JMIR Research Protocols

Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV transmission; yet, many people who would benefit from PrEP are not currently using it. Numerous programs and policies, including those provided under the US Ending the HIV Epidemic effort, have been implemented to increase PrEP use. Programs vary enormously, ranging from telemedicine PrEP support to electronic medical record prompts to social marketing and messaging campaigns. However, limited evidence exists regarding their relative impact on PrEP uptake.

Health literacy, defined as the ability to obtain, understand, evaluate, and use health information, influences health behaviors and outcomes. Low health literacy (LHL) is associated with misunderstandings of treatment instructions, poor adherence, and inadequate preventive behaviors, all of which contribute to health disparities. Although universal precautions, such as plain language and teach-back are recommended, recent studies indicate that these measures alone cannot fully address the challenges faced by patients with LHL. Previous qualitative studies have examined psychosocial processes through which shame and concealment shape patient–provider communication; however, these findings remain fragmented across settings and disciplines, and no scoping or systematic review has yet synthesized this evidence.

Selective serotonin reuptake inhibitors (SSRIs) are first-line antidepressants, however, only around 60% of patients could benefit from them. Acupuncture is supported by insufficient evidence to help with symptom relieving and SSRIs tolerance.

Evening technology use (ETU) has been associated with sleep disturbances, often attributed to blue light exposure and cognitive arousal. However, most of the existing evidence focuses on younger populations and relies primarily on subjective measures. As older adults increasingly engage with both passive and active technology use, it is important to investigate how evening technology use impacts objective sleep. Currently, there is also a limited understanding of how particular evening digital activities, especially active versus passive engagement, affect objective sleep in older adults.

Older patients are frequent users of Z-hypnotics despite consensus recommendations against extended use. Inappropriate Z-hypnotic use among older patients is frequently reported, posing risks of side effects and dependence. Interventions have been mainly at the population level and through prescription regulations. There are few instruments helping general practitioners (GPs) deal with inappropriate use among individual patients.

The growing digitisation of health data has expanded opportunities for professional learning and performance improvement. While providing new means for improving the quality and safety of healthcare these new capabilities for data analysis and performance monitoring come with risks and may exacerbate existing ethico-legal concerns about fairness, accountability, privacy and more.

Sexual minority youth (SMY) are significantly more likely to use alcohol compared with their heterosexual peers. Recent national data also suggest a turning point in alcohol use disparities: Latinx youth now report higher alcohol use than non-Latinx youth. Despite this, little is known about the social context and reasons why Latinx SMY may engage in alcohol use.

Worldwide, mechanical ventilation and ventilator weaning have been widely researched. Nevertheless, rates of weaning failure remain high. According to the Medical Research Council framework, ventilator weaning is a complex intervention. While there are various guidelines on this, there is no abstract theoretical understanding that organizes the interventions, outcomes, and their contexts.

Worker participation has been identified as important for managing the risks of work-related musculoskeletal disorders (WMSDs) and stress-related mental health problems (MHPs). Previously identified barriers include securing long-term management support to implement risk reduction measures. Few studies evaluate how a manager or decision maker’s readiness to act influences the outcomes of a participatory ergonomics program. The Stages of Change (SoC) framework has been suggested for tailoring ergonomics interventions to managers’ receptiveness in a workplace setting.

Dental fear and anxiety affect approximately a quarter of children and adolescents. It significantly contributes to pediatric patients avoiding dental care later in adulthood. Lack of cooperation due to dental fear and anxiety can create a stressful environment, often forcing dentists to end appointments prematurely and consider alternative pharmacological treatments. The use of virtual reality during dental procedures, offering an immersive sensory experience, may serve as an additional non-pharmacologic tool to better manage dental fear and anxiety in children with special healthcare needs undergoing dental treatment.

Despite advances in surgical resection, radiotherapy, and chemotherapy, the prognosis of recurrent malignant gliomas (rMG) remains poor, with limited efficacy of conventional treatments due to the blood-brain barrier (BBB) hindering drug delivery to the tumor site. Studies have demonstrated that albumin-bound paclitaxel (ABX), while potent in vitro, is restricted in its intravenous use due to BBB limitations. To overcome this, specific-mode electrical stimulation (SMES) has shown promise in transiently opening the BBB, enhancing the accumulation of ABX in glioma tumors.Therefore, this protocol designs a single-center, single-arm, prospective phase II clinical trial aiming to evaluate the safety and clinical efficacy of SMES combined with ABX(SMES+ABX) for treating rMG.

California has the largest number of people living with human immunodeficiency virus (HIV) in the United States, and in 2022 there were 4,882 new diagnoses. Veterans with histories of substance use, viral hepatitis, sexually transmitted infections, and homelessness carry substantial HIV burden. Testing is essential, yet approximately 12% of Californians with HIV were undiagnosed in 2020, and 50% of Veterans in care had never been tested as of 2023. HIV self-tests (HIVST) can mitigate stigma, confidentiality, and access barriers, and vending machines (VMs) offer private, convenient distribution. However, VM-dispensed HIVST has not been evaluated for Veterans or within VA settings.