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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Development and Evaluation of Research Methods, Instruments and Tools

Social media offer a promising channel to deliver e-cigarette cessation interventions to adolescents and young adults (AYAs); however, interventions delivered on social media face challenges of low participant retention and decreased engagement over time. Peer mentoring has the potential to ameliorate these challenges.

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Early Results from COVID-19 Studies

Vaccination remains one of the most effective ways to limit the spread of infectious diseases such as that caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19. Unfortunately, vaccination hesitancy continues to be a threat to national and global health. Further research is necessary to determine the modifiable and nonmodifiable factors contributing to COVID-19 vaccine hesitancy in under-resourced, underserved, and at-risk rural and urban communities.

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Formative Evaluation of Digital Health Interventions

The use of web-based methods to seek health information is increasing in popularity. As web-based health information (WHI)–seeking affects health-related decision support and chronic symptom self-management, WHI-seeking from online sources may impact health care decisions and outcomes, including care-seeking decisions. Patients who are routinely connected to physicians are more likely to receive better and more consistent care. Little is known about whether WHI-seeking impacts the frequency at which patients engage with health care providers.

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Formative Evaluation of Digital Health Interventions

Digital data on physical activity are useful for self-monitoring and preventing depression and anxiety. Although previous studies have reported machine or deep learning models that use physical activity for passive monitoring of depression and anxiety, there are no models for workers. The working population has different physical activity patterns from other populations, which is based on commuting, holiday patterns, physical demands, occupations, and industries. These working conditions are useful in optimizing the model used in predicting depression and anxiety. Further, recurrent neural networks increase predictive accuracy by using previous inputs on physical activity, depression, and anxiety.

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Formative Evaluation of Digital Health Interventions

With what has been known as the “triple-win effect”, introducing information and communication technologies (ICTs) in the health care of neurodegenerative diseases is beneficial in delaying the need for institutional care, reducing the associated health care costs, reducing the caregiving burden, and improving individuals’ quality of life. Nevertheless, the mismatch between the users’ expectations and their actual needs remains one of the main challenges that can reduce the usability of technology solutions. Therefore, the European project Personalized Integrated Care Promoting Quality of Life for Older People (PROCare4Life), which aimed to develop an ICT-based platform for all parties involved in the health care of neurodegenerative diseases, adopted a user-centered design approach, where all users are involved from the inception and throughout the platform development and implementation to integrate their needs and requirements in the proposed platform.

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Early Results from COVID-19 Studies

In-person, evidence-based, peer-facilitated chronic disease self-management programs have been shown to be effective for individuals from a variety of backgrounds, including rural and minority populations and those with lower socioeconomic status. Based in social learning theory, these programs use group processes to help participants better manage their chronic disease symptoms and improve their quality of life. During the pandemic, these in-person programs were forced to rapidly transition to remote delivery platforms, and it was unclear whether doing so increased disparities within our rural population.

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Formative Evaluation of Digital Health Interventions

Childbirth is a physiological process with significant medical risk, given that neurological impairment due to the birthing process can occur at any time. Improvements in risk assessment and anticipatory interventions are constantly needed; however, the birthing process is difficult to assess using simple imaging technology because the maternal bony pelvis and fetal skeleton interfere with visualizing the soft tissues. Magnetic resonance imaging (MRI) is a noninvasive technique with no ionizing radiation that can monitor the biomechanics of the birthing process. However, the effective use of this modality requires teamwork and the implementation of the appropriate safeguards to achieve appropriate safety levels.

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Reviews on Usage or other Formative Evaluation Metrics

As a result of the COVID-19 pandemic, providing health care while maintaining social distancing has resulted in the need to provide care remotely, support quarantined or isolated individuals, monitor infected individuals and their close contacts, as well as disseminate accurate information regarding COVID-19 to the public. This has led to an unprecedented rapid expansion of digital tools to provide digitized virtual care globally, especially mobile phone–facilitated health interventions, called mHealth. To help keep abreast of different mHealth and virtual care technologies being used internationally to facilitate patient care and public health during the COVID-19 pandemic, we carried out a rapid investigation of solutions being deployed and considered in 4 countries.

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Formative Evaluation of Digital Health Interventions

In 2022, an estimated 1.105 billion people used smart wearables and 31 million used Fitbit devices worldwide. Although there is growing evidence for the use of smart wearables to benefit physical health, more research is required on the feasibility of using these devices for mental health and well-being. In studies focusing on emotion recognition, emotions are often inferred and dependent on external cues, which may not be representative of true emotional states.

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Formative Evaluation of Digital Health Interventions

Preventive screenings such as mammograms promote health and detect disease. However, mammogram attendance lags clinical guidelines, with roughly one-quarter of women not completing their recommended mammograms. A scalable digital health intervention leveraging behavioral science and reinforcement learning and delivered via email was implemented in a US health system to promote uptake of recommended mammograms among patients who were 1 or more years overdue for the screening (ie, 2 or more years from last mammogram).

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Early Results from COVID-19 Studies

The COVID-19 crisis has led to rapid and far-reaching changes in digital health care, but little is known about what, why, and how changes occurred in eHealth use in Flemish general practice during the pandemic.

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Preprints Open for Peer-Review

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