JMIR Formative Research最新文献

Background: Bipolar disorder requires immediate and frequent daily symptom monitoring due to its extreme mood fluctuations. Ecological momentary assessment (EMA) technology uses high-frequency data collection to achieve ecologically valid capture of patient symptoms. Investigating EMA compliance among Chinese patients with bipolar disorder and its influencing factors is essential for developing more feasible daily symptom monitoring protocols.

Objective: This study aimed to investigate the 14-day compliance rate of EMA among Chinese individuals with bipolar disorder and to examine the demographic and clinical characteristics associated with that compliance.

Methods: A total of 100 adults (63 female individuals) with bipolar disorder across mood states (depressive episode, n=29, 29%; hypomanic or manic episode, n=17, 17%; euthymic state, n=54, 54%) completed self-monitoring via the WeChat Mini Program "Xunkang Assessment System" 3 times daily for 14 days. The compliance rate was calculated as the percentage of completed questionnaires out of the total required over 2 weeks. Multivariate ordinal logistic regression was used to explore the factors associated with the compliance rate.

Results: The median compliance rate was 75% (IQR 35.7%-90.4%). Compliance did not differ significantly across mood states (P=.15). In multivariable models, higher Bech-Rafaelsen Mania Scale scores and lower Functioning Assessment Short Test scores were independently associated with better compliance (Bech-Rafaelsen Mania Scale: B=0.11; P=.03 and Functioning Assessment Short Test: B=-0.06; P=.01).

Conclusions: Two-week EMA monitoring via the WeChat Mini Program is feasible among Chinese individuals with bipolar disorder across mood states. Manic symptom severity and functional impairment were associated with EMA adherence and should be considered in study design and interpretation.

Background: Although sexual exploration is normative during adolescence, sexual activities that are unprotected and occur under the influence of substances can pose significant risks to young people. Youth exposed to adversity are among the groups most vulnerable to sexual risk-taking in adolescence. Selective interventions that consider lived experiences and the local context may help reduce sexual risk-taking among this population.

Objective: This pilot study assessed the feasibility of participant recruitment and retention as well as participant engagement with an adapted version of Focus on Youth with Informed Parents and Children Together for Black youth exposed to household challenges.

Methods: Participants were recruited using school and community presentations, digital flyers, and referrals. A total of 121 youth from 3 sites in Baltimore, Maryland, were screened. Participants completed 3 assessments: baseline, posttest, and 3-month follow-up. Participant enrollment, session attendance, and assessment completion were used to determine feasibility and engagement. Sexual health knowledge, pregnancy intentions, partner communication, and sexual behaviors were explored as secondary outcomes.

Results: Funded by the National Institutes of Health, the data for this study were collected between January 2022 and April 2023. A total of 61 youth (aged 13-16 years) were recruited and randomized to either the intervention or the control condition (n=33 and n=28, respectively). In total, 87% (53/61) of the participants completed all 3 assessments. There was high engagement: 80% (48/61) of participants attended at least 3 sessions, and 75.2% (115/153) of after-session responses revealed they would recommend a session to a friend. Among the 18 participants who reported having any sex, all 18 (100%) abstained from alcohol use and 12 (67%) abstained from drug use before sex. The intervention group showed a significant increase in sexual health knowledge. No changes in sexual health behaviors or partner communication were observed.

Conclusions: Findings suggest that recruiting, retaining, and engaging participants in the adapted Focus on Youth with Informed Parents and Children Together intervention is feasible. Additional research is needed to determine the extent to which this intervention can mitigate sexual risk-taking among youth exposed to adversity. The findings will inform the redesign of our assessments to capture additional factors that may affect sexual health behaviors.

Trial registration: ClinicalTrials.gov NCT05033821; https://clinicaltrials.gov/study/NCT05033821.

Background: Biomedical research studies are increasingly using digital tools to enroll, recruit, and collect data from participants. However, variability in digital literacy and technological acceptance can be challenging for recruitment from groups traditionally underrepresented in research, including those served by Federally Qualified Health Centers.

Objective: This study aimed to (1) measure participant accessibility and comfort with digital platforms and (2) examine the interrelation of technology access, digital literacy, and support preferences during enrollment and data submission.

Methods: A cross-sectional analysis was conducted using enrollment data from Federally Qualified Health Centers participating in the All of Us Research Program. Participants had the option of High-Touch (staff-assisted) or Low-Touch (self-directed) support for enrollment and survey completion. Survey items assessed internet access and technology comfort, while support type was recorded by the research staff based on participants' actual selection. Logistic regression models evaluated relationships between technology access, comfort, and enacted support type, while controlling for age, consent language, and education, as well as race and ethnicity.

Results: The analytic sample included 605 participants. The majority reported access to the internet (539/605, 89.1%) and felt comfortable with technology (448/605, 74.1%). In the group requesting High-Touch support (n=346), 14.5% (n=50) reported no internet access, and 31.5% (n=109) felt uncomfortable with technology. In the group requesting Low-Touch support (n=259), 6.2% (n=16) had no access to the internet, and 3.9% (n=10) reported feeling uncomfortable (P<.001). In the adjusted models, much greater comfort with technology was significantly correlated with reduced odds of requesting High-Touch support (comfortable: adjusted odds ratio 0.118, 95% CI 0.055-0.255 and neutral: adjusted odds ratio 0.212, 95% CI 0.077-0.587), but internet access was not significantly correlated.

Conclusions: The strongest predictor for support preference for digital enrollment among the participants was their comfort with technology rather than access alone. These findings illustrate the significance of participant-centric design methods coupling adaptive support paths, mixed enrollment strategies, and individualized onboarding methods aligned with digital confidence to promote equitable engagement in precision health research.

This study demonstrates that GPT-4o outperforms traditional natural language processing methods in accurately analyzing patient sentiment toward atopic dermatitis treatments on Reddit, enabling more nuanced and reliable extraction of real-world patient perspectives from large-scale social media data.

Background: Cardiovascular diseases remain the leading global cause of mortality, yet traditional electrocardiogram (ECG) interpretation shows subjective variability and limited sensitivity to complex pathologies.

Objective: This study aims to address these challenges by proposing the Cardiovascular Multimodal Prediction Network (CaMPNet), a transformer-based multimodal architecture that integrates raw 12-lead ECG waveforms, 9-structured machine-measured ECG features, and demographic data (age and sex) through cross-attention fusion.

Methods: The model was trained on 384,877 records from the Medical Information Mart for Intensive Care IV - Electrocardiogram Matched Subset database and evaluated across 12 cardiovascular disease labels. To further assess temporal robustness, a temporal external validation was performed using the most recent 10% of the data, withheld chronologically from model development.

Results: On the internal test set, the model achieved a mean area under the curve (AUC) of 0.845 (SD 0.04) and area under the precision-recall curve of 0.489, outperforming the residual networks-ECG baseline (AUC=0.848 but F1-score=0.152) and all single-modality variants. Subgroup analyses demonstrated consistent performance across demographics (male AUC= 0.846 vs female=0.843; youngest quartile 0.884 vs oldest 0.811). CaMPNet retained moderate discriminative ability in temporal external validation with a mean AUC of 0.715 (SD 0.03) and area under the precision-recall curve of 0.298, although performance declined due to temporal distribution shifts. Despite this, major disease categories, such as atrial fibrillation, heart failure, and normal rhythm, maintained high AUCs (>0.84). Attention-based visualization revealed clinically interpretable patterns (eg, ST-segment elevations in ST-segment elevation myocardial infarction), and ablation experiments verified the model's tolerance to missing structured inputs.

Conclusions: CaMPNet demonstrates robust and interpretable multimodal ECG-based diagnosis, offering a scalable framework for comorbidity screening and continual learning under real-world temporal dynamics.

Background: Enhancing care coordination and sharing information in cancer care improves patient experiences by promoting clarity and satisfaction.

Objective: This study aims to assess the impact of cross-sectoral video consultation on patient perceptions of care coordination and satisfaction with received information compared to usual care.

Methods: This study presents secondary outcomes on patient perceptions of care coordination and satisfaction with received information from a 7-month follow-up of the Partnership Project. In this randomized controlled trial, patients with cancer were allocated to either an intervention group receiving cross-sectoral video consultation (oncologist, general practitioner, and patient) or a control group receiving usual care. Patients' perceptions of care coordination and information quality were assessed using the Australian Cancer Care Coordination Questionnaire (CCCQ) and the European Organisation for Research and Treatment of Cancer Quality of Life Information Questionnaire 25 at baseline and 7 months. Changes over time between groups were analyzed using generalized estimating equations.

Results: Of the 278 participants randomized (1:1), only 80 (28.8%) patients received the intervention due to technical and administrative issues. A total of 210 (75.5%) patients completed the baseline questionnaire, while 118 (42.4%) responded at 7 months. No significant differences were observed in the changes over time between the intervention and control groups in any outcome. The estimated differences in the change in score from baseline to 7 months were as follows: for the total CCCQ score, 1.11 (95% CI -2.32 to 4.53; P=.53); for the overall European Organisation for Research and Treatment of Cancer Quality of Life Information Questionnaire 25 score, 1.49 (95% CI -2.98 to 5.96; P=.51); for the CCCQ communication subscale, -1.49 (95% CI -1.33 to 4.31; P=.30); and for the navigation subscale, -0.03 (95% CI -1.52 to 1.46; P=.97).

Conclusions: Our findings indicate no statistically significant improvement in patients' reported care coordination or satisfaction with received information over 7 months. Technical issues with the video setup reduced fidelity rates and follow-up participation. Further research is needed to optimize the structure and content of cross-sectoral video consultations to better support patients' perceived outcomes.

Trial registration: ClinicalTrials.gov NCT02716168; https://clinicaltrials.gov/study/NCT02716168.