Using Natural Language Processing to Facilitate Qualitative #Research: Dementia Experiences in EHR Free Text (preprint) #openscience #PeerReviewMe #PlanP

Inequities in health care start with bias, it's time to change that.
JMIR Medical Education is calling for papers on a new theme issue: Bias, Diversity, Inclusion & Cultural Competence in Medical Education.
🗓️ Submission deadline: July 31, 2026
Learn more: mededu.jmir.org/announcement...

In her first JMIR News and Perspectives article, Vanessa Nirode, examines how standard pain scales often fail to reflect lived experience. As one patient notes, even drawing pain on a diagram highlights the limits of reducing pain to numbers.
Read more: www.jmir.org/2026/1/e97777

Reminder>> Multimodal Symptom-to-ICD-11 Group Classification with External Validation Across Emergency Departments (preprint) #openscience #PeerReviewMe #PlanP

A Risk-Aware Pseudotime Approach for Modeling Heart Failure Progression: A Geometric Analysis of Longitudinal #EHR Data Date Submitted: Mar 27, 2026. Open Peer Review Period: Apr 17, 2026 - Jun 12, 2026.

Reminder>> A Risk-Aware Pseudotime Approach for Modeling Heart Failure Progression: A Geometric Analysis of Longitudinal #EHR Data (preprint) #openscience #PeerReviewMe #PlanP

Moderators of the Effectiveness of a Web-Based Mindfulness Intervention (MINDxYOU) on Perceived Stress in Healthcare Professionals: Secondary Analysis of a Stepped-Wedge Cluster Randomized Trial (preprint) #openscience #PeerReviewMe #PlanP

Dressing, Dignity, and Data: Exploring Apparel-Integrated Technologies Supporting Aging-in-Place with Dementia Date Submitted: Apr 17, 2026. Open Peer Review Period: Apr 18, 2026 - Jun 13, 2026.

Dressing, Dignity, and Data: Exploring Apparel-Integrated Technologies Supporting Aging-in-Place with Dementia (preprint) #openscience #PeerReviewMe #PlanP

Effects of a Modified Exposure Claim for an e-Cigarette on Claim Comprehension, Behavioral Intentions, and Risk Perceptions Among US Adult Tobacco Users and Nonusers: Randomized Experimental Study Background: Effective communication about the relative risks of cigarettes and e-cigarettes can help increase switching away from cigarettes while minimizing unintended use. Objective: This study examined comprehension of a proposed modified exposure claim (MEC) about an e-cigarette (IQOS VEEV, the study product [SP]) and the effects of claim exposure on SP use intentions and risk perceptions among adult tobacco users and nonusers. Methods: Adult smokers with no intention to quit smoking (S-NIQ, n=606), adult smokers with an intention to quit smoking (S-IQ, n=600), adult e-cigarette users (ECU, n=630), adult former smokers (FS, n=619), adult tobacco and nicotine products (TNP) never-users aged 18-24 years (n=648), and adult TNP never-users aged 25 years and older (n=749; total N=3852) participated in a randomized between-groups online experimental study. Participants viewed a marketing brochure for the SP with (test condition) or without (control condition) an embedded MEC. Outcome measures included claim comprehension, intention to use the SP regularly, and perceived health risk to self from using the SP or smoking cigarettes. Results: Most participants were female (n=2110, 54.8%), had a mean age of 40.2 (SD 14.93) years, and were equally split across the 4 US regions. S-IQ and S-NIQ were long-term, frequent cigarette smokers, while 91.4% (566/619) of FS were long-term quitters. ECU on average used e-cigarettes ≥15.2 times per day, and the majority of them (552/630, 87.6%) had started using e-cigarettes more than 12 months before. Most participants correctly understood the key elements of the claim: the SP produces lower levels of harmful chemicals compared to cigarettes (1818/1926, 94.4%), and switching completely from cigarettes to the SP reduces exposure to harmful chemicals (1832/1926, 95.1%). In both conditions, positive intention to use the SP was high among ECU (control: 238/314, 75.8% vs test: 249/315, 79%; P=.33), moderate among S-IQ (control: 127/299, 42.5%; test: 166/299, 55.5%; P

JMIR Formative Res: Effects of a Modified Exposure Claim for an e-Cigarette on Claim Comprehension, Behavioral Intentions, and Risk Perceptions Among US Adult Tobacco Users and Nonusers: Randomized Experimental Study #TobaccoControl #PublicHealth #Nicotine #ECigarettes #SmokingCessation

Access to Technology-Mediated Community Mental Health Care Among Low-Socioeconomic Status Consumers With Serious Mental Illness: Qualitative Study Background: Access to mental health care is critical for the effective management of serious mental illness (SMI), but consumers with low socioeconomic status (SES) have lower rates of service usage and worse retention in care. Digital technologies are often lauded as a way to bridge access gaps; however, little is known about how technology-mediated care may influence care access among low-SES consumers and how consumers use technology in care access. Objective: This study aimed to examine the applicability of Levesque et al’s access framework to technology-mediated care for SMI and analyze how low-SES consumers use technology to facilitate care access. Furthermore, the study assesses whether and how technologies are involved in care access at multiple points within the process of accessing care. Methods: This study used 2 qualitative methods: ethnographic observations at a mental health treatment court and interviews with low-SES consumers with SMI using community mental health care (n=14) and key informant interviews with health and service providers working with this population (n=14). Observations occurred from July 2022 through September 2023, and interviews occurred between January 2022 and May 2024. Data analysis involved both inductive and deductive coding approaches. Data from both the interviews and observations were analyzed in NVivo and further triangulated through analytic memos. Results: Levesque et al’s framework required several extensions to accommodate technology-mediated care related to SMI for low-SES consumers: (1) a cyclical rather than linear trajectory; (2) simultaneous care acquisition from multiple health and service providers; (3) staying in care long-term; (4) identification of both one-time and ongoing health needs; and (5) an emergency pathway for entering care. Consumers often faced challenges related to the varied digital requirements of each provider and a dearth of integrative, patient-facing tools like portals. Within this context, some consumers use mobile apps, communication, and telehealth technologies across various care access stages. Consumers used technology by figuring out how to navigate technology-mediated care, especially by leaning on others, such as case managers, for support. These others provided consumers with temporary technologies, showed them how to use technologies, and accompanied them through the process of using technology for accessing care. Conclusions: This study highlights that accessing care is iterative and ongoing, involving multiple forms of co-occurring service provision. A theoretical contribution of this work is its extension of Levesque et al’s care access framework to better reflect technology-mediated care for SMI among low-SES consumers. This work also underscores ongoing challenges for accessing technology-mediated care and the importance of human support in addressing access difficulties. Clinical implications include incorporating digital readiness assessments and providing comprehensive guidance on how consumers can effectively use technologies for care. Future work should investigate how technology-mediated care can make care access easier rather than harder.

JMIR Formative Res: Access to Technology-Mediated Community Mental Health Care Among Low-Socioeconomic Status Consumers With Serious Mental Illness: Qualitative Study #MentalHealth #TechnologyInHealth #DigitalHealth #HealthcareAccess #LowSES

Participants’ Perspectives and Experiences of #VirtualReality #VR-Supported #Psychotherapy for Negative Symptoms in Schizophrenia: A Qualitative #Study Embedded in the ENGAGE Trial Date Submitted: Apr 8, 2026. Open Peer Review Period: Apr 17, 2026 - Jun 12, 2026.

Reminder>> Participants’ Perspectives and Experiences of #VirtualReality #VR-Supported #Psychotherapy for Negative Symptoms in Schizophrenia: A Qualitative #Study Embedded in the ENGAGE Trial (preprint) #openscience #PeerReviewMe #PlanP

LLM-based conditional perplexity scoring distinguishes #Physician-verified diagnoses from incorrect differential diagnoses in case reports: a preliminary evaluation Date Submitted: Apr 19, 2026. Open Peer Review Period: Apr 19, 2026 - Jun 14, 2026.

LLM-based conditional perplexity scoring distinguishes #Physician-verified diagnoses from incorrect differential diagnoses in case reports: a preliminary evaluation (preprint) #openscience #PeerReviewMe #PlanP

Children’s Attitudes Toward Dementia: #Protocol for a Cross-Sectional #Study Background: #Research on dementia has primarily focused on adults, leaving a gap in understanding related to children’s attitudes toward dementia. This gap is relevant given the growing societal impact of dementia and the potential role of early education in shaping attitudes. Objective: The primary objective of this #Study is to assess attitudes toward dementia in a sample of Spanish primary school children. Secondary objectives include (1) examining the psychometric properties of the questionnaire developed for this #Study, (2) identifying factors associated with differing attitudes toward dementia, and (3) evaluating children’s social desirability and its correlation with questionnaire responses. Methods: A 23-item, tripartite Likert-type questionnaire (Cuestionario de Actitudes de los Niños Españoles Hacia la Demencia, or “Spanish Children’s Attitudes Toward Dementia Questionnaire”) was developed through a comprehensive literature review, a pilot #Study with a convenience sample of 10 children, and expert panel consultation. The #Study sample will comprise children aged 8 to 11 years enrolled in the fourth and fifth grades at 6 selected schools in the Community of Madrid, Spain. Participants will complete the questionnaire alongside a social desirability scale. Additional variables (eg, current or previous cohabitation with grandparents) will be collected to explore factors associated with differing attitudes toward dementia. Results: This #Study is not funded. Data collection began in January 2025 and is projected to conclude in January 2026. As of July 2025, a total of 164 participants from 3 selected schools have been recruited. Data analysis is expected to begin in January 2026, and results are planned for publication in 2027. Conclusions: This #Study represents a feasible and novel initiative that may enhance understanding of children’s attitudes toward dementia. The findings could inform the development of targeted educational interventions and support the inclusion of dementia-related content in school-based education. International Registered Report Identifier (IRRID): DERR1-10.2196/81576

JMIR Res Protocols: Children’s Attitudes Toward Dementia: #Protocol for a Cross-Sectional #Study

Safe@Campus Virtual Reality Training for Campus Shooting Preparedness: Prototype Development and #usability Study Background: Campus shootings, though infrequent, result in significant loss of life, psychological trauma, and disruption to university communities. Traditional preparedness programs developed for K-12 settings do not translate well to university environments. Virtual reality (VR) offers an immersive and engaging method to enhance situational awareness and decision-making during high-stress events. Objective: This study aimed to develop the Safe@Campus prototype, a theory-informed, stakeholder-engaged VR-based prototype designed to prepare university students to recognize and respond to campus shooting threats, and to evaluate its initial #usability and #feasibility among undergraduate students. Methods: We followed a 2-phase, user-centered design process. Phase I (stakeholder-informed #feasibility assessment and prototype refinement): through interviews with campus safety experts, firearm safety practitioners, school safety specialists, and students, we identified key content, scenario requirements, and implementation considerations. A 360-degree video–based VR prototype depicting an active shooter incident in a university classroom was developed using Unity3D, incorporating branching decision points aligned with the “run, hide, or fight” framework. Expert and user feedback guided iterative refinements. Phase II (student #usability and acceptability testing): 2 focus groups with undergraduates at The Ohio State University (N=17) viewed a VR scenario and then participated in guided discussions about prior training experiences, the acceptability of VR, and recommendations for improvement. Transcripts were analyzed using constant comparative methods in ATLAS.ti (version 25). Results: The first focus group comprised 8 students (n=5, 63% female; n=3, 38% White, n=4, 50% Asian/Asian American), and the second comprised 9 students (n=6, 67% female; n=6, 67% White). Across both groups, 82% (14/17) reported participating in active shooter drills during K-12 schooling, yet many felt these experiences did not adequately prepare them for the complexity of university environments. The following four major themes emerged: (1) prior experience with active shooter drills: K-12 drills varied widely in realism and left students uncertain about appropriate actions in university settings; (2) need for university-specific training: participants noted substantial gaps in preparedness and expressed strong support for required, standardized training; (3) perceived usefulness of VR: students found VR highly engaging, realistic, and effective for reinforcing situational awareness and decision-making; and (4) recommendations for prototype improvement: students suggested increasing interactivity, adding time-pressured decisions, expanding scenarios to diverse campus spaces, and integrating the program into required university activities such as orientation. Conclusions: Safe@Campus is a feasible, acceptable, and engaging VR-based approach to campus shooting preparedness. Students viewed the immersive, decision-driven format as an effective way to build practical skills not addressed by traditional training. Future development should expand scenario diversity, increase interactivity, and evaluate program effectiveness in larger trials. Trial Registration:

JMIR Formative Res: Safe@Campus Virtual Reality Training for Campus Shooting Preparedness: Prototype Development and #usability Study #CampusSafety #VirtualReality #ActiveShooterTraining #EmergencyPreparedness #HigherEducation

Spanish Version of the #mHealth #App Usability Questionnaire (S-MAUQ): Translation, Adaptation, and Validation Study Background: In the current #Digital landscape, ensuring optimal usability is one of the most crucial factors determining the success of any #Mobile #App. Questionnaire-based usability evaluations represent a highly prevalent methodology for this purpose. To date, questionnaires have been developed to assess the general system usability; however, there are hardly any questionnaires specifically designed to assess the usability of #Mobile #Health (#mHealth) apps. The most widespread, the #mHealth #App Usability Questionnaire (MAUQ), has been developed in 4 versions according to the type of #App (interactive or standalone) and the target user (patient or provider). Objective: The objective of this study was to translate and validate the English version of the MAUQ (standalone, for patients) into a Spanish version (S-MAUQ). Methods: The methodology used here follows that proposed by Sousa and Rojjanasrirat, which comprises 4 stages. The initial stage of the process entails a translation, harmonization, and adaptation procedure. The second and third entailed content validation (by 10 experts) and face validation (by 12 target users), respectively, which were conducted to evaluate the relevance and clarity of the questionnaire items. The item-level content validity index, scale content validity index (S-CVI), item-level face validity index, and scale face validity index (S-FVI), as well as the modified kappa statistic (κ) were used to evaluate interrater agreement among the raters, considering the probability of agreement by chance (Pc). The fourth and final stage of the process involved the assessment of the questionnaire’s reliability. A sample of 61 young adult participants installed an #mHealth #App (the Yazio #App), used it, and responded to the S-MAUQ. The Cronbach α value for the entire questionnaire and its subscales were then calculated. Results: For the second stage, the S-CVI was initially 0.778. We removed items #14 and #15 from the Spanish version as they were unclear and not relevant. The S-CVI changed to 0.881. The third stage had an S-FVI of 0.927, indicating that the items are clear and straightforward for the nonexpert target user to understand. Furthermore, with each κ value >0.74, the validity of the instrument is supported. The fourth stage demonstrated the reliability of the S-MAUQ with a Cronbach α value of 0.87. Conclusions: The final version of the S-MAUQ met the validation criteria, demonstrating reliability and validity that are comparable with those of the original version. Consequently, the S-MAUQ is suitable for evaluating the usability of #mHealth apps for young Spanish adults. Further research involving larger and more diverse samples is recommended.

New in JMIR mhealth: Spanish Version of the #mHealth #App Usability Questionnaire (S-MAUQ): Translation, Adaptation, and Validation Study

The Impact of Ontario’s Virtual Care Payment Model on Cancer Care: A Natural Policy Experiment

The Impact of Ontario’s Virtual Care Payment Model on Cancer Care: A Natural Policy Experiment

Overcoming the HIV Pre-Exposure Prophylaxis Uptake Barrier With A Health Action Process Approach and Conditional Economic Incentives Among Men Who Have Sex With Men #msm in 3 Chinese Cities: #Protocol for a #RCT #ClinicalTrial Background: Despite high pre-exposure prophylaxis (PrEP) awareness and willingness among Chinese Men Who Have Sex With Men #msm (MSM), actual uptake remains critically low. The health action process approach (HAPA) is a 2-phase theory that addresses both the motivational and volitional phases of health behavior change, making it suitable for tackling the intention-behavior gap in PrEP use. In China, where PrEP is not covered by national health insurance, financial barriers further hinder uptake. Group-based conditional economic incentives (GCEIs) represent an innovative strategy to address cost-related disincentives by leveraging peer influence. Objective: This #RCT #ClinicalTrial aims to evaluate the effectiveness of HAPA-driven interventions, both alone and combined with GCEI, to enhance PrEP initiation and adherence among high-risk, PrEP-naive MSM in China. Methods: High-risk HIV-negative MSM naïve to PrEP were recruited via community-based organizations in 3 Chinese cities. Participants underwent individual randomization to 3 arms: (1) HAPA-based cognitive behavioral intervention featuring tailored WeChat messages and 2 structured motivational interviews targeting stage-specific barriers; (2) combined HAPA intervention with GCEI linked to peer group initiation rates, incorporating facilitated offline group activities; or (3) standard care control receiving nonpersonalized HIV prevention information. The physician-prescribed PrEP initiation rate at 3 months serves as the primary outcome. Secondary outcomes include PrEP adherence, HIV risk perception, PrEP-related stigma, and intervention acceptability. Analysis follows intention-to-treat principles using mixed-effects models. Results: The #Study #Protocol received ethics approval in December 2024 and was funded in December 2025. As of August 2025, 3 community-based organizations in Mianyang, Zibo, and Hohhot have agreed to participate. Preliminary testing has led to refinements in the WeChat mini-program, questionnaires, and motivational interview scripts. Data collection commenced in October 2025 and is projected to be completed by August 2026. As of February 2026, baseline recruitment is complete, with 381 eligible participants enrolled and randomized. The baseline characteristics were balanced across the 3 arms. Outcome data will be collected after the intervention. Data analysis is ongoing, with full results expected to be published before December 2026. Conclusions: This #Study rigorously tests a novel intervention integrating the HAPA with a GCEI model. By addressing both individual cognitive-behavioral barriers and financial disincentives within a supportive group context, this approach offers a potentially scalable strategy to bridge the PrEP uptake gap in China. Findings will provide critical evidence on combining theory-driven behavioral techniques with peer-group economic incentives for HIV prevention. Trial Registration: ClinicalTrials.gov NCT06931106; https://clinicaltrials.gov/#Study/NCT06931106 International Registered Report Identifier (IRRID): PRR1-10.2196/82123

JMIR Res Protocols: Overcoming the HIV Pre-Exposure Prophylaxis Uptake Barrier With A Health Action Process Approach and Conditional Economic Incentives Among Men Who Have Sex With Men #msm in 3 Chinese Cities: #Protocol for a #RCT #ClinicalTrial

Clinical Effectiveness of Immersive Virtual Reality Exercise Interventions: Systematic Review and Meta-Analysis of Randomized Controlled Trials Background: Physical inactivity remains a global health concern, with only one in 5 adults meeting combined aerobic and muscle-strengthening guidelines. Exercise interventions delivered through immersive virtual reality (IVR) offer a novel mode of delivery. Little is known about the clinical effectiveness or feasibility of exercise via IVR across population groups. A detailed understanding of clinical effectiveness and feasibility is required for clinicians to decide whether to include IVR in exercise practice. Objective: The objective of this systematic review was to assess the clinical effectiveness of IVR interventions using aerobic or anaerobic exercise. Methods: A systematic review incorporating meta-analyses was conducted. Searches were conducted across PubMed, Embase, Web of Science, and CINAHL from inception until January 6, 2026. Randomized controlled trials including participants with an acute health condition, chronic disease, history of reconstructive or restorative surgery, and older adults implementing IVR exercise and reporting clinical effectiveness outcomes were included. Random effects meta-analyses were conducted for between-group comparisons for clinical effectiveness outcomes, grouped according to comparator group activity (exercising/nonexercising). Risk of Bias was assessed using the Cochrane Risk of Bias 2 tool and the certainty of evidence with Grading of Recommendations, Assessment, Development, and Evaluation. Results: Twenty-six trials with 846 total participants were included in this review, with 23 progressing to meta-analyses. Pooled analyses revealed a general trend for IVR, but no statistical differences with comparator intervention (exercising or nonexercising) for mobility and functional balance (exercising: standardized mean difference [SMD] −0.345, 95% CI −1.095 to 0.406; =.29; nonexercising SMD −0.322, 95% CI −0.931 to 0.288; =.22), functional leg strength (exercising: SMD −0.161, 95% CI −0.573 to 0.250; =.33; nonexercising: SMD −0.351, 95% CI −1.750 to 1.049; =.48), quality of life (exercising: SMD 0.036, 95% CI −0.444 to 0.516; =.84; nonexercising: SMD −0.053, 95% CI −0.839 to 0.728; =.80) or other outcome domains. Eighty percent of outcomes assessed were rated as “some concerns” (n=16) or at “high” (n=21) risk of overall bias. Grading of Recommendations, Assessment, Development, and Evaluation certainty grading was deemed to be “low” or “very low” for all outcomes. Conclusions: This systematic review incorporating meta-analyses provides initial evidence for the clinical effectiveness of IVR exercise interventions. This review differs from previous literature by systematically collecting and appraising evidence exclusively from IVR aerobic/anaerobic exercise interventions from across a variety of populations and settings, and including a broad range of clinical effectiveness outcomes. Initial evidence may suggest that IVR exercise does not seem to statistically differ from comparators for clinical effectiveness outcomes. However, high heterogeneity, substantial risk of bias among trials, and “low” to “very low” certainty in evidence reduce overall confidence in the findings. While these results indicate that IVR may be a viable option for the delivery of exercise, a more robust methodology in future trials is needed to properly verify findings and improve certainty. This will help to determine the real-world applicability of IVR exercise interventions for the improvement of health-related measures. Trial Registration: PROSPERO CRD420250650110; https://www.crd.york.ac.uk/PROSPERO/view/CRD420250650110

Clinical Effectiveness of Immersive Virtual Reality Exercise Interventions: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective Assessment of Financial Decision-Making With a Simulated Online Money Management Task in Older Adults: #Protocol for a Prospective Observational #Study Background: Technology-enabled tasks to conduct financial transactions are ubiquitous around the world. In a recent survey, about 75% of the respondents endorsed the use of technology to perform financial activities such as reviewing bank statements and keeping track of money spent. However, assessment of financial decision-making (FDM) is limited by tasks that use traditional paper-and-pencil methods or by relying on self or informant reports. Furthermore, such tools have weak psychometric properties, are prone to biases, and are at times limited in scope. Thus, there is an urgent need to develop modern, technology-based tools that have strong psychometric properties and that can assess FDM comprehensively and accurately. Objective: This #Study aimed to develop and establish the psychometric properties of a novel, simulated Online Money Management (OMM) credit card task. Based on existing gaps identified in the literature, this task relied on objective measurement, assessed multiple dimensions within a single task, and mimicked a real-world task to bridge the gap between a controlled, clinical setting and real-world functioning. Methods: This was a prospective cohort #Study that enrolled cognitively healthy older adults. This #Study was funded by the National Institutes of Health. Various recruitment sites were involved, which allowed for the recruitment of older adults across the United States. The OMM task was developed in collaboration with an interdisciplinary team of computer scientists, economists, psychologists, and geriatricians. The tasks consist of both online and offline components, with subcomponents examining the ability to navigate, basic and complex credit card literacy, and statement monitoring. Data about participants’ perception of their financial abilities and a self-report survey on financial exploitation were collected. The test battery consisted of an array of cognitive, financial, and psychosocial tasks. Participants provided written informed consent, and all procedures received institutional review board approval. Results: Data collection began in September 2019, and enrollment stopped in July 2025. A total of 272 participants completed the baseline visit, while 147 completed the longitudinal follow-up visit. Data analysis is underway as of August 2025, and results are expected to be published in 2026. Conclusions: Rigorous standards have been deployed for developing this novel OMM credit card task. If the measurement properties of the task are found adequate, the OMM task can be used to assess FDM in clinical evaluations for early detection and prevention or mitigation of financial mismanagement. International Registered Report Identifier (IRRID): DERR1-10.2196/82488

JMIR Res Protocols: Objective Assessment of Financial Decision-Making With a Simulated Online Money Management Task in Older Adults: #Protocol for a Prospective Observational #Study

Hospital-at-Home: New Technology Brings Acute Care to Patients’ Homes

Hospital-at-Home: New Technology Brings Acute Care to Patients’ Homes

Implementation of a #Cancer Navigation Intervention for Newly Diagnosed Survivors of Breast #Cancer: #Protocol for a #RCT #ClinicalTrial Background: #Cancer inequities among vulnerable populations in rural areas remain a public health challenge in Canada. Rural populations are defined as vulnerable due to geographic isolation, limited access to specialized oncology care, and socioeconomic barriers such as transportation and financial toxicity. Professional navigation offers a potential solution to bridge these gaps, yet there is a lack of evidence on the barriers to and facilitators of its adoption in breast #Cancer survivorship. Objective: The objective of this #Study is to evaluate the effectiveness of a #Cancer navigation intervention using professional navigators compared to the standard of care (medical care) in improving the quality of life and functional outcomes of newly diagnosed survivors of breast #Cancer in interior British Columbia. Methods: A single-center, parallel-group, open-cohort #RCT #ClinicalTrial is being conducted over 3 years. Ethics approval was obtained for the #Study. Participants who provide informed consent are randomized into 2 groups: the intervention group receives the #Cancer navigation intervention and the control group receives the standard of care (the usual medical care offered by health care practitioners). The baseline #Study time point spanned January to March 2025, the first follow-up spanned April to June 2025 at 3 months after enrollment, and the second follow-up spanned July to September 2025 at the end of 6 months after enrollment. The #Cancer navigation intervention comprises direct psychosocial and educational webinars, coordinated telephone support services, and community-based #Cancer care resources. Professional navigators are qualified registered nurses who facilitate information and connect participants with available supportive resources, services, and programs. The main outcomes are financial distress, quality of life, and satisfaction with navigation and interpersonal relationships. The Comprehensive Score for Financial Toxicity–Functional Assessment of Chronic Illness Therapy, Functional Assessment of #Cancer Therapy–Breast, Breast #Cancer Navigation Survey, Participant Satisfaction With Navigation Scale, Satisfaction With Interpersonal Relationships Survey, and Breast #Cancer Navigation Interview are used in the #Study. Steps are being taken to ensure the trustworthiness of the qualitative data. With a 5% level of significance (2 tailed) and 90% power, the sample size was calculated as 108. Results: Data collection took place from January 2 to September 30, 2025. A total of 164 participants were recruited. Conclusions: This #Study aims to demonstrate effectiveness and satisfaction with professional navigation and knowledge translation for future implementation of a #Cancer navigation intervention in British Columbia. Trial Registration: International Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN10220433; https://www.isrctn.com/ISRCTN10220433 International Registered Report Identifier (IRRID): DERR1-10.2196/85820

JMIR Res Protocols: Implementation of a #Cancer Navigation Intervention for Newly Diagnosed Survivors of Breast #Cancer: #Protocol for a #RCT #ClinicalTrial

Implementation of a #Cancer Navigation Intervention for Newly Diagnosed Survivors of Breast #Cancer: #Protocol for a #RCT #ClinicalTrial Background: #Cancer inequities among vulnerable populations in rural areas remain a public health challenge in Canada. Rural populations are defined as vulnerable due to geographic isolation, limited access to specialized oncology care, and socioeconomic barriers such as transportation and financial toxicity. Professional navigation offers a potential solution to bridge these gaps, yet there is a lack of evidence on the barriers to and facilitators of its adoption in breast #Cancer survivorship. Objective: The objective of this #Study is to evaluate the effectiveness of a #Cancer navigation intervention using professional navigators compared to the standard of care (medical care) in improving the quality of life and functional outcomes of newly diagnosed survivors of breast #Cancer in interior British Columbia. Methods: A single-center, parallel-group, open-cohort #RCT #ClinicalTrial is being conducted over 3 years. Ethics approval was obtained for the #Study. Participants who provide informed consent are randomized into 2 groups: the intervention group receives the #Cancer navigation intervention and the control group receives the standard of care (the usual medical care offered by health care practitioners). The baseline #Study time point spanned January to March 2025, the first follow-up spanned April to June 2025 at 3 months after enrollment, and the second follow-up spanned July to September 2025 at the end of 6 months after enrollment. The #Cancer navigation intervention comprises direct psychosocial and educational webinars, coordinated telephone support services, and community-based #Cancer care resources. Professional navigators are qualified registered nurses who facilitate information and connect participants with available supportive resources, services, and programs. The main outcomes are financial distress, quality of life, and satisfaction with navigation and interpersonal relationships. The Comprehensive Score for Financial Toxicity–Functional Assessment of Chronic Illness Therapy, Functional Assessment of #Cancer Therapy–Breast, Breast #Cancer Navigation Survey, Participant Satisfaction With Navigation Scale, Satisfaction With Interpersonal Relationships Survey, and Breast #Cancer Navigation Interview are used in the #Study. Steps are being taken to ensure the trustworthiness of the qualitative data. With a 5% level of significance (2 tailed) and 90% power, the sample size was calculated as 108. Results: Data collection took place from January 2 to September 30, 2025. A total of 164 participants were recruited. Conclusions: This #Study aims to demonstrate effectiveness and satisfaction with professional navigation and knowledge translation for future implementation of a #Cancer navigation intervention in British Columbia. Trial Registration: International Standard Randomised Controlled Trial Number (ISRCTN) ISRCTN10220433; https://www.isrctn.com/ISRCTN10220433 International Registered Report Identifier (IRRID): DERR1-10.2196/85820

JMIR Res Protocols: Implementation of a #Cancer Navigation Intervention for Newly Diagnosed Survivors of Breast #Cancer: #Protocol for a #RCT #ClinicalTrial

Perceptions of Health Care Professionals on the Integration and Use of AI in Clinical Cancer Care: Interview Study Background: Artificial intelligence (AI) is increasingly recognized for its potential to transform cancer care. However, much of the existing evidence of its efficacy comes from controlled settings. There remains a need to complement this knowledge with insights into how AI tools are perceived and used in real-world clinical settings, as well as how their use impacts clinical practice. Objective: This study aimed to explore key factors influencing clinicians’ acceptance of AI tools and examine how AI adoption and use impact clinical workflows in cancer care. Methods: We used purposive sampling for recruiting oncology-related health care professionals and collected data using web-based semistructured interviews to gather their perceptions. Data were thematically analyzed and interpreted through the lenses of sociotechnical systems theory and the Unified Theory of Acceptance and Use of Technology. Results: Participants largely accept and perceive AI tools as beneficial to clinical practice. Unified Theory of Acceptance and Use of Technology constructs were reflected in our data as determinants of intention to adopt AI tools. Trust appears as an influential factor in shaping attitudes toward AI tools. Acceptance is found to both precede AI tool use and to grow following successful integration. The use of AI tools is perceived to yield operational benefits, such as reduced workload and time savings, and clinical benefits, such as increased diagnostic reliability and reduced patient recall. Minimal disruption to clinical workflows following integration of AI tools was reported for some cancer screening applications and organ-at-risk segmentation, whereas greater disruption was anticipated for 3D cancer screening. Although accountability and lack of explainability are highlighted in literature as barriers to AI adoption, participants do not view these as significant obstacles in image-based diagnostic contexts. Additionally, negative impacts, such as overreliance on AI and reduced critical review of AI results, arise in association with the use of AI tools. Conclusions: Participants perceive AI tools to deliver benefits to clinical cancer care. However, their adoption relies on their alignment with clinical needs and seamless integration into clinical workflows. To encourage clinician acceptance, the identified concerns must be addressed. Future work should focus on training programs, co-design with clinicians, and exploration of mitigation strategies for emerging adverse effects, such as automation bias and potential skill erosion.

JMIR HumanFactors: Perceptions of Health Care Professionals on the Integration and Use of AI in Clinical Cancer Care: Interview Study

Understanding the Factors Explaining the Growing Use of Medical Assistance in Dying in Québec: #Protocol for an Interdisciplinary Mixed Methods and Multimethods #Study Background: Medical assistance in dying (MAiD) became a legal end-of-life option on December 10, 2015, in Québec, and on June 17, 2016, in the rest of Canada. Since its legalization, there has been a steady increase in the number of MAiD requests and provisions. Across permissive jurisdictions, Québec now has the highest rate of assisted death. Despite the growing use of MAiD, #Research examining the factors driving this increase remains limited and fragmented. Existing studies offer partial and sometimes contradictory explanations, with little integration of legal, institutional, societal, and individual dimensions. Further #Research is needed to better understand the determinants of MAiD requests and practices, particularly in the Canadian and Québec contexts. Objective: This #Research aims to understand the factors influencing changes in MAiD requests and administrations in Québec by examining laws, practices, societal perspectives, organization of care and services, and individual characteristics of those requesting MAiD, as well as their interrelationships. We present the #Protocol developed by the Consortium interdisciplinaire de recherche sur l'aide médicale à mourir, an interdisciplinary #Research consortium, including an international advisory committee, set up for this #Research. Methods: The design of this #Protocol is multimethods and convergent mixed methods, including (1) an international cross-thematical approach with 4 main #Research methods (a scoping review, key informant interviews, focus groups with health care professionals, and a population-based survey) chosen to partially answer #Research questions across the entire #Study and to compare with other jurisdictions and (2) 11 theme-specific methods (including community forums, media coverage analysis, comparative legal analyses, case studies of triads, individual interviews, and system mapping) to enrich and complement findings from the cross-thematical approach. Results: When this 3-year funded #Study started in July 2024, several #Research methods not requiring ethics committee approval (because no human participants were involved) were initiated, including scoping and systematic reviews, media coverage analysis, and comparative legal analyses. By August 2025, interviews with key informants were completed, and analyses took place in September. Concurrently, other subteams started data collection (focus groups December 2025) or are getting ready to seek ethics approval for their #Protocols and data collection processes involving human participants: case studies of triads, individual interviews, and community forums. Conclusions: Findings from the international cross-thematical approach and theme-specific methods will provide a comprehensive understanding of the factors influencing the use of MAiD in Québec. This #Study has strengths, including the use of a specific theoretical framework, a variety of complementary methods, and an integrated knowledge mobilization strategy. As for its limitations, we foresee challenges with the comparison of jurisdictions in terms of language, culture, and legal systems, as well as access to data about MAiD cases, since reporting systems may differ between jurisdictions.

JMIR Res Protocols: Understanding the Factors Explaining the Growing Use of Medical Assistance in Dying in Québec: #Protocol for an Interdisciplinary Mixed Methods and Multimethods #Study

Detection of Developmental Delay in Children from VR-Derived Facial Action Units: A Comparative #Study of Machine Learning, Deep Learning, and Transformer Models (preprint) #openscience #PeerReviewMe #PlanP

JMIR Report: Can AI and Wearables Fix the "Broken" Pain Scale? [IMAGE] - EurekAlert! (mentions @jmirpub)

Love, Lies and Learning in Online Dating: An Online #RCT #ClinicalTrial of a Serious #Game to Combat Romance Scams (preprint) #openscience #PeerReviewMe #PlanP

User Acceptance of Smart Home Emergency Response Systems: Mixed Methods Study Background: Smart home emergency response systems (SHERS) leverage existing smart home infrastructure to detect critical events and alert emergency services without manual activation. Unlike personal emergency response systems, which require users to trigger alarms, SHERS initiate alerts autonomously. Although technically feasible, user acceptance has received limited empirical attention. Objective: This study examined factors influencing the intention to adopt SHERS in private households, identifying key facilitators and barriers to acceptance. Methods: A mixed methods study followed the Double Diamond framework. In the discover/define phases, expert interviews (n=3) and secondary data analysis informed persona and scenario development. In the “develop” phase, brainwriting workshops (6-3-5 method, n=12) generated design requirements translated into a low-fidelity prototype. In the “deliver” phase, an online survey (n=85) assessed acceptance using the Technology Usage Inventory. Structural equation modeling tested hypothesized relationships, and methodological triangulation integrated qualitative and quantitative findings. Results: Perceived accessibility was the strongest positive predictor of intention to use (β=0.33, =.02), while skepticism showed a marginally negative effect (β=−0.34, =.06). The model explained 66% of variance in behavioral intention (²=0.66). Triangulation confirmed that concerns about complexity, false alarms, and data privacy underlie these effects. Experts emphasized that technology should support rather than replace human decision-making; workshop participants stressed intuitive setup and user control over alarm cancellation. Conclusions: SHERS acceptance is primarily associated with perceived accessibility, while skepticism may act as a barrier. Developers should prioritize seamless integration with existing ecosystems, clear feedback mechanisms to prevent false alarms, and strong data protection.

JMIR HumanFactors: User Acceptance of Smart Home Emergency Response Systems: Mixed Methods Study

Mortality Prediction Among People Living With HIV on Antiretroviral Therapy in Public #health Facilities in Gondar City Administration, Northwest Ethiopia: Machine Learning–Based Study Background: Predicting mortality among people living with HIV enables clinicians to implement timely, targeted, and preventive interventions at the start of antiretroviral therapy (ART). However, prognostic models must rely strictly on baseline predictors to avoid look-ahead bias and ensure scientific validity. This study evaluates machine-learning (ML) algorithms for baseline mortality prediction using routine electronic #medical record data. Objective: This study aims to predict mortality among people living with HIV receiving ART using baseline clinical and sociodemographic characteristics through ML models in public #health facilities of Gondar City Administration, Northwest Ethiopia. Methods: The retrospective cohort study was conducted using electronic #medical record data from 12,871 people living with HIV on ART (2005‐2024). Seven base classifiers were evaluated using stratified 10-fold cross-validation. Synthetic minority oversampling technique (SMOTE)–balanced variants were used only for sensitivity analysis. SMOTE oversampling was applied only to training folds; the final evaluation used the original imbalanced test data. Shapley Additive Explanations (SHAP) analysis identified key baseline predictors. Results: Gradient boosting on the original data achieved superior performance (accuracy 87.0%, -score 0.619, area under the receiver operating characteristic curve 0.859), outperforming extreme gradient boosting (-score 0.609, area under the receiver operating characteristic curve 0.835) and SMOTE variants. The SHAP analysis identified education level, lack of formal education (+0.84), and a low baseline cluster of differentiation 4 (CD4; a type of immune cell count) count of 140 cells/mm³ (+0.54) as substantially increasing predicted mortality risk. Urban residence (−0.35) and working functional status (−0.12) showed protective effects, whereas age (45 y; −0.02) had minimal influence in the illustrated case. Globally, lower CD4 counts and the absence of formal education were consistently associated with increased mortality risk. Conclusions: Ensemble ML models demonstrated moderate-to-strong discrimination for predicting mortality among people living with HIV using strictly baseline routine electronic #medical record data. SHAP-based interpretability confirmed that educational attainment and baseline CD4 count were the dominant determinants of predicted mortality risk, underscoring the combined influence of socioeconomic vulnerability and immunological status at ART initiation. These findings support the potential utility of interpretable ML models for early risk stratification and targeted clinical decision-making in resource-limited settings; however, external validation is required before routine clinical implementation.

New JMIR MedInform: Mortality Prediction Among People Living With HIV on Antiretroviral Therapy in Public #health Facilities in Gondar City Administration, Northwest Ethiopia: Machine Learning–Based Study

Acuity, Diagnosis, and Community Factors in Virtual and In-Person Treatment: Qualitative Study Background: The COVID-19 pandemic accelerated the adoption of virtual psychotherapy, making videoconferencing a vital tool for maintaining continuity of care. While virtual sessions offer flexibility and accessibility, concern has also been raised about the impact of virtual care on therapeutic relationships, a sense of community, and the ability to support clients with higher levels of clinical need. Objective: This study sought to examine how mediums of care (ie, virtual vs in-person) impact the therapeutic experience for clients and providers in critical domains such as community, clinical presentation, and clinicians’ use of clinical skills. The following themes were evaluated: (1) How therapeutic relationships and community dynamics differ across virtual and in-person mediums of mental health care? (2) How acuity and diagnosis influence the perception of effectiveness and safety of these mediums? Methods: This study is a grounded theory design. Participants were intensive outpatient mental health clients and clinicians. Participants were interviewed in focus groups of either 6‐8 clinicians or clients, assessing for important themes (ie, attendance, engagement, and therapeutic alliance) across the 2 modes of care (ie, virtual vs in-person). A total of 6 structured focus groups were conducted. Thematic analysis was conducted to analyze the transcripts until theoretical saturation was achieved. Results: Results highlighted the nuanced differences in client and clinician perceptions of relational dynamics and effectiveness of care in virtual versus in-person mental health care. This study revealed, the perspectives of the client and clinician, that in-person treatment fosters more engagement and interpersonal connection (ie, therapeutic alliance and peer-to-peer) than virtual settings. Additionally, in-person care better supports the ability to exercise important clinical skills, especially for highly acuity clients with complex diagnoses. Conclusions: The results of this study outline how the medium of care (ie, virtual vs in-person) impacts therapeutic experience from the perspective of both client and clinician. It is understood that critical domains such as community, interpersonal relationships, and clinicians’ use of clinical skills are affected by the medium of care, and key factors such as clinical presentation (ie, acuity and diagnosis) must be accounted for when choosing a particular mode of care for a client.

JMIR HumanFactors: Acuity, Diagnosis, and Community Factors in Virtual and In-Person Treatment: Qualitative Study

Use of Digital Technology for Developing Communication Skills in Undergraduate and Postgraduate medical education #mededu: Scoping Review Background: Effective doctor-patient communication is fundamental to safe, high-quality health care and is a core competency across undergraduate and postgraduate medical education #mededu. Communication skills training (CST) has traditionally relied on workforce-intensive methods such as role-play and standardized patient encounters, which face increasing pressure from rising student numbers, constrained faculty capacity, and growing clinical workloads. Digital technologies offer scalable, flexible alternatives, yet the extent, educational design, and strength of evidence supporting digital CST remain unclear. Objective: This study aimed to comprehensively map the digital technologies used for CST in undergraduate and postgraduate medical education #mededu, examine the reported outcomes in the context of educational theory, and identify gaps relevant for future research and clinical practice. Methods: This scoping review followed Joanna Briggs Institute (JBI) methodology and is reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Four electronic databases (Medline, Embase, CINAHL, ERIC) were searched from inception to January 5, 2026. Eligible studies examined any digital technology used to support active, 2-way CST for undergraduate or postgraduate medical learners. Passive learning approaches were excluded. Data were synthesized descriptively. To support structured interpretation of heterogeneous outcomes, interventions were mapped to Kolb’s experiential learning cycle to examine learning processes and to Kirkpatrick’s evaluation model to assess depth of educational and translational impact. Results: A total of 11,179 records were identified, of which 121 studies met the inclusion criteria. Most studies were published within the past decade (92/121, 76%) and were conducted in North America and Europe (93/121, 76.9%), with 58.7% (71/121) of studies focusing on undergraduate learners. Recording-based tools (51/121, 41.8%), live stream platforms (33/121, 27%), and virtual patient simulators (32/121, 26.2%) were the most used digital technologies. General communication and history taking was the most frequent topic taught. Only 28.1% (34/121) of studies used validated objective outcome measures. Educationally, digital interventions overwhelmingly supported early stages of experiential learning (120/121, 99.2%), with almost no progression to abstract conceptualization or active experimentation. Outcome evaluation was similarly limited in depth; most studies assessed outcomes at Kirkpatrick Levels 1 and 2. Few studies evaluated behavior change in clinical practice (6/121, 5%) or patient-level outcomes (1/121, 0.8%). A small but growing subset of studies incorporated artificial intelligence, primarily within virtual patient simulators, showing promising but methodologically limited evidence. Conclusions: Although digital CST interventions show promise for supporting early-stage learning outcomes, the evidence is constrained by weak study designs, inconsistent use of validated measures, and minimal real-world evaluation. Current technologies support only initial phases of experiential learning, with no evidence of progression to competency development or translation into improved patient care. For educators investing in digital CST, these technologies should be integrated thoughtfully within broader curricula rather than treated as standalone solutions, accompanied by evaluation extending to clinical outcomes. Future research that prioritizes robust comparative designs evaluating whether digital training meaningfully improves clinical communication and patient care is warranted.

New in JMIR MedEdu: Use of Digital Technology for Developing Communication Skills in Undergraduate and Postgraduate medical education #mededu: Scoping Review