JMIR Research Protocols

Sexual and gender minority (SGM) populations experience significant mental health disparities, yet continue to face persistent barriers to care. Mental Health America (MHA) provides free, web-based screening and self-guided resources to millions of visitors, including tens of thousands of SGM visitors each year. Digital mental health (DMH) can facilitate access to mental health resources; however, engagement remains a central challenge that limits effectiveness. MHA faces similar engagement challenges, with preliminary analyses indicating that most visitors exit the website without accessing substantive mental health content pages. The QT-Digital Mental Health Engagement study uses an iterative approach to develop and test strategies for improving engagement with DMH resources among SGM users.

World Trade Center (WTC) general responders (GRs) continue to experience long-term mental health conditions, including posttraumatic stress disorder (PTSD), depression, anxiety, and sleep disturbance. A growing number of GRs reside in Florida, where barriers such as stigma, limited access to specialty care, and age-related limitations contribute to persistent unmet mental health needs. PTSD Coach, a mobile app originally developed for trauma-exposed veterans, has shown promise but has not been evaluated with WTC GRs or adapted for Spanish-speaking responders.

Emergency departments (EDs) play a critical role in caring for the aging population, particularly those nearing the end of life. Despite advances in integrating palliative care resources in the ED, targeted research on the impact of hospice and palliative care (HPC) consultations for older adults in ED settings remains limited. This systematic review protocol assesses the effects of ED-initiated HPC consultations on health outcomes and the quality of care for older adults.

Oral appliance therapy (OAT) is a widely used treatment for obstructive sleep apnea; however, titration approaches remain variable and lack standardization across clinical practice. Existing evidence is largely derived from academic or specialty sleep centers, with limited data on how titration strategies are implemented and perform in real-world dental settings.

Cognitive impairment begins early in Parkinson disease (PD) and progresses to dementia in most people with PD, reducing quality of life and contributing to growing health-related costs. Physical exercise has potent antiaging effects and improves many outcomes in PD, including cognition. Identifying biomarkers that respond to exercise and determining how they associate with cognition and underlying disease pathology may elucidate key mechanisms for countering cognitive decline.

Heart failure (HF) imposes a substantial clinical and economic burden in China. Although N-terminal pro-B-type natriuretic peptide (NT-proBNP) is widely used in the diagnostic pathway for HF, conventional thresholds are largely derived from Western populations and may not be fully applicable to Chinese adults.

Cerebral palsy (CP) is a prevalent neurodevelopmental disorder in children, often leading to long-term motor impairments. Rehabilitation robotics has emerged as a promising approach in pediatric neurorehabilitation, offering precise and repetitive motor training. Repetitive transcranial magnetic stimulation (rTMS), a noninvasive neuromodulation technique, has shown potential in modulating cortical excitability and improving motor function in children with CP.

Proficiency in interpersonal communication and social skills is fundamental for health sciences students, but public speaking anxiety and communication apprehension frequently compromise academic performance, emotional well-being, and the acquisition of essential competencies. The postpandemic educational environment has exacerbated student stress, highlighting the urgent need for reliable assessment tools for social anxiety in this population.

Preexposure prophylaxis (PrEP) is a key biomedical HIV prevention strategy that relies heavily on adherence for optimal effectiveness. In China, most PrEP users purchase their medication online, making it challenging to monitor and support adherence effectively.

Parkinson disease (PD) is characterized by motor symptoms as well as progressive cognitive decline leading to long-term functional impairment and diminished quality of life. Mild cognitive impairment in PD (PD-MCI) is a risk factor for developing PD-related dementia. PD-MCI provides a window to assess interventions that can improve cognition. Repetitive transcranial magnetic stimulation (rTMS) shows promise as an effective treatment to improve cognitive performance.

Diseases during childhood and adolescence such as cancer or attention-deficit/hyperactivity disorder (ADHD) can have an impact on brain development and place children and adolescents at increased risk for cognitive long-term problems. Most cognitive trainings currently available have limited efficacy and show limited transfer to nontrained tasks and everyday functioning. We developed a novel intervention (Mio-Training) aiming to increase metacognitive abilities at the intersection between exercise psychology and cognitive science to strengthen the cognitive development of pediatric patients with atypical brain development in the long term.

Diabetic foot osteomyelitis (DFO) is a common complication and major cause of morbidity among people with diabetes mellitus. There has been growing acceptance of primarily nonsurgical (conservative) management of DFO based on antibiotics alone. However, the most appropriate duration of antibiotic therapy for DFO remains controversial. Current guidelines recommend antibiotic duration of up to 6 weeks for DFO. Although there has been growing interest in a shorter duration of antibiotic therapy, in absence of sufficient evidence, the extent to which the duration of antibiotic therapy can be shortened remains debatable. Determination of the optimal duration of antibiotic therapy would improve the outcomes of treatment of DFO while limiting side effects.