Journal of Medical Internet Research最新文献

{"title":"What Health Care Organizations Have Learned From Telecommunication Outages.","authors":"Catharine Solomon","doi":"10.2196/91456","DOIUrl":"10.2196/91456","url":null,"abstract":"","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e91456"},"PeriodicalIF":6.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engagement With Meditation Apps: Cross-Sectional Survey of Use and Associations.","authors":"Julia Adams, Jonathan Davies, Prai Wattanatakulchat, Julieta Galante, Felicity Miller, Simon D'Alfonso, Nicholas T Van Dam","doi":"10.2196/71960","DOIUrl":"https://doi.org/10.2196/71960","url":null,"abstract":"<p><strong>Background: </strong>Meditation apps are increasingly popular, yet there is limited understanding of how much users actually engage with them. While meditation apps show promise for supporting mental health, engagement in real-world settings appears to be notably low. The patterns of app use and the factors that influence usage remain relatively unclear.</p><p><strong>Objective: </strong>This study aims to examine the extent of meditation app use and the factors associated with user engagement.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of 536 recent meditation app users across 5 English-speaking countries. Engagement data were collected via self-report and app-verified screenshots. Assessed factors included user characteristics (age, education, income, sex, country, personality, self-efficacy, readiness and expectations for change, self-compassion, and quality of life), mental health (distress, well-being, life satisfaction, anxiety, depression, support, and stress), and app-related elements (therapeutic alliance, appeal, functionality, aesthetics, information, quality, and perceived impact). The 4 outcome variables representing engagement were app-verified minutes, self-reported minutes, app-verified minutes per year (adjusted for app download date), and self-reported minutes per year (adjusted for app download date). Associations between app use and variables of interest were examined using correlations. Factors with significant associations were then included in multivariable regression models to identify those most strongly associated with engagement.</p><p><strong>Results: </strong>Age (ρ=0.13-0.15, PP<sup>FDR</sup>, where FDR is false discovery rate), expectations for sleep (ρ=0.12-0.33, P<sup>FDR</sup><.05), and expectations for thriving (ρ=0.12-0.18, P<sup>FDR</sup><.05) were associated with all outcome measures except adjusted objective minutes. Readiness to change was associated with all outcome measures (ρ=0.24-0.33, P<sup>FDR</sup><.05). Among app factors, appeal (ρ=0.18-0.23, P<sup>FDR</sup><.05) and perceived impact (ρ=0.23-0.32, P<sup>FDR</sup><.05) were associated with all outcome measures except adjusted self-report minutes, while perceived quality (r=0.28-0.51, P<sup>FDR</sup><.05) was associated with all outcome measures. Robust linear regressions showed that greater readiness to change (β=0.005-0.026, P=.006-.02), higher education level (β=0.029-0.540, P<.001), and higher openness (β=0.004-0.010, P=.008-.03) were associated with increased engagement. Additionally, greater expectations for sleep (β=0.004-0.009, P=.02-.04), greater expectation match (β=0.023, P=.03), and higher perceived app quality (β=0.008-0.042, P=.001-.01) were uniquely associated with increased engagement.</p><p><strong>Conclusions: </strong>Most individuals who download meditation apps engage minimally. Our findings suggest that users who are more educated, open to new experiences, and hold strong beliefs in the effec","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e71960"},"PeriodicalIF":6.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an 8-Week App-Based Mindfulness Intervention on Mental Health in Working Women: Randomized Controlled Trial.","authors":"Riko Uwagawa, Koichiro Adachi, Mariko Shimoda, Ryu Takizawa","doi":"10.2196/62814","DOIUrl":"https://doi.org/10.2196/62814","url":null,"abstract":"<p><strong>Background: </strong>Although working women experience increased work-related stress, preventive interventions to reduce its negative effects on their mental health are insufficient.</p><p><strong>Objective: </strong>This study evaluated the effectiveness of an 8-week mindfulness-based self-help intervention via a smartphone app across 4 domains (general psychological, work-related, family-related, and work-to-conflict) among working women.</p><p><strong>Methods: </strong>This study recruited women workers via various media sources, such as crowdsourcing sites and social networking services. Participants were randomly assigned to the intervention (n=106) or waitlist control groups (n=107). Participants in the intervention group practiced guided mindfulness meditation every day at their convenience via an app on their cell phones for 8 weeks. The app provides an 8-week program with 4 meditation contents per 2 weeks. Participants in the waitlist control group lived as usual for 8 weeks. We conducted web-based questionnaires to assess participants' general psychological (life satisfaction, perceived stress, depressive and anxiety symptoms, trait anger, and mindfulness), work-related (work performance, job satisfaction, quantitative job overload, and job control), family-related (family satisfaction and partner satisfaction), and work-to-family conflict indicators.</p><p><strong>Results: </strong>An analysis of covariance, controlled for preintervention scores, revealed that the intervention significantly increased life satisfaction (b=1.47, β=0.11; P=.005) and decreased perceived stress (b=-2.00, β=-0.17; P=.01), depressive and anxiety symptoms (b=-1.24, β=-0.15; P=.02), and trait anger (reaction; b=-0.59, β=-0.11; P=.04). The intervention group demonstrated significantly increased life satisfaction (t₉₃=-3.36; P=.001) and decreased depressive and anxiety symptoms (t₉₃=2.35; P=.02).</p><p><strong>Conclusions: </strong>The app was effective in reducing perceived stress, depressive and anxiety symptoms, and trait anger (reaction), and in improving life satisfaction among working women. However, to improve work- and family-related indicators, higher-intensity interventions may be required, such as modifying the intervention content or extending its duration.</p><p><strong>Trial registration: </strong>University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) UMIN000051796; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000059110.</p>","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e62814"},"PeriodicalIF":6.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional Rehabilitation Experiences, Unmet Needs, and Perspectives on Virtual Reality-Based Rehabilitation Among Patients With Stroke in China: Qualitative Thematic Analysis and Semistructured Interview Study.","authors":"Xite Zheng, Lu Xing, Haitao Lu, Shimeng Hao, Fen Liu","doi":"10.2196/84532","DOIUrl":"https://doi.org/10.2196/84532","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Traditional stroke rehabilitation is facing challenges, and virtual reality (VR)-based rehabilitation is a promising solution. However, results from studies focusing on VR-based stroke rehabilitation remain inconsistent, largely due to the use of noncustomized interventions in previous trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To enhance rehabilitation services and inform the development of patient-centered VR rehabilitation systems, this study aimed to (1) explore the experiences and unmet needs of survivors of stroke during current hospital rehabilitation, and (2) examine their perspectives on the use of VR technology in poststroke rehabilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a qualitative thematic analysis based on descriptive phenomenology between January and July 2025 at the China Rehabilitation Research Center. Adult patients with a clinical diagnosis of stroke within the past 18 months were eligible. A total of 21 survivors of stroke (mean age, 52.7, SD 17.3 y; men, n=17) were included. Data were collected through face-to-face semistructured interviews, complemented by a short questionnaire on sociodemographic, clinical, and technology-use characteristics. All interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic approach, with thematic saturation used to determine the sample size.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After a stroke, patients experience significant physical and psychological changes. On the one hand, the sudden loss of abilities alters their perceived roles within the family and society; on the other hand, the sharp contrast between their desire for recovery and their current recovery limitations creates substantial psychological pressure. Accepting their condition and rebuilding confidence is a long-term process. Traditional rehabilitation is commonly described as burdensome, monotonous, and lacking continuity after discharge. Although patients desire a better rehabilitation approach and improved outcomes, attitudes toward VR-based rehabilitation vary. Some view VR as a convenient tool, while others express no interest or perceived need for technology-based rehabilitation. Patients indicated that serious games should be diversified to meet different individual and training needs, and should incorporate clearer feedback mechanisms, appropriate scoring systems, adjustable difficulty levels, and progressive game chapters. Functional expectations for VR systems included family involvement, access to personal rehabilitation data, telerehabilitation support, safety monitoring, and technical support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Stroke rehabilitation services in China require improvement in the appeal of rehabilitation content, patient self-management, and continuity of care. Although patients desire better rehabilitation approaches and outcomes, the effective integration of VR technology must account for factors, such as personal characteristics and","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e84532"},"PeriodicalIF":6.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Health for Rare Diseases: A Scoping Review of Artificial Intelligence, Connected Care, and Enabling Digital Technologies for Lysosomal Storage Disorders.","authors":"Alberta M C Spreafico, Luca Neri, Kim Angel, Cinzia Maria Bellettato, Maurizio Scarpa","doi":"10.2196/73612","DOIUrl":"https://doi.org/10.2196/73612","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rare diseases (RDs) affect over 300 million people globally, and only about 5% have approved therapies. Lysosomal storage disorders (LSDs) exemplify the diagnostic and long-term care complexity typical of RDs, and digital health technologies (DHTs), especially artificial intelligence (AI) and connected care (CC), are increasingly reported as tools to support LSD management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This scoping review maps and synthesizes peer-reviewed and grey literature from the past decade on DHTs relevant for LSD care, with a primary analytic focus on AI-enabled and CC solutions, and a contextual mapping of other enabling DHTs. Evidence distribution is charted by population, care-journey phase, and outcome domains to identify gaps, methodological limitations, and timely priorities relevant for research, clinical practice implementation, and policies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a scoping review guided by a Population-Concept-Context (PCC) framework and operationalised through a PICO-informed data-charting structure to map study characteristics and reported outcomes, without causal or effectiveness assumptions and without risk-of-bias assessment. We searched PubMed/MEDLINE, Google Scholar, and ClinicalTrials.gov for studies published between October 2015 and September 2024, complemented by AI-assisted discovery tools (Consensus, SciSpace, Connected Papers) for citation extension. Reproducibility logs (search strings, run dates, filters, and stepwise counts) were maintained. Of 1,751 records retrieved, 245 were included. Evidence was charted by LSD population, intervention class (artificial intelligence, connected care, and other enabling digital health technologies), outcome domains (patient, healthcare, societal), and phase of the care journey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Amongst 245 included records, 92.2% were peer-reviewed and 7.8% were grey literature; no completed and published randomized controlled trials or LSD-specific systematic reviews were identified, with evidence dominated by small, single-center observational studies. 40 peer-reviewed records reported AI-driven DHTs, 89 reported CC DHTs, and 144 reported other enabling DHTs (some multi-labeled). Evidence was concentrated mostly in Gaucher and Fabry diseases. Nearly half of the mapped literature focused on screening/diagnosis, with fewer records addressing treatment intensification, rehabilitation, and end-of-life care. Outcomes were predominantly healthcare-delivery performance measures, with fewer patient and societal outcomes. AI applications mainly supported diagnostic decision support, phenotyping, monitoring/progression tracking, and risk stratification; CC commonly involved telemedicine, remote monitoring, and patient-engagement platforms; enabling DHTs included interoperable data systems, registries, and digital infrastructures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The evidence base is appreciable for a niche fi","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Digital Health Adoption in Older Adults: Scoping Review Informed by Innovation Resistance Theory.","authors":"Yosefa Birati, Roy Tzemah-Shahar","doi":"10.2196/75591","DOIUrl":"10.2196/75591","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The transformation of digital health technologies has reshaped health care delivery in primary care. Despite these benefits, older adults remain among the most resistant users. Traditional technology adoption models may not fully capture this reluctance, which is shaped not only by usability challenges but also by emotional, psychological, and identity-related concerns. Innovation resistance theory (IRT) offers a complementary framework focused on barriers to adoption rather than solely on facilitators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to map and synthesize evidence on older adults' resistance to digital health in primary care through the lens of IRT, and to examine how resistance factors align with, extend, or refine IRT's functional and psychological barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review with concept-driven thematic synthesis was conducted. A search for studies published between 2014 and 2025 was conducted across 5 databases: PubMed, CINAHL, Ovid Medline, Web of Science, and Scopus; the final search was completed in November 2025. Eligible studies were those that examined barriers or resistance to digital health use among adults aged 60 years and older in primary care settings. Search terms included \"older adults,\" \"digital health/eHealth,\" and \"technology resistance.\" We excluded studies outside primary care and in which caregivers or health care professionals were the primary users. Data were extracted into a structured matrix and coded to the IRT domains: usage, value, risk, tradition, and image barriers. Relational integration was used to examine co-occurrence and linkages among barriers to inform the conceptual model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventeen studies were included, comprising 6822 participants (sample sizes ranged from 11 to 4525). Most studies were conducted in high-income Western countries, predominantly with qualitative designs, alongside mixed-methods and cross-sectional surveys. Functional barriers included usability challenges, interface complexity, and age-related impairments. Psychological resistance was linked to emotional discomfort, symbolic misalignment, and concerns about the loss of relational care. Value and risk concerns included distrust in diagnostic accuracy, privacy and data security, and skepticism about care quality. Traditional preferences for face-to-face interactions and generational digital divides reinforced image-based resistance. Interactions between barriers were identified, with low self-efficacy and technology anxiety creating feedback loops that reinforce avoidance behaviors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Older adults' resistance to digital health is not simply a lack of adoption but a complex, emotionally grounded process involving functional, psychological, and identity-based barriers. This review applies IRT to primary care digital health, shifting the focus from adoption facilitators to resistance mechanisms and","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e75591"},"PeriodicalIF":6.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Habits With the Happy Hands App: Qualitative Focus Group Study of a Hand Osteoarthritis Self-Management Intervention.","authors":"Kristine Aasness Fjeldstad, Anne Therese Tveter, Eivor Rasmussen, Lena Olden, Sissel Nyheim, Thalita Blanck, Rikke Munk Killingmo, Ingvild Kjeken","doi":"10.2196/82773","DOIUrl":"https://doi.org/10.2196/82773","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;People with hand osteoarthritis represent a large patient group with limited access to recommended treatment. In recent years, there has been a notable shift in health care delivery, with increased use of digital technologies. The Happy Hands app (The University Information Technology Center [USIT]) is a digital self-management intervention developed to provide evidence-based treatment for people with hand osteoarthritis, with the goal of empowering them to self-manage their disease. Participants' experiences and perceptions of using this digital intervention are crucial for the adoption and continued use of the Happy Hands app.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objective of this qualitative study was to explore participants' experience with using the Happy Hands app, focusing on whether and how it empowered them to self-manage their hand osteoarthritis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study is embedded within a randomized controlled trial (RCT). The participants were recruited from the intervention group in the RCT, who got access to the Happy Hands app. The 12-week self-management intervention included a hand exercise program and informational videos about hand osteoarthritis. Focus groups were conducted in various geographical areas in Norway. The focus groups were transcribed verbatim, coded, and analyzed inductively using reflexive thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven focus groups, with a total of 26 participants, were recruited from both specialist and primary health care. The mean age was 67 years. Three themes were developed from the analysis. The first theme, \"Being acknowledged,\" highlights the essential role of recognition for people with hand osteoarthritis. It suggests that the Happy Hands app provided participants with a sense of validation and support. The second theme, \"Changed perception of hand osteoarthritis,\" indicates that participants gained insights and knowledge about their condition. This new understanding empowered them to make more informed decisions about their care, fostering a sense of hope and motivation by demonstrating that effective measures are available to manage the disease. The third theme, \"Changing habits with the Happy Hands app,\" describes how participants developed new habits after using the self-management intervention delivered through the app. The exercise program was experienced as motivating, flexible, well-structured, and committing. Some challenges were reported, including experiencing pain during or after exercising. The new habits included performing hand exercises and implementing ergonomic working methods, which were tailored to meet the individual needs and integrated into the participants' daily lives and routines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings suggest that the Happy Hands app is a valuable tool for supporting people with hand osteoarthritis in managing their disease by helping them integrate hand osteoarthritis m","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e82773"},"PeriodicalIF":6.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Structure of Psychopathology on Reddit: Network Analysis of Mental Health Communities in Relation to the ICD Diagnostic System.","authors":"Bojan Evkoski, Srebrenka Letina, Petra Kralj Novak","doi":"10.2196/80958","DOIUrl":"https://doi.org/10.2196/80958","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Social media platforms such as Reddit have become important spaces where individuals articulate their distress, seek support, and explore alternative ways of understanding mental health outside traditional institutional frameworks. These environments provide an opportunity to examine mental health discourse at scale, offering perspectives that extend beyond traditional clinical and research settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to examine the structure of mental health communities on Reddit by identifying patterns of association between mental disorders reflected in user activity and assessing how these relationships align with established diagnostic categories in the ICD (International Classification of Diseases).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We manually curated 114 Reddit communities focused on specific mental health conditions from the 20,000 most active subreddits in 2022. Each community was labeled into 49 disorders and categorized under 9 ICD diagnostic categories within the group of mental and behavioral disorders, collectively known as the F codes. We constructed a disorder association network by identifying statistically significant user overlaps based on coposting across subreddit pairs using a bipartite configuration model, with Bonferroni-corrected significance (P&lt;.001). We analyzed the connectivity of the network within and across diagnostic categories, examining inter- and intracategory links. Finally, we compared the structure of disorder associations inferred from Reddit with the ICD classification derived from diagnostic criteria using hierarchical clustering.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The inferred Reddit network of psychopathology revealed an interconnected structure (density=0.135), with all but 6 disorders forming a single giant component that spans across all 9 diagnostic categories. The most prominent disorders by number of users included hyperkinetic disorders (85,000), depressive episodes and recurrent depressive disorders (73,000), habit and impulse disorders (69,000), pervasive developmental disorders (52,000), and generalized anxiety disorder (44,000). In terms of connectivity, posttraumatic stress disorder (17/48 of all possible connections), obsessive-compulsive disorder (16/48), and depersonalization-derealization disorder (15/48) emerged as the most central in the network of positive disorder associations, while schizotypal disorder, avoidant personality disorder, and agoraphobia were the most central when accounting for the association strength. At the level of disorder categories, several disorders, such as bipolar disorder and premenstrual dysphoric disorder, displayed high intercategory associations but weak intracategory ties, indicating blurred diagnostic boundaries. The network of negative coposting associations revealed a divergence from the expectations of past research; for instance, addiction-related communities (eg, alcohol and opioids) were ","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e80958"},"PeriodicalIF":6.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Website Use and Associations With Behavior Change and Weight Loss in Cancer Survivors and Their Partners: Secondary Analysis of a Randomized Controlled Trial.","authors":"Harleen Kaur, Dori Pekmezi, Tracy E Crane, David Farrell, Laura Q Rogers, Wendy Demark-Wahnefried","doi":"10.2196/86908","DOIUrl":"https://doi.org/10.2196/86908","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Web-based lifestyle interventions to promote healthy diet and physical activity among cancer survivors and their partners are recent developments; therefore, few studies have reported patterns of website use or associations with behavior change.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary aim was to describe website use in the DUET (Daughters, Dudes, Mothers, and Others Together) trial and examine the associations between website use and changes in diet quality, moderate to vigorous physical activity (MVPA), and body weight.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This secondary analysis used data from 28 survivor-partner dyads (BMI ≥25 kg/m&lt;sup&gt;2&lt;/sup&gt;) randomized to the 6-month DUET web-based weight loss intervention, which released weekly e-learning sessions on diet and exercise. Website use was quantified as weeks of access, time spent, and frequency of page views. Diet quality was assessed using 2-day dietary recalls; MVPA was measured by the Godin Leisure-Time Exercise Questionnaire and accelerometry. Weight was measured on a scale. Website use was summarized descriptively, and associations were examined using Spearman partial correlations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants had a mean age of 58 (SD 12.5) years; 78.6% (44/56) identified as female, 66.1% (37/56) were non-Hispanic White, and 86% (24/28) were breast cancer survivors. On average, participants viewed 11.2 (SD 7.4) weeks of the 24-week intervention, or a total of 312.9 (SD 255.7) minutes per participant. Sessions (n=2736), Home Page (n=975), and Tools (n=967) features showed the highest activity (5885 total page views). Website use was higher among adults aged 65 years and older than younger participants, showcased by duration of use (mean 14.4, SD 7.4 weeks vs mean 9.2, SD 6.8 weeks; P=.009), time spent per week (mean 17.0, SD 9.7 minutes vs mean 10.5, SD 10.6 minutes; P=.01), and total number of page views (mean 135.7, SD 90 vs mean 85.3, SD 111.9; P=.008); higher website use was also reported among women versus men in terms of duration of use (mean 12.8, SD 7.1 weeks vs mean 5.6, SD 5.9 weeks; P=.003), time spent per week (mean 14.6, SD 10.3 minutes vs mean 7.4, SD 10.3 minutes; P=.02), and total number of page views (mean 120, SD 110.2 vs mean 50.3, SD 64.4; P=.01). Diet quality was positively associated with website use (weeks: r=0.50; P&lt;.001; time: r=0.45; P&lt;.001; total page views: r=0.46; P&lt;.001; and sessions page views: r=0.39; P=.005). Self-reported MVPA was also positively associated with website use (weeks r=0.37; P=.007; time: r=0.36; P=.009; total page views: r=0.36; P=.01; and sessions page views: r=0.35; P=.01). No significant associations were detected for accelerometry-measured MVPA or weight.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Cancer survivors and their partners engaged with the DUET web-based platform to support diet and physical activity (with use particularly high among older adults and females). However, larger, more dive","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e86908"},"PeriodicalIF":6.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Using a Smartphone App Combined With Behavior Change Techniques on the Level of Physical Activity Among Adults and Older Adults: Sequential Multiple Assignment Randomized Trial.","authors":"Maria do Socorro Morais Pereira Simoes, Neli Leite Proença, Vinícius Tonon Lauria, Matheus Bibian do Nascimento, Ricardo da Costa Padovani, Victor Zuniga Dourado","doi":"10.2196/73388","DOIUrl":"10.2196/73388","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The use of tools, such as smartphone apps, to increase the level of physical activity (PA) decreases over time. Adaptive intervention trials have been recommended to test technology-based interventions owing to the possibility of adapting interventions based on individual responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to investigate the effects of using a smartphone app combined with behavior change techniques on the PA level in adults and older adults (assessed using the step count). Moreover, the study investigated the time spent in sedentary behavior and time spent in moderate-to-vigorous PA (MVPA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this single-blinded, sequential multiple assignment randomized trial, participants were randomized into 3 groups during a 24-week intervention (group 1: app with tailored messages; group 2: app with tailored messages plus gamification I; and control group: educational information). In the sixth week, participants from groups 1 and 2 were classified as responders and nonresponders according to their average daily step count. Nonresponders were rerandomized among the other groups, adding a second type of gamification (group 3: app with tailored messages plus gamification II). After another 6 weeks, participants were reassessed and advised to keep monitoring their step count with the app, but without interference from the researchers. Face-to-face assessments were conducted. The behavior change techniques included app features (goal setting, auto-monitoring, ranking, and virtual badges) and researcher-provided resources (tailored messages and in-person sessions of PA). The intervention effects were analyzed using linear mixed models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 53 participants (control group: n=17, group 1: n=17, group 2: n=19; mean age 44.0, SD 12.7 years). Groups 1 and 2 had 63% (10/16) and 47% (7/15) responders, respectively (P=.38). Regarding the PA level, participants from group 1 showed increases in the average daily step count at all assessments (final vs initial: B=797.2 steps/day, 95% CI 475.3-1119.1; P&lt;.001; follow-up vs initial: B=2097.6 steps/day, 95% CI 1577.2-2618.1; P&lt;.001). All participants showed a reduction in the time spent in sedentary behavior at the final assessment compared with the initial assessment (B=-70.8 min/week, 95% CI -88.8 to -52.9; P&lt;.001), without differences among groups. The time spent in MVPA varied across time among all participants. Regardless of the initial group and allocation in the second randomization, responders from groups 1 and 2 showed a constant increase in the average daily step count (week 6 vs week 1: B=1548.0 steps/day, 95% CI 1407.4-1688.6; P&lt;.001; week 12 vs week 1: B=1720.3 steps/day, 95% CI 1568.8-1871.7; P&lt;.001; week 12 vs week 6: B=172.3, 95% CI 20.8-323.8; P=.03).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The adaptive intervention protocol using a smartphone app with behavior change techniques ","PeriodicalId":16337,"journal":{"name":"Journal of Medical Internet Research","volume":"28 ","pages":"e73388"},"PeriodicalIF":6.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}