The Karma system is currently undergoing maintenance (Monday, January 29, 2018).
The maintenance period has been extended to 8PM EST.
Karma Credits will not be available for redeeming during maintenance.
The leading peer-reviewed journal for digital medicine, and health & healthcare in the Internet age
The Journal of Medical Internet Research (JMIR), now in its 20th year, is the pioneer open access eHealth journal and is the flagship journal of JMIR Publications. It is the leading digital health journal globally in terms of quality/visibility (Impact Factor 2016: 5.175, ranked #1 out of 22 journals) and in terms of size (number of papers published). The journal focuses on emerging technologies, medical devices, apps, engineering, and informatics applications for patient education, prevention, population health and clinical care. As leading high-impact journal in its' disciplines (health informatics and health services research), it is selective, but it is now complemented by almost 30 specialty JMIR sister journals, which have a broader scope. Peer-review reports are portable across JMIR journals and papers can be transferred, so authors save time by not having to resubmit a paper to different journals.
As open access journal, we are read by clinicians, allied health professionals, informal caregivers, and patients alike, and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews).
We are also a leader in participatory and open science approaches, and offer the option to publish new submissions immediately as preprints, which receive DOIs for immediate citation (eg, in grant proposals), and for open peer-review purposes. We also invite patients to participate (eg, as peer-reviewers) and have patient representatives on editorial boards.
Be a widely cited leader in the digitial health revolution and submit your paper today!
Right click to copy or hit: ctrl+c (cmd+c on mac)
Social media interventions are a growing area of internet research, particularly for adolescent health. Researchers developing social media intervention approaches face the task of selecting a social...
Social media interventions are a growing area of internet research, particularly for adolescent health. Researchers developing social media intervention approaches face the task of selecting a social media platform for their intervention. In this paper, we present the theoretical framework of affordances to help guide social media platform selection for intervention research. We first describe methodological approaches to incorporating common affordances into intervention design, followed by four examples of intervention design applying the affordance framework. A scientific approach for the selection of the appropriate social media platform for a given intervention is an important research priority to advance the field of internet research.
Background: Men who have sex with men (MSM) frequently seek partners through geosocial networking applications (GSN-APPs). However, it is unclear whether GSN-APPs use is associated with the increase i...
Background: Men who have sex with men (MSM) frequently seek partners through geosocial networking applications (GSN-APPs). However, it is unclear whether GSN-APPs use is associated with the increase in HIV (human immunodeficiency virus) incidence among MSM. Objective: To clarify the characteristics of GSN-APPs users, and to determine the association and putative mechanisms between GSN-APPs use behavior and HIV incidence. Methods: We conducted an eighteen-month prospective cohort study of MSM in Shenyang, China, and the participants were surveyed every three months from March 2015 to December 2016. An in-person interview collected information on socio-demographics, GSN-APPs use, recreational drug use, and sexual behaviors. In addition, blood was drawn to test for HIV and syphilis. We used a multivariable Cox regression model to determine possible predictors for increased HIV incidence. Results: Of the enrolled 686 HIV-negative MSM, 431 (62.8%) were GSN-APPs users. Compared to GSN-APPs nonusers, GSN-APPs users were younger, had an earlier age of sexual debut, and in the past three months, were more likely to have used recreational drugs, more likely to have had 5 or more casual partners (CPs), more likely to have had group sex with males, and more likely to have had condomless anal intercourse (CAI) with male steady partners (SPs). In addition, 59.4% (256/431) of the GSN-APPs users were willing to accept HIV/AIDS (acquired immunodeficiency syndrome) prevention information push services through GSN-APPs. In total, 19 MSM seroconverted to HIV during the follow-up period; the HIV incidence density rate was 8.1 (95% confidence interval (CI): 4.7-12.9)/100 person-years (PY) among GSN-APPs users and 2.2 (95% CI: 0.4-6.2)/100 PY among nonusers (P=.02). New HIV infections were independently associated with ever using GSN-APPs to seek male sexual partners (P=.04), and in the past three months, using recreational drugs (P=.048), having group sex with males (P=.01), and having CAI with male CPs (P=.02). Conclusions: GSN-APPs use is associated with higher HIV incidence, and may be mediated through recreational drug use and having multiple CPs. Researchers must develop an intervention propagated through GSN-APPs to reach this high-risk population in order to mitigate the HIV epidemic in the MSM community.
Background: Routine practice in oncology increasingly relies on electronic Patient Reported Outcome (ePRO) measures. Elderly and less tech‐savvy patients often experience difficulties regarding elec...
Background: Routine practice in oncology increasingly relies on electronic Patient Reported Outcome (ePRO) measures. Elderly and less tech‐savvy patients often experience difficulties regarding electronic questionnaires. Hence, innovative strategies have to be developed to overcome their uncertainty and inexperience in computer usage. Objective: The first objective of this paper is to analyze the status quo of elderly patients regarding their internet usage, technical handling and future interest in internet-based therapy support, by focusing on septuagenarians and older patients who have already participated in a previous survey on breast cancer. The second objective is to examine the required adaptions within the CANKADO eHealth platform to meet the needs of elderly patients. The modifications were based on the results of unstructured interviews conducted with myeloma patients who actively used CANKADO for at least two months. Methods: The eHealth Strategy for Elderly Patients (eStEPs) is a module inside the open online platform CANKADO (www.cankado.com). In the first stage, 124 patients aged 70 years and older were interviewed regarding their internet use and technical equipment. In the second stage, 30 patients with multiple myeloma actively used CANKADO supplementary to their therapy. These patients were treated in eight centers. During the project term of at least two months, all participating Health Care Professionals HCPs and patients were regularly questioned in open interviews on their eHealth practice. Results: The first phase showed a high penetration of internet usage in patients above 70 years: 51% of all surveyed patients had a computer with internet access at home while 36% used the internet every day. In the course of the second phase, 30 patients, 12 nurses and 7 physicians took part in My–eStEPs. Evaluation of the recorded statements led to three significant modifications in CANKADO: The implementation of a simplified login procedure, the possibility of dynamic content adjustment and the development of a simulation mode where HCPs can switch to the patient’s interface to show and explain the application to the patient. Conclusions: To successfully establish eHealth methods among elderly patients, it is important to understand their needs and adapt the services to their requirements. Moreover, a close cooperation between HCPs and their patients is an essential demand during the initial period.
Background: Blood pressure (BP) is a key modifiable risk factor for patients with CKD, with current guidelines recommending strict control to reduce the risk of both progression of CKD and cardiovascu...
Background: Blood pressure (BP) is a key modifiable risk factor for patients with CKD, with current guidelines recommending strict control to reduce the risk of both progression of CKD and cardiovascular disease. Trials of BP lowering require multiple visits to achieve target BP which increases the costs of such trials, and in routine care BP measured in clinic may not accurately reflect usual BP. Objective: We sought to assess whether a telemonitoring system for BP (using a Bluetooth-enable BP machine which could transmit BP measurements to a tablet device which had a bespoke app to guide measurement of BP and collect questionnaire data) was acceptable to patients with CKD, and whether patients would provide sufficient BP readings to assess variability and guide treatment. Methods: 25 participants with CKD were trained to use the telemonitoring equipment, asked to record BP daily for 30 days, attend a study visit, and then record BP on alternate days for the next 60 days. They were also offered a wrist-worn applanation tonometry device (BPro) which measures BP every 15 minutes over a 24 hour period. Participants were given questionnaires at the one-month and three-month time points, derived from the System Usability Scale and Technology Acceptance Model. Results: Mean age was 58 (SD 11) years and mean eGFR was 36 (SD 13) mL/min/1.73m2. 52% of participants provided >90% of expected data and 72% provided >80% expected data. The usability of the telemonitoring system was rated highly with mean scores of 84.9/100 (SE 2.8) after 30 days and 84.2/100 (SE 4.1) after 90 days. The coefficient of variation (CV) for variability of telemonitoring systolic BP was 8.9%, compared to 7.9% for the BPro device (and 9.0% over one year in a recently completed trial with identical eligibility criteria), indicating that most variation in BP is short-term. Conclusions: Telemonitoring is acceptable to patients with CKD and provides sufficient data to inform titration of antihypertensive therapies in either a randomized trial setting (comparing different targets BPs) or routine clinical practice. Such methods could be employed in both scenarios and reduce costs currently associated with such activities. Clinical Trial: ISRCTN13725286
Background: Hypertension is a rapidly growing epidemic in China. Yet it remains inadequately controlled, especially in rural areas. Internet has shown potential for better health management in differe...
Background: Hypertension is a rapidly growing epidemic in China. Yet it remains inadequately controlled, especially in rural areas. Internet has shown potential for better health management in different settings; however, few studies have investigated its role in hypertension management in China. Objective: Our study aimed to examine the association between Internet access and hypertension awareness, treatment and control among elderly Chinese adults, and to investigate whether the association between Internet access and hypertension management differed between those lived in urban areas and those lived in rural areas. Methods: Data were obtained from the nationally representative survey of the China Health and Retirement Longitudinal Study in 2011. Hypertension was defined as (i) an average systolic blood pressure of ≥ 140 mm Hg, and/or an average diastolic blood pressure of ≥ 90 mm Hg; and/or (ii) currently taking antihypertensive medications. Outcome assessed included hypertension awareness, treatment and control. The key independent variable was defined as whether one had Internet access at home. Multivariate logistic regressions were performed for each of the three outcomes. Results: Among 5135 hypertensive respondents (62.4 ± 9.9 years; 45.8% men), 12·9% had Internet access at home. Compared to those had no Internet access, Internet access was positively associated with hypertension awareness (odds ratio, 1.36 [1.07–1.73]) and treatment (odds ratio, 1.38 [1.09–1.75], but not control (odds ratio, 1.19 [0.90–1.58]). Internet access reduced urban-rural disparity in hypertension awareness by 9.6 percentage points (P = 0.02), treatment by 8.3 percentage points (P = 0.05), but not in control. In addition, the moderating effect of Internet access on urban-rural disparities in hypertension management was larger among females. The decreased urban-rural disparities were primarily driven by that Internet access improved the management level in rural areas. Conclusions: Strategies for reducing the disparities in hypertension management and overall disease burden of hypertension among elderly population should consider Internet as a platform.
Background: The prevalence of diabetes and the use of eHealth are increasing. People with diabetes need frequent monitoring and follow-up of health parameters and eHealth services can be of great valu...
Background: The prevalence of diabetes and the use of eHealth are increasing. People with diabetes need frequent monitoring and follow-up of health parameters and eHealth services can be of great value. However, little is known about the association between the use of eHealth and provider-based health care services among people with diabetes. Objective: The objective of this study was to investigate the use of four different eHealth platforms (apps, search engines, video services, and social media sites) and associations with the use of provider-based health care visits among people diagnosed with type 1 diabetes mellitus (T1DM). Methods: We used e-mail survey data from 1,250 members of The Norwegian Diabetes Association (aged 18-89 years), conducted in 2018. Eligible for analyses were the 523 respondents with T1DM. Using descriptive statistics, we estimated the use of eHealth and the use of general practitioners (GPs) and somatic specialist outpatient services. By logistic regressions, we studied the associations between the use of these provider-based health services and the use of eHealth, adjusted for gender, age, education, and self-rated health. Results: Of the sample of 523 people with T1DM, 90.7% had visited a GP once or more and 61.0% had visited specialist services during the previous year. Internet search engines (like Google) were used sometimes or often by 84.0%, apps by 55.5%, social media (like Facebook) by 45.2%, and video services (like YouTube) by 23.3%. Participants aged 18-39 years used all forms of eHealth more than people aged 40 years and over, with the exception of social media. The use of search engines was positively associated with the use of somatic specialist services (odds ratio [OR] 2.56, confidence interval [CI] 1.40-4.68). GP visits were not associated with any kind of eHealth use. Conclusions: eHealth services are now widely used for health support and health information by people with type 1 diabetes, primarily in the form of search engines, but often in the form of apps and social media as well. We found a positive association between the use of search engines and specialist visits, and that people with T1DM are frequent users of eHealth, GPs, and specialist services. We found no evidence that eHealth reduces the use of provider-based health care, and these services seem to be additional rather than alternative. Future research should focus on how health care services can meet and adapt to the high prevalence of eHealth use. Our results also indicate that many patients with T1DM do not visit specialist clinics once a year as recommended. This raises questions about collaboration in health care services, and needs to be followed up in future research.