JMIR Formative Research

Primary health care (PHC) delivery in Pakistan is constrained by persistent workforce shortages, which are further exacerbated by the attrition of trained female physicians following marriage or childbirth. Telehealth platforms, such as Sehat Kahani, have emerged as one response to this gap, enabling female physicians to provide remote primary care from home. Within this model, a digital decision support system (DDSS) was recently piloted for selected febrile illnesses to strengthen clinical decision-making. However, evidence on how such systems are perceived by female PHC providers in low-income and middle-income country settings remains limited. In particular, there is limited understanding of how perceived usefulness, ease of use, and perceived impact on quality of care shape the early adoption of DDSS within tele-PHC workflows.

Postpartum hemorrhage requiring a blood transfusion is a concern for patients and clinicians; its risk and the mode of delivery are important points of discussion before labor. Many high-risk factors associated with postpartum hemorrhage are known prior to delivery and are often unpreventable. Delivery plans are influenced by the patient’s medical history, their preferences, and clinical decision-making. Informed consent regarding known risk factors for postpartum hemorrhage will help guide delivery care plans and mitigate risk. Machine learning models have been used to predict postpartum hemorrhage; however, translation into clinical support tools is challenging. Shared decision-making discussions can be facilitated with machine learning model–based clinical support tools predicting postpartum hemorrhage requiring a transfusion.

Automated machine learning (AutoML) frameworks can lower technical barriers for predictive and prognostic model development in radiomics by enabling researchers without programming expertise to build models. However, their effectiveness in addressing radiomics-specific challenges remains unclear.

Climate change is expected to cause more than 250,000 deaths annually by 2050 and could increase the prevalence of asthma and chronic obstructive pulmonary disease (COPD) by up to 30%. Pressurized metered-dose inhalers (pMDIs), primarily delivering short-acting beta-2 agonists, generate 15 to 30 times more greenhouse gas emissions than dry powder or soft mist inhalers. In France, short-acting beta-2 agonist pMDIs account for 95% of reliever therapy prescriptions, despite their limited effectiveness in controlling disease symptoms.

Adolescent sleep duration can substantially impact mood, behavior, and academic attainment. While hundreds of sleep-related apps are available to download, none have been cocreated with adolescents from underserved populations in the United Kingdom.

Latino/a/x adults have higher rates of unmet mental health needs than other racial and ethnic groups. One promising solution to help bridge this gap in care is digital mental health tools. Digital tools, such as self-help websites, have demonstrated the ability to enhance mental health literacy, reduce stigma, and improve mental health symptoms. Despite the potential benefits, engagement remains a critical challenge, and there has been a large oversight of unique considerations for Latino/a/x adults as end users.

Osteoporosis is a major global health challenge, but treatment uptake and long-term adherence remain low, raising the risk of future fractures. Barriers to effective care include low patient awareness, financial constraints, and challenges with ongoing monitoring and follow-up. Although mobile health and telemedicine tools can support chronic disease management, many osteoporosis apps lack clinical validation and structured medication management features.

Posttraumatic stress disorder (PTSD) is associated with significant health and societal economic burdens, making treatment a priority. There are effective treatments, but there is no indication at this point which treatments will work best for which patients. Patient decision aids (DAs) are evidence-based tools designed to support patients and providers in weighing the benefits and risks of different treatment options and in making value-informed choices as one part of shared decision-making. The National Center for PTSD published an online PTSD Treatment DA in 2017.

Maintaining stable glucose levels is important for metabolic health. Glucose excursions (GEs), which are marked increases in glucose following food intake, have been associated with a higher risk for cardiovascular disease and metabolic dysfunction. Individuals with overweight or obesity who do not have diabetes may still show impaired glucose regulation, as reflected in increased glucose variability. Hunger, as a real-time physiological cue, may be associated with subsequent glucose changes and represents a potential target for just-in-time adaptive interventions.

Chronic insomnia is a highly prevalent sleep disorder that adversely affects quality of life and mental health. Cognitive behavioral therapy for insomnia (CBT-I) is internationally recommended as the first-line treatment, and digital CBT-I (dCBT-I) has been developed to improve accessibility and scalability. While existing dCBT-I systems effectively support structured behavioral training through standardized protocols, they provide relatively limited support for users’ cognitive exploration and meaning-making processes, particularly in helping users reflect on and internalize the rationale behind CBT-I practices in daily life. These limitations may contribute to challenges in sustained engagement and long-term adherence.

Cardiac rehabilitation (CR) is an evidence-based, multicomponent intervention. However, participation in and reach of CR remain suboptimal globally. Digital CR is a promising alternative to traditional center-based CR, with the potential to increase intervention reach and efficiency. However, efforts to increase the efficiency of digital CR require an understanding of the relative effectiveness of the components of CR, which is currently lacking. The Multiphase Optimization Strategy provides a framework to evaluate the effects of individual components within complex interventions.

More than 80% of breast cancer survivors do not meet the recommended levels of exercise, and <50% of health care providers promote exercise as part of survivorship care. Patient-provider communication may enhance exercise engagement by increasing patients’ understanding of exercise benefits and linking patients to resources, such as rehabilitation and exercise programs.