@Article{info:doi/10.2196/21804,
author="Hill, Adele
and Joyner, H. Christopher
and Keith-Jopp, Chloe
and Yet, Barbaros
and Tuncer Sakar, Ceren
and Marsh, William
and Morrissey, Dylan",
title="A Bayesian Network Decision Support Tool for Low Back Pain Using a RAND Appropriateness Procedure: Proposal and Internal Pilot Study",
journal="JMIR Res Protoc",
year="2021",
month="Jan",
day="15",
volume="10",
number="1",
pages="e21804",
keywords="back pain",
keywords="decision making",
keywords="Bayesian methods",
keywords="consensus",
abstract="Background: Low back pain (LBP) is an increasingly burdensome condition for patients and health professionals alike, with consistent demonstration of increasing persistent pain and disability. Previous decision support tools for LBP management have focused on a subset of factors owing to time constraints and ease of use for the clinician. With the explosion of interest in machine learning tools and the commitment from Western governments to introduce this technology, there are opportunities to develop intelligent decision support tools. We will do this for LBP using a Bayesian network, which will entail constructing a clinical reasoning model elicited from experts. Objective: This paper proposes a method for conducting a modified RAND appropriateness procedure to elicit the knowledge required to construct a Bayesian network from a group of domain experts in LBP, and reports the lessons learned from the internal pilot of the procedure. Methods: We propose to recruit expert clinicians with a special interest in LBP from across a range of medical specialties, such as orthopedics, rheumatology, and sports medicine. The procedure will consist of four stages. Stage 1 is an online elicitation of variables to be considered by the model, followed by a face-to-face workshop. Stage 2 is an online elicitation of the structure of the model, followed by a face-to-face workshop. Stage 3 consists of an online phase to elicit probabilities to populate the Bayesian network. Stage 4 is a rudimentary validation of the Bayesian network. Results: Ethical approval has been obtained from the Research Ethics Committee at Queen Mary University of London. An internal pilot of the procedure has been run with clinical colleagues from the research team. This showed that an alternating process of three remote activities and two in-person meetings was required to complete the elicitation without overburdening participants. Lessons learned have included the need for a bespoke online elicitation tool to run between face-to-face meetings and for careful operational definition of descriptive terms, even if widely clinically used. Further, tools are required to remotely deliver training about self-identification of various forms of cognitive bias and explain the underlying principles of a Bayesian network. The use of the internal pilot was recognized as being a methodological necessity. Conclusions: We have proposed a method to construct Bayesian networks that are representative of expert clinical reasoning for a musculoskeletal condition in this case. We have tested the method with an internal pilot to refine the process prior to deployment, which indicates the process can be successful. The internal pilot has also revealed the software support requirements for the elicitation process to model clinical reasoning for a range of conditions. International Registered Report Identifier (IRRID): DERR1-10.2196/21804 ",
doi="10.2196/21804",
url="http://www.researchprotocols.org/2021/1/e21804/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33448937"
}


@Article{info:doi/10.2196/21262,
author="Carlin, Thomas
and Vuillerme, Nicolas",
title="Step and Distance Measurement From a Low-Cost Consumer-Based Hip and Wrist Activity Monitor: Protocol for a Validity and Reliability Assessment",
journal="JMIR Res Protoc",
year="2021",
month="Jan",
day="13",
volume="10",
number="1",
pages="e21262",
keywords="activity monitor",
keywords="pedometer",
keywords="measurement",
keywords="validity",
keywords="reliability",
keywords="walking",
keywords="step count",
keywords="distance",
abstract="Background: Self-tracking via wearable and mobile technologies is becoming an essential part of personal health management. At this point, however, little information is available to substantiate the validity and reliability of low-cost consumer-based hip and wrist activity monitors, with regard more specifically to the measurements of step counts and distance traveled while walking. Objective: The aim of our study is to assess the validity and reliability of step and distance measurement from a low-cost consumer-based hip and wrist activity monitor specific in various walking conditions that are commonly encountered in daily life. Specifically, this study is designed to evaluate whether and to what extent validity and reliability could depend on the sensor placement on the human body and the walking task being performed. Methods: Thirty healthy participants will be instructed to wear four PBN 2433 (Nakosite) activity monitors simultaneously, with one placed on each hip and each wrist. Participants will attend two experimental sessions separated by 1 week. During each experimental session, two separate studies will be performed. In study 1, participants will be instructed to complete a 2-minute walk test along a 30-meter indoor corridor under 3 walking speeds: very slow, slow, and usual speed. In study 2, participants will be required to complete the following 3 conditions performed at usual walking speed: walking on flat ground, upstairs, and downstairs. Activity monitor measured step count and distance values will be computed along with the actual step count (determined from video recordings) and distance (measured using a measuring tape) to determine validity and reliability for each activity monitor placement and each walking condition. Results: Participant recruitment and data collection began in January 2020. As of June 2020, we enrolled 8 participants. Dissemination of study results in peer-reviewed journals is expected in spring 2021. Conclusions: To the best of our knowledge, this is the first study that examines the validity and reliability of step and distance measurement during walking using the PBN 2433 (Nakosite) activity monitor. Results of this study will provide beneficial information on the effects of activity monitor placement, walking speed, and walking tasks on the validity and reliability of step and distance measurement. We believe such information is of utmost importance to general consumers, clinicians, and researchers. International Registered Report Identifier (IRRID): DERR1-10.2196/21262 ",
doi="10.2196/21262",
url="http://www.researchprotocols.org/2021/1/e21262/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33439138"
}


@Article{info:doi/10.2196/25372,
author="Sturgill, Ronda
and Martinasek, Mary
and Schmidt, Trine
and Goyal, Raj",
title="A Novel Artificial Intelligence-Powered Emotional Intelligence and Mindfulness App (Ajivar) for the College Student Population During the COVID-19 Pandemic: Quantitative Questionnaire Study",
journal="JMIR Form Res",
year="2021",
month="Jan",
day="5",
volume="5",
number="1",
pages="e25372",
keywords="mindfulness",
keywords="COVID-19",
keywords="college students",
keywords="emotional intelligence",
abstract="Background: Emotional intelligence (EI) and mindfulness can impact the level of anxiety and depression that an individual experiences. These symptoms have been exacerbated among college students during the COVID-19 pandemic. Ajivar is an app that utilizes artificial intelligence (AI) and machine learning to deliver personalized mindfulness and EI training. Objective: The main objective of this research study was to determine the effectiveness of delivering an EI curriculum and mindfulness techniques using an AI conversation platform, Ajivar, to improve symptoms of anxiety and depression during this pandemic. Methods: A total of 99 subjects, aged 18 to 29 years, were recruited from a second-semester group of freshmen students. All participants completed the online TestWell Wellness Inventory at the start and end of the 14-week semester. The comparison group members (49/99, 49\%) were given routine mental wellness instruction. The intervention group members (50/99, 51\%) were required to complete Ajivar activities in addition to routine mental wellness instruction during the semester, which coincided with the onset of the COVID-19 pandemic. This group also completed assessments to evaluate for anxiety, using the 7-item Generalized Anxiety Disorder (GAD-7) scale, and depression, using the 9-item Patient Health Questionnaire (PHQ-9). Results: Study participants reported a mean age of 19.9 (SD 1.94) years; 27\% (27/99) of the group were male and 60\% (59/99) identified as Caucasian. No significant demographic differences existed between the comparison and intervention groups. Subjects in the intervention group interacted with Ajivar for a mean time of 1424 (SD 1168) minutes. There was a significant decrease in anxiety, as measured by the GAD-7: the mean score was 11.47 (SD 1.85) at the start of the study compared to 6.27 (SD 1.44) at the end (P<.001). There was a significant reduction in the symptoms of depression measured by the PHQ-9: the mean score was 10.69 (SD 2.04) at the start of the study compared to 6.69 (SD 2.41) at the end (P=.001). Both the intervention and comparison groups independently had significant improvements in the TestWell Wellness Inventory from pretest to posttest. The subgroups in the social awareness and spirituality inventories showed significant improvement in the intervention group. In a subgroup of participants (11/49, 22\%) where the GAD-7 was available during the onset of the COVID-19 pandemic, there was an increase in anxiety from the start of the study (mean score 11.63, SD 2.16) to mid-March (ie, onset of the pandemic) (mean score 13.03, SD 1.48; P=.23), followed by a significant decrease at the end of the study period (mean score 5.9, SD 1.44; P=.001). Conclusions: It is possible to deliver EI and mindfulness training in a scalable way using the Ajivar app during the COVID-19 pandemic, resulting in improvements in anxiety, depression, and EI in the college student population. ",
doi="10.2196/25372",
url="http://formative.jmir.org/2021/1/e25372/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33320822"
}


@Article{info:doi/10.2196/23379,
author="Do, Quan
and Marc, David
and Plotkin, Marat
and Pickering, Brian
and Herasevich, Vitaly",
title="Starter Kit for Geotagging and Geovisualization in Health Care: Resource Paper",
journal="JMIR Form Res",
year="2020",
month="Dec",
day="24",
volume="4",
number="12",
pages="e23379",
keywords="geographic mapping",
keywords="medicalGIS guidelines",
keywords="information storage and retrieval",
keywords="mapping",
keywords="geotagging",
keywords="data visualization",
keywords="population",
keywords="public health",
abstract="Background: Geotagging is the process of attaching geospatial tags to various media data types. In health care, the goal of geotagging is to gain a better understanding of health-related questions applied to populations. Although there has been a prevalence of geographic information in public health, in order to effectively use and expand geotagging across health care there is a requirement to understand other factors such as the disposition, standardization, data sources, technologies, and limitations. Objective: The objective of this document is to serve as a resource for new researchers in the field. This report aims to be comprehensive but easy for beginners to understand and adopt in practice. The optimal geocodes, their sources, and a rationale for use are suggested. Geotagging's issues and limitations are also discussed. Methods: A comprehensive review of technical instructions and articles was conducted to evaluate guidelines for geotagging, and online resources were curated to support the implementation of geotagging practices. Summary tables were developed to describe the available geotagging resources (free and for fee) that can be leveraged by researchers and quality improvement personnel to effectively perform geospatial analyses primarily targeting US health care. Results: This paper demonstrated steps to develop an initial geotagging and geovisualization project with clear structure and instructions. The geotagging resources were summarized. These resources are essential for geotagging health care projects. The discussion section provides better understanding of geotagging's limitations and suggests suitable way to approach it. Conclusions: We explain how geotagging can be leveraged in health care and offer the necessary initial resources to obtain geocodes, adjustment data, and health-related measures. The resources outlined in this paper can support an individual and/or organization in initiating a geotagging health care project. ",
doi="10.2196/23379",
url="http://formative.jmir.org/2020/12/e23379/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33361054"
}


@Article{info:doi/10.2196/24490,
author="Sai Prashanthi, Gumpili
and Deva, Ayush
and Vadapalli, Ranganath
and Das, Vipin Anthony",
title="Automated Categorization of Systemic Disease and Duration From Electronic Medical Record System Data Using Finite-State Machine Modeling: Prospective Validation Study",
journal="JMIR Form Res",
year="2020",
month="Dec",
day="17",
volume="4",
number="12",
pages="e24490",
keywords="electronic health records",
keywords="data analysis",
keywords="machine learning",
keywords="algorithms",
keywords="ophthalmology",
abstract="Background: One of the major challenges in the health care sector is that approximately 80\% of generated data remains unstructured and unused. Since it is difficult to handle unstructured data from electronic medical record systems, it tends to be neglected for analyses in most hospitals and medical centers. Therefore, there is a need to analyze unstructured big data in health care systems so that we can optimally utilize and unearth all unexploited information from it. Objective: In this study, we aimed to extract a list of diseases and associated keywords along with the corresponding time durations from an indigenously developed electronic medical record system and describe the possibility of analytics from the acquired datasets. Methods: We propose a novel, finite-state machine to sequentially detect and cluster disease names from patients' medical history. We defined 3 states in the finite-state machine and transition matrix, which depend on the identified keyword. In addition, we also defined a state-change action matrix, which is essentially an action associated with each transition. The dataset used in this study was obtained from an indigenously developed electronic medical record system called eyeSmart that was implemented across a large, multitier ophthalmology network in India. The dataset included patients' past medical history and contained records of 10,000 distinct patients. Results: We extracted disease names and associated keywords by using the finite-state machine with an accuracy of 95\%, sensitivity of 94.9\%, and positive predictive value of 100\%. For the extraction of the duration of disease, the machine's accuracy was 93\%, sensitivity was 92.9\%, and the positive predictive value was 100\%. Conclusions: We demonstrated that the finite-state machine we developed in this study can be used to accurately identify disease names, associated keywords, and time durations from a large cohort of patient records obtained using an electronic medical record system. ",
doi="10.2196/24490",
url="http://formative.jmir.org/2020/12/e24490/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33331823"
}


@Article{info:doi/10.2196/22570,
author="Walker, M. Eloise
and Jasper, E. Alice
and Davis, Lauren
and Yip, Por Kay
and Faniyi, A. Aduragbemi
and Hughes, J. Michael
and Crisford, A. Helena
and Spittle, A. Daniella
and Sapey, Elizabeth
and Belchamber, R. Kylie B.
and Scott, Aaron",
title="Mitigating Health Risks to Reopen a Clinical Research Laboratory During the COVID-19 Pandemic: A Framework",
journal="JMIR Res Protoc",
year="2020",
month="Dec",
day="4",
volume="9",
number="12",
pages="e22570",
keywords="clinical laboratory",
keywords="risk assessment",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="framework",
keywords="research",
keywords="risk",
keywords="lab",
keywords="safety",
abstract="Background: The COVID-19 pandemic has led to many countries implementing lockdown procedures, resulting in the suspension of laboratory research. With lockdown measures now easing in some areas, many laboratories are preparing to reopen. This is particularly challenging for clinical research laboratories due to the dual risk of patient samples carrying the virus that causes COVID-19, SARS-CoV-2, and the risk to patients being exposed to research staff during clinical sampling. To date, no confirmed transmission of the virus has been confirmed within a laboratory setting; however, operating processes and procedures should be adapted to ensure safe working of samples of positive, negative, or unknown COVID-19 status. Objective: In this paper, we propose a framework for reopening a clinical research laboratory and resuming operations with the aim to maximize research capacity while minimizing the risk to research participants and staff. Methods: This framework was developed by consensus among experienced laboratory staff who have prepared to reopen a clinical research laboratory. Results: Multiple aspects need to be considered to reopen a clinical laboratory. We describe our process to stratify projects by risk, including assessment of donor risk and COVID-19 clinical status, the COVID-19 status of the specific sample type, and how to safely process each sample type. We describe methods to prepare the laboratory for safe working including maintaining social distancing through signage, one-way systems and access arrangements for staff and patients, limiting staff numbers on site and encouraging home working for all nonlaboratory tasks including data analysis and writing. Shared equipment usage was made safe by adapting booking systems to allow for the deployment of cleaning protocols. All risk assessments and standard operating procedures were rewritten and approved by local committees, and staff training was initiated to ensure compliance. Conclusions: Laboratories can adopt and adapt this framework to expedite reopening a clinical laboratory during the current COVID-19 pandemic while mitigating the risk to research participants and staff. ",
doi="10.2196/22570",
url="http://www.researchprotocols.org/2020/12/e22570/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33146625"
}


@Article{info:doi/10.2196/24169,
author="BinDhim, F. Nasser
and Althumiri, A. Nora
and Basyouni, H. Mada
and Sims, T. Omar
and Alhusseini, Noara
and Alqahtani, A. Saleh",
title="Arabic Translation of the Weight Self-Stigma Questionnaire: Instrument Validation Study of Factor Structure and Reliability",
journal="JMIR Form Res",
year="2020",
month="Nov",
day="13",
volume="4",
number="11",
pages="e24169",
keywords="overweight",
keywords="stigma",
keywords="weight self-stigma",
keywords="Weight Self-Stigma Questionnaire",
keywords="obesity",
keywords="Saudi Arabia",
keywords="questionnaire",
keywords="validation",
keywords="reliability",
keywords="validity",
abstract="Background: While it is most often associated with its effects on physical health, obesity is also associated with serious self-stigmatization. The lack of a suitable, validated tool to measure weight-related self-stigma in Arabic countries may be partly responsible for the scarcity of literature about this problem. Objective: This study investigated the reliability and validity of an Arabic version of the Weight Self-Stigma Questionnaire (WSSQ). Methods: Data on the Arabic-translated version of the 12-item WSSQ were collected using two cross-sectional electronic questionnaires distributed among Saudi nationals through the Sharik Association for Health Research's database in June 2020. Internal consistency, test-retest reliability, and exploratory factor analysis of the Arabic WSSQ were assessed and compared with the original English version and other translations. Results: For reliability analysis, 43 participants completed the Arabic WSSQ during two time periods. Internal consistency was $\alpha$=.898 for the overall survey, $\alpha$=.819 for the fear of enacted stigma subscale (factor 1), and $\alpha$=.847 for the self-devaluation subscale (factor 2). The test-retest reliability of the intraclass correlation coef?cient was $\alpha$=.982. In the factor structure analysis, 295 participants completed the questionnaire. The Arabic WSSQ loading of the items was consistent with the original WSSQ, except for the loading of item 9, which was stronger in factor 2 than in factor 1. The two factors accounted for the observed variances of 47.7\% and 10.6\%. Conclusions: The Arabic version of the WSSQ has good internal consistency and reliability, and the factorial structure is similar to that of the original WSSQ. The Arabic WSSQ is adaptable for clinicians seeking to assess weight-related self-stigma in Arabic-speaking people. ",
doi="10.2196/24169",
url="http://formative.jmir.org/2020/11/e24169/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33185558"
}


@Article{info:doi/10.2196/19836,
author="Marciniak, Anna Marta
and Shanahan, Lilly
and Rohde, Judith
and Schulz, Ava
and Wackerhagen, Carolin
and Kobyli?ska, Dorota
and Tuescher, Oliver
and Binder, Harald
and Walter, Henrik
and Kalisch, Raffael
and Kleim, Birgit",
title="Standalone Smartphone Cognitive Behavioral Therapy--Based Ecological Momentary Interventions to Increase Mental Health: Narrative Review",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Nov",
day="12",
volume="8",
number="11",
pages="e19836",
keywords="mHealth",
keywords="mobile app",
keywords="ecological momentary intervention",
keywords="EMI",
keywords="cognitive behavioral therapy",
keywords="CBT",
keywords="COVID-19",
keywords="mobile phone",
keywords="smartphone",
abstract="Background: A growing number of psychological interventions are delivered via smartphones with the aim of increasing the efficacy and effectiveness of these treatments and providing scalable access to interventions for improving mental health. Most of the scientifically tested apps are based on cognitive behavioral therapy (CBT) principles, which are considered the gold standard for the treatment of most mental health problems. Objective: This review investigates standalone smartphone-based ecological momentary interventions (EMIs) built on principles derived from CBT that aim to improve mental health. Methods: We searched the MEDLINE, PsycINFO, EMBASE, and PubMed databases for peer-reviewed studies published between January 1, 2007, and January 15, 2020. We included studies focusing on standalone app-based approaches to improve mental health and their feasibility, efficacy, or effectiveness. Both within- and between-group designs and studies with both healthy and clinical samples were included. Blended interventions, for example, app-based treatments in combination with psychotherapy, were not included. Selected studies were evaluated in terms of their design, that is, choice of the control condition, sample characteristics, EMI content, EMI delivery characteristics, feasibility, efficacy, and effectiveness. The latter was defined in terms of improvement in the primary outcomes used in the studies. Results: A total of 26 studies were selected. The results show that EMIs based on CBT principles can be successfully delivered, significantly increase well-being among users, and reduce mental health symptoms. Standalone EMIs were rated as helpful (mean 70.8\%, SD 15.3; n=4 studies) and satisfying for users (mean 72.6\%, SD 17.2; n=7 studies). Conclusions: Study quality was heterogeneous, and feasibility was often not reported in the reviewed studies, thus limiting the conclusions that can be drawn from the existing data. Together, the studies show that EMIs may help increase mental health and thus support individuals in their daily lives. Such EMIs provide readily available, scalable, and evidence-based mental health support. These characteristics appear crucial in the context of a global crisis such as the COVID-19 pandemic but may also help reduce personal and economic costs of mental health impairment beyond this situation or in the context of potential future pandemics. ",
doi="10.2196/19836",
url="https://mhealth.jmir.org/2020/11/e19836",
url="http://www.ncbi.nlm.nih.gov/pubmed/33180027"
}


@Article{info:doi/10.2196/18555,
author="Kalaitzoglou, Evangelia
and Majaliwa, Edna
and Zacharin, Margaret
and de Beaufort, Carine
and Chanoine, Jean-Pierre
and van Wijngaard-DeVugt, Conny
and Sperla, Ervin
and Boot, M. Annemieke
and Drop, S. Stenvert L.",
title="Multilingual Global E-Learning Pediatric Endocrinology and Diabetes Curriculum for Front Line Health Care Providers in Resource-Limited Countries: Development Study",
journal="JMIR Form Res",
year="2020",
month="Nov",
day="5",
volume="4",
number="11",
pages="e18555",
keywords="pediatric endocrinology",
keywords="diabetes mellitus",
keywords="e-learning",
keywords="online learning",
keywords="continuing education",
keywords="resource-limited country",
keywords="multilingual medical education",
abstract="Background: Electronic learning (e-learning) is a widely accessible, low-cost option for learning remotely in various settings that allows interaction between an instructor and a learner. Objective: We describe the development of a free and globally accessible multilingual e-learning module that provides education material on topics in pediatric endocrinology and diabetes and that is intended for first-line physicians and health workers but also trainees or medical specialists in resource-limited countries. Methods: As complements to concise chapters, interactive vignettes were constructed, exemplifying clinical issues and pitfalls, with specific attention to the 3 levels of medical health care in resource-limited countries. The module is part of a large e-learning portal, ESPE e-learning, which is based on ILIAS (Integriertes Lern-, Informations- und Arbeitskooperations-System), an open-source web-based learning management system. Following a review by global experts, the content was translated by native French, Spanish, Swahili, and Chinese--speaking colleagues into their respective languages using a commercial web-based translation tool (SDL Trados Studio). Results: Preliminary data suggest that the module is well received, particularly in targeted parts of the world and that active promotion to inform target users is warranted. Conclusions: The e-learning module is a free globally accessible multilingual up-to-date tool for use in resource-limited countries that has been utilized thus far with success. Widespread use will require dissemination of the tool on a global scale. ",
doi="10.2196/18555",
url="https://formative.jmir.org/2020/11/e18555",
url="http://www.ncbi.nlm.nih.gov/pubmed/33151156"
}


@Article{info:doi/10.2196/18246,
author="McDonnell, Michelle
and Owen, Edward Jason
and Bantum, O'Carroll Erin",
title="Identification of Emotional Expression With Cancer Survivors: Validation of Linguistic Inquiry and Word Count",
journal="JMIR Form Res",
year="2020",
month="Oct",
day="30",
volume="4",
number="10",
pages="e18246",
keywords="linguistic analysis",
keywords="emotion",
keywords="validation",
abstract="Background: Given the high volume of text-based communication such as email, Facebook, Twitter, and additional web-based and mobile apps, there are unique opportunities to use text to better understand underlying psychological constructs such as emotion. Emotion recognition in text is critical to commercial enterprises (eg, understanding the valence of customer reviews) and to current and emerging clinical applications (eg, as markers of clinical progress and risk of suicide), and the Linguistic Inquiry and Word Count (LIWC) is a commonly used program. Objective: Given the wide use of this program, the purpose of this study is to update previous validation results with two newer versions of LIWC. Methods: Tests of proportions were conducted using the total number of emotion words identified by human coders for each emotional category as the reference group. In addition to tests of proportions, we calculated F scores to evaluate the accuracy of LIWC 2001, LIWC 2007, and LIWC 2015. Results: Results indicate that LIWC 2001, LIWC 2007, and LIWC 2015 each demonstrate good sensitivity for identifying emotional expression, whereas LIWC 2007 and LIWC 2015 were significantly more sensitive than LIWC 2001 for identifying emotional expression and positive emotion; however, more recent versions of LIWC were also significantly more likely to overidentify emotional content than LIWC 2001. LIWC 2001 demonstrated significantly better precision (F score) for identifying overall emotion, negative emotion, and anxiety compared with LIWC 2007 and LIWC 2015. Conclusions: Taken together, these results suggest that LIWC 2001 most accurately reflects the emotional identification of human coders. ",
doi="10.2196/18246",
url="https://formative.jmir.org/2020/10/e18246",
url="http://www.ncbi.nlm.nih.gov/pubmed/33124986"
}


@Article{info:doi/10.2196/22528,
author="Gulliver, Amelia
and Calear, L. Alison
and Sunderland, Matthew
and Kay-Lambkin, Frances
and Farrer, M. Louise
and Banfield, Michelle
and Batterham, J. Philip",
title="Consumer-Guided Development of an Engagement-Facilitation Intervention for Increasing Uptake and Adherence for Self-Guided Web-Based Mental Health Programs: Focus Groups and Online Evaluation Survey",
journal="JMIR Form Res",
year="2020",
month="Oct",
day="29",
volume="4",
number="10",
pages="e22528",
keywords="mental health",
keywords="internet",
keywords="anxiety",
keywords="depression",
keywords="technology",
keywords="treatment adherence and compliance",
abstract="Background: Self-guided web-based mental health programs are effective in treating and preventing mental health problems. However, current engagement with these programs in the community is suboptimal, and there is limited evidence indicating how to increase the use of existing evidence-based programs. Objective: This study aims to investigate the views of people with lived experience of depression and anxiety on factors influencing their engagement with self-guided web-based mental health (e--mental health) programs and to use these perspectives to develop an engagement-facilitation intervention (EFI) to increase engagement (defined as both uptake and adherence) with these programs. Methods: A total of 24 community members (female=21; male=3) with lived experience of depression and anxiety or depression or anxiety alone participated in 1 of 4 focus groups discussing the factors influencing their engagement with self-guided e--mental health programs and the appearance, delivery mode, and functionality of content for the proposed EFI. A subsequent evaluation survey of the focus group participants (n=14) was conducted to evaluate the resultant draft EFI. Data were thematically analyzed using both inductive and deductive qualitative methods. Results: Participants suggested that the critical component of an EFI was information that would challenge personal barriers to engagement, including receiving personalized symptom feedback, information regarding the program's content or effectiveness and data security, and normalization of using e--mental health programs (eg, testimonials). Reminders, rewards, feedback about progress, and coaching were all mentioned as facilitating adherence. Conclusions: EFIs have the potential to improve community uptake of e--mental health programs. They should focus on providing information on the content and effectiveness of e--mental health programs and normalizing their use. Given that the sample comprised predominantly young females, this study may not be generalizable to other population groups. There is a strong value in involving people with a lived experience in the design and development of EFIs to maximize their effectiveness. ",
doi="10.2196/22528",
url="http://formative.jmir.org/2020/10/e22528/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33118939"
}


@Article{info:doi/10.2196/19138,
author="Draaijer, Melvin
and Lalla-Edward, Tresha Samanta
and Venter, Francois Willem Daniel
and Vos, Alinda",
title="Phone Calls to Retain Research Participants and Determinants of Reachability in an African Setting: Observational Study",
journal="JMIR Form Res",
year="2020",
month="Sep",
day="30",
volume="4",
number="9",
pages="e19138",
keywords="retention",
keywords="loss to follow-up",
keywords="phone",
keywords="mobile phones",
keywords="HIV",
keywords="ART",
keywords="South Africa",
abstract="Background: Long-term retention of research participants in studies is challenging. In research in sub-Saharan Africa, phone calls are the most frequently used method to distantly engage with participants. Objective: We aimed to get insight into the effectiveness of phone calls to retain contact with participants and evaluated determinants of reachability. Methods: A cross-sectional study was performed using the databases of two randomized controlled trials investigating different kinds of antiretroviral therapy in HIV-positive patients. One trial finished in 2018 (study 1), and the other finished in 2015 (study 2). A random sample size of 200 participants per study was obtained. There were up to 3 phone numbers available per participant collected during the studies. Participants received a maximum of 3 phone calls on every available number on different days and at different times. Voicemails were left, and emails sent wherever possible. We documented how many calls were answered, who answered, as well as after how many attempts participants were reached. To further increase our understanding of reachability, we conducted a short questionnaire assessing factors contributing to reachability. The study was approved by the Research Ethics Committee of the University of Witwatersrand, Johannesburg, South Africa (reference number M1811107). Results: In our sample size of n=200 per study, study 1, with a median time of 11 months since the last visit at the research site, had a response rate of 70.5\% (141/200) participants while study 2, with a median duration of 55 months since the last visit, had a response rate of 50.0\% (100/200; P<.001). In study 1, 61.5\% (123/200) of calls were answered directly by the participant while this was 36.0\% (72/200) in study 2 (P=.003). The likelihood of reaching a participant decreased with time (odds ratio [OR] 0.73, 95\% CI 0.63 to 0.84) for every year since the last face-to-face visit. Having more phone numbers per participant increased reachability (OR 2.32, 95\% CI 1.24 to 4.36 for 2 phone numbers and OR 3.03, 95\% CI 1.48 to 6.22 for 3 phone numbers compared with 1 number). A total of 141 of 241 reached participants responded to the questionnaire. Of the 93 participants who had changed phone numbers, 5\% (50/93) had changed numbers because their phone was stolen. The most preferred method of being contacted was direct calling (128/141) with participants naming this method followed by WhatsApp (69/141). Conclusions: Time since last visit and the number of phone numbers listed were the only determinants of reachability. Longer follow-up time is accompanied with a decrease in reachability by phone while more listed phone numbers increases the likelihood that someone can be reached. Trial Registration: ClinicalTrials.gov NCT02671383; https://clinicaltrials.gov/ct2/show/NCT02671383 and ClinicalTrials.gov NCT02670772; https://clinicaltrials.gov/ct2/show/NCT02670772 ",
doi="10.2196/19138",
url="http://formative.jmir.org/2020/9/e19138/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32996891"
}


@Article{info:doi/10.2196/14450,
author="Holch, Patricia
and Marwood, R. Jordan",
title="EHealth Literacy in UK Teenagers and Young Adults: Exploration of Predictors and Factor Structure of the eHealth Literacy Scale (eHEALS)",
journal="JMIR Form Res",
year="2020",
month="Sep",
day="8",
volume="4",
number="9",
pages="e14450",
keywords="eHealth literacy",
keywords="irrational health beliefs",
keywords="predictors",
keywords="self-efficacy",
keywords="teenagers and young adults",
keywords="need for cognition",
keywords="exploratory factor analysis",
abstract="Background: Increasingly, teenagers and young adults (TYAs) seek out health information online; however, it is not clear whether they possess electronic health (eHealth) literacy, defined as ``the ability to select, appraise, and utilize good quality health information from the internet.'' A number of factors are included in the Lily model proposed by Norman and Skinner underpinning the development of eHealth literacy. It is important to understand which elements may influence the development of eHealth literacy in young people, as the current generation will continue to ``Google it'' when faced with a health problem throughout their lives. Objective: The objectives of this study are to explore potential factors influencing young people's eHealth literacy and explore the underlying constructs of the eHealth Literacy Scale (eHEALS) in a population of UK university students. Methods: A total of 188 undergraduate psychology students from a large UK University were recruited as an opportunity sample. Of these, 88.8\% (167/188) of participants were female with a mean age of 20.13 (SD 2.16) years and the majority were White British (159/188, 84.6\%). Employing a cross-sectional design TYAs completed the following measures exploring eHealth literacy (eHEALS): Irrational Health Belief Scale; Newest Vital Sign (NVS), a measure of functional health literacy; Need for Cognition Scale, a preference for effortful cognitive activity; and General Self-Efficacy (GSE) Scale, exploring personal agency and confidence. The eHEALS was also subject to exploratory factor analysis (EFA), for which in addition to the total variance explained, the scree plot, eigenvalues, and factor loadings were assessed to verify the structure. Results: eHEALS and GSE were significantly positively correlated (r=0.28, P<.001) and hierarchical linear modeling revealed GSE as the significant predictor of scores on the eHEALS (F1,186=16.16, P<.001, R2=0.08), accounting for 8.0\% of the variance. Other notable relationships were GSE and need for cognition (NFC) were also positively correlated (r=0.33, P<.001), and NFC and irrational health beliefs were significantly negatively correlated (r=--.14, P=.03). Using Spearman correlations, GSE and NVS (rs=0.14, P=.04) and NFC and NVS (rs=0.19, P=.003) were positively correlated. An EFA revealed the scale to be stable and identified a 2-factor structure related to information acquisition and information application. Conclusions: This is the first study in the UK to explore relationships between these key variables and verify the structure of the eHEALS in a TYA population in the UK. The findings that self-efficacy has a major influence firmly consolidate its status as fundamental to the development of eHealth literacy. Future studies will explore the influence of body image and the development of eHealth literacy in more diverse TYA populations. ",
doi="10.2196/14450",
url="http://formative.jmir.org/2020/9/e14450/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32897230"
}


@Article{info:doi/10.2196/16727,
author="Li, Shiyu
and Howard, T. Jeffrey
and Sosa, T. Erica
and Cordova, Alberto
and Parra-Medina, Deborah
and Yin, Zenong",
title="Calibrating Wrist-Worn Accelerometers for Physical Activity Assessment in Preschoolers: Machine Learning Approaches",
journal="JMIR Form Res",
year="2020",
month="Aug",
day="31",
volume="4",
number="8",
pages="e16727",
keywords="preschoolers",
keywords="accelerometer",
keywords="physical activity",
keywords="obesity",
keywords="machine learning",
abstract="Background: Physical activity (PA) level is associated with multiple health benefits during early childhood. However, inconsistency in the methods for quantification of PA levels among preschoolers remains a problem. Objective: This study aimed to develop PA intensity cut points for wrist-worn accelerometers by using machine learning (ML) approaches to assess PA in preschoolers. Methods: Wrist- and hip-derived acceleration data were collected simultaneously from 34 preschoolers on 3 consecutive preschool days. Two supervised ML models, receiver operating characteristic curve (ROC) and ordinal logistic regression (OLR), and one unsupervised ML model, k-means cluster analysis, were applied to establish wrist-worn accelerometer vector magnitude (VM) cut points to classify accelerometer counts into sedentary behavior, light PA (LPA), moderate PA (MPA), and vigorous PA (VPA). Physical activity intensity levels identified by hip-worn accelerometer VM cut points were used as reference to train the supervised ML models. Vector magnitude counts were classified by intensity based on three newly established wrist methods and the hip reference to examine classification accuracy. Daily estimates of PA were compared to the hip-reference criterion. Results: In total, 3600 epochs with matched hip- and wrist-worn accelerometer VM counts were analyzed. All ML approaches performed differently on developing PA intensity cut points for wrist-worn accelerometers. Among the three ML models, k-means cluster analysis derived the following cut points: ?2556 counts per minute (cpm) for sedentary behavior, 2557-7064 cpm for LPA, 7065-14532 cpm for MPA, and ?14533 cpm for VPA; in addition, k-means cluster analysis had the highest classification accuracy, with more than 70\% of the total epochs being classified into the correct PA categories, as examined by the hip reference. Additionally, k-means cut points exhibited the most accurate estimates on sedentary behavior, LPA, and VPA as the hip reference. None of the three wrist methods were able to accurately assess MPA. Conclusions: This study demonstrates the potential of ML approaches in establishing cut points for wrist-worn accelerometers to assess PA in preschoolers. However, the findings from this study warrant additional validation studies. ",
doi="10.2196/16727",
url="https://formative.jmir.org/2020/8/e16727",
url="http://www.ncbi.nlm.nih.gov/pubmed/32667893"
}


@Article{info:doi/10.2196/18518,
author="Ukoha, Chukwuma",
title="How Health Care Organizations Approach Social Media Measurement: Qualitative Study",
journal="JMIR Form Res",
year="2020",
month="Aug",
day="14",
volume="4",
number="8",
pages="e18518",
keywords="health care organization",
keywords="social media",
keywords="measurement",
keywords="benchmarking",
keywords="metrics",
keywords="analytics tools",
abstract="Background: Many health care organizations use social media to support a variety of activities. To ensure continuous improvement in social media performance, health care organizations must measure their social media. Objective: The purpose of this study is to explore how health care organizations approach social media measurement and to elucidate the tools they employ. Methods: In this exploratory qualitative research, Australian health care organizations that use social media, varying in size and locality, were invited to participate in the study. Data were collected through semistructured interviews, and the transcripts were analyzed using thematic analysis. Results: The study identified health care organizations' approaches to social media measurement. While some measured their social media frequently, others used infrequent measurements, and a few did not measure theirs at all. Those that measured their social media used one or a combination of the following yardsticks: personal benchmarking, peer benchmarking, and metric benchmarking. The metrics tracked included one or more of the following: reach, engagement, and conversion rates. The tools employed to measure social media were either inbuilt or add-on analytics tools. Although many participants showed great interest in measuring their social media, they still had some unanswered questions. Conclusions: The lack of a consensus approach to measurement suggests that, unlike other industries, social media measurement in health care settings is at a nascent stage. There is a need to improve knowledge, sophistication, and integration of social media strategy through the application of theoretical and analytical knowledge to help resolve the current challenge of effective social media measurement. This study calls for social media training in health care organizations. Such training must focus on how to use relevant tools and how to measure their use effectively. ",
doi="10.2196/18518",
url="http://formative.jmir.org/2020/8/e18518/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32795994"
}


@Article{info:doi/10.2196/17760,
author="Llorens-Vernet, Pere
and Mir{\'o}, Jordi",
title="The Mobile App Development and Assessment Guide (MAG): Delphi-Based Validity Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Jul",
day="31",
volume="8",
number="7",
pages="e17760",
keywords="assessment",
keywords="Delphi method",
keywords="MAG",
keywords="mobile apps",
keywords="mobile health",
keywords="validity",
keywords="guide",
abstract="Background: In recent years, there has been an exponential growth of mobile health (mHealth)--related apps. This has occurred in a somewhat unsupervised manner. Therefore, having a set of criteria that could be used by all stakeholders to guide the development process and the assessment of the quality of the apps is of most importance. Objective: The aim of this paper is to study the validity of the Mobile App Development and Assessment Guide (MAG), a guide recently created to help stakeholders develop and assess mobile health apps. Methods: To conduct a validation process of the MAG, we used the Delphi method to reach a consensus among participating stakeholders. We identified 158 potential participants: 45 patients as potential end users, 41 health care professionals, and 72 developers. We sent participants an online survey and asked them to rate how important they considered each item in the guide to be on a scale from 0 to 10. Two rounds were enough to reach consensus. Results: In the first round, almost one-third (n=42) of those invited participated, and half of those (n=24) also participated in the second round. Most items in the guide were found to be important to a quality mHealth-related app; a total of 48 criteria were established as important. ``Privacy,'' ``security,'' and ``usability'' were the categories that included most of the important criteria. Conclusions: The data supports the validity of the MAG. In addition, the findings identified the criteria that stakeholders consider to be most important. The MAG will help advance the field by providing developers, health care professionals, and end users with a valid guide so that they can develop and identify mHealth-related apps that are of quality. ",
doi="10.2196/17760",
url="http://mhealth.jmir.org/2020/7/e17760/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32735226"
}


@Article{info:doi/10.2196/14833,
author="Jennings Mayo-Wilson, Larissa
and Glass, E. Nancy
and Labrique, Alain
and Davoust, Melissa
and Ssewamala, M. Fred
and Linnemayr, Sebastian
and Johnson, W. Matthew",
title="Feasibility of Assessing Economic and Sexual Risk Behaviors Using Text Message Surveys in African-American Young Adults Experiencing Homelessness and Unemployment: Single-Group Study",
journal="JMIR Form Res",
year="2020",
month="Jul",
day="17",
volume="4",
number="7",
pages="e14833",
keywords="HIV",
keywords="sexual risk behaviors",
keywords="homelessness",
keywords="text messages",
keywords="young adults",
keywords="economic",
keywords="mobile phones",
abstract="Background: Text messages offer the potential to better evaluate HIV behavioral interventions using repeated longitudinal measures at a lower cost and research burden. However, they have been underused in US minority settings. Objective: This study aims to examine the feasibility of assessing economic and sexual risk behaviors using text message surveys. Methods: We conducted a single-group study with 17 African-American young adults, aged 18-24 years, who were economically disadvantaged and reported prior unprotected sex. Participants received a text message survey once each week for 5 weeks. The survey contained 14 questions with yes-no and numeric responses on sexual risk behaviors (ie, condomless sex, sex while high or drunk, and sex exchange) and economic behaviors (ie, income, employment, and money spent on HIV services or products). Feasibility measures were the number of participants who responded to the survey in a given week, the number of questions to which a participant responded in each survey, and the number of hours spent from sending a survey to participants to receiving their response in a given week. One discussion group was used to obtain feedback. Results: Overall, 65\% (n=11/17) of the participants responded to at least one text message survey compared with 35\% (n=6/17) of the participants who did not respond. The majority (n=7/11, 64\%) of the responders were women. The majority (n=4/6, 67\%) of nonresponders were men. An average of 7.6 participants (69\%) responded in a given week. Response rates among ever responders ranged from 64\% to 82\% across the study period. The mean number of questions answered each week was 12.6 (SD 2.7; 90\% of all questions), ranging from 72\% to 100\%. An average of 6.4 participants (84\%) answered all 14 text message questions in a given week, ranging from 57\% to 100\%. Participants responded approximately 8.7 hours (SD 10.3) after receiving the survey. Participants were more likely to answer questions related to employment, condomless sex, and discussions with sex partners. Nonresponse or skip was more often used for questions at the end of the survey relating to sex exchange and money spent on HIV prevention services or products. Strengths of the text message survey were convenience, readability, short completion time, having repeated measures over time, and having incentives. Conclusions: Longitudinal text message surveys may be a valuable tool for assessing HIV-related economic and sexual risk behaviors. Trial Registration: ClinicalTrials.gov NCT03237871; https://clinicaltrials.gov/ct2/show/NCT03237871 ",
doi="10.2196/14833",
url="https://formative.jmir.org/2020/7/e14833",
url="http://www.ncbi.nlm.nih.gov/pubmed/32706656"
}


@Article{info:doi/10.2196/18279,
author="O'Donovan, Rebecca
and Sezgin, Emre
and Bambach, Sven
and Butter, Eric
and Lin, Simon",
title="Detecting Screams From Home Audio Recordings to Identify Tantrums: Exploratory Study Using Transfer Machine Learning",
journal="JMIR Form Res",
year="2020",
month="Jun",
day="16",
volume="4",
number="6",
pages="e18279",
keywords="machine learning",
keywords="scream detection",
keywords="audio event detection",
keywords="tantrum identification",
keywords="autism",
keywords="behavioral disorder",
keywords="data-driven approach",
abstract="Background: Qualitative self- or parent-reports used in assessing children's behavioral disorders are often inconvenient to collect and can be misleading due to missing information, rater biases, and limited validity. A data-driven approach to quantify behavioral disorders could alleviate these concerns. This study proposes a machine learning approach to identify screams in voice recordings that avoids the need to gather large amounts of clinical data for model training. Objective: The goal of this study is to evaluate if a machine learning model trained only on publicly available audio data sets could be used to detect screaming sounds in audio streams captured in an at-home setting. Methods: Two sets of audio samples were prepared to evaluate the model: a subset of the publicly available AudioSet data set and a set of audio data extracted from the TV show Supernanny, which was chosen for its similarity to clinical data. Scream events were manually annotated for the Supernanny data, and existing annotations were refined for the AudioSet data. Audio feature extraction was performed with a convolutional neural network pretrained on AudioSet. A gradient-boosted tree model was trained and cross-validated for scream classification on the AudioSet data and then validated independently on the Supernanny audio. Results: On the held-out AudioSet clips, the model achieved a receiver operating characteristic (ROC)--area under the curve (AUC) of 0.86. The same model applied to three full episodes of Supernanny audio achieved an ROC-AUC of 0.95 and an average precision (positive predictive value) of 42\% despite screams only making up 1.3\% (n=92/7166 seconds) of the total run time. Conclusions: These results suggest that a scream-detection model trained with publicly available data could be valuable for monitoring clinical recordings and identifying tantrums as opposed to depending on collecting costly privacy-protected clinical data for model training. ",
doi="10.2196/18279",
url="http://formative.jmir.org/2020/6/e18279/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32459656"
}


@Article{info:doi/10.2196/17077,
author="Kedroske, Jacob
and Koblick, Sarah
and Chaar, Dima
and Mazzoli, Amanda
and O'Brien, Maureen
and Yahng, Lilian
and Vue, Rebecca
and Chappell, Grant
and Shin, Youn Ji
and Hanauer, A. David
and Choi, Won Sung",
title="Development of a National Caregiver Health Survey for Hematopoietic Stem Cell Transplant: Qualitative Study of Cognitive Interviews and Verbal Probing",
journal="JMIR Form Res",
year="2020",
month="Jan",
day="23",
volume="4",
number="1",
pages="e17077",
keywords="hematopoietic stem cell transplantation",
keywords="caregivers",
keywords="mobile applications",
keywords="qualitative research",
abstract="Background: Roadmap 1.0 is a mobile health app that was previously developed for caregivers of patients who have undergone hematopoietic stem cell transplantation (HSCT). Formative research targeted toward its end users (caregivers) can help inform app design and development, allowing additional components to be incorporated into the app, which can then be tested in a future randomized controlled trial. Objective: This study aimed to create a methodologically rigorous national survey that would help inform the development of Roadmap 2.0. Methods: We conducted a prospective, qualitative research study that took place between November 18, 2018, and February 7, 2019, in a blood and marrow transplant unit within a large academic medical institution in the midwestern part of the United States. Cognitive interviews, including think-aloud and verbal probing techniques, were conducted in 10 adult caregivers (?18 years) of patients who had undergone HSCT. Results: Most participants were female (9/10, 90\%), white (9/10, 90\%), married (9/10, 90\%), employed at least part time (6/10, 60\%), caregivers of adult patients (7/10, 70\%), and had some college education (9/10, 90\%) and an annual household income of \$60,000 or higher (6/10, 60\%). All but one interview was audio-recorded, with permission. Overall, participants were engaged in the cognitive interview process of the draft survey, which included 7 topics. The interviews highlighted areas wherein survey items could be further refined, such as offering more response choices (eg, ``NA'') or clarifying the type of transplant (eg, autologous or allogeneic) or context of transplant care (eg, pre-HSCT, during HSCT, post-HSCT, inpatient, and outpatient). Apart from these findings, the items in demographics, caregiving experiences, technology, positive activities, and mood were generally interpreted as intended. On the basis of the transcript data and field notes by the interviewer, items within self-efficacy (Caregiver Self-Efficacy Scale) and coping (Brief Coping Orientation to Problems Experienced inventory) questionnaires generated more confusion among interviewer and participants, reflecting difficulties in interpreting the meaning of some survey items. Conclusions: This study incorporated the four cognitive aspects of survey methodology that describe the question-answering process---(1) comprehension, (2) information retrieval, (3) judgment and decision making, and (4) responding---by using the think-aloud and probing techniques in cognitive interviews. We conclude that this methodologically rigorous process informed revisions and improved our final questionnaire design. International Registered Report Identifier (IRRID): RR2-10.2196/resprot.49188 ",
doi="10.2196/17077",
url="http://formative.jmir.org/2020/1/e17077/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32012037"
}


@Article{info:doi/10.2196/14886,
author="Russomanno, Jennifer
and Patterson, G. Joanne
and Jabson Tree, M. Jennifer",
title="Social Media Recruitment of Marginalized, Hard-to-Reach Populations: Development of Recruitment and Monitoring Guidelines",
journal="JMIR Public Health Surveill",
year="2019",
month="Dec",
day="2",
volume="5",
number="4",
pages="e14886",
keywords="transgender",
keywords="LGBTQ",
keywords="TGNC",
keywords="marginalized populations",
keywords="cyberbullying",
keywords="engagement",
keywords="compassion fatigue",
keywords="human subjects",
keywords="research protections",
keywords="adverse events",
abstract="Background: Social media can be a useful strategy for recruiting hard-to-reach, stigmatized populations into research studies; however, it may also introduce risks for participant and research team exposure to negative comments. Currently, there is no published formal social media recruitment and monitoring guidelines that specifically address harm reduction for social media recruitment of marginalized populations. Objective: The purpose of this research study was to investigate the utility, successes, challenges, and positive and negative consequences of using targeted Facebook advertisements as a strategy to recruit transgender and gender nonconforming (TGNC) people into a research study. Methods: TGNC adults living in the Southeast Unites States were recruited via targeted Facebook advertisements over two cycles in April and June 2017. During cycle 1, researchers only used inclusion terms to recruit the target population. During cycle 2, the social media recruitment and monitoring protocol and inclusion and exclusion terms were used. Results: The cycle 1 advertisement reached 8518 people and had 188 reactions, comments, and shares but produced cyberbullying, including discriminatory comments from Facebook members. Cycle 2 reached fewer people (6976) and received 166 reactions, comments, and shares but produced mostly positive comments. Conclusions: Researchers must consider potential harms of using targeted Facebook advertisements to recruit hard-to-reach and stigmatized populations. To minimize harm to participants and research staff, researchers must preemptively implement detailed social media recruitment and monitoring guidelines for monitoring and responding to negative feedback on targeted Facebook advertisements. ",
doi="10.2196/14886",
url="http://publichealth.jmir.org/2019/4/e14886/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31789598"
}


@Article{info:doi/10.2196/14372,
author="Allison, Rosalie
and Hayes, Catherine
and McNulty, M. Cliodna A.
and Young, Vicki",
title="A Comprehensive Framework to Evaluate Websites: Literature Review and Development of GoodWeb",
journal="JMIR Form Res",
year="2019",
month="Oct",
day="24",
volume="3",
number="4",
pages="e14372",
keywords="user experience",
keywords="usability",
keywords="human-computer interaction",
keywords="software testing",
keywords="quality testing",
keywords="scoping study",
abstract="Background: Attention is turning toward increasing the quality of websites and quality evaluation to attract new users and retain existing users. Objective: This scoping study aimed to review and define existing worldwide methodologies and techniques to evaluate websites and provide a framework of appropriate website attributes that could be applied to any future website evaluations. Methods: We systematically searched electronic databases and gray literature for studies of website evaluation. The results were exported to EndNote software, duplicates were removed, and eligible studies were identified. The results have been presented in narrative form. Results: A total of 69 studies met the inclusion criteria. The extracted data included type of website, aim or purpose of the study, study populations (users and experts), sample size, setting (controlled environment and remotely assessed), website attributes evaluated, process of methodology, and process of analysis. Methods of evaluation varied and included questionnaires, observed website browsing, interviews or focus groups, and Web usage analysis. Evaluations using both users and experts and controlled and remote settings are represented. Website attributes that were examined included usability or ease of use, content, design criteria, functionality, appearance, interactivity, satisfaction, and loyalty. Website evaluation methods should be tailored to the needs of specific websites and individual aims of evaluations. GoodWeb, a website evaluation guide, has been presented with a case scenario. Conclusions: This scoping study supports the open debate of defining the quality of websites, and there are numerous approaches and models to evaluate it. However, as this study provides a framework of the existing literature of website evaluation, it presents a guide of options for evaluating websites, including which attributes to analyze and options for appropriate methods. ",
doi="10.2196/14372",
url="http://formative.jmir.org/2019/4/e14372/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31651406"
}


@Article{info:doi/10.2196/12836,
author="Engler, Kim
and Ahmed, Sara
and Lessard, David
and Vicente, Serge
and Lebouch{\'e}, Bertrand",
title="Assessing the Content Validity of a New Patient-Reported Measure of Barriers to Antiretroviral Therapy Adherence for Electronic Administration in Routine HIV Care: Proposal for a Web-Based Delphi Study",
journal="JMIR Res Protoc",
year="2019",
month="Aug",
day="02",
volume="8",
number="8",
pages="e12836",
keywords="HIV",
keywords="antiretroviral therapy, highly active",
keywords="patient-reported outcome measure",
keywords="medication adherence",
keywords="Delphi technique",
keywords="stakeholder participation",
keywords="Canada",
keywords="France",
abstract="Background: Adherence to lifesaving antiretroviral therapy (ART) for HIV infection remains a challenge for many patients. Routine screening for barriers to ART adherence could help make HIV care more patient-centered and prevent virologic rebound or failure. Our team is currently developing a new HIV-specific patient-reported outcome measure (PROM) of these barriers for use in Canada and France along with a digital app for its electronic administration. In our previous work, we developed the PROM's multidimensional conceptual framework and generated 100 English items, which have been translated to French. Objective: This study aims to use a Web-based Delphi to help validate and select the content of this new HIV-specific PROM, based on the perspective of anglophone and francophone patients and providers in Canada and France. Here, we present the proposal for this Delphi. Methods: This modified Delphi will involve a diverse panel of patients (n=32) and providers (n=52) recruited especially from the 9 sites of the PROM development study (site locations in Canada: Montreal, Toronto, Vancouver; in France: Paris, Nantes, Clermont-Ferrand, Saint-Martin, Cayenne). Overall, 2 rounds of Web-based questionnaires will be conducted. The threshold for consensus is set at 60\% and will determine which items are carried forward to the second round. Per item, 3 aspects will be rated: importance as a barrier to ART adherence, relevance for HIV care, and clarity. In both rounds, space will be available for free text comments. Overall comprehensiveness will be assessed in the second round. Results: This study has undergone a methodological review by experts in patient-oriented research. It has received approval from a research ethics board of the McGill University Health Centre. It is financially supported, in part, by the Canadian Institutes of Health Research's Strategy for Patient-Oriented Research-Quebec Support Unit (M006). As of May 21, 2019, 15 people living with HIV and 25 providers completed the first round of the Delphi (24 from Canada and 16 from France). Conclusions: To our knowledge, this is the first Delphi to seek consensus on the most relevant and clinically actionable barriers to ART adherence, collecting opinions on an extensive list of barriers. Drawing on a relatively large and diverse panel of HIV patients and providers, it essentially engages key stakeholders in decision making about the PROM's final content, helping to ensure its utility and adoption. International Registered Report Identifier (IRRID): PRR1-10.2196/12836 ",
doi="10.2196/12836",
url="https://www.researchprotocols.org/2019/8/e12836/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31376275"
}


@Article{info:doi/10.2196/13870,
author="Vidal-Alaball, Josep
and Fernandez-Luque, Luis
and Marin-Gomez, X. Francesc
and Ahmed, Wasim",
title="A New Tool for Public Health Opinion to Give Insight Into Telemedicine: Twitter Poll Analysis",
journal="JMIR Form Res",
year="2019",
month="May",
day="28",
volume="3",
number="2",
pages="e13870",
keywords="telemedicine",
keywords="Twitter messaging",
keywords="health care surveys",
abstract="Background: Telemedicine draws on information technologies in order to enable the delivery of clinical health care from a distance. Twitter is a social networking platform that has 316 million monthly active users with 500 million tweets per day; its potential for real-time monitoring of public health has been well documented. There is a lack of empirical research that has critically examined the potential of Twitter polls for providing insight into public health. One of the benefits of utilizing Twitter polls is that it is possible to gain access to a large audience that can provide instant and real-time feedback. Moreover, Twitter polls are completely anonymized. Objective: The overall aim of this study was to develop and disseminate Twitter polls based on existing surveys to gain real-time feedback on public views and opinions toward telemedicine. Methods: Two Twitter polls were developed utilizing questions from previously used questionnaires to explore acceptance of telemedicine among Twitter users. The polls were placed on the Twitter timeline of one of the authors, which had more than 9300 followers, and the account followers were asked to answer the poll and retweet it to reach a larger audience. Results: In a population where telemedicine was expected to enjoy big support, a significant number of Twitter users responding to the poll felt that telemedicine was not as good as traditional care. Conclusions: Our results show the potential of Twitter polls for gaining insight into public health topics on a range of health issues not just limited to telemedicine. Our study also sheds light on how Twitter polls can be used to validate and test survey questions. ",
doi="10.2196/13870",
url="http://formative.jmir.org/2019/2/e13870/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31140442"
}


@Article{info:doi/10.2196/10400,
author="Mazor, M. Kathleen
and King, M. Ann
and Hoppe, B. Ruth
and Kochersberger, O. Annie
and Yan, Jie
and Reim, D. Jesse",
title="Video-Based Communication Assessment: Development of an Innovative System for Assessing Clinician-Patient Communication",
journal="JMIR Med Educ",
year="2019",
month="Feb",
day="14",
volume="5",
number="1",
pages="e10400",
keywords="communication",
keywords="crowdsourcing",
keywords="health care",
keywords="mobile phone",
keywords="patient-centered care",
keywords="video-based communication assessment",
doi="10.2196/10400",
url="http://mededu.jmir.org/2019/1/e10400/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30710460"
}


@Article{info:doi/10.2196/11025,
author="Allen, M. Alicia
and Lundeen, Kim
and Murphy, E. Sharon
and Spector, Logan
and Harlow, L. Bernard",
title="Web-Delivered Multimedia Training Materials for the Self-Collection of Dried Blood Spots: A Formative Project",
journal="JMIR Formativ Res",
year="2018",
month="Nov",
day="05",
volume="2",
number="2",
pages="e11025",
keywords="dried blood spot",
keywords="internet",
keywords="feasibility studies",
abstract="Background: The use of dried blood spots (DBS) in biomedical research has been increasing as an objective measure for variables that are typically plagued by self-report, such as smoking status and medication adherence. The development of training materials for the self-collection of DBS that can be delivered through the Web would allow for broader use of this methodology. Objective: The objective of this study was to evaluate the acceptability and feasibility of the self-collection of DBS using newly developed multimedia training materials that were delivered through the Web. We also aimed to assess the usability of the collected DBS samples. Methods: We recruited participants through Facebook advertising for two distinct studies. The first study evaluated the acceptability of our newly developed DBS training materials, while the second assessed the implementation of this protocol into a larger Web-based study. Results: In the first study, participants (N=115) were aged, on average, 26.1 (SD 6.4) years. Training materials were acceptable (113/115, 98.2\%, of participants were willing to collect DBS again) and produced usable samples (110/115, 95.7\%, collected DBS were usable). In the second study, response rate was 25.0\% (41/164), with responders being significantly younger than nonresponders (20.3 [SD 0.2] vs 22.0 [SD 0.4]; P<.001), and 92\% (31/41) of collected DBS samples were usable by the laboratory. Conclusions: Overall, while the protocol is acceptable, feasible, and produced usable samples, additional work is needed to improve response rates. ",
doi="10.2196/11025",
url="http://formative.jmir.org/2018/2/e11025/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30684406"
}


@Article{info:doi/10.2196/10474,
author="van Velsen, Lex
and Evers, Mirka
and Bara, Cristian-Dan
and Op den Akker, Harm
and Boerema, Simone
and Hermens, Hermie",
title="Understanding the Acceptance of an eHealth Technology in the Early Stages of Development: An End-User Walkthrough Approach and Two Case Studies",
journal="JMIR Formativ Res",
year="2018",
month="Jun",
day="15",
volume="2",
number="1",
pages="e10474",
keywords="eHealth",
keywords="acceptance",
keywords="design",
keywords="walkthrough",
keywords="agile design",
abstract="Background: Studies that focus on the acceptance of an electronic health (eHealth) technology generally make use of surveys. However, results of such studies hold little value for a redesign, as they focus only on quantifying end-user appreciation of general factors (eg, perceived usefulness). Objective: We present a method for understanding end-user acceptance of an eHealth technology, early in the development process: The eHealth End-User Walkthrough. Methods: During a walkthrough, a participant is guided by using the technology via a scenario, a persona, and a low-fidelity protoype. A participant is questioned about factors that may affect acceptance during and after the demonstration. We show the value of the method via two case studies. Results: During the case studies, participants commented on whether they intend to use a technology and why they would (not) use its main features. They also provided redesign advice or input for additional functions. Finally, the sessions provide guidance for the generation of business models and implementation plans. Conclusions: The eHealth End-User Walkthrough can aid design teams in understanding the acceptance of their eHealth application in a very early stage of the design process. Consequently, it can prevent a mismatch between technology and end-users' needs, wishes and context. ",
doi="10.2196/10474",
url="http://formative.jmir.org/2018/1/e10474/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30684434"
}


@Article{info:doi/10.2196/formative.8202,
author="Oremus, Mark
and Sharafoddini, Anis
and Morgano, Paolo Gian
and Jin, Xuejing
and Xie, Feng",
title="A Computer-Assisted Personal Interview App in Research Electronic Data Capture for Administering Time Trade-off Surveys (REDCap): Development and Pretest",
journal="JMIR Formativ Res",
year="2018",
month="Jan",
day="23",
volume="2",
number="1",
pages="e3",
keywords="computer-assisted personal interview",
keywords="health-related quality-of-life",
keywords="REDCap",
keywords="time trade-off",
abstract="Background: The time trade-off (TTO) task is a method of eliciting health utility scores, which range from 0 (equivalent to death) to 1 (equivalent to perfect health). These scores numerically represent a person's health-related quality of life. Software apps exist to administer the TTO task; however, most of these apps are poorly documented and unavailable to researchers. Objective: To fill the void, we developed an online app to administer the TTO task for a research study that is examining general public proxy health-related quality of life estimates for persons with Alzheimer's disease. This manuscript describes the development and pretest of the app. Methods: We used Research Electronic Data Capture (REDCap) to build the TTO app. The app's modular structure and REDCap's object-oriented environment facilitated development. After the TTO app was built, we recruited a purposive sample of 11 members of the general public to pretest its functionality and ease of use. Results: Feedback from the pretest group was positive. Minor modifications included clarity enhancements, such as rearranging some paragraph text into bullet points, labeling the app to delineate different question sections, and revising or deleting text. We also added a research question to enable the identification of respondents who know someone with Alzheimer's disease. Conclusions: We developed an online app to administer the TTO task. Other researchers may access and customize the app for their own research purposes. ",
doi="10.2196/formative.8202",
url="http://formative.jmir.org/2018/1/e3/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30684429"
}