JMIR Research Protocols

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality in China. Although the National Basic Public Health Service Program provides annual health check-ups for older adults, post-screening management of CVD risk factors such as hypertension, dyslipidemia, and diabetes is often inadequate. The CardioCare System is a digital cardiovascular management platform that integrates risk prediction, personalized health interventions, and continuous engagement to address these gaps.

Antipsychotic-induced weight gain (AIWG) is a common side effect of antipsychotic drug treatment, particularly with second generation medications such as clozapine and olanzapine. Weight gain in patients undergoing antipsychotic therapies is a significant concern, often compounded by factors related to their condition that can be particularly challenging in a secure care setting. While there is significant evidence to support the benefit of semaglutide, one of the available glucagon-like peptide-1 receptor agonists (GLP-1 RAs) to promote weight loss for those who have a general weight-related health issue and meet the referral criteria for specialist services, it is unclear whether it will be as successful in people who have specifically gained weight due to medication-associated side effects and who reside in a secure care setting.

People with HIV are aging rapidly and face accelerated aging-related comorbidities, including cardiovascular diseases and cognitive impairment, due to prolonged HIV-associated inflammation. Physical activity (PA) is a well-established intervention to mitigate these risks; yet, most older people with HIV remain sedentary. Despite considerable efforts to understand PA determinants and design interventions for people with HIV, outcomes have been suboptimal.

Hemolytic disease of the fetus and newborn (HDFN) is a rare but serious condition caused by maternal-fetal red blood cell antigen incompatibility. In an affected pregnancy, maternal immunoglobulin G antibodies cross the placenta and target fetal or neonatal red blood cells, leading to hemolysis, hyperbilirubinemia, and anemia. Although routine screening and alloimmunization prevention programs have contributed to the decline in HDFN in the United States, further understanding of its epidemiology is still needed.

In India, 20-30% pregnancies fall under high-risk category, contributing to 75% of perinatal mortality and morbidity. An effective approach to reduce maternal and neonatal mortality/morbidity is early identification, effective management, and timely referral of high-risk pregnancies (HRPs). The Integrated High-Risk Pregnancy Tracking and Management (IHRPTM) program aims to enhance capacity of auxiliary nurse midwives (ANMs), medical officers (MOs), and specialist gynaecologists by: i. providing algorithmic, color-coded, detailed (yet simple) protocols for six HRP conditions, customized for each role, ii. offering live training, iii. delivering digital training and hand-holding, and iv. facilitating tracking pregnancies and management of HRPs. Equipping health workers (HWs) on these interventions facilitates early identification, effective management, and timely referrals, ultimately improving primary care and satisfaction of mothers with HRPs. Stated interventions are implemented in the intervention arm for 18 months, while during this period, HWs of intervention and control arms will receive routine training through state and national programs, ensuring pregnant women have equal access to routine maternity services.

Qualitative research offers a valuable lens for understanding human experiences, behaviors, and social contexts, drawing upon communication, social interaction, and sociological perspectives. Focus groups are a key method within qualitative research for exploring these complex topics. While traditional focus groups offer valuable insights into group dynamics and shared perspectives, they can be limited by logistical challenges such as geographic constraints and participant availability. To mitigate these issues, virtual modalities have emerged as a viable alternative, offering greater flexibility and accessibility for diverse populations. However, they also highlight persistent challenges such as managing group dynamics in online settings and ensuring participant engagement and privacy concerns. Our protocol considers these issues and implements strategies such as co-facilitators, more engaged research assistants, and the use of important security measures (participant name obfuscation, sharing links only on the day of the session, and password protection) as a way to overcome said issues.

Endometriosis is a chronic inflammatory condition experienced by approximately 6-10% of women worldwide. Women living with endometriosis experience multi-dimensional burdens often attributed to pain, fatigue, anxiety, and depression. Treatment patterns frequently focus on acute symptom management, while endometriosis is a lifelong condition. In addition, endometriosis-associated symptoms are complex, requiring multimodal treatment strategies. New complementary approaches for symptom management are needed, where further exploration of current online programs is a necessary next step. Online programs can be non-invasive, convenient, provide a sense of comfort, and are often more cost-effective than traditional in-person medicine. Mapping components within the online programs, using the behavior change ontologies, for women living with endometriosis, is necessary for developing effective and long-lasting endometriosis-management options.

Cerebral small vessel disease (CSVD) is a leading cause of vascular cognitive impairment, contributing to 36% to 67% of vascular dementia cases. Current therapies, primarily cholinesterase inhibitors, offer limited efficacy and significant adverse effects. Traditional Chinese medicine, particularly the zishenyizhi pill, which is a multiherb formulation targeting yin deficiency and blood stasis, has shown promise in preliminary studies but lacks robust clinical validation.

Human activity recognition (HAR) is the use of technology to detect a person’s movements. Sensors can be passive like cameras monitoring an area, or active like those attached to a person’s watch. HAR is a burgeoning field whose uses span from personal health tracking to at-home physical degradation monitoring. The benefit of having sensors attached to a person for constant HAR tracking can be seen in the personal fitness field where people track their number of steps or distance ran. For older adults, HAR can be used in combination with mobility tasks like sit-to-stand, timed-up-and-go, and other tasks to monitor a person’s ability to be self-sufficient and to live alone at home. Together, HAR and mobility tasks are an effective method to measure health, especially in older adults. Consumer wearables like Fitbits and Apple watches are currently being used to measure many of these mobility tasks. The wide adoption of these devices is a result of their ease of use and simplicity. Despite this, most wearables go unused shortly after purchase. A potential solution is the use of consumer devices that are already adopted like headphones or hearing aids. These devices can perform the same measurements as the wearables but have the advantage of being used for other reasons than health monitoring. Despite this, no scoping review has summarized the current capabilities of what can be done using head-worn sensors.

Motor imagery ability (MIA) is a critical cognitive process that enables the mental simulation of movements, facilitating skill acquisition in the use of myoelectric prostheses and their effective control in individuals who have undergone amputation. Although MIA is essential, its impact on upper extremity function and proprioception in myoelectric prosthesis users remains insufficiently studied.

Type 2 diabetes mellitus (T2DM) is a growing global health concern. In 2016, 9.7% of Bruneian adults aged 18 to 69 years had diabetes, making it the third leading cause of death. Effective self-management can mitigate complications that require health care interventions and lower health care costs. Brunei Darussalam has deployed BruHealth, a national mobile health platform synced with the Brunei Health Information Management System, allowing patients to access health records, schedule appointments, and explore medical articles. A digital therapeutics module for T2DM (diabetes mellitus digital therapeutics [DM DTx]) has been developed, consisting of a digital lifestyle intervention module within BruHealth and a separate health care professional portal for health coaches. The 16-week BALANCE program aims to support self-management. This study explores the efficacy of DM DTx in managing T2DM through digital lifestyle interventions.

Efforts in mental health research have long focused on the care and long-term outcomes of mental disorders. More recently, a shift in focus has occurred toward mental health promotion and prevention. One priority target population for promotion and prevention is youth with climate change–related distress. In light of the real-world threat of climate change, adaptive emotion regulation and engagement in meaningful action are 2 important strategies for promoting mental health. Ecological momentary interventions (EMIs) allow for the delivery of accessible interventions for young people with climate change–related distress, but evidence on their feasibility or beneficial effects is currently lacking.