JMIR Research Protocols

Digital mental health interventions (DMHIs) can help close persistent gaps in access to assessment, prevention, and treatment. Recent advances in generative AI, particularly large language models (LLMs), further expand this promise by enabling natural language understanding, personalization, and empathic interaction across assessment, support, and therapeutic contexts. However, significant evaluation challenges persist, including a lack of standardized constructs and validated instruments, which limit the comparability, reproducibility, and generalizability of the findings. No systematic synthesis currently documents the frameworks, methodologies, and tools used to evaluate LLMs in DMHIs, thereby hampering the development of a comprehensive evidence base to guide future evaluation efforts.

Sexual and gender diverse populations experience inequities in health and health care access, as well as gaps in health professional education. Preregistration nursing and midwifery education represents a critical formative stage for developing inclusive and affirming practice; however, the integration of sexual and gender diversity within curricula remains variable and inconsistently described. Mapping how inclusive pedagogical practices address sexual and gender diversity in preregistration nursing and midwifery education will clarify current approaches and identify gaps in the literature.

Increasing attention has been directed toward environmental and climatic exposures as potential factors influencing reproductive function and fertility-related outcomes. However, the available evidence is dispersed across populations, study designs, and exposures.

Recent advancements in digital health have enabled the development of technology-enhanced diabetes coaching programs that offer personalized, data-driven, and adaptive support. However, evidence on their implementation and impact is scattered and has not been comprehensively synthesized. Although numerous studies have informed intervention development using different theories and models, the diversity of these approaches creates a significant challenge in developing an evidence-based intervention that is adaptable and effective across different population groups.

Emerging adults (EAs), typically ranging from 18 to 29 years, navigate a transitional period marked by rapid developmental, social, and psychological change. Despite heightened vulnerability to mental health (MH) concerns during this stage, service systems are often fragmented, with gaps between adolescent and adult care streams that leave many EAs without developmentally appropriate support. In response, developing approaches such as transdiagnostic stratification, which structures care around shared symptom processes and informs treatment intensity, and digital measurement-based care (dMBC), based on routine patient-reported outcome measures (PROMs), have gained traction but remain challenging to implement consistently. This reinforces the need for rapid learning health system (RLHS) approaches that leverage continuous data and feedback for ongoing improvement, as well as co-design (CD) methods that meaningfully integrate EA perspectives into service improvement.

HIV incidence among adolescent girls and young women (AGYW) aged 15-24 years in Eastern and Southern Africa remains unacceptably high. Unprotected sex increases the risk of HIV and other sexually transmitted infections and unintended pregnancies, reflecting an unmet need for effective contraception among AGYW. Long-acting injectable preexposure prophylaxis (LAI-PrEP) and long-acting reversible contraception (LARC) offer effective, durable protection against HIV and unintended pregnancy. However, uptake and persistence remain suboptimal due to low awareness, fear of side effects, stigma, limited decision-making autonomy, and poor integrated reproductive health and HIV prevention services. Evidence on community-driven and behaviorally informed strategies to support integrated rollout and uptake of LAI-PrEP and LARC among AGYW in Uganda remains limited.

Total joint arthroplasty (TJA) is among the most common elective surgeries performed in the United States, and recent advances in perioperative care have shortened hospital stays and streamlined recovery. Yet, even brief periods of mechanical ventilation and anesthesia measurably weaken respiratory muscle function in the early postoperative period. Preoperative inspiratory strength training (IST) has been shown to reduce postoperative pulmonary complications in patients undergoing major cardiothoracic surgery, but whether these benefits extend to shorter procedures such as TJA, where hospital stays are already brief, remains unknown.

Early epidemiological studies suggested that pre- and postmenopausal women receiving estrogen therapy were less likely to develop severe disease or die from COVID-19 infection. Potential mechanisms include estrogen-mediated immunomodulation and 17β-estradiol–induced downregulation of angiotensin-converting enzyme type 2 (ACE2), the cellular receptor for SARS-CoV-2.

Persistent disparities in diversity, equity, and inclusion (DEI) remain across US residency programs despite recent accreditation requirements. In this context, DEI disparities refer to inequities in the representation, recruitment, advancement, and educational experiences of individuals from underrepresented and marginalized groups. Numerous specialty-specific studies have evaluated DEI content on residency program websites, but these studies differ in their methodologies, assessed content, and reporting practices. There is currently no comprehensive synthesis of how DEI content is presented across the different existing literature in multiple residency specialties. Therefore, a scoping review is needed to map the existing literature.

Despite increasing recognition of adolescents’ and young adults’ mental health needs, many young people continue to experience barriers in accessing timely, acceptable, and responsive mental health and psychosocial support (PSS) services. There is a need for contextually relevant and youth-responsive approaches that meaningfully engage young people, caregivers, and service providers in implementation strategy development. The study aims to co-design a mental health and PSS implementation strategy for adolescents and young adults in KwaZulu-Natal (KZN), South Africa, using a human-centered design (HCD) approach.

Large language models (LLMs) are increasingly applied in health care for clinical decision-making, education, and patient communication. However, bias in LLM outputs may exacerbate health care disparities and compromise trust. Despite rapid adoption, there is limited synthesis of how bias is identified, measured, and mitigated in medical applications of LLMs.

Ethics of care lies at the heart of the nursing profession. Grounded in the work of Gilligan and Tronto, it emphasizes relationships and responsiveness to the needs of those receiving care. Although Tronto’s framework specifies 5 elements of care, no systematic synthesis has yet examined how each element is expressed through observable behavioral indicators in the nursing context.