JMIR Formative Research

Process evaluations, early results, and feasibility/pilot studies of digital and non-digital interventions

Editor-in-Chief:

Amaryllis Mavragani, Scientific Editor (Acting)


Impact Factor 2023

JMIR Formative Research (JFR, ISSN 2561-326X) publishes peer-reviewed, openly accessible papers containing results from process evaluations, feasibility/pilot studies and other kinds of formative research and preliminary results. While the original focus was on the design of medical- and health-related research and technology innovations, JMIR Formative Research publishes studies from all areas of medical and health research.

Formative research is research that occurs before a program is designed and implemented, or while a program is being conducted. Formative research can help

  • define and understand populations in need of an intervention or public health program
  • create programs that are specific to the needs of those populations
  • ensure programs are acceptable and feasible to users before launching
  • improve the relationship between users and agencies/research groups
  • demonstrate the feasibility, use, satisfaction with, or problems with a program before large-scale summative evaluation (looking at health outcomes)

Many funding agencies will expect some sort of pilot/feasibility/process evaluation before funding a larger study such as a Randomized Controlled Trial (RCT).

Formative research should be an integral part of developing or adapting programs, and should be used while the program is ongoing to help refine and improve program activities. Thus, formative evaluation can and should also occur in the form of a process evaluation alongside a summative evaluation such as an RCT.

This journal fills an important gap in the academic journals landscape, as it publishes sound and peer-reviewed formative research that is critical for investigators to apply for further funding, but that is usually not published in outcomes-focused medical journals aiming for impact and generalizability.

Summative evaluations of programs and apps/software that have undergone a thorough formative evaluation before launch have a better chance to be published in high-impact flagship journals; thus, we encourage authors to submit - as a first step - their formative evaluations in JMIR Formative Research (and their evaluation protocols in JMIR Research Protocols). 

JMIR Formative Research is indexed in PubMed, PubMed CentralDOAJ, Scopus, and the Emerging Sources Citation Index (Clarivate).

Recent Articles

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Formative Evaluation of Digital Health Interventions

Pregnant women have self-declared that they have difficulties in estimating nutrient intakes. The Nutrition Information System for Indonesian Pregnant Women (SISFORNUTRIMIL) application was created as a dietary assessment and calorie-counting tool to guide pregnant women to eat the right portion sizes for each meal.

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Formative Evaluation of Digital Health Interventions

Loneliness is a significant well-being issue that affects older adults. Existing, commonly used social connection platforms do not contain facilities to break the cognitive cycle of loneliness, and loneliness interventions implemented without due processes could have detrimental effects on well-being. There is also a lack of digital technology designed with older adults.

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Formative Evaluation of Digital Health Interventions

Many individuals with suicide risk present to acute care settings such as emergency departments (EDs). However, staffing and time constraints mean that many EDs are not well equipped to deliver evidence-based interventions for patients experiencing suicidality. An existing intervention initiated in the ED for patients with suicide risk (Emergency Department Safety Assessment and Follow-up Evaluation [ED-SAFE]) has been found to be effective but faces trenchant barriers for widespread adoption.

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Formative Evaluation of Digital Health Interventions

Eating disorders (EDs) are severe mental disorders associated with notable impairments in the quality of life. Despite the severity of the disorders and extensive research in the field, effective treatment for EDs is lacking. Digital interventions are gaining an evidence-based position in mental health, providing new perspectives in psychiatric treatment. Maze Out is a serious game coproduced by patients and therapists that focuses on supporting patients with EDs.

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Formative Evaluation of Digital Health Interventions

The development of mobile technology with substantial computing power (ie, smartphones) has enabled the adaptation of performance-based cognitive assessments to remote administration and novel intensive longitudinal study designs (eg, measurement burst designs). Although an “ambulatory” cognitive assessment paradigm may provide new research opportunities, the adaptation of conventional measures to a mobile format conducive to intensive repeated measurement involves balancing measurement precision, administration time, and procedural consistency.

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Formative Evaluation of Non-Ehealth Innovations

Mental health disorders are the most common perinatal conditions. They affect mothers, babies, partners, and support networks. However, <15% of pregnant and postpartum women seek timely help for their mental health care. Low perinatal mental health knowledge and universal screening unacceptability are cited as important deterrents to obtaining timely mental health care.

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Formative Evaluation of Non-Ehealth Innovations

Handwashing is an effective and cost-efficient health behavior for preventing infectious diseases; however, its practice is shaped by multiple contextual factors and inequalities between different social groups in Sierra Leone. To address these inequalities, participatory approaches that allow a more equitable distribution of resources and the development of locally tailored interventions are increasingly used. However, social power dynamics have not been well integrated into the concept of participation, despite their known impact.

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Formative Evaluation of Digital Health Interventions

Despite the health benefits of engaging in regular physical activity (PA), the majority of American adults do not meet the PA guidelines for aerobic and muscle-strengthening activities. Self-efficacy, the belief that one can execute specific actions, has been suggested to be a strong determinant of PA behaviors. With the increasing availability of digital technologies, collecting longitudinal real-time self-efficacy and PA data has become feasible. However, evidence in longitudinal real-time assessment of self-efficacy in relation to objectively measured PA is scarce.

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Formative Evaluation of Digital Health Interventions

eConsults are increasingly used worldwide to reduce specialist referrals and increase access to medical care. An additional benefit of using an eConsult tool is a reduction of health care costs while improving the quality of health care and patient participation. Currently, shared decision making is increasingly implemented and preferred by patients. eConsults are also a promising tool to improve access to the hospital pharmacist. Patients often have questions about their medication. When medication is started during a hospital admission or outpatient visit, community pharmacists are not always sufficiently informed to answer patient questions. Direct contact with hospital pharmacists may be more appropriate and efficient. This contact is facilitated through the eConsult feature in the hospital’s patient portal.

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Pilot studies (ehealth)

A growing number of studies highlight the importance of emotion regulation in the treatment and recovery of individuals with psychosis and concomitant disorders such as substance use disorder (SUD), for whom access to integrated dual-disorder treatments is particularly difficult. In this context, dedicated smartphone apps may be useful tools to provide immediate support to individuals in need. However, few studies to date have focused on the development and assessment of apps aimed at promoting emotional regulation for people with psychosis.

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Formative Evaluation of Digital Health Interventions

Waiting for a long time to make payments in outpatient wards and long queues of insured patients at the checkout window are common in many hospitals across China. To alleviate the problem of long queues for payment, many hospitals in China have established various mobile apps that those without health insurance can use. However, medically insured outpatients are still required to pay manually at the checkout window. Therefore, it is urgent to use information technology to innovate and optimize the outpatient service process, implement mobile payment for medically insured outpatients, and shorten the waiting time for outpatients, especially in the context of the COVID-19 epidemic. Furthermore, smartphone-based mobile payment for outpatients with health insurance could be superior to on-site cashier billing.

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Pilot studies (ehealth)

eHealth potentially can make health care more accessible and efficient and help reduce the workload in primary health care. Homelab is an eHealth tool implemented in a general practice environment, and it offers relatively simple laboratory diagnostic tests without the referral of the general practitioner. After logging in this eHealth tool, patients select and order a diagnostic test based on their symptoms. The test results are presented online to the general practitioner and the patient.

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Preprints Open for Peer-Review

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