Personal Health Questionnaire Research Articles

Mental Health and Well-Being Among Home Health Aides

Home health aides and attendants (HHAs) provide essential care to older adults and those with chronic conditions in the home. However, some HHAs struggle with poor mood and stress, which may have been exacerbated by the COVID-19 pandemic. To elicit HHAs' perspectives toward mental health and well-being, including how their job influences both and how to better support the workforce in the future. For this qualitative study, focus groups and interviews with HHAs were facilitated in English and Spanish from August 17, 2022, to February 9, 2023, in partnership with the 1199SEIU Training and Employment Fund, a benefit fund of the 1199SEIU United Healthcare Workers East and the largest health care union in the US. Included were HHAs at risk for poor mental health and well-being, which were defined as having at least mild or more symptoms on either the 8-item Personal Health Questionnaire depression scale, the 4-item Cohen Perceived Stress Scale, or the University of California, Los Angeles Loneliness Scale. Mental health and well-being of HHAs. Focus groups and interviews were audio recorded, professionally transcribed, and translated. A thematic analysis was performed that was informed by Pender's Health Promotion Model and the National Institute for Occupational Safety and Health's Total Worker Health model. A total of 28 HHAs from 14 different agencies participated (mean [SD] age, 54.3 [10.8] years; 26 female [93%]). Seventeen participants (61%) spoke Spanish at home. Five key themes emerged: (1) HHAs' attitudes toward mental health and well-being were influenced by a variety of personal and cultural factors; (2) HHAs' relationships with their patients impacted their mood in both positive and negative ways; (3) structural and organizational aspects of the job, alongside the COVID-19 pandemic, impacted HHAs' mood and stress levels; (4) HHAs used a variety of strategies to cope with their emotions; and (5) HHAs were eager for interventions that can improve their mood, particularly those that bring them closer to their colleagues. These findings suggest that HHAs' mental health and well-being may be influenced by both personal and occupational factors. Interventions and policies to better support their emotional well-being on the job are warranted.

Mental healthcare utilization and psychosocial outcomes among patients with recently diagnosed cancer: A National Health Interview Survey report.

12096 Background: Individual's diagnosed with cancer (IWC) often experience heightened psychosocial distress. Studies suggest 25-50% of IWC experience some form of psychosocial distress (Mehnert-Theuerkauf et al., 2023). Further, research shows that an individual's risk of developing a new mental disorder increases by 30% during the first year after being diagnosed with cancer (Hu et al., 2023). Although many IWC experience distress, literature depicts the underutilization of psychosocial services, with estimates suggesting that fewer then 10% of IWC receive support for their distress (Forsyth et al., 2013). This is concerning as research in rodents and humans shows that unaddressed distress can lead to faster growing tumors and rapidly advancing disease (Eckerling et al., 2021). The present study aimed to characterize mental healthcare utilization among Americans recently diagnosed with various types of cancer. We also aimed to illustrate prevalence of anxiety and depression in this population. Methods: Data from the 2022 National Health Interview Survey was used in this report. A total of 667 recently diagnosed IWC were included in the final analytic sample. Cancer type was divided into five subcategories: blood cancers (n=76), breast cancer (n=193), gynecologic cancer (n=87), colorectal cancer (n=72), lung cancer (n=62), and prostate cancer (n=177). Participants’ mental healthcare utilization at the time of the survey and within the last 12 months was assessed. The General Anxiety Disorder-7 (GAD-7) was used to measure participants’ anxiety levels and the Personal Health Questionnaire Depression Scale (PHQ-8) was used to assess depressive symptoms. Results: Over 28% of recently diagnosed IWC reported moderate-severe levels of anxiety on the GAD7, and 43% of participants reported high levels depression on the PHQ8. One-way ANOVA demonstrated significant differences in PHQ8 (F(5, 666)=3.332, p=0.006) and GAD7 (F(5,666)=3.35, p=0.005) scores across cancer groups. Post Hoc testing found that participants coping with colorectal cancers reported the highest levels of anxiety and depression compared to other cancer types. Of newly diagnosed patients, only 1.2% of patients reported currently receiving psychosocial support from a mental health professional, and only 13.6% reported receiving therapy from a mental health professional in the last year. Conclusions: Consistent with many studies, psychosocial distress among recently diagnosed IWC was very common, yet mental health care utilization remained low. These results indicate that efforts to target newly diagnosed IWC with psychosocial support interventions remains challenged. As such, our results underscore the importance of developing novel means of reaching IWC, and particularly colorectal cancer, as these individuals continue to struggle with significant levels of psychosocial distress.

Lifestyle redesign, quality of life, depressive symptoms in older adults

ABSTRACT The aim of this study was to explore the effects of the Israeli Lifestyle Program (ILP) on older adults’ quality of life (QoL) and depressive symptoms. The study employed a non-randomized controlled pre-post intervention design, (N = 99), ages 60+ years, living independently in the community. The ILP group (n = 79) participated in 15 weekly group meetings and two individual sessions. The control group (n = 20) received an educational booklet based on the ILP content. Participants completed the (WHOQoL-BREF) and a Personal Health Questionnaire (PHQ-9) pre and post intervention. At baseline, no significant differences were found between the groups. Post-intervention, the ILP group values improved in the psychological (p < .001, η2 = .154), social relationship (p < .001, η2 = .131), and environmental (p = .002, η2 = .105) domains of the WHOQoL- BREF, whereas no change was found in these domains among the control group. Physical QoL increased beyond group (p = .020, η2 = .056), although not significantly. ILP participants showed no change in the depressive symptom report (p = .424, η2 = .007), whereas participants in the control group, reported more depressive symptoms (p = .009, η2 = .070). The ILP was found to increase participants’ QoL and deemed as a promising health enhancement intervention for community-dwelling older adults.

Incidence and predictors of post-stroke cognitive impairment among patients admitted with first stroke at tertiary hospitals in Dodoma, Tanzania: A prospective cohort study.

Stroke survivors develop cognitive impairment, which significantly impacts their quality of life, their families, and the community as a whole but not given attention. This study aims to determine the incidence and predictors of post-stroke cognitive impairment (PSCI) among adult stroke patients admitted to a tertiary hospital in Dodoma, Tanzania. A prospective cohort study was conducted at tertiary hospitals in the Dodoma region, central Tanzania. A sample size of 158 participants with the first stroke confirmed by CT/MRI brain aged ≥ 18 years met the criteria. At baseline, social-demographic, cardiovascular risks and stroke characteristics were acquired, and then at 30 days, participants were evaluated for cognitive functioning using Montreal Cognitive Assessment (MoCA). Key confounders for cognitive impairment, such as depression and apathy, were evaluated using the Personal Health Questionnaire (PHQ-9) and Apathy Evaluation Scale (AES), respectively. Descriptive statistics were used to summarise data; continuous data were reported as Mean (SD) or Median (IQR), and categorical data were summarised using proportions and frequencies. Univariate and multivariable logistic regression analysis was used to determine predictors of PSCI. The median age of the 158 participants was 58.7 years; 57.6% of them were female, and 80.4% of them met the required criteria for post-stroke cognitive impairment. After multivariable logistic regression, left hemisphere stroke (AOR: 5.798, CI: 1.030-32.623, p = 0.046), a unit cm3 increase in infarct volume (AOR: 1.064, 95% CI: 1.018-1.113, p = 0.007), and apathy symptoms (AOR: 12.259, CI: 1.112-89.173, p = 0.041) had a significant association with PSCI. The study revealed a significant prevalence of PSCI; early intervention targeting stroke survivors at risk may improve their outcomes. Future research in the field will serve to dictate policies and initiatives.

Prevalence of depression and anxiety among newly diagnosed cancer patients: a single centre experience in the Middle East.

Failure to identify and treat depression and anxiety affecting 10% of patients with cancer, increases the disease burden. This study aimed to assess the psychological well-being of newly diagnosed patients in a tertiary healthcare centre in Lebanon. In this cross-sectional study, data were collected for 187 adult patients, from medical records and interviews using standardised questionnaires (Personal health questionnaire-9 (PHQ-9) and generalised anxiety disorder-7). Karnofsky performance status was also assessed, and incidence was calculated using descriptive statistics, chi-square, and T-tests. The rates of moderate or severe anxiety, minimal anxiety, mild depression, moderate or severe depression, and suicidality are 14.9%, 35.6%, 40.7% 22.7% and 6.2%, respectively. Participants with a past history of seeking help from mental health services (OR: 3.978, CI: (1.680-9.415), p = 0.002), those developing cancer-related complications (OR: 3.039, CI: (1.187-7.777), p = 0.020), and those who had an Eastern Cooperative Oncology Group of ≥2 (OR: 5.306, CI: (1.582-17.797), p = 0.007) were independently associated with depression (diagnosed with PHQ-9) in multivariate logistic regression analysis. Patients with cancer exhibit higher evidence of depression and anxiety and should have a thorough psychiatric history and additional psychiatric care.

Mental health changes in partners of transgender and gender nonconforming individuals as a result of partner gender transition: What about me?

Purpose Research on the psychosocial impact of gender transitioning on partners of transgender and gender nonconforming (TGNC) individuals is scarce in the literature. Here, we assessed mental health in partners of TGNC individuals. Methods Anonymous surveys were administered via Amazon Mturk. Eligible participants were ≥ 18 years with a partner who transitioned genders. Relationship satisfaction and mental health were assessed via perceived changes, Personal Health Questionnaire Depression Scale (PHQ-8), General Anxiety Disorder (GAD-7), Self-Esteem and Relationship Questionnaire (SEAR), Resilience Scale, and Difficulties in Emotion Regulation Scale (DERS-5). Multivariable linear regression assessed associations between relationship satisfaction and type of partner transitioning. Results Of the 337 study respondents, 42.4% were assigned male, 57.6% assigned female (43.9% identify as male; 55.8% as female) and 1.76% nonbinary, with a mean age of 35.8. 44.4% had partners who are transgender women, while a third (36.8%) had partners who are transgender men, 7.7% from assigned male to nonbinary, and 11.2% from assigned female to nonbinary. Most (72.4%) partners underwent surgical transitioning (15.1% top surgery; 5.6% bottom; 51.6% both) versus 27.6% non-surgical transitioning. PHQ-8, SEAR, confidence, self-esteem, relationship satisfaction, and resilience scores were higher among respondents whose partners underwent surgical transitioning (p < 0.001). SEAR scores differed significantly among participants whose partners underwent top only versus bottom only surgery (p = 0.004). Conclusion Partner mental health and relationship satisfaction were most impacted by surgical transitioning of their TGNC partner. Supportive services for partners of TGNC individuals during the transition process to protect these romantic relationships should be considered.

Intimate Partner Violence among College Women: A Single-Centred Cross-Sectional Study

This study aimed to identify the prevalence of sexual violence between intimate partners among college women at Ankara University. The depression symptoms were compared with the history of their sexual abuse in the past and in six months. The study, a cross-sectional observational study was conducted on 400 college women. Intimate partner sexual violence was evaluated using the Intimate Partner Violence Victim version and depression was evaluated with the Personal Health Questionnaire-9. Study data were evaluated using statistics such as number, percentage, and mean Mann-Whintey U test, and sample t-test. Sexual violence between intimate partners is present during romantic relationships in college women. Using tobacco, alcohol compulsion, or substance abuse are risk factors for sexual violence with an intimate partner. Furthermore, depression is double diagnosed in college women with sexual violence from intimate partners.

A STUDY TO ESTABLISH THE RELATIONSHIP BETWEEN DEPRESSION AND OSTEOARTHRITIS ACCORDING TO THE SEVERITY OF PAIN AND LOSS OF FUNCTION

Objective: To establish a relationship between depression and osteoarthritis according to the severity of pain and loss of function. &#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of study: Orthopedic and Rheumatology department of Combined Military Hospital, Lahore from October 2022 to March 2023&#x0D; Patients and Methods: All the patients reporting to the outpatient department of either gender aged more than 45 years with a diagnosis of OA based on X-ray findings and a consultant review were included in our study. Severity of OA was studied using the WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index. Depression was measured using the Personal Health Questionnaire (PHQ-9) scale in these patients simultaneously. (12) It was translated in Urdu for the ease of our participants.&#x0D; Results: Out of the 196 participants of our study, 71 (36.2%) were males while 125 (63.8%) were females. Mean age of the participants of our study was 55.49 Years + 8.98. Mean WOMAC index score was 61.02 + 19.11. 3 (1.5%) patients of OA had mild disease in our study and no depression was found in them. In the moderate disease group, 34 (17.3%) had no symptoms of depression, 62 (31.6%) had minimal depression, none had mild, moderate or severe depression while only 1 (0.5%) had moderately severe depression. Out of 96 (48.9%) of the OA patients with severe disease as per the WOMAC index, 3 (1.5%) had minimal depression, 47 (23.9%) had mild depression, 15 (7.6%) had moderate depression, 27 (13.8%) had moderately severe depression and 4 (2.0%) had severe depression.&#x0D; Conclusion: OA is a debilitating disease. Quality of life of patients is severely affected as the duration increases due to pain, stiffness and loss of function of joints. Long term disease leads to depression of variable degrees. . Thus early diagnosis and timely intervention in such patients with an individualized management plan can improve the outcome and quality of life of patients.&#x0D; &#x0D; Keywords: Osteoarthritis, Depression, Morbidity

Testing 3 Digital Health Platforms to Improve Mental Health Outcomes in Adults With Type 1 Diabetes: A Pilot Trial

ObjectiveOur aim in this study was to examine the potential impact of a 3-pronged digital health pilot intervention (TRIFECTA) on diabetes distress and depressive symptoms among adults with type 1 diabetes (T1D) in British Columbia. MethodsWe recruited 60 adults with T1D (mean age 38.9±15.1 years, 75% female, 77% Caucasian) who participated in the 6-month pilot intervention involving 3 digital health platforms: monthly, provider-led, group-based sessions over Zoom (virtual huddles); a WhatsApp peer texting group; and a web-based “Ask-the-expert” portal. Assessments were conducted at baseline and 6 months and measured diabetes distress (T1D Diabetes Distress Scale), depressive symptoms (9-item Personal Health Questionnaire), and TRIFECTA engagement metrics. ResultsParticipation in TRIFECTA was associated with significant reductions in Overall Distress (p=0.011) and 4 distress subscales: Powerlessness (p=0.006), Management Distress (p=0.001), Hypoglycemia Distress (p=0.029), and Eating Distress (p<0.001). A higher number of virtual huddles attended predicted lower Overall Distress (p=0.019) and Family/Friends Distress (p=0.023). A higher number of “Ask-the-expert” posts viewed predicted lower Overall Distress (p=0.046), whereas a higher number of WhatsApp messages posted predicted lower Management Distress (p=0.006). Furthermore, engagement in all 3 metrics was a predictor for lower Negative Social Perceptions Distress (p<0.05). No associations were seen in other distress subscales or for depressive symptoms. ConclusionsParticipation in TRIFECTA was linked to reduced diabetes distress levels, but not depressive symptoms, in a platform-dependent manner. This study provides promising pilot data for a subsequent large-scale and fully powered randomized controlled trial.

0871 Outcomes in Overlap Syndrome of COPD and OSA: A Secondary Data Analysis of STAGES

Abstract Introduction Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are highly prevalent, and termed Overlap Syndrome (OVS) when coexistent. Patient-reported outcomes (PROs) are impaired in both COPD and OSA alone, but their combined impact is unclear. We examined differences in the impact of COPD on PROs in adults with and without OSA. Methods Analyses included adults aged≥8 years with polysomnographic (PSG) data from the Stanford Technology Analytics and Genomics in Sleep (STAGES) study. We created sets of individuals with and without COPD, matched up to 1:5 on age±5 years, BMI±2.5 kg/m2, AHI±5 events/hour, and sex. Among all matched sets, we estimated the impact of COPD on fatigue (Fatigue Severity Scale), sleepiness (Epworth Sleepiness Scale), anxiety (Generalized Anxiety Disorder Questionnaire), depression (Personal Health Questionnaire-9), insomnia (Insomnia Severity Index), and function (Functional Outcomes of Sleep Questionnaire) using linear mixed effects models. We also examined whether the effect of COPD differed between those with (AHI≥10 events/hour) and without (AHI&amp;lt; 10 events/hour) OSA. Results Overall, 56 patients with COPD were matched to a total of 199 non-COPD controls (51.0% males). The sample was middle aged (55.8±11.8 years), overweight/obese (BMI 29.8±6.9 kg/m2), and had mild/moderate OSA (AHI 11.0±11.5 events/hour) on average; 26 (46.4%) of COPD cases had an AHI≥10. Among all patients, COPD was associated with worse PROs on average (p&amp;lt; 0.05 for all but ESS [p=0.070]). Among those with AHI&amp;lt; 10, there were no differences for any PRO between groups with and without COPD. However, COPD was associated with worse values of all PROs among those with OSA, including fatigue (mean [95% CI] difference = 9.8 [2.9, 16.7], p=0.006), sleepiness (2.8 [0.01, 5.7], p=0.050), anxiety (3.6 [1.1, 6.0], p=0.005), depression (4.4 [1.8, 7.0], p=0.001), insomnia (4.8 [2.0, 7.6], p=0.001) and function (-3.3 [-5.2, -1.5], p=0.001). Conclusion The effect of COPD on PROs is modified by OSA, with worse outcomes among those with OVS compared to OSA alone, but no impact of COPD among those without OSA. Identification of adults with OVS through early screening is crucial to prompt treatment of disease and reduce symptom burden. Support (if any) T32HL07713 P01 HL094307

Psychosocial Factors Associated with Self-Management in Patients with Diabetes.

Despite the significant advances in research on diabetes, relatively few researchers have examined the theoretical and empirical usefulness of explanatory models that contribute to self-management of the disease. In response to the theoretical and empirical approaches related to this topic, the objective of this research was to assess a hypothetical model to explain self-management behavior in patients with type II diabetes through structural equation modeling in a population of users of the services of the State Health Department of Tamaulipas, Mexico. The study used a cross-sectional and explanatory design. The sample was intentional. A total of 183 patients with a diabetes diagnosis completed a sociodemographic data questionnaire, the Partners in Health Scale, the Duke-UNC-11, the Family Apgar, the Self-Efficacy Scale, the Personal Health Questionnaire and the Physical Activity Scale. The results indicated that the hypothetical model was improved by excluding the exercise variable. The appropriate model was used to determine the effects of depression, social support, self-efficacy, family functioning, years of formal education and years with a diagnosis on self-management. The goodness-of-fit indices (GFIs) were good, i.e., χ2/gl = 0.89 (p = 0.529), root mean square error of approximation (RMSEA) = 0.000, and comparative fit index (CFI) = 1.000, with an acceptable degree of parsimony (PNFI = 0.409 and PGFI = 317). The model explained 33.6% of the variance. Therefore, this model represents an important advance in knowledge concerning self-management and provides empirical and theoretical evidence, particularly for the Mexican or Latino population.

Disruptions in Lifestyle Habits and Access to Social Support in the Time of COVID-19: Associations With Diabetes Distress and Depression Among Adults With Type 1 Diabetes Living in British Columbia

ObjectivesIn this study, we examined rates of diabetes distress and depressive symptoms in adults with type 1 diabetes (T1D) during the COVID-19 lockdown and its association with disruptions in lifestyle habits and access to social support. MethodsThis cross-sectional investigation included a convenience sample of 60 adults with T1D who completed a survey assessing diabetes distress (Type 1 Diabetes Distress Scale), depressive symptoms (Personal Health Questionnaire-9), and disruptions in lifestyle habits (sleep patterns, dietary patterns, exercise routine) and access to support from family/friends. Linear regression analyses examined COVID-19 disruption variables as predictors of diabetes distress and depressive severity. ResultsSeventy-three percent and 38% of participants reported elevated diabetes distress and depressive symptoms, respectively. Greater eating disruption predicted higher depressive symptom severity (β=1.33, p=0.045) and eating distress (β=0.28, p=0.045). Greater social support disruption predicted higher eating distress (β=0.36, p=0.019). ConclusionsFindings revealed high rates of diabetes distress and depressive symptoms in this T1D sample during the COVID-19 lockdown. Moreover, disruptions in some lifestyle habits and access to social support were associated with worse mental health outcomes.

Self-Reported Chronic Back Pain and Current Depression in Brazil: A National Level Study.

There is limited literature investigating the association between chronic back pain (CBP) and depression in Brazil. This study evaluates the association between CBP, CBP-related physical limitations (CBP-RPL), and self-reported current depression (SRCD), in a nationally representative sample of Brazilian adults. The data for this cross-sectional study came from the 2019 Brazilian National Health Survey (n = 71,535). The Personal Health Questionnaire depression scale (PHQ-8) was used to measure the SRCD outcome. The exposures of interest were self-reported CBP and CBP-RPL (none, slight, moderate, and high limitation). Multivariable weighted and adjusted logistic regression models were used to investigate these associations. The weighted prevalence of SRCD among CBP was 39.5%. There was a significant weighted and adjusted association between CBP and SRCD (weighted and adjusted odds ratio (WAOR) 2.69 (95% CI: 2.45-2.94). The WAOR of SRCD among individuals with high, moderate, and slight levels of physical limitation was significantly greater than for those without physical limitation due to CBP. Among Brazilian adults with high levels of CBP-RPL, there was over a five-fold increased risk of SRCD compared to those without CBP-RPL. These results are important for increasing awareness of the link between CBP and SRCD and for informing health services policies.

Transition Readiness in Youth with Inflammatory Bowel Disease

To examine readiness of adolescents and young adults (AYAs) with inflammatory bowel disease (IBD) to transition to adult care. A cross-sectional multicenter study evaluating transition readiness in individuals with IBD 16-19 years old prospectively recruited from 8 Canadian IBD centers using the validated ON Taking Responsibility for Adolescent to Adult Care (ON TRAC) questionnaire. Secondary aims included (1) screening for depression and anxiety using the 8-item Personal Health Questionnaire Depression Scale and The Screen for Child Anxiety Related Emotional Disorders questionnaires, respectively; (2) evaluating the association between depression and anxiety with readiness and disease activity; and (3) subjectively evaluating AYA readiness based on physician and parent assessments. In total, 186 participants (139 adolescent, 47 young adult) were enrolled, mean age 17.4years (SD, 0.87). ON TRAC scores determined that 26.6% of AYAs at pediatric and 40.4% at adult centers reached the threshold of readiness. On multivariable linear regression analysis age was positively (P=.001) and disease remission negatively (P=.03) associated with ON TRAC scores. No statistically significant differences were determined across centers. A significant percentage of AYAs reported moderate-to-severe depression (21.7%) and generalized anxiety (36%); however, neither were significantly associated with ON TRAC scores. Notably, physician and parental assessment of AYA readiness correlated poorly with ON TRAC scores (⍴=0.11, ⍴=0.24, respectively). Assessment of transition readiness in AYAs with IBD highlighted that a large proportion do not have adequate knowledge or behavior skills needed for transition to adult care. This study infers that readiness assessment tools are essential during transition to identify deficits in knowledge and behavior skills that could be specifically targeted by the youth, caregivers, and multidisciplinary team.

Factors Associated With Diabetes Distress Among Patients With Poorly Controlled Type 2 Diabetes.

Examine factors associated with increased diabetes distress (DD) among patients with type 2 diabetes with DD assessed by Diabetes Distress Scale (DDS) total and subscale scores (emotional burden, physician-related distress, regimen-related distress, and interpersonal distress). Cross-sectional analysis of data from veterans with persistently poorly controlled diabetes mellitus. Multivariable linear regression models included baseline patient characteristics (independent variables) and DDS total and subscale scores (dependent variable). The cohort's (N = 248) mean age was 58 years (SD 8.3); 21% were female, 79% were non-White, and 5% were Hispanic/Latinx. Mean hemoglobin A1c (HbA1c) was 9.8%, and 37.5% had moderate to high DD. Hispanic/Latinx ethnicity (β=0.41; 95% CI 0.01, 0.80), baseline HbA1c (0.07; 95% CI 0.01,0.13), and higher Personal Health Questionnaire-8 (PHQ-8) scores (0.07; 95% CI 0.05, 0.09) were associated with higher total DD. Hispanic/Latinx ethnicity (0.79; 95% CI 0.25, 1.34) and higher PHQ-8 (0.05; 95% CI 0.03, 0.08) were associated with higher interpersonal-related distress. Higher HbA1c (0.15; 95% CI 0.06, 0.23) and higher PHQ-8 scores (0.10; 95% CI 0.07, 0.13) were associated with higher regimen-related distress. The use of basal insulin (0.28; 95% CI 0.001, 0.56) and higher PHQ-8 (0.02; 95% CI 0.001, 0.05) were associated with higher physician-related distress. Higher PHQ-8 (0.10; 95% CI 0.07, 0.12) was associated with higher emotional burden. Hispanic/Latinx ethnicity, depressive symptoms, uncontrolled hyperglycemia, and insulin use were associated with higher risk for DD. Future research should explore these relationships, and interventions designed to reduce diabetes distress should consider accounting for these factors.

Effectiveness and Implementation of a Text Messaging Intervention to Reduce Depression and Anxiety Symptoms Among Latinx and White Adults During the COVID-19 Pandemic

Background SMS text messaging interventions are increasingly being used to help people manage mental health symptoms due to the COVID-19 pandemic. Despite the widespread adoption of SMS text messaging interventions, little is known about racial and ethnic differences in effectiveness, feasibility, and implementation factors. Objective A hybrid type 1 mixed-methods study was conducted to compare the effectiveness and implementation of the StayWell intervention for Latinx and non-Latinx White (White) adults using elements of the RE-AIM framework. Methods Adults using the StayWell intervention received daily mood inquiries and skills–based text messages for 60 days and reported symptoms via online surveys and the HealthySMS portal. Reach was assessed by the share of adults reached via distinct recruitment methods, and effectiveness was evaluated using the Personal Health Questionnaire (PHQ-8) depression scale and General Anxiety Disorder (GAD-7) scale. Adoption was assessed with user engagement, defined as the share of responses to the (60) daily mood inquiries. Implementation was evaluated based on user feedback on the number/timing of messages, the difficulty of using the program, and the System Usability Scale. Maintenance was assessed with user reports of the likelihood of continuing and recommending the program. Quantitative RE-AIM indicators were assessed using a t test for continuous outcomes and a chi-square test for categorical outcomes. Mixed-effects linear regressions examined heterogeneity among Latinx and White users in the outcomes’ (ie, PHQ-8 and GAD-7) changes over time. A thematic text analysis of responses to an open-ended question about participant experiences of the program was conducted to help contextualize differences in the effectiveness and implementation of StayWell between Latinx and White users. Results Among 398 users, 262 (65.8%) responded to the postintervention assessment. Upon completion, depressive (–1.48; P=.001) and anxiety (–1.38; P=.001) symptoms decreased among all users. Compared to White adults, Latinx adults reported an additional –1.45 (P&lt;.05) decline in PHQ-8 scores, adjusting for demographics, recruitment sample, and engagement. Among Latinx adults, StayWell resulted in a greater improvement of depression symptoms (25.8% vs 13.8% reduction; P=.02) but not in anxiety symptoms (21.2% vs 15.9% reduction; P=.23). Despite Latinx adults reporting lower usability (76.8 vs 83.9; P=.001) than White adults, they were more likely to report interest in continuing the program (7.5 vs 6.2; P=.001) and recommend StayWell to a family member or friend (7.8 vs 7.0; P=.013). Repetitive content was a critical barrier to engaging Latinx adults in StayWell; among Latinx adults, support groups and bidirectional messages were considered important program modifications. Conclusions Although anxiety and depressive symptoms decreased among all StayWell users after receiving 2 messages daily for 60 days, Latinx users experienced greater reductions in depression symptoms compared to White users. Bidirectional text messaging using contextual information and ecological momentary analysis of mood data are promising adaptations to enable the tailoring of messages and improved usability of StayWell, which may be especially effective in improving Latinx user engagement. Trial Registration ClinicalTrials.gov NCT04473599; https://clinicaltrials.gov/ct2/show/NCT04473599 Conflicts of Interest None declared.

Prevalence and clinical correlates for depression in women with urinary incontinence: a cross-sectional study.

The coexistence of urinary incontinence (UI) and depression has been intensively examined in women. This study aimed to investigate the prevalence and some clinical correlates of depression in women with UI. The National Health and Nutrition Examination Survey (NHANE) 2005-2018 was used in this cross-sectional study, and a total of 7250 UI patients were included. Patientss were defined as having UI if they answered "yes" to the UI screening question. Depression symptoms were measured by Personal Health Questionnaire (PHQ-9). The age-standardized prevalence of depression in women with UI was 13.7 (95% CI: 12.5-14.9). Multiple logistic regression showed that being younger (age <60 years), widowed, divorced or separated and having lower income, lower education level, more severe incontinence and mixed UI were associated with an increased likelihood of depression. This population-based study suggested that the prevalence of depression in women with UI was high. The main clinical correlates for depression were younger age (<60 years), lower education level, lower income, being widowed, divorced or separated, and having more severe incontinence and mixed UI.

Blended Therapies and Mobile Phones for Improving the Health of Female Victims of Gender Violence.

We carried out a case study with a group of female victims of gender violence (n = 39) with the objective of evaluating a blended psychotherapeutic intervention. The results show that blended therapies with mobile text messages combined with face-to-face group therapies significantly improved the health of these women. Mood states and the symptoms of depression were measured with a PHQ-9 personal health questionnaire and evolved positively. In the group of women (n = 39) the scores improved from an initial 13.5 (SD = 7.2, range 3–34) to 6.0 at the end of the period of messages (SD = 5.2, range 0–18), which was a significant difference (t (39) = 2.02; p = 0.000). Most of the women stated that the messages had helped them improve their mood (91.6%) and their general health (83.3%), which made them feel more connected to their social environment (80.6%). We observed that adherence to medication for each woman improved. With mixed therapies and mobile phones, social service professionals can incorporate technology into daily practices and offer personalized attention and daily counseling to victims of gender-based violence.

Health-Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN-IT Study.

BackgroundThere is a paucity of research describing health‐related quality of life (HRQOL) in older adults considered for advanced heart failure surgical therapies. Using data from our SUSTAIN‐IT (Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support) study, we aimed to compare HRQOL among 3 groups of older (60–80 years) patients with heart failure before heart transplantation (HT) or long‐term mechanical circulatory support (MCS) and identify factors associated with HRQOL: (1) HT candidates with MCS, (2) HT candidates without MCS, or (3) candidates ineligible for HT and scheduled for long‐term MCS.Methods and ResultsPatients from 13 US sites completed assessments, including self‐reported measures of HRQOL (EuroQol‐5 Dimension Questionnaire, Kansas City Cardiomyopathy Questionnaire–12), depressive symptoms (Personal Health Questionnaire–8), anxiety (State‐Trait Anxiety Inventory–state form), cognitive status (Montreal Cognitive Assessment), and performance‐based measures (6‐minute walk test and 5‐m gait speed). Analyses included ANOVA, χ2 tests, Fisher’s exact tests, and linear regression. The sample included 393 patients; the majority of patients were White men and married. Long‐term MCS candidates (n=154) were significantly older and had more comorbidities and a higher New York Heart Association class than HT candidates with MCS (n=118) and HT candidates without MCS (n=121). Long‐term MCS candidates had worse HRQOL than HT candidates with and without MCS (EQ‐5D visual analog scale scores, 46±23 versus 68±18 versus 54±23 [P<0.001] and Kansas City Cardiomyopathy Questionnaire–12 overall summary scores, 35±21 versus 60±21 versus 49±22 [P<0.001], respectively). In multivariable analyses, lower 6‐minute walk distance, higher New York Heart Association class, depressive symptoms, and not being an HT candidate with MCS were significantly associated with worse overall HRQOL.ConclusionsOur findings demonstrate important differences in overall and domain‐specific HRQOL of older patients with heart failure before HT or long‐term MCS. Understanding HRQOL differences may guide decisions toward more appropriate and personalized advanced heart failure therapies.

Association of impulsivity, physical development, and mental health to perceptual-motor control after concussion in adolescents

ABSTRACT Sport-related concussion (SRC) can affect multiple domains including impairment in perceptual-motor control (PMC) in adolescents, potentially increasing subsequent injury risk. Research suggests that impulsivity, physical development, and mental health may be associated with PMC after SRC, but researchers have yet to examine this association. Adolescents (12–18y; n = 48) within 21 days of SRC were compared to 20 healthy adolescents with no concussion history using the Perception-Action Coupling Task (PACT), Barratt Impulsivity Scale (BIS), Pubertal Development Scale (PDS), Generalized Anxiety Disorder-7 (GAD-7) and Personal Health Questionnaire-9 (PHQ-9). All outcomes were entered as predictors in linear regression (LR) models to predict PACT outcomes (accuracy; initiation, movement, and reaction times). Concussed adolescents had lower PACT accuracy (p = 0.016), higher PHQ-9 (p = 0.029), total BIS (p = 0.004), attention impulsivity (p = 0.005), and cognitive instability impulsivity (p = 0.004). All four LRs were statistically significant (R2 = 0.18–0.38; p < 0.05), and included 1 + impulsivity domains as significant predictors (p < 0.05). Cognitive instability impulsivity appeared in 3/4 models of PACT outcomes. ADD/ADHD history, anxiety, and physical development ratings were also significant predictors of PACT outcomes. This study revealed associations between PMC and medical history, impulsivity, physical development and mental health in adolescents following SRC. Future studies should investigate the temporal relationship among these variables in this at-risk population. Highlights After SRC, adolescents had deficits in action boundary perception accuracy, while reporting higher depression symptoms and impulsivity, including attention and cognitive instability components. Certain domains of impulsivity were predictive of action boundary perception accuracy and each perception actualization measure in the concussed group. ADD/ADHD history, anxiety scores, and physical development ratings were also significant predictors of perceptual-motor accuracy and actualization time.