JMIR Research Protocols

Monitoring Within-Person Dynamics in Adolescents Hospitalized for Acute Suicidal Distress: Protocol for an Intensive Longitudinal Study

2026-09-25T16:30:36-04:00

Background: Adolescence represents a developmental period marked by heightened vulnerability to suicidal thoughts and behaviors (STBs), which remain a leading cause of death among youth, particularly psychiatric inpatients and after discharge. Contemporary ideation-to-action models conceptualize suicidal crises as dynamic processes driven by proximal psychological factors rather than static risk markers. While recent work has begun to examine these processes as they unfold in daily life, their integration into the clinical course of suicidal distress remains limited. From this perspective, relating short-term microlevel processes of STBs to their broader temporal changes across the transition of adolescents from acute inpatient hospitalization to early ambulatory aftercare constitutes an important area for further investigation. Objective: This protocol describes a multimodal, intensive longitudinal study examining the temporal unfolding of suicidal distress across complementary timescales. The integrative framework aims to identify prototypical trajectories of STBs from inpatient admission through the early postdischarge period. It further seeks to characterize heterogeneity in within-person processes central to ideation-to-action theories and STB-related affect regulation. Finally, the study aims to interrelate these microlevel dynamics of suicidal distress with its longitudinal trajectories at the macrolevel. Within this framework, the study examines how modifiable bioregulatory factors, including sleep and physical activity, as well as clinical process factors such as therapeutic alliance, are dynamically implicated across timescales. Methods: The study plans to recruit 100 adolescents hospitalized at a single site in French-speaking Switzerland. Within 72 hours of admission, participants start a first assessment period of up to 14 days, comprising 4 daily Ecological Momentary Assessment (EMA) surveys and continuous actigraphy recordings. A second assessment period follows participants for the 10 days after discharge and includes 2 daily EMA surveys. In addition, 4 in-person assessment sessions contextualize the intensive longitudinal time series with baseline clinical characteristics, diagnostic status, therapeutic processes, and episodic stressors. Planned analyses will use multilevel and latent class modeling approaches to identify longitudinal patterns of STBs, characterize between-person differences in within-person dynamics, and examine how these patterns relate to contextual factors. Results: Recruitment began on October 31, 2025, and is expected to continue until June 2028. The protocol was developed through the active integration of former patients’ perspectives and clinicians’ lived experience. Feedback from the first 5 participants supported the current implementation of the protocol. Conclusions: By focusing on the link between intraindividual short-term processes and clinical trajectories of STBs, this study will advance our understanding of how STBs and related psychological and behavioral processes interact over time during a critical period of distress. These insights aim to inform targeted, person-centered approaches to acute psychiatric care, offering better support for vulnerable adolescents transitioning from inpatient to outpatient care.

The Role of MicroRNAs and Other Molecular Biomarkers in Uveitis: Protocol for a Scoping Review

2026-09-25T16:30:21-04:00

Background: Uveitis is a complex disease involving inflammation of the iris, ciliary body, and choroid. The Standardization of Uveitis Nomenclature working group has developed classification criteria for 25 of the most common uveitis entities based on a number of descriptor terms. Due to the broad range of causes of uveitis and the different treatment modalities depending on etiology, investigative aids are vital in expediting accurate diagnosis and management. MicroRNAs, small noncoding RNAs, have exciting potential as biomarkers of disease. They function to alter gene expression at the posttranscriptional level. Other biomarkers of inflammatory disease include cytokines and chemokines. With a substantial proportion of uveitis being classified as “idiopathic,” biomarker research may provide important diagnostic clues and subsequently improve patient outcomes globally. Scoping reviews represent a format for systematically searching the literature. We will use a formal framework for conducting scoping reviews and the Joanna Briggs Institute guidelines. Objective: The aim of this review protocol is to lay the foundation for identifying what biomarkers have been studied in various uveitis subtypes, including cytokines, chemokines, and multiomic data, with particular focus on microRNAs, thus guiding the selection of biomarkers that may be of interest in future research. Methods: Studies will be included if they have human participants with a defined diagnosis of a uveitis subtype who are of any age, gender, or ethnicity and from any country or health care setting; assess molecular biomarkers (including but not limited to microRNAs, cytokines, chemokines, human leucocyte antigen types, gene variants, and multiomics) using any sample type (including but not limited to blood, peripheral blood mononuclear cells, aqueous humor, vitreous humor, cerebrospinal fluid, and urine), are primary research studies, are written in English or with an English translation, and were published in any year. Studies will be excluded if they have animal participants, investigate therapeutics in uveitis only, are review articles or letters to the editor, are research in progress, or are not in English. The MEDLINE, Embase, and Scopus databases will be searched from inception to June 8, 2026. Results will be descriptively analyzed and presented in the form of a data extraction chart. Results: The proposed scoping review is currently in the screening stage. The start date for this project was January 6, 2026. The projected completion date is in October 2026. A total of 946 articles were subject to title and abstract screening using Covidence software. One reviewer screened all papers, while a second reviewer screened 20% of the papers. Conclusions: The findings from this scoping review will highlight the broad range of molecular biomarkers currently studied in uveitis and identify gaps in the field, guiding the selection of biomarkers, with a particular focus on microRNAs, for future laboratory analysis in our research group. Trial Registration: OSF Registries N5HJR; https://osf.io/n5hjr/overview

Evidence for Clinical Skills Training Using Virtual Reality in Nursing and Midwifery Education: Protocol for an Umbrella Review

2026-09-25T15:15:11-04:00

Background: Virtual reality (VR) is increasingly used in health care training and nursing education to address clinical skills gaps and provide immersive learning experiences. While multiple systematic reviews have synthesized primary research on VR effectiveness, no umbrella review has comprehensively evaluated and integrated findings from existing systematic reviews specifically focused on nursing and midwifery education. Objective: This umbrella review aims to systematically identify, critically appraise, and synthesize findings from published systematic reviews and meta-analyses examining the use of VR in nursing and midwifery education, with particular emphasis on clinical skills training. Methods: This protocol will follow the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) 2015 statement and is registered with PROSPERO (CRD420261303572). Nine databases will be searched, including PubMed, CINAHL, Scopus, Web of Science, ERIC, PsycInfo, Cochrane Library, African Journals Online, and SciELO. Two independent reviewers will conduct screening, data extraction, and methodological appraisal using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews, version 2). The overlap of primary studies across reviews will be calculated using the corrected covered area (CCA) method, and decision rules for managing overlap will be applied. Narrative synthesis will follow Synthesis Without Meta-Analysis guidance. Certainty of evidence will be assessed using an adapted GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach with a prespecified framework for downgrading based on AMSTAR 2 ratings, overlap, heterogeneity, imprecision, and indirectness. Results: The review search and screening commenced in July 2026 and are ongoing as of August 2026. Full-text screening and data extraction are scheduled for September to October 2026, followed by methodological appraisal, overlap assessment, and evidence synthesis from October to December 2026. Manuscript preparation is planned for November to December 2026, with the review findings expected to be submitted for publication in early 2027. Conclusions: This umbrella review will provide the first comprehensive, high-level synthesis of evidence on the use of VR in nursing and midwifery clinical training. By systematically appraising and grading the certainty of existing systematic reviews, it will identify the most robust findings while exposing critical evidence gaps. The resulting evidence gap map and summary of findings will offer clinicians, policymakers, and researchers a clear roadmap for evidence-based decision-making and prioritization of future primary research. International Registered Report Identifier (IRRID): PRR1-10.2196/94779

Manifestations and Impacts of Racial Aggressions on Black Individuals’ Health and Well-Being in University Settings Across Organization for Economic Cooperation and Development Countries: Protocol for an Integrative Review

2026-09-25T14:45:10-04:00

Background: The number of international migrants continues to rise globally, particularly in countries belonging to the Organization for Economic Cooperation and Development (OECD). This growing diversity presents sociopolitical challenges related to social cohesion, which are also reflected in academic settings. Some individuals are exposed to different forms of discrimination based on skin color, including both racial microaggressions and macroaggressions. Racism is a major determinant of health and has deleterious effects on those exposed to it. Objective: This protocol aims to analyze and synthesize existing knowledge on racial aggressions, both macroaggressions and microaggressions, experienced by Black individuals as students or members of the teaching staff (including lecturers and professors) in university contexts across OECD countries. The research question posed for this purpose is as follows: What does the scientific literature reveal about racial aggressions (both macroaggressions and microaggressions) experienced by Black individuals as students or members of the teaching staff in university contexts across OECD countries? Methods: This integrative review protocol is developed in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. An integrative review will be conducted following the framework of Whittemore and Knafl. It will be carried out in 7 distinct phases: (1) problem identification, (2) literature search, (3) study selection, (4) data evaluation, (5) data extraction and analysis, (6) data synthesis, and (7) presentation of findings. A literature search will be conducted using electronic databases such as CINAHL, PubMed/MEDLINE, PsycINFO, Scopus/Web of Science, and Embase to identify studies addressing various forms of racial aggression in academic environments. The methodological framework of Whittemore and Knafl will guide the entire review process, from study selection to data analysis and synthesis. The quality assessment of the studies included in this integrative review will be conducted using the Mixed Methods Appraisal Tool (MMAT; 2018 version). Results: The study identification and selection process began in September 2025. A total of 7098 records were identified through electronic database searches. The literature to be reviewed is expected to include studies conducted across multiple OECD countries involving diverse university populations, such as students, faculty, and administrative staff, and using a range of methodological approaches. This integrative review will examine how racial aggressions (both microaggressions and macroaggressions) manifest in academic settings, the strategies developed by Black individuals to cope with these experiences, and their impacts on health and well-being. Study completion is anticipated between August and September 2026. Conclusions: The findings will inform future research on racial aggressions in higher education and contribute to the development of evidence-based prevention strategies. Ultimately, the review aims to support the development of university policies and programs that promote inclusive environments and ensure equitable access to resources and opportunities for all students and staff. Trial Registration: Research Registry 11635; https://www.researchregistry.com/browse-the registry/#home/registrationdetails/690b97538fb8310325a93b2d/ International Registered Report Identifier (IRRID): DERR1-10.2196/92748

A Transition of Care Service to Reduce Hospital Readmissions for High-Risk Cardiology Patients (RECARD): Protocol for a Pre-Post Interventional Trial

2026-09-25T14:15:11-04:00

Background: Transition of care (TOC) is a high-risk period for medication errors as patients move between multiple health care professionals, settings, and changing medication regimens. Ineffective communication systems further increase the likelihood of medication harm and hospital readmission. A TOC service with tailored, patient-specific support may help reduce these risks. Cardiovascular medicines significantly contribute to medication harm, and patients recovering from acute myocardial infarction (AMI) or cardiothoracic surgery (CS) are vulnerable due to complex regimens and frequent medication changes. Pharmacists, as medication experts embedded within cardiology teams, are well positioned to support these high-risk patients, facilitate safer transitions from hospital to home, and provide coordinated postdischarge follow-up. Objective: This study aims to evaluate the impact of a pharmacist-led interdisciplinary TOC service on reducing medication harm for cardiology patients post-AMI or CS. Methods: The study will be conducted in two phases: phase 1—intervention development will combine scoping review findings with stakeholder input to design an evidence-based, cocreated, culturally relevant intervention, underpinned by implementation science. A risk prediction model will be developed and validated to identify AMI/CS patients at high risk of medication-related unplanned readmission within 30 days. Phase 2: the RECARD (Reduce Hospital Readmissions for High-Risk Cardiology Patients) trial will use a pre-post design across 3 Australian tertiary hospitals (2 metropolitan and 1 regional) to compare a retrospective usual care patient cohort (referred to as “pre”) with a different prospective patient cohort (referred to as “post”) that includes both usual care and intervention AMI/CS patients receiving the TOC service. Only high-risk poststudy patients will receive the intervention TOC service, consisting of an individualized bundle of TOC activities to optimize medication management, while the remaining poststudy patients will receive usual care. A unique feature of the service is its capacity for hospital clinicians to conduct postdischarge home visits for patients needing additional support. The primary outcome for this study is medication-related 30-day hospital readmission. The analysis will consist of multivariable logistic regression. An economic analysis will be conducted to evaluate the costs associated with the intervention and medication-related readmissions. A comprehensive process evaluation will be conducted using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to enable learnings from the trial to inform sustainable improvements in this field. A patient survey will be administered at the end of the trial to assess patient experience and elicit patient preferences using a discrete choice experiment. Results: The predata are currently being collected for patients discharged from the 3 hospital sites during the 12-month prestudy period. The postdata intervention began on December 10, 2025. As of May 27, 2026, a total of 343 patients have been recruited at the 3 study sites. Conclusions: The findings of this study will inform future implementation of a sustainable cardiac TOC model within the Australian health care setting. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12624001009505; https://tinyurl.com/35a3d2dz International Registered Report Identifier (IRRID): DERR1-10.2196/94841

Healthy Trust and Pandemic Readiness in the Context of Messenger RNA Vaccines: Protocol for a Sequential Deliberative Dialogue Study

2026-09-25T12:30:11-04:00

Background: Pandemics threaten economies, security, and public health, requiring strong global and local collaboration and coordination. Public receptivity to emergent vaccine technologies is essential to pandemic readiness. Although messenger RNA (mRNA) vaccines offer rapid adaptability and hold promise, their use during the COVID-19 pandemic was met with polarizing debates that raise questions about the conditions needed to support acceptable and equitable use of new vaccines. Objective: This deliberative dialogue study aims to generate consensus on how to ensure informed, accessible public engagement and strengthen public trust in a climate of divisiveness and misinformation, disinformation, and malinformation. Using mRNA vaccines as a case study, the project’s specific research objective is to seek insights into what people believe is needed for public understanding, equitable access, and acceptance of emerging vaccine technologies. Methods: Using a sequential deliberative dialogue design, this study invites individuals with significant influence on pandemic readiness and those most likely to be disproportionately affected by related decisions into reflective, conversational, workshop-style online events and self-led dialogues. Dialogues and guiding questions are informed by a knowledge synthesis on what is unknown about mRNA vaccine public sentiments based on a rapid review, an environmental scan, consultations with experts across sectors, and ongoing updates from the dialogues. Data will be analyzed in situ in an iterative and collaborative synthesis of general agreements between dialogue contributors in response to guiding questions and emerging themes. Dialogue reports will be drafted by the research team based on observational notes, transcripts, and video recordings and reviewed by contributors. In summative dialogues, the research team will present main threads of dialogue, responding to research objectives and newly identified knowledge gaps and collecting input to inform dialogue outputs. Results: This study was funded in May 2025. As of June 2026, we have conducted 10 deliberative dialogues and supported 1 self-led dialogue, engaging 77 contributors across sectors and disciplines. We held 2 summative dialogues with 18 attendees, where we presented the main threads of dialogue as identified by the research team through collaborative analysis. We have started incorporating input from closing dialogues into the final reports and expect to publish the results in the second half of 2026, both as lay-language reports and peer-reviewed manuscripts. Conclusions: This protocol outlines a consensus-building process capable of deepening the understanding of vaccine hesitancy and strengthening pandemic readiness and public trust in Canada. Dialogues are expected to provide general agreements on how to enhance science and health literacy, tailor communications considering historical inequities, respond to the needs of health care workers, and navigate polarization around vaccination. By creating space for shared learning and collective insight, this study supports the rebuilding of trust in public health institutions as they adapt to evolving societal expectations. International Registered Report Identifier (IRRID): DERR1-10.2196/91534

Comparing the Feasibility of In-Person and Online Preventive Cognitive Therapy for Major Depressive Disorder After Partial Response to Repetitive Transcranial Magnetic Stimulation: Protocol for a Pilot Randomized Controlled Trial

2026-09-25T12:00:16-04:00

Background: In recent years, repetitive transcranial magnetic stimulation (rTMS) has become a first-line recommendation in the Netherlands for individuals with major depressive disorder (MDD) who have not responded to a minimum of 2 prior treatments. Although rTMS can be effective, there is a significant risk of relapse after treatment. Currently, there are no standardized treatment options available after rTMS treatment completion aimed at preventing relapse. Preventive cognitive therapy (PCT) is a brief psychological intervention designed to prevent relapse in partially and fully remitted individuals with MDD. Objective: This study aims to establish the feasibility of 2 distinct forms of PCT (online and face-to-face) after intensive rTMS treatment for responding patients. Methods: Participants who demonstrate partial or full response to rTMS, defined as at least 25% reduction in symptoms, as quantified using the Inventory of Depressive Symptomatology–Self-Report (IDS-SR) or an IDS-SR score of 22 or lower will be included. Twenty participants will be randomly allocated to either face-to-face or online PCT, and treatment adherence will be compared between face-to-face and online treatment. The study will be deemed feasible if at least 75% of participants complete PCT during the grant duration of 1.5 years. For PCT, we aim to see which delivery format is the most feasible. Secondarily, changes in affective states, assessed through experience sampling data during PCT, will be studied to establish usefulness for a larger randomized controlled trial aimed at evaluating the effectiveness of PCT after rTMS. Finally, possible MDD relapse will be monitored throughout the intervention and follow-up periods. Results: This study was funded in November 2023 by the Netherlands Organisation for Health Research and Development. It was reviewed and approved according to the Medical Research Involving Human Subjects Act () by the Medical Research Ethics Committee of Amsterdam University Medical Center on June 17, 2024. Data collection started in August 2024 and ended in April 2026, with an inclusion of 11 participants. As of June 2026, data analysis has not yet started. We expect data analysis and manuscript preparation of results to be completed in December 2026. Conclusions: If this pilot study shows preferred feasibility of a specific format of PCT (either online or face-to-face) following rTMS treatment for depression, a larger-scale randomized controlled clinical trial may be performed to study the effects of PCT on remission duration, relapse rates, and affective states in remitted individuals with MDD after rTMS treatment using this preferred delivery format. This pilot will provide insights into the feasibility of face-to-face or online PCT after successful rTMS treatment in depression. Trial Registration: Dutch National Trial Register NL85703.018.23; https://www.onderzoekmetmensen.nl/en/trial/56852 International Registered Report Identifier (IRRID): DERR1-10.2196/101839

The Role of Carotid Graft Interposition During Elective and Emergent Interventions: Protocol for a Scoping Review

2026-09-25T12:00:15-04:00

Background: In a significant proportion of carotid interventions, carotid graft replacement is required to achieve a successful outcome either as a primary method or as a bailout solution. Whether carotid grafting should be performed, the indications for its use, and other technical aspects remain insufficiently addressed in the literature. An exhaustive mapping of the sparse and heterogeneous evidence available in the literature may provide a more comprehensive understanding of this topic. Objective: This scoping review aims to examine and summarize the scientific evidence on the indications, graft types, and outcomes of graft interposition during elective and emergency carotid interventions. Methods: This scoping review will be conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines for reporting. Peer-reviewed papers written in English will be identified through searches of the following databases: PubMed (MEDLINE), Embase, Scopus, and Web of Science. The web-based systematic review platform Rayyan will be used for deduplication and study screening. The review will encompass the following clinical scenarios: elective carotid endarterectomy, emergent carotid endarterectomy, carotid artery restenosis, carotid artery trauma, carotid artery aneurysm, carotid artery dissection, carotid patch infection, radiation-induced carotid fibrosis, and carotid body tumors. All study designs (randomized controlled trials, observational studies, and case series) will be considered. Non-English studies, animal studies, cadaveric or anatomical-only reports, and purely technical notes without clinical data will be excluded. Data regarding extracranial-to-intracranial bypass will be excluded. Study selection based on title and abstract screening (first stage), full-text review (second stage), and data extraction (third stage) will be performed by a group of researchers, whereby each paper will be reviewed by at least 2 researchers. Any conflict regarding the inclusion or exclusion of a study and the data extraction will be resolved by discussion between the researchers who evaluated the papers; a third researcher will be involved if consensus is not reached. Data synthesis will be performed with the aim of clearly presenting the indications, graft types, and outcomes of graft interposition during carotid interventions. Results: The search strategy was finalized in July 2026. Preliminary searches of PubMed (MEDLINE), PROSPERO, and JBI Evidence Synthesis databases identified no published or registered systematic or scoping reviews specifically addressing carotid interposition grafting across elective and emergent carotid interventions. As of September 2026, formal database searches and study selection had not yet begun and were scheduled to start in October 2026. Data extraction and evidence synthesis are expected to be completed by spring 2027, and submission of the final scoping review is planned for summer 2027. Conclusions: Our scoping review will seek to provide an overview of the available evidence and identify research gaps regarding the role of graft interposition during elective and emergent carotid interventions. International Registered Report Identifier (IRRID): PRR1-10.2196/91594

Mental Health Outcomes Among International College Students in the COVID-19 Pandemic: Protocol for a Scoping Review

2026-09-25T11:45:10-04:00

Background: International college students in the United States experience unique academic, cultural, financial, and immigration-related challenges that place them at increased risk of adverse mental health outcomes, including stress, anxiety, depression, and suicidal ideation. The COVID-19 pandemic further intensified these challenges through disruptions in education, travel restrictions, social isolation, and uncertainty regarding immigration and visa policies. Although numerous studies have examined international students’ mental health during this period, the available evidence has not been comprehensively mapped to characterize the extent, nature, and methodological characteristics of the literature or to identify gaps requiring further investigation. Objective: The objective of this scoping review is to systematically map the available evidence on stress, anxiety, depression, and suicidal ideation among international college students enrolled in US institutions during and following the COVID-19 pandemic, describe the characteristics of the existing literature, and identify knowledge gaps to inform future research, policy, and practice. Methods: This protocol follows the Joanna Briggs Institute methodology for scoping reviews and the methodological frameworks. The completed review will be reported in accordance with the PRISMA-ScR, and the search strategy will be developed and reported following the PRISMA-S recommendations. Electronic searches will be conducted in PubMed (MEDLINE), PsycINFO, CINAHL Complete, Scopus, ERIC, and Web of Science Core Collection for peer-reviewed English-language studies published between January 1, 2020, and December 31, 2025. Eligible studies will include quantitative, qualitative, and mixed methods research examining stress, anxiety, depression, or suicidal ideation among international college students enrolled in US institutions. The 2 independent reviewers will screen studies, extract data on study characteristics, participant demographics, mental health outcomes, measurement instruments, COVID-19-related contextual factors, and key findings, and synthesize the evidence using descriptive and narrative approaches. Consistent with scoping review methodology, no formal risk of bias assessment will be conducted. Results: The a priori protocol for this unfunded scoping review was registered with the Open Science Framework. We conducted the review from December 25, 2025, through April 17, 2026. After protocol registration, we added 2 additional reviewers to assist with study screening and data abstraction. After screening, 253 records underwent further eligibility assessment, and 16 studies met the eligibility criteria for inclusion. Data analysis and synthesis are complete, and the findings and discussion are being revised and formatted for manuscript submission. Publication of the completed review is tentatively anticipated by December 31, 2026. Conclusions: This scoping review will provide the first comprehensive evidence map of stress, anxiety, depression, and suicidal ideation among international college students enrolled in US institutions during and following the COVID-19 pandemic. The completed review will identify research gaps, summarize methodological trends, and provide evidence to inform future investigations, institutional initiatives, and policies aimed at improving mental health support for international college students. Trial Registration: OSF Registries T27JN; https://osf.io/t27jn/overview International Registered Report Identifier (IRRID): DERR1-10.2196/91839

Using Momentary Measures to Understand Physical Activity Adoption and Maintenance: Protocol for a Longitudinal Study

2026-09-25T11:30:13-04:00

Background: Physical inactivity is prevalent among adults in the United States and is related to various health disparities. The search for effective policies and interventions to promote physical activity (PA) is severely hampered by the paucity of research on the mechanisms underlying PA behavior change. Objective: This paper describes a research protocol that uses mobile health technology to examine the influence of contextual and environmental factors and acute momentary precipitants on PA adoption and maintenance among Pacific Islanders in the United States. Methods: The study is guided by an overarching conceptual framework derived from models of the social and environmental determinants of health, social cognitive theories of behavior change, and prior empirical findings. Participants will be assessed using real-time, field-based, state-of-the-art methodologies consisting of MotionSense, ecological momentary assessment, and GPS tracking. MotionSense tracks behavioral and physiological data in real time and can objectively detect PA behaviors of participants. GPS tracking permits real-time mapping of an individual’s space-time trajectories and relevant environmental exposures and characteristics (eg, proximity to PA facilities and neighborhood safety) using Geographic Information System data. Principal outcomes of interest are PA adoption and PA maintenance. Results: This study was funded by the National Cancer Institute of the National Institutes of Health in August 2023. Data collection started on May 23, 2025, and is expected to finish by March 2028. As of August 10, 2026, the project has recruited all 150 participants. Data analysis is ongoing, and results are expected to be published in May 2028. Conclusions: This is among the first studies to link objective and momentary indexes of PA to key environmental and psychosocial factors in PA behavior studies. The comprehensive, multi-method approach addresses 2 long-standing limitations in PA research: the reliance on self-reported outcome measures and the use of static residential locations as proxies for neighborhood exposure. In addition, this study is among the first to apply dynamic prediction models, a novel statistical approach well suited to the high-frequency, intensive longitudinal data generated by real-time mobile health assessment. The findings will provide actionable evidence to inform policies and interventions aimed at reducing PA-related health disparities among Pacific Islanders and other racial and ethnic groups that experience similar health problems. International Registered Report Identifier (IRRID): DERR1-10.2196/108686