JMIR Research Protocols

Postpartum depression (PPD) rates in the United States are among the highest globally, and PPD can pose significant, long-term risks to families. Concurrently, perinatal cannabis use is increasing in prevalence and may exacerbate PPD. Although evidence links cannabis use with PPD, little is known about its impact on immediate depressive symptoms or depression trajectories across the perinatal period. Moreover, the potential impact of cannabis use on mother-child attachment, bonding, and emotional availability could intensify the effects of cannabis on PPD.

Postextraction ridge resorption compromises the aesthetics and function of the subsequent implant therapy or prosthetic rehabilitation. Several techniques are employed to reduce ridge resorption, ranging from basic socket fillers such as blood clot preservation to more advanced techniques using barrier membranes and bone grafts such as autografts, allografts, xenografts, and synthetic materials.

The US cancer survivor population is projected to hit 26M by 2040. Chemotherapy is an effective cancer treatment, but can diminish cancer survivors’ quality of life—particularly cognitive function—through select pathophysiological processes, including immune system and antioxidant dysregulation. The resulting cytokine release can impair cerebrovascular function—likely contributing to chemotherapy-induced cognitive impairment (CICI; “chemo-brain”). Type 2 diabetes mellitus (T2DM)—a common cancer survivor comorbidity—shares underlying pathophysiology with CICI. Cancer survivors with T2DM might thus have a higher CICI risk than those without T2DM. Physical activity (PA) counteracts CICI’s and T2DM’s pathophysiology, but little to no research has been conducted assessing the impact of PA on this joint pathophysiology.

Nonnutritive sweeteners (NNSs) are widely used as sugar substitutes to help individuals with diabetes manage glycemic control. However, emerging evidence suggests that even low doses of NNSs, such as saccharin and sucralose, may adversely affect metabolic health by impairing glycemic regulation, potentially through alterations in the gut microbiota. In Malaysia, where gut microbiome research is still limited, particularly among individuals with type 2 diabetes mellitus (T2DM), further investigation is warranted to inform safe and evidence-based use of NNSs.

Regular participation in some type of physical activity brings improvements in health indicators such as cardiorespiratory fitness, muscle strength, and body composition. However, despite evidence indicating health benefits, 1 in 4 adults is physically inactive, a situation that also occurs in the university population. Walking is a physical activity modality that can be easily incorporated into daily activities; therefore, using a walking-based physical activity intervention could improve some health indicators.

In the United States, mental health complications and cardiovascular events are the 2 leading causes of death for birthing parents in the year following delivery. Most of these deaths are preventable, with Black and Latinx individuals experiencing higher rates of these postpartum complications. Current postpartum care has not reduced these disparities.

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.