JMIR Formative Research

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

Editor-in-Chief:

Amaryllis Mavragani, PhD, Scientific Editor at JMIR Publications, Canada


Impact Factor 2.0 CiteScore 2.7

JMIR Formative Research (JFR, ISSN 2561-326X, Journal Impact Factor™ 2.0 (Clarivate, 2024)) 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.

JMIR Formative Research 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 to JMIR Research Protocols). 

JMIR Formative Research is indexed in MEDLINEPubMed, PubMed CentralDOAJ, Scopus, Sherpa/Romeo, EBSCO/EBSCO Essentials, and the Emerging Sources Citation Index (ESCI).

Recent Articles

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Formative Evaluation of Digital Health Interventions

While mobile health applications (mHealth apps) have been made for various diseases, including sickle cell disease (SCD), most focus on a single purpose. SCD is a chronic disease that requires knowledge of the disease, self-management, and adherence to treatment plans. While mHealth apps have been made with single features for SCD, there is limited understanding of using a mHealth app with a more comprehensive set of features that could engage adults with SCD depending on what features they prefer and need to engage and empower them in their disease.

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Formative Evaluation of Digital Health Interventions

The primary aim of genetic counseling at a human genetics center is to empower individuals at risk for hereditary diseases to make informed decisions regarding their health. In Germany, genetic counseling sessions typically last approximately one hour and provide highly personalized information by a specialist in human genetics. Despite this, many counselees report a need for additional support following the counseling session.

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Formative Evaluation of Digital Health Interventions

Collaborative Creativity (CC) is a social process of generating creative and innovative solutions to real-world problems through collective effort and interaction. By engaging in this process, medical students can develop abilities and mindset for creative thinking, teamwork, interdisciplinary learning, complex problem-solving, and enhanced patient care. However, medical students have demonstrated limited creativity, constrained by existing pedagogical approaches that predominantly emphasize knowledge outcomes. The increasing complexity of healthcare challenges necessitates a pedagogical framework for medical students to foster collaborative creativity in a rapidly evolving professional environment.

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Development and Evaluation of Research Methods, Instruments and Tools

Nurse scheduling is a complex challenge in healthcare, impacting both patient care quality and nurse well-being. Traditional scheduling methods often fail to consider individual preferences, leading to dissatisfaction, burnout, and high turnover. Inadequate scheduling practices, including restricted autonomy and lack of transparency, can further reduce nurse morale and negatively affect patient outcomes. Research suggests that participative scheduling approaches incorporating nurse preferences can improve job satisfaction. Artificial intelligence (AI) and mathematical optimization methods, such as Mixed-Integer Programming (MIP), Constraint Programming (CP), Genetic Programming (GP), and Reinforcement Learning (RL), offer potential solutions to optimize scheduling and address these challenges.

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Development and Evaluation of Research Methods, Instruments and Tools

Evaluating health counseling services is crucial for ensuring their quality and effectiveness. However, this process is hampered by challenges such as language barriers and limited awareness of their needs and concerns.

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Pilot studies (ehealth)

Childhood cancer has an annual incidence of 150-160 cases per million children worldwide but remains vastly under-diagnosed in low to middle income countries (LMIC) such as in Sub-Saharan Africa. Moi Teaching and Referral Hospital (MTRH) serves a population of 25 million people, including 10 million children. The average number of pediatric cancer diagnoses was 216 cases annually in 2017-2019, well below the anticipated 1500 cases based on epidemiology data. The remaining 75-80% of pediatric cancer cases remain undiagnosed and these patients do not likely survive. Prior outreach and needs assessment demonstrated lack of medical knowledge related to pediatric cancer as a primary barrier to improved referrals, diagnoses, and ultimately cure.

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Formative Evaluation of Non-Ehealth Innovations

Innovative approaches to community-level data collection are crucial to inform policies and programs that support people in aging well within their communities. For example, community-level data can proactively identify unmet health needs, inform preventative care strategies, and ensure the equitable distribution of resources that enable older adults to age in place.

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Development and Evaluation of Research Methods, Instruments and Tools

Many mental health conditions (eg, substance use or panic disorders) involve long-term patient assessment and treatment. Growing evidence suggests that the progression and presentation of these conditions may be highly individualized. Digital sensing and predictive modeling can augment scarce clinician resources to expand and personalize patient care. We discuss techniques to process patient data into risk predictions, for instance, the lapse risk for a patient with alcohol use disorder (AUD). Of particular interest are idiographic approaches that fit personalized models to each patient.

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Pilot studies (ehealth)

Depression is the top contributor to global disability. Early detection of depression and depressive symptoms enables timely intervention and reduces their physical and social consequences. Prevalence estimates of depression approach 30% among college students. Passive, device-based sensing further enables detection of depressive symptoms at a low burden to the individual.

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Formative Evaluation of Non-Ehealth Innovations

During pregnancy, self-rated health (SRH) and self-rated mental health (SRMH) are key indicators of health status and predictors of future healthcare needs. The relationship between pregnant women’s health perceptions and their choice of antenatal care providers, midwives or general practitioners (GPs), is not known. Factors like childhood experiences and socioeconomic status are important determinants of health throughout life. Understanding these health determinants can help healthcare providers better address the diverse needs of pregnant women.

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Pilot studies (ehealth)

Family engagement in hospitals is crucial for improving outcomes and ensuring holistic, patient-centered care. However, there is limited understanding of how providers document family engagement in electronic medical records (EMR) and how factors like race and health disparities influence engagement practices. The absence of standardized EMR templates complicates tracking engagement and its impact on patient outcomes. Retrospective chart review (RCR) is an effective method for investigating clinical practice and how family engagement is documented, using both structured and unstructured data from patient records. Despite its potential, gaps remain in literature that distinguish between the pre-pilot and pilot phases in RCR studies.

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Formative Evaluation of Digital Health Interventions

Phenylketonuria (PKU) is a rare, hereditary disease that causes disruption in phenylalanine (Phe) metabolism. Despite early intervention, individuals with PKU may have difficulty in several different cognitive domains, including verbal fluency, processing speed, and executive functioning.

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