%0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e66979 %T Assessing the Impact of a Virtual Reality Cognitive Intervention on Tennis Performance in Junior Tennis Players: Pilot Study %A Anguera,Joaquin A %A Choudhry,Aleem %A Seaman,Michael %A Fedele,Dominick %+ Neuroscape, Department of Neurology and Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA, 94158, United States, 1 415 702 4322, joaquin.anguera@ucsf.edu %K executive function %K serious games %K cognitive training %K performance enhancement %K athletes %K sport %K pilot study %K VR %K virtual reality %K serious game %K tennis %K adolescents %K teenagers %K youth %K randomized controlled trial %K players %D 2025 %7 7.2.2025 %9 Short Paper %J JMIR Form Res %G English %X Background: There is evidence that cognitive training interventions can positively impact executive functions, and that some studies have demonstrated that athletes typically exhibit greater accuracy and faster response times on select cognitive tasks. While the engagement of executive functions is suggested to be part of high-level sporting activities, it is unclear whether such training approaches could directly benefit athletic performance. Objective: The objective of this study was to evaluate the impact of a combined virtual reality (VR)– and tablet-based cognitive training intervention on adolescent tennis players’ performance. Here, we examined differences in Universal Tennis Rating (UTR) between players who supplemented their regular tennis training with a cognitive training intervention and a group that continued regular tennis training alone. This custom cognitive training program targeted specific cognitive control abilities including attention, working memory, and goal management. Methods: Data were collected from a cohort of tennis players in a randomized controlled trial design led by the dedicated research team. Participants (N=23, age: mean 14.8, SD 2.4 years) from the Czech Lawn Tenis Klub (Prague, Czech Republic) were invited to participate in this study. These individuals were randomized into an intervention + training-as-usual group (n=13) or training-as-usual group (control group; n=10), with the change in UTR score being the primary metric of interest. Results: There was no difference in UTR between the 2 groups at baseline (intervention: mean 8.32, SD 2.7; control: mean 7.60, SD 2.3). Following the treatment period, individuals in the intervention group showed a significant improvement in their UTR (an increase of 0.5; t12=4.88, P<.001) unlike the control group (an increase of 0.02; t9=1.77, P=.12). On comparing the change in UTR (posttraining UTR minus pretraining UTR) attained by each group, we found that the intervention group had a 38% greater improvement in UTR than the control group. An analysis of covariance revealed a significantly greater improvement in UTR for the intervention group than for the control group (F1,20=8.82, P=.008). Conclusions: The present findings suggest that training cognitive abilities through an immersive visual platform may benefit athletic performance, including tennis. Such a result warrants careful consideration, given the known difficulties in evidencing far transfer not only in cognitive studies but also in athletic activities. These preliminary pilot findings suggest that the Mastermind Cognitive Training program may be a viable tool for supplementing athletic training practices, although this result warrants further investigation and replication. However, many questions remain unanswered, and further work is needed to better understand the potential utility and mechanisms underlying potential effects of such a platform. %M 39918854 %R 10.2196/66979 %U https://formative.jmir.org/2025/1/e66979 %U https://doi.org/10.2196/66979 %U http://www.ncbi.nlm.nih.gov/pubmed/39918854 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e64483 %T Identifying the Minimal Clinically Important Difference in Emotion Regulation Among Youth Using the JoyPop App: Survey Study %A Charlton,Jaidyn %A Malik,Ishaq %A Ashley,Angela M %A Newton,Amanda %A Toombs,Elaine %A Schmidt,Fred %A Olthuis,Janine V %A Stasiuk,Kristine %A Bobinski,Tina %A Mushquash,Aislin %+ Department of Psychology, Lakehead University, 955 Oliver Road, Thunder Bay, ON, Canada, 1 8073438010 ext 8771, aislin.mushquash@lakeheadu.ca %K mHealth %K mobile health %K app %K psychometrics %K emotion regulation %K Indigenous mental health %K Indigenous youth %K mental health interventions %K resilience %K clinical psychology %K adolescent mental health %K mental health %K JoyPop %K pediatrics %K mobile phone %D 2025 %7 23.1.2025 %9 Short Paper %J JMIR Form Res %G English %X Background: The minimal clinically important difference (MCID) is an important threshold to consider when evaluating the meaningfulness of improvement following an intervention. The JoyPop app is an evidence-based smartphone app designed to improve resilience and emotion regulation. Information is needed regarding the JoyPop app’s MCID among culturally diverse youth. Objective: This study aims to calculate the MCID for youth using the JoyPop app and to explore how the MCID may differ for a subset of Indigenous youth. Methods: Youth (N=36; aged 12-18 years) were recruited to use the JoyPop app for up to 4 weeks as part of a larger pilot evaluation. Results were based on measures completed after 2 weeks of app use. The MCID was calculated using emotion regulation change scores (Difficulties in Emotion Regulation–Short Form [DERS-SF]) and subjective ratings on the Global Rating of Change Scale (GRCS). This MCID calculation was completed for youth overall and separately for Indigenous youth only. Results: A significant correlation between GRCS scores and change scores on the DERS-SF supported face validity (r=–0.37; P=.04). The MCID in emotion regulation following the use of the JoyPop app for youth overall was 2.80 on the DERS-SF. The MCID for Indigenous youth was 4.29 on the DERS-SF. In addition, most youth reported improved emotion regulation after using the JoyPop app. Conclusions: These MCID findings provide a meaningful threshold for improvement in emotion regulation for the JoyPop app. They provide potential effect sizes and can aid in sample size estimations for future research with the JoyPop app or e-mental health technologies in general. The difference between overall youth and Indigenous youth MCID values also highlights the importance of patient-oriented ratings of symptom improvement as well as cultural considerations when conducting intervention research and monitoring new interventions in clinical practice. %M 39847426 %R 10.2196/64483 %U https://formative.jmir.org/2025/1/e64483 %U https://doi.org/10.2196/64483 %U http://www.ncbi.nlm.nih.gov/pubmed/39847426 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e53510 %T Occurrence of Stigmatizing Documentation Among Hospital Medicine Encounters With Opioid-Related Diagnosis Codes: Cohort Study %A Bradford,William S %A Bratches,Reed W R %A Porras,Hollie %A Chen,David R %A Gagnon,Kelly W %A Ascher,Simon B %+ Division of Infectious Diseases, University of Alabama Birmingham, Boshell Building 8th floor, 1808 7th Ave S, Birmingham, AL, 35233, United States, 1 205 934 8610, wsbradford@uabmc.edu %K stigmatizing language %K OUD %K opioid use disorder %K people with opioid use disorder (POUD) %K people who inject drugs (PWID) %K people who use drugs (PWUD) %K drug use %D 2024 %7 24.10.2024 %9 Short Paper %J JMIR Form Res %G English %X Background: Physician use of stigmatizing language in the clinical documentation of hospitalized adults with opioid use is common. However, patient factors associated with stigmatizing language in this setting remain poorly characterized. Objective: This study aimed to determine whether specific demographic factors and clinical outcomes are associated with the presence of stigmatizing language by physicians in the clinical documentation of encounters with opioid-related ICD-10 (International Statistical Classification of Diseases, Tenth Revision) codes. Methods: Hospital encounters with one or more associated opioid-related ICD-10 admission diagnoses on the hospital medicine service during the 2020 calendar year were analyzed for the presence of stigmatizing language in history and physical and discharge summaries. Multivariable adjusted logistic regression models were used to determine associations of age, race, gender, medication for addiction treatment use, against medical advice discharge, homelessness, comorbid polysubstance use, comorbid psychiatric disorder, comorbid chronic pain, cost, and 30-day readmission with the presence of stigmatizing language. Results: A total of 221 encounters were identified, of which 64 (29%) encounters had stigmatizing language present in physician documentation. Most stigmatizing language was due to use of “substance abuse” rather than the preferred term “substance use” (63/66 instances). Polysubstance use and homelessness were independently associated with the presence of stigmatizing language (adjusted odds ratio [aOR] 7.83; 95% CI 3.42-19.24 and aOR 2.44; 95% CI 1.03-5.90) when controlling for chronic pain and other covariates. Conclusions: Among hospital medicine encounters with an opioid-related diagnosis, stigmatizing language by physicians in clinical documentation was common and independently associated with comorbid polysubstance use and homelessness. %M 39447164 %R 10.2196/53510 %U https://formative.jmir.org/2024/1/e53510 %U https://doi.org/10.2196/53510 %U http://www.ncbi.nlm.nih.gov/pubmed/39447164 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e56327 %T Impact of COVID-19 on Characteristics and Funding of U.S. Healthcare Startups: Retrospective Review %A Ganeshan,Smitha %A Goldstein,Joshua %A Sohn,Young-Jin %A Pollack,Amie %A Phillips,Russell S %A Rotenstein,Lisa %+ Division of Hospital Medicine, Department of Medicine, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94117, United States, 1 4155141000, smitha.ganeshan@ucsf.edu %K artificial intelligence %K venture capital %K COVID-19 %K health care startup %K health care %K AI %K retrospective study %K telehealth %K telemedicine %K pandemic %K patients %K digital health %K coronavirus %D 2024 %7 27.8.2024 %9 Short Paper %J JMIR Form Res %G English %X Background: The rise of telehealth and telemedicine during the pandemic allowed patients and providers to develop a sense of comfort with telehealth, which may have increased the demand for virtual-first care solutions with spillover effects into venture capital funding. Objective: We aimed to understand the size and type of digital health investments occurring in the prepandemic and pandemic periods. Methods: We examined health care companies founded from March 14, 2019, to March 14, 2020 (prepandemic) versus those founded from March 15, 2020, to March 14, 2022, after pandemic onset. Data were obtained from Crunchbase, a publicly available database that catalogs information about venture capital investments for companies. We also compared companies founded prepandemic to those founded after the first year of the pandemic (pandemic steady-state). We performed a Wilcoxon rank sum test to compare median funding amounts. We compared the 2 groups of companies according to the type of funding round raised, geography, health care subcategory, total amount of funding per year since founding, and number of founders. Results: There were 2714 and 2218 companies founded prepandemic and during the pandemic, respectively. The companies were similarly distributed across geographies in the prepandemic and pandemic periods (P=.46) with no significant differences in the number of founders (P=.32). There was a significant difference in total funding per year since founding between prepandemic and pandemic companies (US $10.8 million vs US $20.9 million; P<.001). The distribution of funding rounds differed significantly for companies founded in prepandemic and pandemic periods (P<.001). On excluding data from the first year of the pandemic, there were 581 companies founded in the pandemic steady-state period from March 14, 2021, to March 14, 2022. Companies founded prepandemic had a significantly greater mean number of founders than those founded during the pandemic (P=.02). There was no significant difference in total funding per year since founding between prepandemic and steady-state pandemic companies (US $10.8 million vs US $14.4 million; P=.34). The most common types of health care companies included wellness, biotech/biopharma, and software companies. Distributions of companies across health care subcategories were not significantly different before and during the pandemic. However, significant differences were identified when data from the first year of the pandemic were excluded (P<.001). Companies founded during the steady-state pandemic period were significantly more likely to be classified as artificial intelligence (7.3% vs 4.7%; P=.005), software (17.3% vs 12.7%; P=.002), and insurance (3.3% vs 1.7%; P=.003), and were significantly less likely to be classified as health care diagnostics (2.4% vs 5.1%; P=.002). Conclusions: We demonstrate no significant changes in the types of health care companies founded before versus during the pandemic, although significant differences emerge when comparing prepandemic companies to those founded after the first year of the pandemic. %M 39190909 %R 10.2196/56327 %U https://formative.jmir.org/2024/1/e56327 %U https://doi.org/10.2196/56327 %U http://www.ncbi.nlm.nih.gov/pubmed/39190909 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e43022 %T Using a Smartphone-Based Chatbot for Postoperative Care After Intravitreal Injection During the COVID-19 Pandemic: Retrospective Cohort Study %A Wu,Pei-Chang %A Chiang,Wei-Yu %A Lo,Jung %A Lee,Jong-Jer %A Chen,Yung-Jen %A Kuo,Hsi-Kung %A Chiau,Jie-Shin %A Hsu,Shu-Hui %A Chen,Yi-Hao %+ Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Da-Pi Road, Niao-Sung District, Kaohsiung, 88301, Taiwan, 886 77317123 ext 2801, kaneyhc@gmail.com %K smartphone chatbot %K postoperative care %K intravitreal injection %K age-related macular degeneration %K self-report, endophthalmitis %K COVID-19 %D 2024 %7 2.8.2024 %9 Short Paper %J JMIR Form Res %G English %X Background: During the COVID-19 pandemic period, it was difficult to carry out regular and scheduled follow-up of patients in the outpatient department, especially during lockdown periods. However, early detection of initial infection or other serious conditions is vital for patients after ocular surgery, such as intravitreal injection (IVI) for age-related macular degeneration (AMD). Objective: We evaluated the use of a smartphone-based postoperative care chatbot system (PCCS) with an instant bidirectional feedback system for patients to self-report postoperative symptoms and signs. Methods: During the COVID-19 level 3 epidemic alert in July 2021 in Taiwan, the PCCS alerted the patients to report and grade 6 ocular symptoms and signs associated with ocular inflammation or retinal detachment. Patients used the PCCS for 7 days post surgery to assess their symptoms and signs each day after receiving an alert. Data were automatically collected using a cloud computer system, including symptom grades and messages sent to medical staff for further medical assistance. A user satisfaction questionnaire was administered to the patients on the seventh day post surgery. Results: In total, 185 patients participated in this study. There were 26 (3.03%) reports of symptom grade deterioration (including increased blurred vision, eye swelling, nausea, and floaters or flashes) from 12 (6.5%) patients. We found no difference in the gender of patients who received an early medical consultation. One case of endophthalmitis was reported, wherein an improvement was observed after prompt administration of IVI antibiotics twice. Overall, 87% (n=185) of patients were satisfied or very satisfied with communicating their symptoms instantly through the app; they were willing to use it again and believed that it could improve the quality of care. Seven of the 185 (3.8%) patients had an earlier medical consultation and 1 (0.5%) had endophthalmitis. Conclusions: The chatbot system, designed for self-reporting postoperative symptoms and providing instant bidirectional feedback on smartphones, could be beneficial for enhancing the quality of care in early medical consultations without gender differences among patients with AMD receiving IVI, and achieved satisfactory responses from patients. %M 38643063 %R 10.2196/43022 %U https://formative.jmir.org/2024/1/e43022 %U https://doi.org/10.2196/43022 %U http://www.ncbi.nlm.nih.gov/pubmed/38643063 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e52583 %T Tailoring of Health-Promotion Video Messaging for Reproductive-Aged Women at Risk for Developing Cardiometabolic Disease: Qualitative Focus-Groups Study %A Kent-Marvick,Jacqueline %A Gibson,Bryan %A Bristol,Alycia A %A St Clair,Stephanie %A Simonsen,Sara E %+ College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, United States, 1 4356686932, jacqueline.kent-marvick@utah.edu %K cardiometabolic disease %K type 2 diabetes mellitus %K gestational diabetes mellitus %K hypertensive disorder of pregnancy %K prediabetes %K obesity %K women’s health %K lifestyle change %K health promotion technology %K qualitative research %D 2024 %7 5.3.2024 %9 Short Paper %J JMIR Form Res %G English %X Background: Targeting reproductive-aged women at high risk for type 2 diabetes (T2D) provides an opportunity for prevention earlier in the life course. A woman’s experiences during her reproductive years may have a large impact on her future risk of T2D. Her risk is 7 to 10 times higher if she has had gestational diabetes (GDM). Despite these risks, T2D is preventable. Evidence-based programs, such as the National Diabetes Prevention Program (DPP), can reduce the risk of developing T2D by nearly 60%. However, only 0.4% of adults with prediabetes have participated in the DPP to date and reproductive-aged women are 50% less likely to participate than older women. In prior work, our team developed a mobile 360° video to address diabetes risk awareness and promote DPP enrollment among at-risk adults; this video was not designed, however, for reproductive-aged women. Objective: This study aims to obtain feedback from reproductive-aged women with cardiometabolic disease risk about a 360° video designed to promote enrollment in the DPP, and to gather suggestions about tailoring video messages to reproductive-aged women. Methods: Focus groups and a qualitative descriptive approach were used. Women with at least 1 previous pregnancy, aged 18 to 40 years, participated in one of three focus groups stratified by the following health risks: (1) a history of GDM or a hypertensive disorder of pregnancy, (2) a diagnosis of prediabetes, or (3) a BMI classified as obese. Focus-group questions addressed several topics; this report shared findings regarding video feedback. The 3 focus-group discussions were conducted via Zoom and were recorded and transcribed for analysis. Deductive codes were used to identify concepts related to the research question and inductive codes were created for novel insights shared by participants. The codes were then organized into categories and themes. Results: The main themes identified were positive feedback, negative feedback, centering motherhood, and the importance of storytelling. While some participants said the video produced a sense of urgency for health-behavior change, all participants agreed that design changes could improve the video’s motivating effect on health-behavior change in reproductive-aged women. Participants felt a tailored video should recognize the complexities of being a mother and how these dynamics contribute to women’s difficulty engaging in healthy behaviors without stirring feelings of guilt. Women desired a video with a positive, problem-solving perspective, and recommended live links as clickable resources for practical solutions promoting health behavior change. Women suggested using storytelling, both to describe how complications experienced during pregnancy impact long-term health and to motivate health behavior change. Conclusions: Reproductive-aged women require tailored lifestyle-change messaging that addresses barriers commonly encountered by this population (eg, parenting or work responsibilities). Moreover, messaging should prioritize a positive tone that harnesses storytelling and human connection while offering realistic solutions. %M 38441920 %R 10.2196/52583 %U https://formative.jmir.org/2024/1/e52583 %U https://doi.org/10.2196/52583 %U http://www.ncbi.nlm.nih.gov/pubmed/38441920