JMIR Formative Research最新文献_第10页

Retrieval-Augmented Generation for Medical Question Answering on a Heart Failure Dataset: Performance Analysis. 在心力衰竭数据集上用于医疗问题回答的检索增强生成：性能分析。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/84932

Shiran Zhang, Evelyn Phan, Pedro Velmovitsky, Quynh Pham, Scott Sanner

Background: The integration of retrieval-augmented generation (RAG) systems into the domain of medical question-answering (QA) presents a significant opportunity to enhance the effectiveness and accuracy of clinical support systems.Objective: This study aimed to explore the design choices within the RAG framework and the use of large language model (LLM) classifiers to optimize medical QA systems, enhancing response quality for patient and caregiver queries of varying risk levels.Methods: In total, we curated a dataset of 109 patient and caregiver questions related to heart failure (HF)-categorized into answerable (direct, fact-based queries), helpful deferral (general guidance or lifestyle advisory queries), and nonanswerable (out-of-scope or high-risk and medical intervention queries) types-along with relevant documents and a target answer for each question from the website The Heart Hub. Applying a system architecture leveraging RAG with a structured query taxonomy and robust classification mechanisms, this paper provided an empirical assessment for medical QA on a HF dataset and introduced a QA system pipeline design, providing a foundation for extended application across various medical fields. Specifically, we evaluated design choices in the initial retrieval stage of RAG and their impact on performance. We assessed final answer quality from the generation stage using popular passage scoring methods for QA, such as Recall-Oriented Understudy for Gisting Evaluation (ROUGE), BERTScore, and Intersection over Union score.Results: The pipeline first uses an LLM-based classifier, achieving 65% accuracy for answerable and helpful deferral queries and 100% accuracy for identifying nonanswerable queries. In information retrieval, the BioMedical Contrastive Pre-trained Transformers (MedCPT) cross encoder performed best as a dense retrieval method, delivering an average of 93% recall @ 7 through ranked relevance scores to obtain the top documents with recall @ k denoting recall computed over the top-k retrieved items. For further retrieving snippets from such documents, its average performance was 72.5% for sentence-level snippets and 83% for paragraph-level snippets. A second LLM-based classifier, used to refine the generated responses, resulted in an overall reduction in ROUGE-1 recall by 13% and Bidirectional Encoder Representations from Transformers (BERT) precision by 11%. However, Intersection over Union scores, or the overlap between "gold answers" and system answers, increased by 24%, demonstrating enhanced alignment with ground truth responses. This also indicates the system's improved ability to generate concise and accurate medical responses.Conclusions: The implementation of a structured RAG framework paired with LLM classifiers for medical QA introduces a promising avenue for enhancing clinical decision support systems. By s

背景：将检索增强生成（RAG）系统集成到医学问答（QA）领域，为提高临床支持系统的有效性和准确性提供了一个重要的机会。目的：本研究旨在探讨在RAG框架下的设计选择和使用大语言模型（LLM）分类器来优化医疗质量保证系统，提高对不同风险水平的患者和护理人员查询的响应质量。方法：总的来说，我们整理了109个与心力衰竭（HF）相关的患者和护理人员问题的数据集，分为可回答的（直接的，基于事实的查询），有用的延迟（一般指导或生活方式咨询查询）和不可回答的（超出范围或高风险和医疗干预查询）类型，以及相关文档和来自the heart Hub网站的每个问题的目标答案。采用基于RAG的系统架构，结合结构化查询分类法和鲁棒分类机制，对高频数据集上的医学QA进行了实证评估，并介绍了QA系统的流水线设计，为跨医学领域的扩展应用奠定了基础。具体来说，我们评估了RAG初始检索阶段的设计选择及其对性能的影响。我们从生成阶段开始使用流行的问答评分方法来评估最终答案的质量，例如面向记忆的替代评分（ROUGE）、BERTScore和交叉评分。结果：该管道首先使用了基于llm的分类器，对于可回答的和有用的延迟查询实现了65%的准确率，对于识别不可回答的查询实现了100%的准确率。在信息检索中，生物医学对比预训练变形器（MedCPT）交叉编码器作为密集检索方法表现最好，通过排序相关分数获得顶级文档的平均召回率为93% @ 7，召回率@ k表示对前k个检索项目计算的召回率。对于从这些文档中进一步检索片段，它的平均性能为句子级片段的72.5%和段落级片段的83%。第二个基于llm的分类器，用于改进生成的响应，导致ROUGE-1召回率总体降低了13%，双向编码器表示从变压器（BERT）精度降低了11%。然而，Union分数的交集，或“黄金答案”与系统答案之间的重叠，增加了24%，表明与地面真实答案的一致性增强。这也表明该系统产生简明准确的医疗反应的能力有所提高。结论：将结构化RAG框架与医学QA的LLM分类器配对，为增强临床决策支持系统引入了一条有希望的途径。通过系统地分析查询分类法、检索配置和响应策略的影响，该方法使用HF数据集阐明了医疗RAG系统中每个组件的相对重要性。我们的研究结果为优化设计选择提供了可操作的指导，以最大限度地提高检索和响应精度；因此，为开发健壮的、可扩展的医疗质量保证系统提供了信息。

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引用次数: 0

Web-Based Acceptance and Commitment Therapy Tobacco Cessation Program for Veterans With Mental Health Disorders: Adaptation and Usability Testing. 基于网络的接受和承诺治疗戒烟计划的退伍军人心理健康障碍：适应性和可用性测试。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/75394

Megan M Kelly, Abigail Dempsey, Victoria Ameral, Beth Ann Petrakis, Erin D Reilly, Karen Quigley, Jonathan B Bricker, Jaimee L Heffner

Background: US veterans with mental health disorders have high rates of smoking and low rates of smoking cessation.

Objective: This study aims to focus on an adaptation of a web-based acceptance and commitment therapy (ACT) tobacco cessation intervention (Vet WebQuit) for veterans with mental health disorders who use tobacco and used a qualitative approach to test its usability (n=16).

Methods: Participants were asked to walk through the site during laboratory-based usability testing and "think aloud" about the features of the intervention. A trained facilitator used semistructured interview questions to assess participants' experiences with Vet WebQuit and obtain feedback on their impressions of the site. Qualitative analyses identified themes regarding participants' experiences with the intervention, usability concerns, and recommendations for improving Vet WebQuit.

Results: Overall, veterans found that the Vet WebQuit layout was simple and easy to navigate and use. Veterans reported that several features of the program were useful, including the quit plan, identification of triggers, content that targets mental health concerns (eg, dealing with anger), information on the health effects of smoking, tools for managing triggers (eg, urge surfing), and involving others in their quit plan. Veterans reported that particular features of the ACT approach for tobacco cessation were appealing to them, including the distinction between internal and external smoking triggers, the inclusion of the serenity prayer, and mindfulness exercises, which they could use as a tool reduce the intensity of cravings. Veterans reported wanting more information on the health aspects of smoking (ie, effects on breathing and lung capacity) as a way to motivate them to quit smoking. In addition, they suggested targeting specific mental health concerns that serve as triggers for smoking, including nightmares, boredom, and social isolation.

Conclusions: Overall, results from this project identified important elements of ACT digital tobacco cessation interventions for veterans with mental health disorders.

背景：患有精神健康障碍的美国退伍军人吸烟率高，戒烟率低。目的：本研究旨在研究基于网络的接受和承诺治疗（ACT）戒烟干预（Vet WebQuit）对使用烟草的精神健康障碍退伍军人的适应性，并使用定性方法测试其可用性（n=16）。方法：参与者被要求在实验室可用性测试期间浏览网站，并“大声思考”干预措施的特征。一位训练有素的主持人使用半结构化的面试问题来评估参与者在Vet WebQuit上的体验，并获得他们对网站印象的反馈。定性分析确定了参与者在干预方面的体验、可用性问题和改进Vet WebQuit的建议。结果：总体而言，退伍军人发现Vet WebQuit布局简单，易于导航和使用。退伍军人报告说，该计划的几个特点是有用的，包括戒烟计划，识别诱因，针对心理健康问题的内容（例如，处理愤怒），关于吸烟对健康影响的信息，管理诱因的工具（例如，冲动冲浪），以及让其他人参与戒烟计划。退伍军人报告说，ACT戒烟方法的某些特点对他们很有吸引力，包括区分内部和外部吸烟诱因，包括宁静祈祷和正念练习，他们可以把这些作为减少渴望强度的工具。退伍军人报告说，他们想要更多关于吸烟健康方面的信息（即对呼吸和肺活量的影响），以此来激励他们戒烟。此外，他们建议针对引发吸烟的特定心理健康问题，包括噩梦、无聊和社会孤立。结论：总体而言，该项目的结果确定了ACT数字戒烟干预措施对患有精神健康障碍的退伍军人的重要因素。

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引用次数: 0

Effects of a Semantically Irrelevant Virtual Reality Experience on Memory and Emotion After Watching a Traumatic Event: Randomized Controlled Experimental Study. 语义无关虚拟现实体验对创伤性事件后记忆和情绪的影响：随机对照实验研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/75848

Changwon Son, Killian Parker, Mohammad Jamshidzadeh

Background: First responders, such as firefighters, experience significant mental health issues due to the high-stress nature of their work. Existing mental health interventions, such as meditation and debriefing, despite their benefits, do not target cognitive processing of traumatic events such as memory and emotion.Objective: This work aims to examine effects of semantically irrelevant virtual reality (VR) content to intervene in the retrieval of an adverse event memory and its associated emotions. Cognitive models of posttraumatic stress disorder posit that exposure to stimuli that are similar to a previous trauma acts as a trigger for retrieval of the associated memory and bodily reaction (eg, elevated heart rate). This work uses semantically irrelevant VR as an intervention to interrupt the retrieval of the traumatic memory by placing a participant in a VR environment that has a distant semantic connection to the trauma.Methods: A total of 107 participants recruited from a large public university in Texas were randomly assigned to 1 of 3 groups: control (n=33), comparison (n=37), and intervention (n=37). In stage 1, participants in all groups watched a short video of an actual severe house fire to create a traumatic event memory. In stage 2, the control group stayed seated without doing anything, the comparison group read a paragraph about the Red Sea as semantically irrelevant follow-up information, and the intervention group watched a 360° VR video of the Red Sea that featured opposite attributes to the fire (eg, blue water vs red fire, cool water vs hot fire). The Positive and Negative Affect Schedule, which has 10 items for positive emotions (eg, attentive and excited) and 10 items for negative emotions (eg, scared and distressed), was administered after each of the two stages. In stage 3, the memory accuracy of the house fire video was assessed using a forced recognition test of 15 pairs of a true image and a fake image generated by artificial intelligence software.Results: A 1-way ANOVA revealed no difference in memory accuracy between the three groups (P=.48). Mean memory accuracy was 0.714 (SD 0.125) for the control group, 0.732 (SD 0.117) for the comparison group, and 0.694 (SD 0.155) for the intervention group. However, a repeated-measures ANOVA found that the semantically irrelevant VR experience significantly boosted positive emotions among the intervention group participants (P=.04) and reduced negative feelings among participants in all groups (P<.001).Conclusions: Our findings suggest that semantically irrelevant VR was effective in changing the emotional states of participants. This implies that a semantically irrelevant VR experience can serve as a quick and affordable way to address psychological reactions after watching a traumatic event. Future research is required to design semantically irrelevant VR conte

背景：第一响应者，如消防员，由于他们工作的高压力性质，经历了严重的心理健康问题。现有的心理健康干预措施，如冥想和汇报，尽管有好处，但并不针对记忆和情感等创伤事件的认知处理。目的：本研究旨在研究语义无关的虚拟现实（VR）内容对不良事件记忆及其相关情绪检索的影响。创伤后应激障碍的认知模型假设，暴露于与先前创伤相似的刺激，可以触发相关记忆和身体反应的恢复（例如，心率升高）。这项工作使用语义无关的虚拟现实作为干预，通过将参与者置于与创伤有遥远语义连接的虚拟现实环境中，来中断创伤记忆的检索。方法：从德克萨斯州一所大型公立大学招募107名参与者，随机分为3组：对照组（n=33）、对照组（n=37）和干预组（n=37）。在第一阶段，所有小组的参与者都观看了一段真实的严重房屋火灾的短视频，以创造创伤性事件记忆。在第二阶段，对照组坐在座位上不做任何事情，对照组阅读一段关于红海的文字，作为语义上无关的后续信息，干预组观看一段360°的红海VR视频，该视频具有与火灾相反的属性（例如，蓝水vs红火，冷水vs热火）。积极和消极情绪时间表，其中有10个项目用于积极情绪（例如，注意和兴奋）和10个项目用于消极情绪（例如，害怕和痛苦），在两个阶段之后进行管理。在第三阶段，使用人工智能软件生成的15对真实图像和虚假图像的强制识别测试来评估房屋火灾视频的记忆准确性。结果：单因素方差分析显示，三组之间的记忆准确性无差异（P=.48）。对照组的平均记忆准确率为0.714 (SD 0.125)，对照组为0.732 (SD 0.117)，干预组为0.694 （SD 0.155）。然而，重复测量方差分析发现，语义无关的虚拟现实体验显著提高了干预组参与者的积极情绪（P= 0.04），并减少了所有组参与者的消极情绪(P结论：我们的研究结果表明，语义无关的虚拟现实体验在改变参与者的情绪状态方面是有效的。这意味着语义无关的VR体验可以作为一种快速且负担得起的方式来解决观看创伤事件后的心理反应。未来的研究需要设计语义无关的VR内容来产生记忆抑制效果。试验注册：ClinicalTrials.gov NCT07393776；https://clinicaltrials.gov/study/NCT07393776。

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引用次数: 0

Using AI in Forward-Backward Translation of Questionnaires for Men Invited to Prostate Cancer Screening: Methodological Study. 利用人工智能对受邀参加前列腺癌筛查的男性问卷进行前后翻译：方法学研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/81900

Sofie Meyer Andersen, Pia Kirkegaard, Krzysztof Tupikowski, Katarzyna Hodyra-Stefaniak, Mette Bach Larsen

Background: Translation is important in research to ensure cultural relevance, accuracy, and generalizability, particularly in cross-cultural studies. The forward-backward translation method of the World Health Organization (WHO) is commonly used to improve linguistic and conceptual accuracy but is often time-consuming and resource intensive. The development of advanced artificial intelligence (AI) offers new opportunities to make the translation process more efficient, potentially reducing time and costs. However, concerns remain regarding the ability of AI to capture cultural nuances and complex linguistic structures, which may affect translation quality. Therefore, evidence on how AI can be effectively integrated into established translation frameworks remains limited.Objective: This study aimed to explore the use of AI in the forward-backward translation process for questionnaires.Methods: We used an adapted version of the WHO 4-step forward-backward translation method to translate the questionnaires from English into Polish. The questionnaires included the Prostate Cancer Screening Education (PROCASE) Knowledge Index, the Attitude Scale, Risk Perception items, and the Brief Health Literacy Scale for Adults. First, 2 AI tools (ChatGPT [GPT-3.5] and Microsoft Bing Copilot) were used for translating from English to Polish. Second, 2 native Polish speakers focused on content understanding independently reviewed and corrected the AI-generated Polish version and agreed on a new version. Third, the AI-generated Polish translation was back-translated from Polish into English using the same AI tools. Any discrepancies were discussed by an expert panel consisting of native speakers of English and Polish. This procedure ensured linguistic accuracy and conceptual similarity. Finally, 3 individual cognitive interviews were conducted with native Polish-speaking men to identify whether the questionnaires measured the intended constructs and to find any issues that the respondents might encounter during the response process.Results: Minor discrepancies between the two AI-generated Polish phrases "umiera z innej przyczyny" and "umiera z powodu innych przyczyn" were merged by native Polish speakers in the PROCASE Knowledge Index. The original questionnaires and the AI-generated questionnaires had minor differences, but they did not affect the meaning of the questions or what was being asked. We conducted individual cognitive interviews (n=3) with participants aged 47 to 74 years. After the interviews, the questionnaires were adjusted with a few changes to make them easier to understand. In the Attitude Scale, the AI-generated Polish translation was changed from "nieco" to "trochę" to align with everyday language and improve understanding.Conclusions: AI can be an effective tool in the translation process, offering time and resource savings while

背景：翻译在确保文化相关性、准确性和概括性的研究中非常重要，特别是在跨文化研究中。世界卫生组织（WHO）的前向后翻译方法通常用于提高语言和概念的准确性，但往往耗时且资源密集。先进人工智能（AI）的发展为提高翻译效率提供了新的机会，有可能减少时间和成本。然而，人们仍然担心人工智能捕捉文化细微差别和复杂语言结构的能力，这可能会影响翻译质量。因此，关于如何将人工智能有效地整合到现有翻译框架中的证据仍然有限。目的：本研究旨在探索人工智能在问卷前向后向翻译过程中的应用。方法：采用世界卫生组织四步前后翻译法，将问卷从英语翻译成波兰语。问卷内容包括前列腺癌筛查教育（PROCASE）知识指数、态度量表、风险认知项目和成人健康素养简易量表。首先，我们使用了两个人工智能工具（ChatGPT [GPT-3.5]和Microsoft Bing Copilot）将英语翻译成波兰语。其次，2名专注于内容理解的波兰语母语人士独立审查和纠正了人工智能生成的波兰语版本，并同意了一个新版本。第三，使用相同的AI工具将AI生成的波兰语翻译从波兰语回译为英语。由英语和波兰语母语人士组成的专家小组讨论了任何差异。这一过程保证了语言的准确性和概念的相似性。最后，对母语为波兰语的男性进行了3次个体认知访谈，以确定问卷是否测量了预期的结构，并发现受访者在回答过程中可能遇到的任何问题。结果：两个人工智能生成的波兰语短语“umiera z innej przyczyny”和“umiera z powodu innych przyczyn”之间的微小差异被母语为波兰语的人在PROCASE知识指数中合并。原始问卷和人工智能生成的问卷有微小的差异，但它们并不影响问题的含义或问题的内容。我们对47 - 74岁的参与者进行了个体认知访谈（n=3）。访谈结束后，我们对问卷进行了一些调整，使其更容易理解。在态度量表中，人工智能生成的波兰语翻译从“nieco”改为“trochzi”，以与日常语言保持一致，提高理解能力。结论：人工智能可以成为翻译过程中的有效工具，在保持准确性的同时节省时间和资源。然而，优化翻译仍然需要人的参与。

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引用次数: 0

Formative Research to Identify Contributors to Risky Drinking and Adapt an Alcohol Reduction Intervention Among Young Adults Vulnerable to HIV: Qualitative Focus Group Study. 形成性研究，以确定危险饮酒的贡献者和适应酒精减少干预的年轻人易感染艾滋病毒：定性焦点小组研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/76460

Fidelis Sesenu, Sally Kirklewski, Bryce Takenaka, Jaime Brown, Erin Nicholson, Kimberly Haney, Kaylia Carroll, Arjee Restar, Donte Travon Boyd, Keisa Fallin-Bennett, Trace Kershaw, Carolyn Lauckner

Background: Across populations, risky drinking has been demonstrated to increase HIV risk behaviors. This is of special concern for sexually minoritized cisgender men and gender-diverse young adults (aged 18-34 years), who report greater incidence of hazardous drinking (as defined by the Alcohol Use Disorders Identification Test - Consumption criteria) and HIV compared to their heterosexual and/or cisgender peers.

Objective: This study aimed to examine alcohol perceptions, patterns of use, and the role that anti-LGBTQ+ (lesbian, gay, bisexual, transgender, queer) policies and discrimination played in alcohol risk behaviors for sexually minoritized cisgender men and gender-diverse individuals. Results were used to inform the development of an alcohol reduction intervention for this population.

Methods: A qualitative study was conducted with data collected via 4 focus groups among young adult sexually minoritized cisgender men and gender-diverse individuals in the United States from April to June 2023 (N=21). Participants were grouped according to identity as cisgender men, transgender men, transgender women, and nonbinary individuals. Transcripts were analyzed using codebook thematic analysis.

Results: Alcohol use was described as a way to navigate belonging, social connection, and identity expression within LGBTQ+ contexts. Alcohol was viewed as a mainstay of LGBTQ+ spaces, with many using it as a social lubricant and coping mechanism for LGBTQ+-related stress, as well as for relaxation and having fun. Drinking intensity was often tied to an individual's comfort with their evolving sexually minoritized cisgender men and gender-diverse identity, with drinking being higher in earlier stages of exploration. The consequences of drinking discussed by participants included impaired decision-making and negative effects on mental and physical health. Anti-LGBTQ+ laws and policies were seen as contributing to the further stigmatization of sexually minoritized cisgender men and gender-diverse individuals, and hazardous use of alcohol was used as a means of escape and coping.

Conclusions: Alcohol use among sexually minoritized cisgender men and gender-diverse individuals is an important aspect of negotiating identity within different social settings and coping with stigma. Findings have valuable implications for tailoring alcohol reduction interventions for sexually minoritized cisgender men and gender-diverse young adults as they encounter stressors in real time.

背景：在人群中，危险饮酒已被证明会增加艾滋病毒风险行为。对于性少数的顺性男性和性别多样化的年轻人（18-34岁）来说，这是一个特别值得关注的问题，与异性恋和/或顺性同龄人相比，他们报告的危险饮酒（根据酒精使用障碍识别测试-消费标准的定义）和艾滋病毒的发病率更高。目的：本研究旨在研究酒精的认知、使用模式，以及反lgbtq +（女同性恋、男同性恋、双性恋、跨性别、酷儿）政策和歧视在性少数的异性恋男性和性别多元化个体的酒精风险行为中的作用。研究结果用于为这一人群制定酒精减少干预措施。方法：采用定性研究方法，于2023年4 - 6月在美国通过4个焦点小组（N=21）收集性少数的成年顺性男性和性别多样化个体的数据。参与者根据性别认同分为顺性男性、跨性别男性、跨性别女性和非二元个体。使用代码本主题分析对转录本进行分析。结果：酒精使用被描述为在LGBTQ+环境中导航归属、社会联系和身份表达的一种方式。酒精被视为LGBTQ+空间的支柱，许多人将其作为社交润滑剂和应对LGBTQ+相关压力的机制，以及放松和娱乐。饮酒强度通常与个体对性少数的顺性男性和性别多样性认同的适应程度有关，在探索的早期阶段饮酒程度更高。参与者讨论的饮酒后果包括决策能力受损以及对身心健康的负面影响。反lgbtq +的法律和政策被视为助长了对性少数的直男和性别多样化个体的进一步污名化，危险地使用酒精被用作逃避和应对的手段。结论：性少数的顺性男性和性别多样化个体的酒精使用是在不同社会环境中协商身份和应对耻辱的一个重要方面。研究结果对于针对性少数的顺性男性和性别多样化的年轻人定制酒精减少干预措施具有重要意义，因为他们会实时遇到压力源。

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引用次数: 0

Acceptability of a Culturally Tailored eHealth Video Intervention "Put Yourself First" to Promote Preexposure Prophylaxis Awareness and Knowledge Among Young Black Women: Mixed Methods Pilot Study. 可接受的文化定制电子健康视频干预“把自己放在第一位”，以促进暴露前预防意识和知识的年轻黑人妇女：混合方法试点研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/74132

Porche M Williams, Portia Thomas, David Babayev, Alana Gunn

Background: Black women experience dual disparities with disproportionately high rates of HIV infection and low uptake of preexposure prophylaxis (PrEP). To address this issue, a culturally relevant eHealth video intervention was developed to increase awareness and uptake of PrEP.

Objective: This study aims to evaluate the usability, acceptability, and impact of a culturally tailored eHealth video intervention ("Put Yourself First") on PrEP-related knowledge and motivation among young Black women.

Methods: This study used a sequential, mixed methods design. Thirteen young, primarily heterosexual, Black women, aged 18-25 years, were recruited from community-based organizations and social networks in New York City to participate in 2 evaluation focus groups. Participants completed pre- and postvideo assessments, followed by facilitated focus group discussions to elicit qualitative feedback on the video's usability, acceptability, and impact on PrEP knowledge.

Results: After watching the eHealth video, knowledge scores increased significantly postviewing (P=.04). Most participants indicated willingness to consider PrEP (10/13, 77%), and all reported intentions to recommend it to others (13/13, 100%). Overall, 92% (12/13) of the participants rated the video as very good or excellent. Participants found the video to be very interesting (11/13, 85%) and useful (12/13, 92%). The qualitative findings suggest that representation, authenticity, and the normalization of PrEP use emerged as critical drivers of acceptability. It also highlighted the video's relatability, cultural relevance, and ability to dispel misconceptions, while also identifying areas for refinement for future studies.

Conclusions: Findings support the acceptability and usability of culturally tailored sex-positive eHealth interventions for improving PrEP awareness and motivation among young Black women. Culturally resonant multimedia centering the voices of young Black women to affirming pleasure, agency, and addressing structural barriers to engagement offers a promising strategy for HIV prevention.

背景：黑人妇女经历了双重差异：不成比例的高艾滋病毒感染率和暴露前预防（PrEP）的低吸收。为了解决这一问题，我们开发了一种与文化相关的电子健康视频干预，以提高对预科的认识和吸收。目的：本研究旨在评估一种文化定制的电子健康视频干预（“把自己放在第一位”）对年轻黑人女性预科相关知识和动机的可用性、可接受性和影响。方法：本研究采用顺序、混合方法设计。从纽约市的社区组织和社交网络中招募了13名年龄在18-25岁的年轻黑人女性，主要是异性恋者，参加了两个评估焦点小组。参与者完成了视频前和视频后的评估，随后进行了重点小组讨论，以获得关于视频可用性、可接受性和对PrEP知识影响的定性反馈。结果：观看eHealth视频后，知识得分显著提高（P=.04）。大多数参与者表示愿意考虑PrEP(10/13, 77%)，并且所有参与者都报告有意向他人推荐PrEP（13/13, 100%）。总的来说，92%（12/13）的参与者认为视频非常好或优秀。参与者发现视频非常有趣（11/13,85%）和有用（12/13,92%）。定性研究结果表明，PrEP使用的代表性、真实性和规范化成为可接受性的关键驱动因素。它还强调了视频的相关性、文化相关性和消除误解的能力，同时也确定了未来研究需要改进的领域。结论：研究结果支持了文化定制性阳性电子健康干预措施的可接受性和可用性，以提高年轻黑人女性的PrEP意识和动机。以年轻黑人女性的声音为中心的文化共鸣多媒体肯定了快乐，代理和解决参与的结构性障碍，为预防艾滋病毒提供了一种有希望的策略。

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引用次数: 0

Requirements for mHealth and Augmented Reality Apps for Patient Education Regarding Colorectal Cancer Surgery: Focus Group Study. 对移动健康和增强现实应用程序的要求，患者教育有关大肠癌手术：焦点小组研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/75972

Steffen Busse, Verena Uslar, Sebastian Fudickar, Veysel Ödemis, Sandra Hellmers, Anja U Bräuer, Andreas Hein, Dirk Weyhe

Background: The purpose of preoperative informed consent is to provide patients with comprehensive information about their treatment, including risks and alternatives, to enable informed decision-making. However, studies have shown that patients are often unable to understand or remember important information. Mobile health (mHealth) and augmented reality (AR) apps have been identified as promising solutions to improve patient education and knowledge retention.

Objective: This study aims to identify the essential requirements for an mHealth app to support informed decision-making for patients with colorectal cancer, with a specific focus on the potential of AR for visualization. This research explores the patient and physician perspectives on these requirements, particularly regarding information delivery and visualization to guide app design.

Methods: A qualitative focus group study was conducted with groups of mostly patients with colorectal cancer and a physician's group. Topics related to patient education were discussed, guided by a semistructured interview guide covering personal experience; information content; context of use; and acceptance and presentation of content, which included presenting various visualizations in 2D, 3D, and AR. The interviews were transcribed and analyzed using qualitative content analysis.

Results: We conducted 4 focus groups with patients (n=23) and 1 focus group with physicians (n=7), for a total of 30 participants. Relevant informational content for the app and its presentation was identified. Patients consistently expressed a desire for personalized, detailed, and visual information about their condition and treatment tailored to their specific case throughout the treatment journey, so they could prepare for the informed consent discussion after diagnosis, prepare for treatment, access guidance and track progress during hospitalization, and access information and resources during recovery after treatment. Patients demonstrated a strong preference for interactive 3D visualizations, while physicians favored simpler 2D images that could be easily integrated into their existing workflow. AR visualizations were seen as a potential tool to provide a general overview of anatomy and surgical approaches but more as a novelty feature and a supplement to more traditional visualizations.

Conclusions: An ideal patient education app combines comprehensive content with interactive, customizable visualizations like 3D models and AR and should be accessible throughout a patient's treatment journey. This study highlights the need for a patient-centered design that balances detailed information with ease of understanding and considering different preferences for visualization modalities and levels of detail.

背景：术前知情同意的目的是为患者提供有关其治疗的全面信息，包括风险和替代方案，以便知情决策。然而，研究表明，患者往往无法理解或记住重要信息。移动医疗（mHealth）和增强现实（AR）应用程序已被确定为改善患者教育和知识保留的有前途的解决方案。目的：本研究旨在确定移动健康应用程序的基本要求，以支持结直肠癌患者的知情决策，并特别关注AR在可视化方面的潜力。本研究探讨了患者和医生对这些需求的看法，特别是在信息传递和可视化方面，以指导应用程序设计。方法：采用定性焦点组研究，以大肠癌患者为主组和医师组为研究对象。在涵盖个人经验的半结构化访谈指南的指导下，讨论了与患者教育相关的主题；信息内容;使用语境；以及内容的接受和呈现，包括以2D、3D和AR的形式呈现各种可视化。访谈被转录并使用定性内容分析进行分析。结果：我们进行了4个患者焦点组（n=23）和1个医生焦点组（n=7），共30名参与者。确定了应用程序及其演示的相关信息内容。在整个治疗过程中，患者始终希望获得针对其具体病例的个性化、详细和可视化的病情和治疗信息，以便为诊断后的知情同意讨论做好准备，为治疗做准备，在住院期间获得指导和跟踪进展，并在治疗后恢复期间获取信息和资源。患者表现出对交互式3D可视化的强烈偏好，而医生更喜欢简单的2D图像，可以很容易地集成到他们现有的工作流程中。AR可视化被视为一种潜在的工具，可以提供解剖学和外科手术方法的总体概述，但更多的是作为一种新颖的功能和传统可视化的补充。结论：理想的患者教育应用程序将全面的内容与交互式、可定制的可视化（如3D模型和AR）相结合，并且应该在患者的整个治疗过程中都可以访问。本研究强调了以患者为中心的设计的必要性，该设计需要平衡详细信息与易于理解的关系，并考虑到可视化方式和细节水平的不同偏好。

{"title":"Requirements for mHealth and Augmented Reality Apps for Patient Education Regarding Colorectal Cancer Surgery: Focus Group Study.","authors":"Steffen Busse, Verena Uslar, Sebastian Fudickar, Veysel Ödemis, Sandra Hellmers, Anja U Bräuer, Andreas Hein, Dirk Weyhe","doi":"10.2196/75972","DOIUrl":"10.2196/75972","url":null,"abstract":"Background: The purpose of preoperative informed consent is to provide patients with comprehensive information about their treatment, including risks and alternatives, to enable informed decision-making. However, studies have shown that patients are often unable to understand or remember important information. Mobile health (mHealth) and augmented reality (AR) apps have been identified as promising solutions to improve patient education and knowledge retention.Objective: This study aims to identify the essential requirements for an mHealth app to support informed decision-making for patients with colorectal cancer, with a specific focus on the potential of AR for visualization. This research explores the patient and physician perspectives on these requirements, particularly regarding information delivery and visualization to guide app design.Methods: A qualitative focus group study was conducted with groups of mostly patients with colorectal cancer and a physician's group. Topics related to patient education were discussed, guided by a semistructured interview guide covering personal experience; information content; context of use; and acceptance and presentation of content, which included presenting various visualizations in 2D, 3D, and AR. The interviews were transcribed and analyzed using qualitative content analysis.Results: We conducted 4 focus groups with patients (n=23) and 1 focus group with physicians (n=7), for a total of 30 participants. Relevant informational content for the app and its presentation was identified. Patients consistently expressed a desire for personalized, detailed, and visual information about their condition and treatment tailored to their specific case throughout the treatment journey, so they could prepare for the informed consent discussion after diagnosis, prepare for treatment, access guidance and track progress during hospitalization, and access information and resources during recovery after treatment. Patients demonstrated a strong preference for interactive 3D visualizations, while physicians favored simpler 2D images that could be easily integrated into their existing workflow. AR visualizations were seen as a potential tool to provide a general overview of anatomy and surgical approaches but more as a novelty feature and a supplement to more traditional visualizations.Conclusions: An ideal patient education app combines comprehensive content with interactive, customizable visualizations like 3D models and AR and should be accessible throughout a patient's treatment journey. This study highlights the need for a patient-centered design that balances detailed information with ease of understanding and considering different preferences for visualization modalities and levels of detail.","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"10 ","pages":"e75972"},"PeriodicalIF":2.0,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306134","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}

引用次数: 0

Exploring Use of Digital Health Technologies, Digital Health Care Literacy, and Attitudes Toward Digital Health Among Norwegian Health Care Personnel Involved in Home-Based Pediatric Palliative Care: Cross-Sectional Study. 探索数字卫生技术的使用、数字卫生保健素养和挪威卫生保健人员参与家庭儿科姑息治疗对数字健康的态度：横断面研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/74928

Judith Schröder, Kirsti Riiser, Heidi Holmen

Background: Digital health technologies can potentially increase the efficiency and quality of pediatric palliative care (PPC), yet their use in home-based PPC remains limited. Limited digital health care literacy and inadequate training can reduce confidence and foster negative attitudes, whereas positive experiences and basic digital health care literacy may encourage adoption.Objective: This study aims to explore the use of digital health technologies by Norwegian health care personnel in home-based PPC and examine the association between their digital health care literacy and their attitudes toward digital health.Methods: A cross-sectional study was conducted from September 2023 to May 2024, with an online survey targeting health care personnel involved in home-based PPC through primary or specialist health care services. Data were collected using selected items from the Norwegian Healthcare Personnel Survey on eHealth 2022, the Digital Health Care Literacy Scale (DHLS), and the Information Technology Attitude Scales for Health (ITASH), alongside demographic characteristics. Higher DHLS scores indicate greater digital health care literacy, while higher ITASH scores reflect more positive attitudes toward digital health technologies. Pearson correlation, ANOVA, and multiple linear regression analyses were conducted to comprehensively explore the relationships and associations among the variables.Results: Health care personnel (n=148) from diverse health care services responded to the survey. Half of the respondents (72/144, 50%) had experience with real-time video consultation, while phone calls were the primary communication method (138/145, 95.2%). Additionally, 55.6% (79/142) of the respondents had limited or minimal access to electronic health records from other health care services. Health care personnel perceived digital health technologies for remote PPC as a supplement (126/135, 93.3%) rather than a replacement for in-person care. Mean digital health care literacy was 18.29 (SD 3.8) on a scale from 0 to 23. On a scale from 1 to 4, the highest recorded scores pertained to attitudes toward digital health technologies in supporting care (mean 3.17, SD 0.39) and the perceived need for training (mean 3.16, SD 0.43). A statistically significant association was found between the respondents' level of digital health care literacy and their attitudes toward digital health technologies in supporting care (β=0.030, 95% CI 0.014-0.047; P<.001).Conclusions: This study examined the use of digital health technologies by Norwegian health care personnel in home-based PPC, their digital health care literacy, and attitudes toward digital health. Despite positive attitudes and high digital health care literacy, use of digital health technologies was limited, suggesting that inadequate digital health solutions may hinder effective implementati

背景：数字卫生技术可以潜在地提高儿科姑息治疗（PPC）的效率和质量，但它们在以家庭为基础的PPC中的应用仍然有限。有限的数字卫生保健知识和不充分的培训会降低信心并助长消极态度，而积极的经验和基本的数字卫生保健知识可能会鼓励采用。目的：本研究旨在探讨挪威卫生保健人员在家庭PPC中使用数字卫生技术的情况，并研究他们的数字卫生保健素养与他们对数字卫生的态度之间的关系。方法：于2023年9月至2024年5月进行横断面研究，对通过初级或专科卫生保健服务参与家庭PPC的卫生保健人员进行在线调查。数据收集使用了挪威卫生保健人员电子健康调查2022、数字卫生保健素养量表（DHLS）和健康信息技术态度量表（ITASH）中的选定项目，以及人口统计学特征。DHLS得分越高，表明数字卫生保健素养越高，而ITASH得分越高，表明对数字卫生技术的态度越积极。采用Pearson相关分析、方差分析和多元线性回归分析，全面探讨各变量之间的关系和相关性。结果：来自不同卫生保健机构的卫生保健人员（n=148）回应了调查。一半的受访者（72/ 144,50%）有过实时视频咨询的经历，而电话是主要的沟通方式（138/ 145,95.2%）。此外，55.6%（79/142）的受访者从其他卫生保健服务机构获取电子健康记录的机会有限或很少。卫生保健人员认为远程PPC的数字卫生技术是一种补充（126/135,93.3%），而不是面对面护理的替代品。在0到23的范围内，平均数字医疗素养为18.29 （SD 3.8）。在从1到4的范围内，记录得分最高的是对支持护理的数字卫生技术的态度（平均3.17,SD 0.39）和对培训需求的感知（平均3.16,SD 0.43）。被调查者的数字卫生保健素养水平与他们对支持护理的数字卫生技术的态度之间存在统计学上显著的关联（β=0.030, 95% CI 0.014-0.047）。结论：本研究考察了挪威卫生保健人员在家庭PPC中使用数字卫生技术、他们的数字卫生保健素养和对数字卫生的态度。尽管态度积极，数字保健素养高，但数字保健技术的使用有限，这表明数字保健解决方案不足可能阻碍有效实施。消除这些障碍对于加强在家庭PPC中实施数字卫生至关重要。未来的研究应侧重于将数字医疗技术整合到现有的基础设施和工作流程中，同时探索它们对个性化护理的影响，以确保高质量的家庭PPC。

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引用次数: 0

Correction: Transition From a Paper Diary to an Electronic Diary by Parents of Preschool Children With Food Allergies: Pilot Study. 更正：学龄前食物过敏儿童的父母从纸质日记到电子日记的过渡：试点研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/92855

Yoriko Kato

引用次数: 0

Evaluation of the Accuracy of Probabilistic Record Linkage Across Sociodemographic Categories in 4 Databases: Exploratory Study. 4个数据库中跨社会人口分类的概率记录关联的准确性评价：探索性研究。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES

JMIR Formative Research

Pub Date : 2026-02-26 DOI: 10.2196/78622

Cristina Barboi, Fangqian Ouyang, Lauren Lembcke, Andrew Martin, Ashley Griffith, Katie S Allen, Xiaochun Li, Huiping Xu, Shaun J Grannis

Background: Accurate patient record linkage is essential for clinical care, health information exchange, research, and public health surveillance. However, linkage accuracy may vary across demographic groups due to differences in data completeness, quality, and the structural factors underlying how demographic information is captured.

Objective: This study aimed to explore whether probabilistic patient matching accuracy varies by age, sex, race, and ethnicity and to identify potential sources of bias that may influence matching performance.

Methods: We used 4 Indiana data sources-the Indiana Network for Patient Care, Newborn Screening, Social Security Administration Death Master File, and Marion County Public Health Department-and applied a modified Fellegi-Sunter probabilistic linkage algorithm accommodating missing data under a missing at random assumption. Gold standard match status was established through dual manual review with adjudication. For each dataset, matching sensitivity, positive predictive value, and F1-scores were estimated and stratified by age, sex, race, and ethnicity. Data completeness, distinct value ratio, and Shannon entropy were assessed to characterize data quality. Ninety-five percent bootstrap CIs were used to assess significance.

Results: The algorithm-matching F1-score was greater than 0.82 for all age strata, ranging from 0.88 to 0.97 for sex, 0.85 to 0.99 for race, and 0.88 to 0.99 for ethnicity. Sensitivity ranged from 0.70 to 0.97 across age strata, 0.76 to 0.97 across sex, 0.85 to 0.99 across race, and 0.85 to 0.989 across ethnicity. Lower sensitivity and F1-scores were consistently observed in strata with greater missingness or discordance, particularly in Newborn Screening and Social Security Administration Death Master File. Race and ethnicity exhibited the highest missingness and lowest informational diversity, coinciding with the largest declines in accuracy. Shannon entropy and distinct value ratio varied across demographic groups and were strongly associated with performance, indicating that both low and excessively high informational diversity can impair matching.

Conclusions: Probabilistic patient matching accuracy is not uniform across demographics and is strongly influenced by data quality and completeness. Although overall matching performance, as assessed by the F1-score, remained above 0.8, it varied across datasets when stratified by sociodemographic characteristics. Sociodemographic data missingness is associated with lower matching accuracy, raising equity and ethical concerns for clinical, research, and public health applications. Routine demographic-stratified evaluations of matching accuracy, improved standardization of sociodemographic data, and fairness-aware linkage methods are essential to prevent the amplification of structural inequities in linked health datasets.

背景：准确的患者病历链接对于临床护理、卫生信息交换、研究和公共卫生监测至关重要。然而，由于数据完整性、质量和捕获人口统计信息的结构因素的差异，不同人口统计组之间的链接准确性可能有所不同。目的：本研究旨在探讨概率患者匹配准确性是否因年龄、性别、种族和民族而异，并确定可能影响匹配表现的潜在偏倚来源。方法：我们使用了印第安纳州的4个数据来源——印第安纳州患者护理网络、新生儿筛查、社会保障局死亡主档案和马里昂县公共卫生部门——并应用了一种改进的Fellegi-Sunter概率关联算法，在随机缺失假设下适应缺失数据。金标准比赛状态是通过两次人工评审和裁判来确立的。对于每个数据集，匹配灵敏度、阳性预测值和f1分数被估计并按年龄、性别、种族和民族分层。评估数据完整性、不同值比和香农熵来表征数据质量。95%的自举ci用于评估显著性。结果：各年龄层的算法匹配f1得分均大于0.82，性别为0.88 ~ 0.97，种族为0.85 ~ 0.99，民族为0.88 ~ 0.99。不同年龄层的敏感性为0.70 ~ 0.97，不同性别的敏感性为0.76 ~ 0.97，不同种族的敏感性为0.85 ~ 0.99，不同民族的敏感性为0.85 ~ 0.989。在缺失或不一致较大的阶层中，特别是在新生儿筛查和社会保障管理死亡主档案中，始终观察到较低的敏感性和f1评分。种族和民族表现出最高的缺失和最低的信息多样性，与准确性的最大下降相一致。Shannon熵和显著值比在不同的人口统计群体中存在差异，并且与绩效密切相关，表明低和过高的信息多样性都会损害匹配。结论：概率患者匹配准确性在人口统计学上并不统一，并且受到数据质量和完整性的强烈影响。尽管总体匹配性能（f1分）保持在0.8以上，但按社会人口统计学特征分层时，不同数据集的匹配性能有所不同。社会人口统计数据缺失与匹配准确性较低有关，提高了临床、研究和公共卫生应用的公平性和伦理问题。对匹配准确性进行常规的人口分层评估、改进社会人口统计数据的标准化以及具有公平性意识的关联方法对于防止关联卫生数据集中结构性不公平的扩大至关重要。

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引用次数: 0