JMIR Formative Research
Process evaluations, early results, and feasibility/pilot studies of digital and non-digital interventions
Editor-in-Chief:
Amaryllis Mavragani, PhD, Scientific Editor at JMIR Publications, Canada
Impact Factor 2.4 More information about Impact Factor CiteScore 4.2 More information about CiteScore
Recent Articles

Pregnancy-related weight gain is both physiologically complex and socially charged, and online discussions often combine clinical information with implicit emotional distress. Although automated sentiment analysis could support research on pregnancy-related discourse, model performance in this context remains inadequately characterized relative to expert human judgment.

Atrial fibrillation (AF) affects more than 33 million people globally, with many cases remaining undiagnosed due to the paroxysmal nature of the condition. Current portable AF detection devices require additional hardware, and their cost may limit their accessibility in community screening programs. Facial camera–based remote photoplethysmography (rPPG) is a novel alternative to conventional fingertip-based photoplethysmography (PPG) that enables contact-free cardiac rhythm assessment.

Community-acquired pneumonia in frail older people requiring hospital admission is considered to be commonly associated with swallowing difficulties (dysphagia). A rehabilitation program (chin tuck against resistance [CTAR]) targeting the anterior neck musculature involved in laryngeal movement can improve swallowing safety. We have developed a swallowing exercise rehabilitation intervention (CTAR-SwiFt [Chin Tuck Against Resistance Exercise With Feedback to Improve Swallowing, Eating, and Drinking in Frail Older People Admitted to Hospital With Pneumonia]) by adapting a previously established swallowing exercise. The CTAR-SwiFt intervention consists of a feedback-enabled exercise ball that can be squeezed under the chin, with real-time feedback provided via a mobile app.

An estimated 18‐23 million Americans have had long COVID (LC), yet 54% and 72% of US physicians reported not being confident in diagnosing and treating LC, respectively. Continuing medical education (CME) is crucial to maintaining and improving clinical skills, and CME that incorporates need-based educational methods is associated with improved patient outcomes. Given limited clinician familiarity with LC, there is a need for an effective, widely accessible LC CME program.

Research on fitness technologies to support older adults has grown significantly. However, reviews of older adult fitness technologies found mixed results and their use in practice by older adults lags behind other age groups. Our previous work, a scoping review, showed a lack of alignment between proposed technologies and expressed needs and preferences of older adults. We present the Older Adult Fitness Design Framework aimed to address this gap and use a proof-of-concept case study of a “smart chair” as an example of the framework in use.

Substantial unwarranted variations exist in laboratory test ordering practices in the emergency department (ED), despite a plethora of digital health interventions to facilitate laboratory test ordering consistent with best-practice recommendations. Drivers of such variation are many and varied and deeply ingrained within organizational culture and work practices. An appreciation of the impact of contextual factors on digital health implementation is essential for achieving intended outcomes.

Digital mental health has become increasingly capable of representing and adapting to individuals in time. When support is delivered through another person, however, the relevant decision context includes conditions that cannot be specified from the primary user alone. This viewpoint proposes making selected conditions relevant to a support decision within a specified relationship explicit. We introduce relational ecological momentary assessment (REMA) as a conceptual method for representing these conditions in a relational decision space. In its initial dyadic implementation, REMA combines a low-burden report of the primary user’s emotional zone (Z) with supporter contact availability (Cp) and supporter capacity (Cs). The meaning of these reports depends on the relationship and the proposed form of support. Willingness, consent, and safety determine whether an action is permissible to consider, while data validity concerns whether the reports are current and interpretable. These conditions and rules delimit relational support eligibility by specifying which classes of support can still be considered. Coregulation as a reciprocal temporal process remains outside the scope of this implementation. We situate the proposal within research on ecological momentary assessment, just-in-time adaptive interventions, dyadic digital health, and systemic digital mental health; provide a hypothetical implementation example; and show how 1 Z report can inform separate decisions involving different supporters. REMA remains conceptual and requires empirical evaluation. Its broader proposition is that when digital health recruits another person, the decision-relevant conditions across that specified relationship should be made explicit.


Transitions of care, where patients move between clinical settings or providers, pose considerable risks to patient safety, situations exacerbated by the absence of adequate digital infrastructure that enables information exchange. The timeliness and accuracy of medication information transfer are central to ensuring patient safety during transitions of care, including post-discharge from the hospital. In designing a multifaceted digital intervention to support the transfer of medication information from hospital to community settings, it was necessary to gauge the views of all relevant stakeholders on the practical challenges involved in transferring medication information.

Mobile health is emerging as a ubiquitous paradigm for delivering health care interventions when self-management is feasible. However, interventions targeting older or frail participants should account for age-related cognitive, visual, and physical needs to optimize usability and long-term retention.

Virtual consultations (VCs), including telephone and video consultations, are increasingly central to primary care. However, evaluation often prioritizes patient satisfaction or technology over quality and safety. Existing frameworks incorporate limited input from general practitioners (GPs) and lack standardized quality and safety indicators.
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