JMIR Research Protocols

Cognitive-communication disorders are pervasive following traumatic brain injury (TBI), disrupting communication at the level of discourse and social interaction. Discourse impairments impact functioning across major life domains, such as work and social relationships, and overall quality of life. Problems with discourse affect all severity levels of TBI and persist over time. Veterans may experience even greater functional decline due to comorbid health conditions (eg, posttraumatic stress disorder, pain). The functional impact and chronicity of discourse impairments following TBI underscore the importance of treating these impairments.

School health policies and practices are key components of health promotion for children and adolescents and play a central role in shaping healthy school environments, reducing health inequities, and fostering intersectoral collaboration between education and health systems. Despite their relevance, systematic and comparable assessments of how these policies and practices are implemented across different national contexts remain limited, particularly in low- and middle-income countries. Internationally comparable data are essential to identify strengths, gaps, and priorities for investment in school health.

Nicotine addiction among youth is a continuing public health concern, and vaping serves as a major pathway to nicotine use. Conventional assessments of craving and addiction risk rely on self-reports, which are prone to bias and lack sensitivity to real-time processes. Virtual reality (VR) enables controlled cue exposure while capturing real-time multimodal data, including subjective experiences, behavioral patterns, and physiological responses, which offer a more implicit and dynamic approach to identifying addiction risk.

Despite high prevalence of suicidal ideation and behavior, adolescents and young adults often underuse mental health services due to both structural and personal barriers. Simultaneously, massive social media (SM) expansion has introduced new mental health threats, while also creating vital spaces where adolescents and young adults can express psychological distress, seek support, and access mental health information. Designed as a bridge to care and a counterbalance to digital risks, the Équipe en Ligne de Prévention du Suicide (ELIOS) project connects adolescents and young adults with suicidal ideation or behaviors with a team of professionally trained web clinicians (nurses or psychologists supervised by a psychiatrist) through SM platforms. ELIOS is currently being evaluated within the Online Referral and Intervention to Prevent Adolescent and Young Adult Suicide (ORIAS) trial to assess its efficacy.

Nearly 1 in 5 Black Americans are first- or second-generation immigrants; however, little research to date focuses on the experiences of these communities in a disaggregated and culturally specific way. Emerging adults (ages 18‐29) from Black immigrant backgrounds face multiple intersecting challenges to their mental health as they try to transition to adulthood and develop their identity, all while navigating intergenerational traumas from the immigration process and ongoing challenges faced as Black people in the United States. Our preliminary research has identified significant mental health disparities affecting Ethiopian and Eritrean emerging adults in Atlanta. Despite these threats to mental health and well-being, and the growing representation of Ethiopian, Eritrean, and other immigrant groups within the larger Black population, there are no evidence-based interventions that have been developed or tested specifically for Black immigrant emerging adults.

Health and health care systems are progressively challenged by more frequent natural and human-caused hazards. A hazard becomes a disaster when vulnerability and exposure interact in complex ways with system capacity to trigger major disruptions in the functioning of a community or society. Patients with kidney diseases, especially those on dialysis, are particularly vulnerable.

Menstrual restrictions remain widespread in Nepal, where approximately 90% of women and girls follow at least one restriction. One of the most harmful practices, chhaupadi (severe menstrual seclusion), requires women and girls to isolate in huts during menstruation and is associated with substantial physical and psychological risks, including injury, assault, smoke inhalation, and social exclusion. Although interventions have attempted to address chhaupadi, effectiveness has varied, and no comprehensive assessment has identified which components work, for whom, and under what conditions. Few prior efforts have meaningfully engaged communities in intervention design to ensure contextual relevance and sustainability.

Chronic musculoskeletal pain (CMP) imposes a significant psychological, physical, and emotional burden on millions of adults in the United States. A challenge in treating CMP is its tendency to become enmeshed with a person’s sense of self. Mindfulness-based interventions (MBIs) offer a promising approach to help patients disentangle pain from their sense of self. However, rigorous research is needed to determine which styles of mindfulness practice most effectively promote self-transcendence, a candidate mechanism for durable pain relief.

Accreditation programs are used by hospitals and health services to be independently reviewed against established safety and quality standards and have been a feature of global health systems for over a century. While evidence that accreditation programs directly improve patient safety and quality outcomes exists, the findings of various researchers remain mixed. Inefficiencies and a culture of “gaming” the system have also been observed, raising questions about the overall effectiveness of accreditation programs and assessment processes. Consequently, exploration of other formats of accreditation assessment, such as short-notice accreditation assessment, has arisen. From July 1, 2023, the Australian Commission on Safety and Quality in Healthcare mandated that Australian public and private hospitals must engage in short-notice accreditation assessment.

Research is needed to better understand mental health (MH) problems among higher education (HE) students and how to address them. The Observatory on Student Mental Health in Higher Education (OSMHHE) brings together 350 members across Quebec (Canada) and internationally. Its mission is to develop, promote, and disseminate knowledge to foster a culture that supports student MH in HE.

The COVID-19 pandemic has a lasting impact on health care utilization, as both the acute infection and post COVID condition (PCC) can lead to increased demand for medical services due to ongoing symptoms.

Cesarean section (CS) requires perioperative antibiotic prophylaxis (PAP) for the prevention of surgical site infections. However, systemic antibiotics during the peripartum period may induce compositional perturbations of the maternal gut microbiome, a system already characterized by reduced resilience. Data on maternal gut microbiome dynamics after CS with PAP are scarce, largely due to logistical and feasibility barriers that limit the participation of pregnant women and new mothers in conventional clinical studies.