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, JFR 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.

JFR 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 JFR (and their evaluation protocols to JMIR Research Protocols). 

JFR 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

According to the World Health Organization, globally, one in seven 10- to 19-year-olds experiences a mental disorder, accounting for 13% of the global burden of disease in this age group. Half of all mental illnesses begin by the age of 14 years and some teenagers with severe presentations must be admitted to the hospital and assessed by highly skilled mental health care practitioners. Digital telehealth solutions can be useful for the assessment of young individuals remotely. Ultimately, this technology can save travel costs for the health service rather than assessing adolescents in person at the corresponding hospital. Especially in rural regions, where travel times can be high, this innovative approach can make a difference to patients by providing quicker assessments.

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Development and Evaluation of Research Methods, Instruments and Tools

Patient navigation (PN) programs have demonstrated efficacy in improving health outcomes for marginalized populations across a range of clinical contexts by addressing barriers to health care, including social determinants of health (SDoHs). However, it can be challenging for navigators to identify SDoHs by asking patients directly because of many factors, including patients’ reluctance to disclose information, communication barriers, and the variable resources and experience levels of patient navigators. Navigators could benefit from strategies that augment their ability to gather SDoH data. Machine learning can be leveraged as one of these strategies to identify SDoH-related barriers. This could further improve health outcomes, particularly in underserved populations.

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Formative Evaluation of Digital Health Interventions

Augmented reality (AR) and virtual reality (VR) have increasingly appeared in the medical literature in the past decade, with AR recently being studied for its potential role in remote health care delivery and communication. Recent literature describes AR’s implementation in real-time telemedicine contexts across multiple specialties and settings, with remote emergency services in particular using AR to enhance disaster support and simulation education. Despite the introduction of AR in the medical literature and its potential to shape the future of remote medical services, studies have yet to investigate the perspectives of telemedicine providers regarding this novel technology.

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Formative Evaluation of Digital Health Interventions

Despite bariatric surgery showing significant weight loss trajectories for many patients, a substantial proportion regain weight after the first year following surgery. The addition of telemedicine to standard care could support patients with engaging in a more active lifestyle and thus improve clinical outcomes.

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Pilot studies (ehealth)

Veterans with posttraumatic stress disorder (PTSD) and moral injury can encounter several barriers to treatment, including limited access to care and low engagement with therapy. Furthermore, most treatment approaches focus on alleviating distress rather than cultivating positive experiences that could facilitate trauma recovery. A potential way to address these issues is through moral elevation: feeling uplifted and inspired by others’ virtuous actions.

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Pilot studies (non-ehealth)

Although there is a need for gender-specific health care, especially within the context of vocational rehabilitation for youth with disabilities, clinicians, trainees, and community service providers commonly report lacking training in gender-sensitive approaches. Therefore, an educational tool designed for clinicians working with youth, that addresses how to approach such issues, could help clinicians to augment the care they provide.

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Formative Evaluation of Digital Health Interventions

Hypertension is the leading modifiable risk factor for cardiovascular disease and mortality. Adopting lifestyle modifications, like increasing physical activity (PA), can be an effective strategy in blood pressure (BP) control, but many adults do not meet the PA guidelines. Financial incentive interventions have the power to increase PA levels but are often limited due to cost. Further, mobile health technologies can make these programs more scalable. There is a gap in the literature about the most feasible and effective financial incentive PA framework; thus, pay-per-minute (PPM) and self-funded investment incentive (SFII) frameworks were explored.

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Pilot studies (ehealth)

Communication across language barriers is a particular challenge for health care providers. In emergency medical services, interpreters are mostly not available on rescue scenes, which jeopardizes safe and high-quality medical care. In a cocreative process together with paramedics and software designers, we developed a fixed-phrase translation app with 600 phrases and 18 supported languages that supports paramedics when providing care to foreign-language patients. This paper reports on the results of a pilot study to evaluate the app’s effect on paramedic-patient communication.

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Formative Evaluation of Digital Health Interventions

Black Americans, particularly in the southern United States, are disproportionately affected by the US HIV epidemic. Patient-reported outcome (PRO) data collection can improve patient outcomes and provide oft-overlooked data on mental health, substance use, and patient adherence to antiretroviral therapy.

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Formative Evaluation of Digital Health Interventions

Internet-based mental health interventions have been demonstrated to be effective in alleviating psychological distress and promoting mental well-being. However, real-world uptake and engagement of such interventions have been low. Rather than being stand-alone interventions, situating internet-based interventions under a stratified stepped care system can support users to continue with mental health practice and monitor their mental health status for timely services that are commensurate with their needs. A user-centered approach should be used in the development of such web-based platforms to understand the facilitators and barriers in user engagement to enhance platform uptake, usability, and adherence so it can support the users’ continued adoption and practice of self-care for their mental health.

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Formative Evaluation of Digital Health Interventions

Voluntary medical male circumcision (VMMC) is a safe and effective HIV prevention strategy. However, adherence to recommended in-person, postoperative follow-up is inefficient for procedures with few adverse events. Two-way texting (2wT)–based follow-up appears to be a safe and an efficient alternative to scheduled clinic visits for low-risk patients who underwent VMMC. To ensure that 2wT responds to the needs of health care workers (HCWs) and patients, HCWs were closely involved in app design using a human-centered design (HCD) approach.

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Early Results in Infodemiology and Infoveillance

Anxiety disorders are the most prevalent mental disorders globally, with a substantial impact on quality of life. The prevalence of anxiety disorders has increased substantially following the COVID-19 pandemic, and it is likely to be further affected by a global economic recession. Understanding anxiety themes and how they change over time and across countries is crucial for preventive and treatment strategies.

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Preprints Open for Peer-Review

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