JMIR Research Protocols

Chronic pain affects approximately 1 in 5 adults worldwide and imposes a major personal and societal burden. Supported self-management, increasingly delivered through digital health systems, is recommended to improve quality of life and function. Dual-facing digital health systems (DDHSs), which engage both patients and professionals, show promise but remain underexplored, with limited use of established frameworks to guide their design and evaluation.

Clinical skills deficits are a patient-safety concern, yet remediation remains underexamined, particularly in low- and middle-income countries, where faculty shortages, uneven access to simulation and supervised practice, inconsistent assessment, and stigma can hinder timely and effective support. The effects of trainee underperformance extend beyond the individual, with implications for patient care, supervisory workload, and team functioning. Although interest in remediation is increasing, the evidence base remains fragmented, dominated by high-income settings, and largely descriptive. A theory-driven review is therefore needed to explain how remediation works, for whom, and under what conditions.

Influenza, a highly contagious acute respiratory illness, causes annual seasonal epidemics worldwide, imposing a substantial public health burden. Although neuraminidase inhibitors, such as oseltamivir, can shorten symptom duration, their use is limited by antiviral resistance and adverse reactions. Kanggan mixture (KGM), an in-hospital traditional Chinese medicine preparation at Jiangsu Province Hospital of Chinese Medicine, has been widely used in clinical practice for influenza treatment, showing favorable effects on fever reduction and symptom improvement; however, high-quality comparative evidence on the efficacy and safety of KGM remains limited. This study is designed to address this gap by evaluating whether KGM is noninferior to oseltamivir for the treatment of influenza.

Hispanic adults with type 1 diabetes (T1D) have suboptimal access to continuous glucose monitoring (CGM). Widening access to and increasing uptake of CGM for Hispanic adults with T1D are warranted.

Intensive care units (ICUs) present a highly stressful environment for patients, relatives, and health care professionals, often resulting in psychological distress. Despite the well-documented psychosocial burden, there is a lack of low-threshold, integrated support structures for all target groups. Based on the findings of phase A, a complex intervention was developed involving the permanent integration of study therapists into ICU teams.

Transitioning to residential centers often induces significant psychological stress in older adults, adversely affecting their psychological well-being (PWB) and ability to age healthily. Chinese art activities and their combination with peer group participation have demonstrated efficacy in improving emotional well-being and fostering social connectivity among younger populations but have not been examined in older adult populations to date.

The rising burden of alcohol-associated liver disease (ALD) calls for effective interventions. Alcohol cessation remains the only intervention known to reduce long-term ALD morbidity and mortality. Integrating treatment for alcohol use disorder with medical and hepatology care shows significant promise.

Physical activity (PA) is safe and beneficial for children and adolescents diagnosed with cancer, yet most engage in low levels of PA. We developed IMPACT (IMplementation of Physical Activity for Children and adolescents on Treatment), a PA intervention delivered by videoconference to enhance PA among young people during treatment for cancer and blood disorder diagnoses. IMPACT is being evaluated in a type II hybrid effectiveness-implementation trial in Alberta, Canada. While referral rates are high and early visual analyses suggest IMPACT may enhance PA and aspects of quality of life and physical function, participation, retention, and adherence rates are low. Findings signal the positive effect of IMPACT for those who participate and underscore the necessity of implementation adaptations. On the basis of these early findings, a demonstrated desire, and funding for PA at sites across Canada, we must first reimagine IMPACT through active collaboration with research users–those who will refer to and/or use or benefit from the intervention.

Cancer remains a leading cause of morbidity worldwide. To reduce this burden, scalable, effective approaches are needed to address modifiable risk factors for cancer and support behavioral self-management. With smartphone ownership now nearly ubiquitous, mobile health (mHealth) interventions offer a powerful means to extend the reach, accessibility, and sustainability of evidence-based treatments for a variety of modifiable risk factors (eg, excessive alcohol use, physical inactivity, poor diet, and smoking). Moreover, the flexibility of mHealth platforms enables efficient delivery of novel interventions, supports innovative study designs, and facilitates real-time data collection to advance public health research.

Many substance use disorder (SUD) care pathways exist in health care systems. However, patients with SUD often report poor care experiences, particularly regarding timely follow-up, clinician and general satisfaction ratings, and care communication. As SUD care pathways involve transitions across clinicians and venues of care, adequate treatment requires coordination across clinicians and settings to ensure unmet needs are addressed, and appropriate SUD care is delivered. Surprisingly little is known about the real-world care pathways patients engage in once identified as having SUD.

Approximately 25% of combat veterans with posttraumatic stress disorder (PTSD) seek treatment for traumas involving potentially morally injurious events (PMIEs), which involve acts of commission, omission, or betrayal that deeply transgress one’s sense of right and wrong. The sequelae of exposure to PMIEs, called “moral injury,” are associated with functional and psychiatric impairment and disrupt veterans’ sense of identity and meaning, ability to connect with and trust others, and engender disturbing guilt, shame, rage, and disgust. Currently, no first-line treatments directly address moral injury, and evidence-based treatments for PTSD may be limited because they were derived from civilian contexts, poorly fit the war zone context, and do not allow veterans to discuss the details of the PMIEs with other veterans.

Early childhood development (ECD) programs refer to policies and programs aimed at protecting young children’s rights to achieve their full potential. Parenting interventions are effective at improving children’s cognitive development and overall well-being. However, there is limited evidence on how to effectively implement and integrate such programs into routine service delivery at scale. The Government of China launched the ECD program in 2013 and the ECD scale-up program in 2023.