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Background: Generative artificial intelligence (GenAI) has increasingly entered psychiatric practice through patient-facing chatbots, self-help tools, and clini...
Background: Large language models (LLMs) require specialized methodologies to quantify model confidence for safe deployment in health care systems; however, the...
Artificial intelligence has made its way into children’s toys. In this News and Perspectives article, JMIR Correspondent Simon Spichak reports on the potentia...
Background: Phishing remains a dominant initial attack vector in health care, exploiting psychological factors such as urgency and authority. Despite extensive investment in technical controls and awareness training, health care staff remain highly susceptible in real operational conditions. Cognitive dissonance (CD), the discomfort arising from inconsistencies between beliefs and actions, has been proposed as a mechanism to disrupt unsafe rationalization at the moment of exposure, but has rarely been evaluated in live organizational settings using objective behavioral outcomes. Objective: This study examined whether a brief CD-based priming intervention, delivered immediately prior to a real-world phishing simulation, was associated with differences in phishing susceptibility among health care staff. Secondary objectives explored whether CD exposure was associated with directional differences in security-related perceptions and self-reported practices. Methods: A 2-stage hybrid randomized-encouragement experiment was conducted at a large Norwegian hospital. In Stage 1, staff were randomly assigned to a control or CD-primed condition and completed a survey assessing security perceptions and self-reported practices (n=62). In Stage 2, an in-the-wild phishing simulation was sent to all staff, enabling objective measurement of phishing susceptibility via observed link-click behavior. Behavioral outcomes were analyzed across 3 groups—control (n=34), CD-primed (n=32), and neutral nonresponders (n=753)—using a prespecified omnibus chi-square test as the sole confirmatory analysis. Survey-based multivariate and univariate analyses were treated as exploratory due to limited sample size and variable construct reliability. Results: Due to voluntary uptake, only a subset of randomized participants received the intervention. Observed phishing click rates were 65% (22/34) in the control group, 44% (14/32) in the CD-primed group, and 53% (396/753) in the neutral group. The omnibus chi-square test did not detect a statistically significant association between group membership and click behavior (²=3.00; n=819; =.22; Cramér V=0.06). Descriptive comparisons within the randomized subset suggested lower click rates in the CD-primed group, but effect estimates were imprecise and associated with wide CIs. Survey-based analyses indicated group differences across combined psychological constructs; however, several constructs exhibited low internal consistency, and follow-up analyses were underpowered. Conclusions: In a real-world hospital phishing simulation, pre-exposure CD priming was associated with a directional but statistically nonsignificant pattern of reduced phishing click behavior. This evidence does not establish a reliable behavioral effect, and construct-level findings are exploratory. CD-based prompts may serve as a lightweight behavioral signal in real-world conditions, but larger, fully randomized, and longitudinal studies with improved psychometric validation are needed before such interventions can be considered reliable complements to established cybersecurity controls.
Background: Robotic technology has the potential to assist nurses, but the complexity and unpredictability of health care environments cannot be replicated in a...
Digital health governance frameworks have primarily focused on prospective safeguards, including informed consent at the point of data collection, lawful proces...
Background: Adverse posttraumatic neuropsychiatric sequelae are common after trauma. Early identification of individuals at risk for these outcomes could enable...
Recent shifts in US policy and digital platforms are making obesity medications more affordable. In this News and Perspectives article, JMIR Correspondent Xiang...
Background: Heart failure with preserved ejection fraction (HFpEF) is a major clinical manifestation of cardiac amyloidosis, a condition frequently underdiagnos...
Background: Phenotype-driven prenatal diagnosis relies on the precise correlation between ultrasound findings and genetic outcomes; however, this process is hin...
Background: Patient-centered care remains a foundational principle of modern health care. The digital transformation of health systems has accelerated the adopt...