{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:12:22Z","timestamp":1785510742886,"version":"3.56.0"},"reference-count":61,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Chronic opioid use, a key predictor of opioid overdose, is common among adolescents and young adults (AYA) with inflammatory bowel diseases (IBD), underscoring a need for tailored interventions to monitor risk for opioid-related harm. Prior research highlights the need to engage both AYA patients with IBD and IBD-focused clinicians in the development of pain management and opioid safety interventions. Human-centered design offers a promising approach to address this gap by directly engaging patients and clinicians in cocreating solutions.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n We aimed to explore and identify AYA patient and clinician perspectives to inform the design and development of a digital opioid safety tool.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Using convenience sampling, we conducted semistructured interviews with AYA patients with IBD and IBD-focused clinicians (gastroenterologists, surgeons, and nurses) in July-August 2023 in person or by video-based conferencing. Interviews explored patient experiences with pain management, opioid use, and transitions to adult care, as well as clinician experiences in monitoring pain and prescribing opioids. A co-design workshop, following the interviews, brought patient and clinician participants together to reflect as a group on the unique challenges of managing pain in IBD care, and consider potential creative solutions to enhance pain management safety. The workshop was facilitated in person in September 2023 and included 7 patients and 8 clinicians who previously participated in individual interviews. Data were audio recorded, transcribed, and thematically analyzed using an inductive approach to identify themes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Twenty participants (7 AYA patients and 13 clinicians) contributed to the study. Thematic analysis generated three domains of needs that a digital opioid safety tool should address: (1) Intersecting Needs (ie, relevant at the patient and clinician and\/or health system levels), (2) Patient-Level Needs (ie, relevant at the patient level only), and (3) Clinician- and\/or Health System\u2013Level Needs (ie, relevant at the clinician and\/or health system levels only). Intersecting needs included integrating opioid safety interventions into multidisciplinary chronic care, supporting AYA transitions to independence, and acknowledging individual patient differences. Patient-level needs included assessing lived experiences of pain routinely, setting clear expectations about pain management, and connecting patients with safe nonopioid alternatives. Clinician- and\/or health system\u2013level needs included accounting for pain management received outside the IBD clinic; addressing gaps in information, education, and resources regarding opioid risk or pain management; and coordinating safety efforts across clinical teams.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Incorporating these insights into the development of a digital opioid safety tool may enhance alignment between patient and clinician expectations on pain management and opioid use. This study underscores the value of human-centered design in developing digital opioid safety tools that are practical, patient-focused, and effectively integrated into clinical workflows. Findings may guide future intervention design, prototyping, and testing with continued engagement of AYA patients with IBD and clinicians.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/92202","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T19:25:08Z","timestamp":1780946708000},"page":"e92202-e92202","source":"Crossref","is-referenced-by-count":0,"title":["End User Needs and Perspectives for a Digital Opioid Safety Tool in Adolescents and Young Adults With Inflammatory Bowel Disease: A Qualitative Human-Centered Design Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7702-0487","authenticated-orcid":false,"given":"Maria","family":"Younan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1872-6005","authenticated-orcid":false,"given":"Amanda","family":"Acquaire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7811-1053","authenticated-orcid":false,"given":"Lauren","family":"Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5551-4561","authenticated-orcid":false,"given":"Deysi","family":"Paniagua-Perez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6876-2461","authenticated-orcid":false,"given":"Devyani","family":"Dharanipragada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3268-932X","authenticated-orcid":false,"given":"Stephen B","family":"Hanauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2934-1672","authenticated-orcid":false,"given":"Jane L","family":"Holl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1527-2661","authenticated-orcid":false,"given":"Mehul V","family":"Raval","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3167-4716","authenticated-orcid":false,"given":"Andrew B L","family":"Berry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4336-7489","authenticated-orcid":false,"given":"Salva N","family":"Balbale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"R1","unstructured":"Uchitel J Hadland S Raman S McClellan M Wong C . The opioid epidemic: a needed focus on adolescents and young adults. Health Affairs Forefront. 2019. URL: https:\/\/www.healthaffairs.org\/content\/forefront\/opioid-epidemic-needed-focus-adolescents-and-young-adults [Accessed 30-06-2026]"},{"issue":"5","key":"R2","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1016\/j.cgh.2020.08.041","article-title":"Opioid use among patients with inflammatory bowel disease: a systematic review and meta-analysis","volume":"19","author":"Niccum","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024-070224","article-title":"Adolescent and young adult access to opioid use disorder care","volume":"156","author":"Ball","journal-title":"Pediatrics"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.jadohealth.2020.04.002","article-title":"Medication treatment for opioid-addicted youth-what are we waiting for?","volume":"67","author":"Woody","journal-title":"J Adolesc Health"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2024.209352","article-title":"Engagement, initiation, and retention in medication treatment for opioid use disorder among young adults: a narrative review of challenges and opportunities","volume":"166","author":"Fishman","journal-title":"J Subst Use Addict Treat"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1136\/flgastro-2023-102471","article-title":"Chronic abdominal pain in inflammatory bowel disease: a practical guide","volume":"15","author":"Baillie","journal-title":"Frontline Gastroenterol"},{"issue":"6","key":"R7","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1007\/s00384-021-03852-7","article-title":"Targeted housestaff intervention reduces opioid use without worsening patient-reported pain scores and improves outcomes among patients with IBD: the \u201cIBD pain ladder\u201d","volume":"36","author":"Kaimakliotis","journal-title":"Int J Colorectal Dis"},{"issue":"6","key":"R8","doi-asserted-by":"publisher","first-page":"1777","DOI":"10.1007\/s10620-019-05906-x","article-title":"Pain in inflammatory bowel disease is not improved during hospitalization: the impact of opioids on pain and healthcare utilization","volume":"65","author":"Berry","journal-title":"Dig Dis Sci"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otaa009","article-title":"Opioid use in patients with inflammatory bowel disease","volume":"2","author":"Lin","journal-title":"Crohn\u2019s & Colitis 360"},{"issue":"8","key":"R10","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1007\/s10620-019-05968-x","article-title":"Opioid analgesics do not improve abdominal pain or quality of life in Crohn\u2019s disease","volume":"65","author":"Coates","journal-title":"Dig Dis Sci"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.mayocp.2018.09.013","article-title":"Mechanisms of disease: inflammatory bowel diseases","volume":"94","author":"Ramos","journal-title":"Mayo Clin Proc"},{"key":"R12","unstructured":"IBD facts and stats. Centers for Disease Control and Prevention. 2024. URL: https:\/\/www.cdc.gov\/inflammatory-bowel-disease\/php\/facts-stats\/index.html [Accessed 30-06-2026]"},{"issue":"5","key":"R13","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1002\/ibd.20848","article-title":"Pain and inflammatory bowel disease","volume":"15","author":"Bielefeldt","journal-title":"Inflamm Bowel Dis"},{"issue":"10","key":"R14","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1093\/ibd\/izy222","article-title":"Starting young: trends in opioid therapy among us adolescents and young adults with inflammatory bowel disease in the Truven MarketScan database between 2007 and 2015","volume":"24","author":"Wren","journal-title":"Inflamm Bowel Dis"},{"issue":"4","key":"R15","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1016\/j.cgh.2017.10.022","article-title":"Increasing prescription of opiates and mortality in patients with inflammatory bowel diseases in England","volume":"16","author":"Burr","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otaa010","article-title":"Patterns of opioid use among patients with inflammatory bowel disease: do we need better disease control or multidisciplinary interventions?","volume":"2","author":"Barnes","journal-title":"Crohn\u2019s & Colitis 360"},{"issue":"7","key":"R17","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1093\/ibd\/izy040","article-title":"The association between sustained poor quality of life and future opioid use in inflammatory bowel disease","volume":"24","author":"Anderson","journal-title":"Inflamm Bowel Dis"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otac033","article-title":"A missing piece of the puzzle: patient and provider perspectives on pain management needs and opioid prescribing in inflammatory bowel disease care","volume":"4","author":"Balbale","journal-title":"Crohn\u2019s & Colitis 360"},{"issue":"2","key":"R19","doi-asserted-by":"publisher","DOI":"10.1177\/2381468320940708","article-title":"The gray zone: adolescent and young adult decision support needs for ulcerative colitis","volume":"5","author":"Meisman","journal-title":"MDM Policy Pract"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1542\/peds.2011-0969","article-title":"Supporting the health care transition from adolescence to adulthood in the medical home","volume":"128","author":"American Academy of Pediatrics","journal-title":"Pediatrics"},{"issue":"2","key":"R21","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1093\/jcag\/gwad054","article-title":"Patient and public involvement in inflammatory bowel disease research\u2014a scoping review","volume":"7","author":"Elsolh","journal-title":"J Can Assoc Gastroenterol"},{"issue":"24","key":"R22","doi-asserted-by":"publisher","first-page":"7610","DOI":"10.1080\/09638288.2021.1979667","article-title":"Co-designed healthcare transition interventions for adolescents and young adults with chronic conditions: a scoping review","volume":"44","author":"Bray","journal-title":"Disabil Rehabil"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-020-0847-1","article-title":"America\u2019s opioid crisis: the need for an integrated public health approach","volume":"10","author":"Blanco","journal-title":"Transl Psychiatry"},{"issue":"Supplement_1","key":"R24","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1093\/intqhc\/mzaa127","article-title":"Innovating health care: key characteristics of human-centered design","volume":"33","author":"Melles","journal-title":"Int J Qual Health Care"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/21639","article-title":"Developing patient-centered inflammatory bowel disease-related educational videos optimized for social media: qualitative research study","volume":"6","author":"Khalil","journal-title":"JMIR Med Educ"},{"issue":"4","key":"R26","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1007\/s11606-023-08500-0","article-title":"The role of human-centered design in healthcare innovation: a digital health equity case study","volume":"39","author":"Levander","journal-title":"J Gen Intern Med"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2019.03.004","article-title":"Using a human-centered design approach for collaborative decision-making in pediatric asthma care","volume":"170","author":"Eberhart","journal-title":"Public Health"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.915231","article-title":"Communicating risk for obesity in early life: engaging parents using human-centered design methodologies","volume":"10","author":"Cheng","journal-title":"Front Pediatr"},{"issue":"2","key":"R29","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1055\/a-2040-0578","article-title":"Human-centered design of a clinical decision support for anemia screening in children with inflammatory bowel disease","volume":"14","author":"Miller","journal-title":"Appl Clin Inform"},{"issue":"3","key":"R30","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/j.cgh.2024.04.042","article-title":"The IBD clinic of tomorrow: holistic, patient-centric, and value-based care","volume":"23","author":"Click","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","DOI":"10.2196\/humanfactors.8083","article-title":"Co-designing a collaborative chronic Care Network (C3N) for inflammatory bowel disease: development of methods","volume":"5","author":"Seid","journal-title":"JMIR Hum Factors"},{"issue":"3","key":"R32","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1177\/19322968211043921","article-title":"The role of human-centered design in insulin pen innovation and the future of insulin delivery","volume":"16","author":"Watterson","journal-title":"J Diabetes Sci Technol"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2023.100677","article-title":"From formative design to service-ready therapeutic: a pragmatic approach to designing digital mental health interventions across domains","volume":"34","author":"Meyerhoff","journal-title":"Internet Interv"},{"issue":"12","key":"R34","doi-asserted-by":"publisher","DOI":"10.2196\/28102","article-title":"The application of human-centered design approaches in health research and innovation: a narrative review of current practices","volume":"9","author":"G\u00f6ttgens","journal-title":"JMIR Mhealth Uhealth"},{"issue":"6","key":"R35","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","journal-title":"Int J Qual Health Care"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0437-x","article-title":"Six \u201cbiases\u201d against patients and carers in evidence-based medicine","volume":"13","author":"Greenhalgh","journal-title":"BMC Med"},{"issue":"8","key":"R37","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1016\/j.healthpol.2018.06.007","article-title":"\u201cNot an afterthought\u201d: power imbalances in systemic partnerships between health service providers and consumers in a hospital setting","volume":"122","author":"Scholz","journal-title":"Health Policy"},{"issue":"13","key":"R38","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies: guided by information power","volume":"26","author":"Malterud","journal-title":"Qual Health Res"},{"key":"R39","doi-asserted-by":"crossref","unstructured":"Berry ABL Lim CY Hirsch T et al. Supporting communication about values between people with multiple chronic conditions and their providers. Presented at: CHI \u201919: Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems; May 4-9, 2019:1-14; Glasgow, Scotland, UK. 2019.[doi: 10.1145\/3290605.3300700]","DOI":"10.1145\/3290605.3300700"},{"issue":"2","key":"R40","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.5573","article-title":"Co-design for people-centred care digital solutions: a literature review","volume":"21","author":"Sanz","journal-title":"Int J Integr Care"},{"issue":"6","key":"R41","doi-asserted-by":"publisher","first-page":"1979","DOI":"10.1007\/s10620-024-08377-x","article-title":"Psychological care for people with inflammatory bowel diseases: exploring consumers\u2019 perspectives to inform future service co-design","volume":"69","author":"Lores","journal-title":"Dig Dis Sci"},{"issue":"12","key":"R42","doi-asserted-by":"publisher","first-page":"4368","DOI":"10.1007\/s10620-023-08146-2","article-title":"Co-design and consultation ensure consumer needs are met: building an eHealth platform for children with inflammatory bowel disease","volume":"68","author":"Pipicella","journal-title":"Dig Dis Sci"},{"key":"R43","unstructured":"Miles MB Huberman AM . Qualitative Data Analysis: An Expanded Sourcebook. 2nd ed. Sage Publisher, Inc; 1994. ISBN: 9780803955400"},{"key":"R44","doi-asserted-by":"crossref","unstructured":"Corbin J Strauss A . Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. 3rd ed. Sage Publications, Inc; 2008. [doi: 10.4135\/9781452230153]","DOI":"10.4135\/9781452230153"},{"issue":"10","key":"R45","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1038\/ajg.2014.230","article-title":"The prevalence and predictors of opioid use in inflammatory bowel disease: a population-based analysis","volume":"109","author":"Targownik","journal-title":"Am J Gastroenterol"},{"issue":"9","key":"R46","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1093\/ecco-jcc\/jjy062","article-title":"The impact of opioid epidemic trends on hospitalised inflammatory bowel disease patients","volume":"12","author":"Cohen-Mekelburg","journal-title":"J Chrons Colitis"},{"issue":"6","key":"R47","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156666","article-title":"Pain in IBD patients: very frequent and frequently insufficiently taken into account","volume":"11","author":"Zeitz","journal-title":"PLoS One"},{"issue":"1","key":"R48","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1023\/a:1005492806777","article-title":"Concerns of patients with inflammatory bowel disease: a review of emerging themes","volume":"45","author":"Casati","journal-title":"Dig Dis Sci"},{"issue":"12","key":"R49","doi-asserted-by":"publisher","first-page":"13712","DOI":"10.1002\/cam4.6001","article-title":"Learning from long-term adolescent and young adult (AYA) cancer survivors regarding their age-specific care needs to improve current AYA care programs","volume":"12","author":"Janssen","journal-title":"Cancer Med"},{"key":"R50","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/260807","article-title":"The emerging adult with inflammatory bowel disease: challenges and recommendations for the adult gastroenterologist","volume":"2015","author":"Trivedi","journal-title":"Gastroenterol Res Pract"},{"issue":"1","key":"R51","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s41687-019-0154-x","article-title":"A qualitative study exploring the health-related quality of life and symptomatic experiences of adults and adolescents with ulcerative colitis","volume":"3","author":"Newton","journal-title":"J Patient Rep Outcomes"},{"issue":"1","key":"R52","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-022-01794-2","article-title":"How do we best engage young people in decision-making about their health? A scoping review of deliberative priority setting methods","volume":"22","author":"Watson","journal-title":"Int J Equity Health"},{"issue":"7","key":"R53","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.34067\/KID.0000392022","article-title":"Using human-centered design principles to create a decision aid on conservative kidney management for advanced kidney disease","volume":"3","author":"Wong","journal-title":"Kidney360"},{"key":"R54","doi-asserted-by":"publisher","DOI":"10.1016\/j.pecinn.2023.100226","article-title":"An exploration of facilitators and barriers to patient navigator core functions with breast cancer patients: Implications for the development of a human-centered mHealth app","volume":"3","author":"Carr","journal-title":"PEC Innov"},{"key":"R55","doi-asserted-by":"publisher","DOI":"10.3389\/frhs.2025.1474699","article-title":"Extending care beyond the clinic: integrating patient-reported outcomes in chronic pain management through human factors engineering","volume":"5","author":"Kazi","journal-title":"Front Health Serv"},{"issue":"3","key":"R56","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1001\/jamasurg.2019.4385","article-title":"Practical guide to qualitative analysis","volume":"155","author":"Schwarze","journal-title":"JAMA Surg"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.1177\/16094069241296206","article-title":"Sample sizes for 10 types of qualitative data analysis: an integrative review, empirical guidance, and next steps","volume":"23","author":"Wutich","journal-title":"Int J Qual Methods"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001032","article-title":"Leveling up: on the potential of upstream health informatics interventions to enhance health equity","volume":"57 Suppl 6 Suppl 2","author":"Veinot","journal-title":"Med Care"},{"issue":"8","key":"R59","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1093\/jamia\/ocy052","article-title":"Good intentions are not enough: how informatics interventions can worsen inequality","volume":"25","author":"Veinot","journal-title":"J Am Med Inform"},{"issue":"10","key":"R60","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31909","article-title":"\u201cTechquity\u201d in pediatric, adolescent, and young adult oncology: addressing inequities through artificial intelligence and immersive technologies","volume":"72","author":"Puthenpura","journal-title":"Pediatr Blood Cancer"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.1177\/20552076231219117","article-title":"Co-design of digital health interventions with young people: a scoping review","volume":"9","author":"Malloy","journal-title":"Digit Health"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:53:26Z","timestamp":1785509606000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e92202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":61,"URL":"https:\/\/doi.org\/10.2196\/92202","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]},"article-number":"v10i5e92202"}}