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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 2017: 4.671, 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!
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Background: People using apps for mental health and wellbeing are likely to try multiple apps over time. In general, people use apps to meet immediate needs, and often use a variety of apps to meet l...
Background: People using apps for mental health and wellbeing are likely to try multiple apps over time. In general, people use apps to meet immediate needs, and often use a variety of apps to meet larger goals (for example people may have multiple apps to manage various transportation needs). IntelliCare is a mental health app platform that was designed with these principles in mind: the apps are elemental in that each app targets a different change strategy; they are simple and brief to use; and they are eclectic, allowing the user to select which strategies are useful to them. While this may improve engagement, it creates the same challenges faced by users of app stores. Thus, mental health app platforms will require navigation aids, such as recommender systems that can quickly get a person to an app that is useful. Objective: As a first step towards developing navigation and recommender tools, this study explored app use patterns across the IntelliCare platform, and their relationship to depression and anxiety outcomes. Methods: This secondary analysis of the IntelliCare Field Trial recruited people with depression and/or anxiety. Participants received 8 weeks of coaching, primarily by text, and weekly recommendations for apps. App use metrics included frequency of use and lifetime use were defined. Depression and anxiety, measured using the PHQ-9 and GAD-7, were assessed at baseline and end of treatment. Ordinal logistic regression models, log-rank tests and cluster analysis were utilized to determine patterns of use, and if these use metrics alone, or in combination, predicted improvement or remission(I/R) in depression or anxiety. Results: The analysis included 96 people with depression and/or anxiety. Peole generally followed recommendations to download and try new apps each week. Apps clustered into 5 groups: Thinking (apps that targeted or relied on thinking), Calming (relaxation and insomnia), Checklists (apps that used checklists), Activity (behavioral activation and activity), and Other. Both overall frequency of use and lifetime use were predictive in response for depression and anxiety. The Thinking, Calming, and Checklist clusters were associated with improvement in depression and anxiety, and the Activity cluster was associated with improvement in Anxiety only. However, the use of clusters was not more strongly associated with improvement than individual app use. Conclusions: Participants in a field trial remained engaged with a suite of apps for the full eight weeks of the trial. App use patterns did fall into clusters, suggesting knowing something about use of one app may be useful in helping select another app that the person is more likely to use. Clinical Trial: Clinicaltrials.gov NCT02176226
Background: Ethnic minority cancer survivors remain an understudied and underrepresented population in cancer research in part due to the challenge of low participant recruitment rates. Therefore, ide...
Background: Ethnic minority cancer survivors remain an understudied and underrepresented population in cancer research in part due to the challenge of low participant recruitment rates. Therefore, identifying effective recruitment strategies is imperative for reducing cancer health disparities among this population. With the widespread use of social media, health researchers have turned to Facebook as a potential source of recruitment. Objective: We evaluated the feasibility and effectiveness of purchasing ads on Facebook to recruit Chinese, Korean, and Latinx cancer survivors residing in the United States. We assessed their experience with participating in the present online survey and their interest for future research. Methods: Five purchased ads in English, Simplified Chinese, Traditional Chinese, Korean, and Spanish were shown on Facebook. Participants who clicked on the Facebook ad were directed to the study website and asked to submit their emails to receive the link to the 30-minute online survey. Inclusion criteria included being of Asian or Latinx heritage, 18 years or older, having a cancer diagnosis, and being within five years of cancer treatment. Participants who completed the survey were sent a $10 USD Walmart eGiftcard. Results: The Facebook ads were shown for 48 consecutive days for a total spending of $1,200.46 ($25/day budget). Overall, 11 East Asian and 15 Latinx cancer survivors completed the study, resulting in an average cost per participant of $46.17 USD. The East Asian and Latinx cancer survivors did not significantly differ in age, years lived in the United States, education level, generation status, and time since diagnosis. However, Latinx cancer survivors were marginally more likely to have limited English proficiency and lower annual income than East Asian cancer survivors. Both Latinx and East Asian cancer survivors reported that they enjoyed participating in the present study and indicated an interest in participating in future psychosocial research studies. Conclusions: The use of Facebook ads successfully resulted in the recruitment of East Asian and Latinx cancer survivors with different cancer diagnoses who resides in various geographic regions of the United States. We found that East Asian and Latinx cancer survivors recruited from Facebook were interested in participating in future psychosocial research, thereby providing support for the feasibility and effectiveness of using Facebook as a source of recruitment for ethnic minority cancer survivors.
Background: Falls are the leading cause of injury related death in older adults. Due to various constraints, objective fall risk screening is seldom performed in clinical settings. Smartphones offer h...
Background: Falls are the leading cause of injury related death in older adults. Due to various constraints, objective fall risk screening is seldom performed in clinical settings. Smartphones offer high potential to provide fall risk screening for older adults in home settings. However, there is limited understanding of whether smartphone technology for falls screening is usable by older adults who present age-related changes in perceptual, cognitive, and motor capabilities. Objective: The aims of this study were to develop a fall risk mobile health application (app) and to determine the usability of the fall risk app in healthy, older adults. Methods: A fall risk app was developed that consists of health history questionnaires and five mobility tasks to measure individual fall risk. An iterative design-evaluation process of semi-structured interviews were performed to determine the usability of the app on a smartphone and tablet. Participants also completed a Systematic Usability Scale (SUS). Six older adults participated in the first round of interviews, and five older adults participated in the second round. Interviews were videotaped and transcribed, and the data was coded to create themes. Average SUS scores were calculated for the smartphone and tablet. Results: Two themes were identified from the first round of interviews related to perceived ease of use and perceived usefulness. While instructions for balance tasks were difficult to understand, participants found it beneficial to learn about their risk for falls, found the app easy to follow, and reported confidence in using the app on their own. Modifications were made to the app, and following a second round of interviews, participants reported high ease of use and usefulness in learning about their risk of falling. Little differences were reported between using a smartphone or tablet. Average SUS scores ranged from 79 to 84. Conclusions: Our fall risk app was found to be highly usable by older adults as reported from interviews and high scores on the SUS. When designing a mobile health app for older adults, developers should include clear and simple instructions and preventative strategies to improve health. Furthermore, if the design accommodates for age-related sensory changes, smartphones can be as effective as tablets. A mobile app to assess fall risk has potential to be used in home settings by older adults.
Background: Effective patient-provider communication is an important condition to deliver optimal care and it supports patients in coping with their disease. The complex and emotionally loaded setting...
Background: Effective patient-provider communication is an important condition to deliver optimal care and it supports patients in coping with their disease. The complex and emotionally loaded setting of oncology care challenges both healthcare providers and patients in reaching effective communication. ListeningTime is developed for elderly cancer patients and their oncological healthcare providers to help them (better) prepare the clinical encounter and overcome communication barriers. ListeningTime is a web-based preparatory communication tool including modeling videos and has an audio-facility to listen back to recorded encounters. Objective: To evaluate the usability, perceived usefulness and actual use of ListeningTime, through the eyes of elderly cancer patients and their oncological healthcare providers. If evaluated positively, the ultimate goal is to make ListeningTime publicly available. Methods: First, members of a panel of elderly (ex-)cancer patients (≥ 65 years) were approached to evaluate ListeningTime via an online questionnaire. Usability and perceived usefulness were assessed. Second, ListeningTime was evaluated in real-life practice through a pilot study in three Dutch hospitals. In these hospitals, elderly cancer patients and their oncological healthcare providers were approached to evaluate ListeningTime via a similar online questionnaires, measuring perceived usefulness. Additionally, we examined log files and user statistics to get insight in how the program was used. Results: Thirty (ex-)cancer patients from the patient panel, and seventeen patients and eight healthcare providers from the hospitals, evaluated ListeningTime. Overall, both the panel members and the hospital patients were positive about the ListeningTime website, the audio-facility and the video fragments. Some patients suggested improvements with respect to the actors’ performances in the video fragments and believed that ListeningTime is mainly suitable for non-experienced patients. Healthcare providers were also positive about ListeningTime. They valued the video fragments for patients and the audio-facility for patients and themselves. However, providers did not listen back to their own recorded encounters. Patients did use the audio-facility to listen back to their encounters. Conclusions: ListeningTime was evaluated positively, both by patients and their oncological healthcare providers. As a result, the video fragments of ListeningTime are now made publicly available for elderly cancer patients through the Dutch website ‘kanker.nl’. Clinical Trial: not applicable
Background: Low physical activity levels can negatively affect nurses’ health. Given the low physical activity levels nurses report, the need for brief and economical interventions designed to incre...
Background: Low physical activity levels can negatively affect nurses’ health. Given the low physical activity levels nurses report, the need for brief and economical interventions designed to increase physical activity in this population is clear. We developed a web-based intervention which utilized motivational strategies to increase nurses’ physical activity levels. The intervention provided nurses with feedback from an activity monitor coupled with a web-based individual, friend or team physical activity challenge. Objective: In this parallel-group randomized trial, we examined whether nurses’ motivation at baseline predicted changes in objectively-measured physical activity during the 6-week intervention. Methods: Participants were 76 nurses (97% female; mean age=46 years, SD=11) randomly assigned to one of three physical activity challenge conditions: 1) individual, 2) friend, or 3) team. Nurses completed a questionnaire online assessing motivational regulations for physical activity prior to the intervention and wore a Tractivity® activity monitor prior to and during the 6-week intervention. We analyzed data using multilevel modeling for repeated measures. Results: Nurses’ physical activity levels increased (linear estimate=10.30, SE=3.15), but the rate of change decreased over time (quadratic estimate=-2.06, SE=0.52). External and identified regulations, but not intrinsic and introjected regulations, predicted changes in nurses’ physical activity levels. Conclusions: Our findings provide evidence that an intervention incorporating self-monitoring and physical activity challenges can be effective in increasing nurses’ physical activity levels. Also, largely consistent with motivational theories and prior research, they suggest interventions incorporating strategies promoting motivation for physical activity should be developed and tested. Clinicaltrials.gov registration: This trial was not registered with clinicaltrials.gov like other trials conducted during the same enrollment period as registration was not required by the study sponsor. Clinical Trial: This trial was not registered with clinicaltrials.gov like other trials conducted during the same enrollment period as registration was not required by the study sponsor.
Background: As the use of digital media for health promotion becomes increasingly common, descriptive studies exploring current and innovative marketing strategies will enhance understanding of effect...
Background: As the use of digital media for health promotion becomes increasingly common, descriptive studies exploring current and innovative marketing strategies will enhance understanding of effective strategies and best practices. Objective: To describe the implementation of a provincial digital media campaign using complementary advertising platforms to promote healthy pregnancy weight gain messages and direct an online audience to a credible website. Methods: The digital media campaign occurred in three phases, each for eight weeks, and consisted of search engine marketing using Google AdWords and social media advertising through Facebook. All advertising materials directed users to evidence-based pregnancy-related weight gain content on the Healthy Parents, Healthy Children website. Results: Google ads received a total of 43,449 impressions, 2,522 clicks and an average click through rate (CTR) of 5.80%. Of the people who clicked on a Google ad, 78.9% completed an action on the website. Across all Facebook ads there was a total of 772,263 impressions, 14,482 clicks and an average CTR of 1.88%. The highest performing ad was an image of a group of diverse pregnant women with the headline: Pregnancy weight is not the same for every woman. Conclusions: This study supports the use of digital marketing as an important avenue for delivering health messages and directing online users to credible sources of information. The opportunity to reach large, yet targeted audiences, along with the ability to monitor and evaluate metrics in order to optimize activities throughout a campaign is a powerful advantage over traditional marketing tactics. Health organizations can use the results and insights of this study to help inform the design and implementation of similar online activities.