JMIR Research Protocols

Insomnia during pregnancy is a modifiable risk factor for depression. Research in nonpregnant populations and preliminary findings in a pregnant population suggest that targeting insomnia with digital cognitive behavioral therapy for insomnia (CBT-I) may prevent depression.

Approximately 40%‐60% of children diagnosed with autism spectrum disorder (ASD) exhibit challenging behaviors such as aggression, elopement, self-injury, and property destruction that can endanger the health and safety of the child or others, often cause significant distress for families, and hinder the child’s developmental progress. Although behavioral treatments grounded in the principles of applied behavior analysis have been shown to effectively reduce or eliminate these behaviors, significant gaps remain in how to deliver these interventions equitably.

Odontectomy is a common surgical procedure often associated with significant preoperative anxiety, particularly when performed under general anesthesia. Anxiety can lead to physiological changes, such as increased blood pressure and heart rate, and may affect anesthetic requirements and postoperative recovery. Virtual reality (VR) has emerged as a promising non-pharmacological intervention to reduce anxiety through immersive distraction.

Every patient receiving kidney replacement therapy that is, hemodialysis, peritoneal dialysis or a kidney transplant, should have an advanced treatment escalation plan. This should include a decision on cardiopulmonary resuscitation (CPR) status. The existing literature suggests kidney replacement therapy recipients who undergo in-hospital CPR have outcomes similar to the general population. However, these data originate exclusively from North America and Taiwan, do not include transplant recipients, and neurological outcomes are poorly reported. This paucity of evidence influences how kidney replacement therapy recipients, their families and care providers make informed discussions on CPR status and may leave kidney replacement therapy recipients vulnerable to false assumptions of poor suitability.

Chronic pain affects approximately 12 million individuals in Germany and significantly impairs quality of life. Although multimodal treatment approaches—combining physical, psychological, and behavioral strategies—are considered the gold standard, access to specialized multidisciplinary pain treatment, including physiotherapy and psychological interventions, is often hampered by long waiting times, which highlights the need for scalable, low-threshold treatment options. Digital health interventions, particularly those grounded in established therapeutic models, offer a promising solution to bridge this treatment gap. The German Digital Health Care Act has opened pathways for reimbursable digital applications, such as CHRONIC, which is grounded in acceptance and commitment therapy as a third-wave cognitive behavioral therapy framework and integrates selected cognitive behavioral techniques, mindfulness-based strategies, and physiotherapy into a structured web-based program.

Cardiac rehabilitation is an evidence-based, multidisciplinary intervention integrating therapeutic exercise, patient education, nutritional counseling, optimized pharmacological management, and psychological support. It reduces cardiovascular mortality and improves functional capacity and quality of life. However, real-world implementation remains suboptimal due to limited accessibility, high dropout rates, and urban-rural inequities. Traditional center-based models rely on in-person supervision, limiting scalability and long-term monitoring beyond structured phases. These limitations are particularly evident during the transition from supervised rehabilitation to long-term self-management, when sustained cardiovascular risk control and maintenance of healthy behaviors are essential. Cardiovascular prevention and cardiac rehabilitation should therefore be understood as interconnected components of a continuum of care. Within this framework, digital health innovations—particularly wearable technologies and artificial intelligence (AI)—offer opportunities to bridge supervised rehabilitation and long-term prevention. Wearables enable continuous remote monitoring of physiological and behavioral parameters, facilitating early detection of adverse events and personalized feedback. AI enhances these capabilities through advanced analysis of clinical and sensor-derived data, supporting risk stratification, prediction of adherence and disease progression, and individualized decision-making across the care pathway.

With the advent of antiretroviral therapy, the life expectancy of people living with HIV has increased significantly, leading to a growing prevalence of frailty and its associated adverse outcomes. However, frailty prediction models developed for the general older population may not apply to people living with HIV due to their distinct immunologic, inflammatory, and comorbidity profiles. To the best of our knowledge, no systematic review to date has comprehensively evaluated frailty prediction models specifically developed for people living with HIV.

Acute infectious symptoms are a leading cause of pediatric emergency department visits in Canada, many of which are low acuity and could be safely managed at home. Artificial intelligence (AI) chatbots offer a promising avenue for delivering accessible, evidence-based guidance to support families in managing these symptoms.

Innovative disease management strategies have significantly improved clinical outcomes in inflammatory arthritis (IA). Although more than 80% of patients achieve low disease activity (LDA), the disease continues to exert a considerable impact on patients’ lives. For these patients with IA, a lifestyle intervention program may add value by reducing inflammatory activity, potentially alleviating the disease burden and the risk of a flare.

About 1 in 3 individuals will sustain a secondary anterior cruciate ligament (ACL) injury within 24 months of returning to sport after ACL reconstruction (ACLR). While aberrant biomechanics and poor quadriceps strength have been associated with secondary ACL injury risk, unresolved injury-related fear has also been identified as a potential risk factor for additional ACL injuries in previously high-functioning, physically active populations. Virtual reality mindfulness meditation (VRMM) is a psychological intervention that may reduce injury-related fear and improve an individual’s ability to stay in the present moment during stressful situations such as sport. There is a critical need to identify whether VRMM is a feasible intervention that could be implemented to address injury-related fear and reduce secondary ACL injury risk.

Cardiovascular disease (CVD) is the leading cause of death in women. Risk factors can be compounded by hormonal changes, especially during the menopause transition. Positive health promotion through a behavioral change strategy may be the most effective approach to reducing CVD mortality and morbidity.

Postoperative delirium (POD) is a frequent and serious complication in older surgical patients, characterized by acute cognitive dysfunction and fluctuating levels of consciousness. POD is associated with prolonged hospitalization, long-term cognitive decline, reduced quality of life, and increased mortality. Despite its clinical relevance, the underlying pathophysiological mechanisms remain poorly understood, and reliable biomarkers for early prediction and prevention are lacking.