JMIR Formative Research

Process evaluations, early results, and feasibility/pilot studies of digital and non-digital interventions

Editor-in-Chief:

Amaryllis Mavragani, PhDc, Scientific Editor at JMIR Publications, Canada


Impact Factor 2.0 CiteScore 2.7

JMIR Formative Research (JFR, ISSN 2561-326X, Journal Impact Factor™ 2.0 (Journal Citation Reports™ from Clarivate, 2023)) publishes peer-reviewed, openly accessible papers containing results from process evaluations, feasibility/pilot studies and other kinds of formative research and preliminary results. While the original focus was on the design of medical- and health-related research and technology innovations, JMIR Formative Research publishes studies from all areas of medical and health research.

Formative research is research that occurs before a program is designed and implemented, or while a program is being conducted. Formative research can help

  • define and understand populations in need of an intervention or public health program
  • create programs that are specific to the needs of those populations
  • ensure programs are acceptable and feasible to users before launching
  • improve the relationship between users and agencies/research groups
  • demonstrate the feasibility, use, satisfaction with, or problems with a program before large-scale summative evaluation (looking at health outcomes)

Many funding agencies will expect some sort of pilot/feasibility/process evaluation before funding a larger study such as a Randomized Controlled Trial (RCT).

Formative research should be an integral part of developing or adapting programs and should be used while the program is ongoing to help refine and improve program activities. Thus, formative evaluation can and should also occur in the form of a process evaluation alongside a summative evaluation such as an RCT.

JMIR Formative Research fills an important gap in the academic journals landscape, as it publishes sound and peer-reviewed formative research that is critical for investigators to apply for further funding, but that is usually not published in outcomes-focused medical journals aiming for impact and generalizability.

Summative evaluations of programs and apps/software that have undergone a thorough formative evaluation before launch have a better chance to be published in high-impact flagship journals; thus, we encourage authors to submit - as a first step - their formative evaluations in JMIR Formative Research (and their evaluation protocols to JMIR Research Protocols). 

JMIR Formative Research is indexed in MEDLINEPubMed, PubMed CentralDOAJ, Scopus, Sherpa/Romeo, EBSCO/EBSCO Essentials, and the Emerging Sources Citation Index (Clarivate).

Recent Articles

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Formative Evaluation of Digital Health Interventions

Wrong-site surgery (WSS) is a critical but preventable medical error, often resulting in severe patient harm and substantial financial costs. While protocols exist to reduce wrong-site surgery, underreporting and inconsistent documentation continue to contribute to its persistence. Machine learning (ML) models, which have shown success in detecting medication errors, may offer a solution by identifying unusual procedure-diagnosis combinations. This study investigated whether an ML approach can effectively adapt to detect surgical errors.

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Development and Evaluation of Research Methods, Instruments and Tools

Patient satisfaction surveys can offer crucial information on the quality of care but are rarely conducted in low-income settings. In contrast with in-person exit interviews, phone-based interactive voice response (IVR) surveys may offer benefits including standardization, patient privacy, reduced social desirability bias, and cost and time efficiency. IVR surveys have rarely been tested in low-income settings, particularly for patient satisfaction surveys.

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Pilot studies (ehealth)

The use of unsupervised digital cognitive assessments provides considerable opportunities for early and comprehensive testing for Alzheimer’s disease, minimizing the demand on time and personnel resources in medical practices. However, the acceptance within health care has yet to be assessed.

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Development and Evaluation of Research Methods, Instruments and Tools

Accumulating evidence supports the use of virtual reality (VR) in mental health care, with one potential application being its use to assist individuals with relaxation exercises. Despite studies finding support for the potential of VR to effectively aid in relaxation, its implementation remains limited outside of specialized clinics. Known barriers are insufficient knowledge regarding VR operation, lack of availability of VR relaxation apps tailored to local health care systems, and cost concerns. Unfortunately, many VR relaxation apps are designed exclusively for stand-alone headsets, limiting accessibility for a broad audience.

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Development and Evaluation of Research Methods, Instruments and Tools

Public deliberation is an approach used to engage persons with diverse perspectives in discussions and decision-making about issues affecting the public that are controversial or value laden. Because experts have identified the need to evaluate facilitator performance, our research team developed a framework to assess the fidelity of facilitator remarks to key principles of public deliberation.

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Formative Evaluation of Digital Health Interventions

Decreasing aggression through stress reduction is an important part of forensic psychiatric treatment. DEEP is an experience-based virtual reality intervention that uses biofeedback to train diaphragmatic breathing and increase relaxation. Although DEEP has shown promising results in reducing stress and anxiety in students and adolescents in special education, it has not been examined in forensic psychiatric populations.

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Formative Evaluation of Digital Health Interventions

Emergency departments (EDs) are high-pressure environments where clinicians diagnose patients under significant constraints, including limited medical histories, severe time pressures, and frequent interruptions. Current ED care practices often inadequately support meaningful patient participation. Most interventions prioritize clinical workflow and health care provider communication, inadvertently overlooking patients’ needs. Additionally, patient-facing technologies in EDs are typically developed without meaningful patient input, leading to solutions that may not effectively address patients’ specific challenges. To enhance both patient-centered care practices and the diagnosis process in EDs, patient involvement in technology design is essential to ensure their needs during emergency care are understood and addressed.

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Formative Evaluation of Digital Health Interventions

In the Netherlands, 545,900 people suffered from COPD in 2022. Physical therapy following the Royal Dutch Society for Physiotherapy (KNGF) guidelines, for COPD treatment is a proven effective treatment for people with COPD. The revised guidelines includes a new recommendation: a patient’s physical activity level should be assessed with an activity tracker (AT). Literature shows that the implementation of eHealth in clinical practice, in this case, activity trackers, is challenging.

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Early Results from COVID-19 Studies

Geospatial data science can be a powerful tool to aid the design, reach, efficiency, and impact of community-based intervention trials. The project titled Take Care Texas aims to develop and test an adaptive, multilevel, community-based intervention to increase COVID-19 testing and vaccination uptake among vulnerable populations in three Texas regions: Harris County, Cameron County, and Northeast Texas.

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Pilot studies (ehealth)

The Otago Program (OP) is evidence-based and focuses on fall prevention in older people. The feasibility and usability of a short-term digital program modeled after the principles of the OP in the setting of early geriatric rehabilitation (EGR) is unclear.

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Formative Evaluation of Digital Health Interventions

Technology is more likely to be used when it is designed to meet the needs of end-users. To supplement the [PROGRAM] diabetes prevention program, a smartphone application was developed in partnership with past [PROGRAM] clientele. Usability testing is critical for the ongoing use and adoption of mHealth applications by providing insight on where appropriate adjustemnts and improvements need to be made to ensure user satisfaction.

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Formative Evaluation of Digital Health Interventions

Despite the growing interest in smart glasses, it is striking that they are not widespread among health care professionals. Previous research has identified issues related to social interactions involving the use of smart glasses in public settings, which may differ from those associated with their application in health care contexts.

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