with more severe disabilities are needed to confirm these results.

JMIR Serious Games: Feasibility and User Experience of Immersive #VirtualReality #VR–Based Rehabilitation in Patients With Stroke: Single-Arm Pretest-Posttest Pilot Study

Clinical Model Autophagy: The Risk of Interpretative Drift in Recursive #Medical AI Date Submitted: Mar 6, 2026. Open Peer Review Period: Mar 11, 2026 - May 6, 2026.

Clinical Model Autophagy: The Risk of Interpretative Drift in Recursive #Medical AI (preprint) #openscience #PeerReviewMe #PlanP

Impacts of a Knowledge Mobilization Campaign for Carer-Inclusive Workplace Tools in Canada: Knowledge-to-Action Design Study Background: Coupled with an aging population and lower fertility rates, there is a growing number of carer-employees (CEs), those balancing unpaid care with paid employment. Over 5.2 million Canadians are CEs juggling this dual role, often incurring negative impacts to their mental and physical health as a result. Given that unpaid care makes up 75% of care provided in Canada, the economic importance of supporting CEs extends to sustaining health care systems. Supporting and accommodating CEs in the workplace has not only been proved to be beneficial to the well-being of CEs but also to the organization through increased productivity and lower turnover rates. Despite the clear advantages of implementing carer-inclusive workplace practices (CIWPs) in the workplace, many organizations across Canada remain largely unsupportive of CE accommodations. The present study evaluated the impact of a knowledge mobilization (KMb) campaign. Objective: The primary objective of the 2-phased campaign was to raise awareness of CIWPs in Canada and increase the uptake of various tools designed to support the implementation of CIWPs. Phase 1 published 4 articles in leading national industry magazines geared toward the target audiences; Phase 2 entailed a webinar series based around Phase 1. Methods: This study uses a quantitative methodology using data collected primarily through the various magazine article publishing companies, as well as project partner McMaster Continuing Education. Engagement metrics and analytics associated with each KMb activity were collected through social media platforms and website analytics. Tracking engagement metrics, such as views, unique views, social media impressions, social media clicks, registrations, and attendees, was used to evaluate the impact of the campaign. Results: The collected engagement metrics and analytics were analyzed to evaluate the campaign activities’ impact on increasing the engagement with and uptake of specific tools. Phase 1 activities brought in a total of 36,308 views (mean 9077, SD 17,336), 2469 unique views (mean 617, SD 548), 55,445 social media impressions (mean 13,861, SD 19,424), and 432 social media clicks (mean 108, SD 101) across all 4 articles. The most successful activity was Article 3, pitched toward the small- to medium-sized business audience. Phase 2 was successful in engaging the target audiences with the campaign materials to further promote and disseminate the tools. Webinar attendance rates varied across sessions (22.1%‐30.6%) with overlapping 95% CIs. Noticeable increases in engagement with the CIWP tools are observed during the months when Articles 3 and 4 were published. Conclusions: Results of the campaign suggest that published magazine articles targeted to the respective audiences are the most effective method of knowledge mobilization for this work, recognizing that paid activities had greater reach and better resources for dissemination. Future research in this area should focus on engaging with employers and professional stakeholders more directly.

JMIR Formative Res: Impacts of a Knowledge Mobilization Campaign for Carer-Inclusive Workplace Tools in Canada: Knowledge-to-Action Design Study #KnowledgeMobilization #CarerInclusion #WorkplaceWellness #SupportCaregivers #MentalHealthAwareness

Revolutionizing Dental Radiology: A Live Podcast Study at University of Freiburg YouTube video by JMIR Publications

In a study in JMIR Medical Education, researchers Anna- Lena Hillebrecht & Wiebke Semper Hogg tested a live podcast where students joined and discussed clinical cases.
Watch the video on our Youtube to discover what they found: https://www.youtube.com/watch?v=ciQ7lXtexss