{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:04:32Z","timestamp":1782846272944,"version":"3.54.5"},"reference-count":60,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Digital tools are known to promote public health interventions such as vaccine delivery. The recommendation that health care professionals (HCPs) use vaccination-related mobile apps or web-based applications has contributed to improving vaccine awareness and acceptance in the United States. The state of Texas, which has one of the lowest human papillomavirus (HPV) vaccination rates, has seen a significant increase in HPV vaccine hesitancy, particularly during the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to examine the association between changes in HPV vaccine hesitancy observed by HCPs among patients in Texas and promotion of vaccination-related applications at the health care facilities where they practiced during the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A population-based cross-sectional survey was administered in 2021 by the MD Anderson Cancer Center to HCPs working in Texas using email addresses obtained from the LexisNexis Master Provider Referential Database. HCPs were asked if they assessed HPV vaccination status during every patient encounter. Those who responded \u201cOften\/Always\u201d or \u201cSometimes\u201d were subsequently asked whether they observed any change (\u201cDecreased,\u201d \u201cNo change,\u201d \u201cIncreased,\u201d or \u201cNot sure\u201d) in HPV vaccine hesitancy during the COVID-19 pandemic. Additionally, HCPs were asked whether their practice offers HPV vaccination. Those who responded \u201cYes\u201d to this question were further asked whether vaccination-related applications are promoted at the facility where they practice, with response options being \u201cYes,\u201d \u201cNo,\u201d or \u201cI don\u2019t know.\u201d Logistic regression analysis was performed to examine the association between changes in HPV vaccine hesitancy observed by HCPs and promotion of vaccination-related applications at the facility where they practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1283 HCPs completed the survey. Of the 730 HCPs who observed changes in HPV vaccine hesitancy, 51 (7%) reported a decrease in their patients\u2019 HPV vaccine hesitancy. Of these 730 HCPs, 578 (79.2%) responded to the questions regarding vaccination-related applications, of whom 104 (18%) reported that vaccination-related applications were promoted at their facilities. Compared to HCPs who reported not promoting vaccination-related applications, those who reported doing so at their facilities had significantly higher odds of observing a decrease in HPV vaccine hesitancy among patients (adjusted odds ratio [aOR] 2.48, 95% CI 1.10-5.55;\n                      <jats:italic>P<\/jats:italic>\n                      =.03). HCPs working at federally qualified health centers or city, county, or public health care facilities (aOR 4.02, 95% CI 1.33-12.14;\n                      <jats:italic>P<\/jats:italic>\n                      =.01) and HCPs who administered the HPV vaccine under standing orders at their facilities (aOR 2.91, 95% CI 1.11-7.63;\n                      <jats:italic>P<\/jats:italic>\n                      =.03) had significantly higher odds of observing a decrease in HPV vaccine hesitancy at their practices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that promoting vaccination-related applications at health care facilities in areas with high HPV vaccine hesitancy such as Texas could further decrease HPV vaccine hesitancy in the population. This may be potentially applicable across diverse health care settings, particularly in the context of pandemic preparedness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/77778","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:25:07Z","timestamp":1774571107000},"page":"e77778-e77778","source":"Crossref","is-referenced-by-count":0,"title":["Vaccination-Related Applications and Health Care Professionals\u2019 Observed Changes in Human Papillomavirus Vaccine Hesitancy: Cross-Sectional Survey"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5451-7254","authenticated-orcid":false,"given":"Manali","family":"Desai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4668-5020","authenticated-orcid":false,"given":"Shreela","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4722-9262","authenticated-orcid":false,"given":"Joel","family":"Fokom-Domgue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1549-7115","authenticated-orcid":false,"given":"Robert","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3329-5282","authenticated-orcid":false,"given":"Wenyaw","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9139-7645","authenticated-orcid":false,"given":"Onyema G","family":"Chido-Amajuoyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0063-7856","authenticated-orcid":false,"given":"Charles","family":"Darkoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7622-376X","authenticated-orcid":false,"given":"Sanjay","family":"Shete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"R1","unstructured":"Cancers linked with HPV each year. Centers for Disease Control and Prevention. 2025. URL: https:\/\/www.cdc.gov\/cancer\/hpv\/cases.html [Accessed 15-4-2026]"},{"issue":"8","key":"R2","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1056\/NEJMoa1405044","article-title":"A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women","volume":"372","author":"Joura","journal-title":"N Engl J Med"},{"key":"R3","unstructured":"Human papillomavirus (HPV) vaccination: information for health care providers. Centers for Disease Control and Prevention. 2021. URL: https:\/\/www.cdc.gov\/vaccines\/vpd\/hpv\/hcp\/recommendations.html [Accessed 10-09-2025]"},{"issue":"4","key":"R4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060993","article-title":"Ten-year follow-up of 9-valent human papillomavirus vaccine: immunogenicity, effectiveness, and safety","volume":"152","author":"Restrepo","journal-title":"Pediatrics"},{"key":"R5","unstructured":"Human papillomavirus (HPV) vaccine safety. Centers for Disease Control and Prevention. URL: https:\/\/www.cdc.gov\/vaccine-safety\/vaccines\/hpv.html#:~:text=HPV%20vaccine%20is%20safe%20and,sore%20arm%20from%20the%20shot [Accessed 15-04-2026]"},{"issue":"12","key":"R6","doi-asserted-by":"publisher","first-page":"e255","DOI":"10.1097\/OLQ.0000000000001407","article-title":"Barriers to and facilitators of human papillomavirus vaccination among people aged 9 to 26 years: a systematic review","volume":"48","author":"Zheng","journal-title":"Sex Transm Dis"},{"issue":"30","key":"R7","doi-asserted-by":"publisher","first-page":"466","DOI":"10.15585\/mmwr.mm7430a1","article-title":"Vaccination coverage among adolescents aged 13-17 years - National Immunization Survey-Teen, United States, 2024","volume":"74","author":"Pingali","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"6","key":"R8","doi-asserted-by":"publisher","first-page":"1566","DOI":"10.1080\/21645515.2015.1125055","article-title":"Interventions to increase HPV vaccination coverage: a systematic review","volume":"12","author":"Smulian","journal-title":"Hum Vaccin Immunother"},{"key":"R9","unstructured":"About the Vaccines for Children (VFC) program. Centers for Disease Control and Prevention. 2025. URL: https:\/\/www.cdc.gov\/vaccines-for-children\/about\/index.html [Accessed 15-04-2026]"},{"key":"R10","unstructured":"HPV vaccination. Centers for Disease Control and Prevention. URL: https:\/\/www.cdc.gov\/hpv\/vaccines\/index.html [Accessed 27-4-2026]"},{"issue":"RR-2","key":"R11","first-page":"1","volume":"56","author":"Markowitz","journal-title":"MMWR Recomm Rep"},{"key":"R12","unstructured":"How to pay for vaccines. Centers for Disease Control and Prevention. URL: https:\/\/www.cdc.gov\/vaccines-adults\/recommended-vaccines\/how-to-pay-adult-vaccines.html [Accessed 10-09-2025]"},{"issue":"33","key":"R13","doi-asserted-by":"publisher","first-page":"708","DOI":"10.15585\/mmwr.mm7333a1","article-title":"National vaccination coverage among adolescents aged 13-17 years - National Immunization Survey-Teen, United States, 2023","volume":"73","author":"Pingali","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R14","unstructured":"Increase the proportion of adolescents who get recommended doses of the HPV vaccine \u2014 IID\u201108. Office of Disease Prevention and Health Promotion. URL: https:\/\/odphp.health.gov\/healthypeople\/objectives-and-data\/browse-objectives\/vaccination\/increase-proportion-adolescents-who-get-recommended-doses-hpv-vaccine-iid-08 [Accessed 10-09-2025]"},{"key":"R15","unstructured":"Ten threats to global health in 2019. World Health Organization. URL: https:\/\/www.who.int\/news-room\/spotlight\/ten-threats-to-global-health-in-2019 [Accessed 10-09-2025]"},{"key":"R16","unstructured":"Vaccine hesitancy: a growing challenge for immunization programmes. World Health Organization. 2015. URL: https:\/\/www.who.int\/news\/item\/18-08-2015-vaccine-hesitancy-a-growing-challenge-for-immunization-programmes [Accessed 10-09-2025]"},{"issue":"5","key":"R17","doi-asserted-by":"publisher","first-page":"2368","DOI":"10.1111\/jan.16653","article-title":"HPV vaccine hesitancy and uptake: a conceptual analysis using Rodgers\u2019 evolutionary approach","volume":"81","author":"Kyei","journal-title":"J Adv Nurs"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvacx.2022.100231","article-title":"Exploring HPV vaccine hesitant parents\u2019 perspectives on decision-making and motivators for vaccination","volume":"12","author":"Beavis","journal-title":"Vaccine X"},{"issue":"5","key":"R19","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/j.jadohealth.2016.11.028","article-title":"Characteristics of adolescents lacking provider-recommended human papillomavirus vaccination","volume":"60","author":"Krakow","journal-title":"J Adolesc Health"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2021.1885968","article-title":"A pilot intervention combining assessment and feedback with communication training and behavioral nudges to increase HPV vaccine uptake","volume":"18","author":"Bradley-Ewing","journal-title":"Hum Vaccin Immunother"},{"issue":"9","key":"R21","doi-asserted-by":"publisher","first-page":"e484","DOI":"10.1016\/S2468-2667(20)30139-0","article-title":"Parental intent to initiate and complete the human papillomavirus vaccine series in the USA: a nationwide, cross-sectional survey","volume":"5","author":"Sonawane","journal-title":"Lancet Public Health"},{"issue":"38","key":"R22","doi-asserted-by":"publisher","first-page":"6027","DOI":"10.1016\/j.vaccine.2020.06.074","article-title":"Prevalence and characteristics of HPV vaccine hesitancy among parents of adolescents across the US","volume":"38","author":"Szilagyi","journal-title":"Vaccine"},{"issue":"9","key":"R23","doi-asserted-by":"publisher","first-page":"2131","DOI":"10.1080\/21645515.2020.1735226","article-title":"How health care providers should address vaccine hesitancy in the clinical setting: evidence for presumptive language in making a strong recommendation","volume":"16","author":"Jacobson","journal-title":"Hum Vaccin Immunother"},{"issue":"2","key":"R24","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11020249","article-title":"Digital health interventions to improve adolescent HPV vaccination: a systematic review","volume":"11","author":"Choi","journal-title":"Vaccines (Basel)"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/47334","article-title":"The effectiveness of mHealth interventions targeting parents and youth in human papillomavirus vaccination: systematic review","volume":"6","author":"Ou","journal-title":"JMIR Pediatr Parent"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/19503","article-title":"Vaccipack, a mobile app to promote human papillomavirus vaccine uptake among adolescents aged 11 to 14 years: development and usability study","volume":"3","author":"Teitelman","journal-title":"JMIR Nurs"},{"issue":"7","key":"R27","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1097\/CIN.0000000000000832","article-title":"A Vax4HPV mobile application for parents of human papillomavirus vaccine-eligible children: iterative formative assessments","volume":"40","author":"Kim","journal-title":"Comput Inform Nurs"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2021.693688","article-title":"Vacteens.org: a mobile web app to improve HPV vaccine uptake","volume":"3","author":"Woodall","journal-title":"Front Digit Health"},{"issue":"5","key":"R29","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2022.2087430","article-title":": impact of a digital behavior change intervention on parental HPV vaccine-related perceptions and behaviors","volume":"18","author":"Shegog","journal-title":"Hum Vaccin Immunother"},{"issue":"4","key":"R30","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1016\/j.jadohealth.2025.06.015","article-title":"TeenVac.org: a mobile web app to improve human papillomavirus vaccine uptake for adolescent boys","volume":"77","author":"Woodall","journal-title":"J Adolesc Health"},{"key":"R31","unstructured":"National Immunization Survey-Teen (NIS-Teen) 2024, Texas. Texas Department of State Health Services. URL: https:\/\/www.dshs.texas.gov\/immunizations\/data\/surveys\/nis\/teens [Accessed 16-04-2026]"},{"issue":"2","key":"R32","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1177\/00333549221138855","article-title":"Reduced access to preventive care due to the COVID-19 pandemic, by chronic disease status and race and Hispanic origin, United States, 2020-2021","volume":"138","author":"Irimata","journal-title":"Public Health Rep"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/s10900-021-01017-9","article-title":"Parental perspectives on immunizations: impact of the COVID-19 pandemic on childhood vaccine hesitancy","volume":"47","author":"He","journal-title":"J Community Health"},{"issue":"2","key":"R34","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2023.2225388","article-title":"Pediatricians\u2019 perspectives on COVID-19 and HPV vaccine hesitancy","volume":"19","author":"Ryan","journal-title":"Hum Vaccin Immunother"},{"issue":"4","key":"R35","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkac053","article-title":"HPV vaccination uptake, hesitancy, and refusal: observations of health-care professionals during the COVID-19 pandemic","volume":"6","author":"Chido-Amajuoyi","journal-title":"JNCI Cancer Spectr"},{"issue":"23","key":"R36","doi-asserted-by":"publisher","first-page":"840","DOI":"10.15585\/mmwr.mm7023a2","article-title":"Impact of the COVID-19 pandemic on administration of selected routine childhood and adolescent vaccinations - 10 U.S. jurisdictions, March-September 2020","volume":"70","author":"Patel Murthy","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R37","unstructured":"Transform your risk decision making. LexisNexis Risk Solutions. URL: https:\/\/risk.lexisnexis.com\/ [Accessed 10-09-2025]"},{"issue":"9596","key":"R38","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","journal-title":"Lancet"},{"key":"R39","unstructured":"Rural-Urban Continuum Codes. U.S. Department of Agriculture. URL: https:\/\/www.ers.usda.gov\/data-products\/rural-urban-continuum-codes [Accessed 10-09-2025]"},{"key":"R40","unstructured":"Income in the past 12 months (in 2022 inflation-adjusted dollars). United States Census Bureau. URL: https:\/\/data.census.gov\/table\/ACSST1Y2022.S1901?t=Income+and+Poverty&g=010XX00US_040XX00US48,48$8600000&y=2022 [Accessed 01-12-2025]"},{"issue":"16","key":"R41","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11162276","article-title":"Relationship between satisfaction scores and racial\/ethnic and sex concordance in primary care","volume":"11","author":"Walker","journal-title":"Healthcare (Basel)"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-024-01318-0","article-title":"Impact of the COVID-19 pandemic on HPV vaccine uptake in a predominantly Hispanic border community: a retrospective cross-sectional analysis of the \u201cTiempo de Vacunarte Program\u201d","volume":"82","author":"Nguyen","journal-title":"Arch Public Health"},{"issue":"10","key":"R43","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1001\/jamapediatrics.2021.1585","article-title":"Safety concerns or adverse effects as the main reason for human papillomavirus vaccine refusal","volume":"175","author":"Chido-Amajuoyi","journal-title":"JAMA Pediatr"},{"issue":"14","key":"R44","doi-asserted-by":"publisher","first-page":"5281","DOI":"10.1002\/cam4.3192","article-title":"Reasons for not receiving the HPV vaccine among eligible adults: lack of knowledge and of provider recommendations contribute more than safety and insurance concerns","volume":"9","author":"Fokom Domgue","journal-title":"Cancer Med"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.vaccine.2016.11.012","article-title":"Clinician knowledge, clinician barriers, and perceived parental barriers regarding human papillomavirus vaccination: association with initiation and completion rates","volume":"35","author":"Rutten","journal-title":"Vaccine"},{"issue":"4S","key":"R46","doi-asserted-by":"publisher","first-page":"S24","DOI":"10.1016\/j.acap.2021.01.018","article-title":"Communicating with vaccine-hesitant parents: a narrative review","volume":"21","author":"Limaye","journal-title":"Acad Pediatr"},{"issue":"10","key":"R47","doi-asserted-by":"publisher","first-page":"2395","DOI":"10.1080\/21645515.2015.1057362","article-title":"Apps for immunization: leveraging mobile devices to place the individual at the center of care","volume":"11","author":"Wilson","journal-title":"Hum Vaccin Immunother"},{"issue":"5","key":"R48","doi-asserted-by":"publisher","DOI":"10.2196\/17371","article-title":"Use of apps to promote childhood vaccination: systematic review","volume":"8","author":"de Cock","journal-title":"JMIR Mhealth Uhealth"},{"issue":"3 Suppl","key":"R49","doi-asserted-by":"publisher","first-page":"S80","DOI":"10.1016\/j.jadohealth.2005.05.007","article-title":"Applying a transtheoretical behavioral change model to HIV\/STD and pregnancy prevention in adolescent clinics","volume":"37","author":"Hacker","journal-title":"J Adolesc Health"},{"key":"R50","unstructured":"CDC vaccine schedules app for healthcare providers. Centers for Disease Control and Prevention Vaccines & Immunizations. 2025. URL: https:\/\/www.cdc.gov\/vaccines\/hcp\/imz-schedules\/app.html [Accessed 10-09-2025]"},{"key":"R51","unstructured":"Vaccine apps. Immunize.org. URL: https:\/\/www.immunize.org\/clinical\/external\/apps\/ [Accessed 10-09-2025]"},{"key":"R52","unstructured":"Vaccines. Texas Department of State Health Services. URL: https:\/\/www.dshs.texas.gov\/immunizations\/public\/vaccines [Accessed 10-09-2025]"},{"key":"R53","unstructured":"Community Health & Wellness Division. Harris County Public Health. URL: https:\/\/publichealth.harriscountytx.gov\/Divisions-Offices\/Divisions\/Community-Health-Wellness-Division [Accessed 10-09-2025]"},{"issue":"33","key":"R54","doi-asserted-by":"publisher","first-page":"4149","DOI":"10.1016\/j.vaccine.2014.05.058","article-title":"Identifying human papillomavirus vaccination practices among primary care providers of minority, low-income and immigrant patient populations","volume":"32","author":"Bruno","journal-title":"Vaccine"},{"key":"R55","unstructured":"TACHC annual report 2024. Texas Association of Community Health Centers; URL: https:\/\/tachc.org\/wp-content\/uploads\/2025\/05\/TACHC_annual-report_2024-FINAL.pdf.pdf [Accessed 16-04-2026]"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2024.100694","article-title":"Factors associated with parental human papillomavirus vaccination intentions among adolescents from socioeconomically advantaged versus deprived households: a nationwide, cross-sectional survey","volume":"31","author":"Sonawane","journal-title":"Lancet Reg Health Am"},{"issue":"4","key":"R57","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10040577","article-title":"Adherence to the recommended HPV vaccine dosing schedule among adolescents aged 13 to 17 years: findings from the National Immunization Survey-Teen, 2019-2020","volume":"10","author":"Ejezie","journal-title":"Vaccines (Basel)"},{"key":"R58","unstructured":"Using standing orders for administering vaccines: what you should know. Immunize.org. URL: https:\/\/www.immunize.org\/wp-content\/uploads\/catg.d\/p3066.pdf [Accessed 10-09-2025]"},{"issue":"19","key":"R59","doi-asserted-by":"publisher","first-page":"3981","DOI":"10.1016\/j.vaccine.2024.05.008","article-title":"HPV vaccine standing orders and communication in primary care: a qualitative study","volume":"42","author":"Mansfield","journal-title":"Vaccine"},{"issue":"3","key":"R60","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/j.ajic.2019.07.023","article-title":"Maximizing the impact of, and sustaining standing orders protocols for adult immunization in outpatient clinics","volume":"48","author":"Tan","journal-title":"Am J Infect Control"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e77778","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:10:04Z","timestamp":1782843004000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e77778"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,14]]},"references-count":60,"URL":"https:\/\/doi.org\/10.2196\/77778","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,14]]},"article-number":"v14i8e77778"}}