Evaluating Workforce Mental Health and Well-Being: A Review of Assessments.

Objective: Given the importance of mental health and well-being assessments to employers' efforts to optimize employee health and well-being, this paper reviews mental health assessments that have utility in the workplace.

Data Source: A review of publicly available mental health and well-being assessments was conducted with a primary focus on burnout, general mental health and well-being, loneliness, psychological safety, resilience, and stress.

Inclusion Criteria: Assessments had to be validated for adult populations; available in English as a stand-alone tool; have utility in an employer setting; and not have a primary purpose of diagnosing a mental health condition.

Evaluation of a Commercial Mobile Health App for Depression and Anxiety (AbleTo Digital+): Retrospective Cohort Study.

Background: Digital solutions, such as web-based and mobile interventions, have the potential to streamline pathways to mental health services and improve access to mental health care. Although a growing number of randomized trials have established the efficacy of digital interventions for common mental health problems, less is known about the real-world impact of these tools. AbleTo Digital+, a commercially available mental health app for depression and anxiety, offers a unique opportunity to understand the clinical impact of such tools delivered in a real-world context.

Comparison of DASS-21, PHQ-8, and GAD-7 in a virtual behavioral health care setting.

Background: Validated depression and anxiety symptom screeners are commonly used in clinical settings. How results from different brief depression and anxiety symptom assessment tools compare to each other is not well established, especially in real world healthcare settings. This study aimed to compare the Depression Anxiety Stress Scales 21 Depression scale (DASS-Depression) and Anxiety (DASS-Anxiety) scale to the Patient Health Questionnaire 8 (PHQ-8) and Generalized Anxiety Disorder 7 (GAD-7) respectively, in a real-world virtual behavioral healthcare setting.

Using Telehealth to Implement Cognitive-Behavioral Therapy.

Behavioral health issues are common among patients with comorbid medical conditions but often go unrecognized or untreated, resulting in worse clinical outcomes and avoidable medical expenditures. This column describes an innovative telehealth solution that includes proactive and targeted patient identification and engagement and nationwide delivery of a technology-enabled, standardized, and evidence-based behavioral health program delivered via phone or video. A retrospective before-after evaluation of the program demonstrated national reach, high patient satisfaction, and significant reductions in symptoms of depression, anxiety, and stress.

A Nationally Scaled Telebehavioral Health Program for Chronic Pain: Characteristics, Goals, and Psychological Outcomes.

Background: Millions of U.S. adults suffer from chronic pain with a high prevalence of comorbid mental health issues.

A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management.

Background: Depression is prevalent among individuals with diabetes and associated with suboptimal self-management. Little is known about the feasibility and potential impact of tele-behavioral therapy to improve depressive symptoms and self-management among diabetes patients.

Methods: This was a retrospective observational study of consecutive graduates enrolled in a national 8-week diabetes behavioral telehealth program between August 1, 2014, and January 31, 2015 (N = 466; mean age 56.

Survival Following Veno-Venous Extracorporeal Membrane Oxygenation and Mortality in a Diverse Patient Population.

Racial and ethnic disparities in cardiovascular disease are well established; however, there is limited information about survival differences following veno-venous extracorporeal membrane oxygenation (VV-ECMO) in contemporary adult populations. The purpose of this study was to assess survival at discharge, 30 days, and at 1 year following institution of VV-ECMO in an ethnically diverse population, and to examine potential risk factors for mortality. This was a single-center study of 41 patients (49% female, 27% minorities, 7% > 65 years) who received VV-ECMO between the years 2004 and 2013 at an academic medical center.

Short-term and longer-term survival after veno-arterial extracorporeal membrane oxygenation in an adult patient population: does older age matter?

Background: Veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) is increasingly being used for patients with refractory cardiopulmonary failure. This study evaluates the short-term (to discharge) and longer-term (1 year) survival among older (⩾65 years) versus younger (<65 years) adults, adjusted for comorbidities, in a diverse cohort of V-A ECMO patients.

Methods: This was a retrospective cohort analysis of 131 adult patients (28% ⩾65 years old) who received V-A ECMO at an academic medical center from 2004-2013.

Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines-Stroke Registry.

Background: Differences in activation of emergency medical services (EMS) may contribute to racial/ethnic and sex disparities in stroke outcomes. The purpose of this study was to determine whether EMS use varied by race/ethnicity and sex among a current, diverse national sample of hospitalized acute stroke patients.

Methods And Results: We analyzed data from 398,798 stroke patients admitted to 1613 Get With The Guidelines-Stroke participating hospitals between October 2011 and March 2014.

Duration of conventional cardiopulmonary resuscitation prior to extracorporeal cardiopulmonary resuscitation and survival among adult cardiac arrest patients.

Purpose: The purpose of this study was to evaluate the association between survival and the duration of conventional cardiopulmonary resuscitation (CCPR) prior to extracorporeal cardiopulmonary resuscitation (ECPR) and possible confounding factors.

Methods: This was a retrospective analysis of 31 adults who received ECPR at an academic medical center between 2004 and 2013. Odds of 30-day survival and Kaplan Meier survival curves were compared among patients who received CCPR ⩾ 45 min (n=8, 26%) vs.

Differential Outcomes by Race and Ethnicity in Patients with Coronary Heart Disease: A Contemporary Review.

Coronary heart disease (CHD) is a leading cause of death for people of most ethnicities in the USA. However, several racial and ethnic minority groups are disproportionately burdened by CHD and experience higher mortality rates and rehospitalization rates compared with whites. Contemporary CHD research has been dedicated in part to broadening our understanding of the root causes of racial and ethnic disparities in CHD outcomes.

Factors associated with medication adherence among heart failure patients and their caregivers.

Background: Reducing the rate of rehospitalization among heart failure patients is a major public health challenge; medication non-adherence is a crucial factor shown to trigger rehospitalizations. Objective: To collect pilot data to inform the design of educational interventions targeted to heart failure patients and their caregivers to improve medication adherence.

Methods: Heart failure patients with an implantable cardioverter defibrillator and their family caregivers were recruited from an outpatient electrophysiology clinic at an urban university medical center (N = 10 caregiver and patient dyads, 70% race/ethnic minority, mean patient age = 63 years).

Racial/Ethnic differences in medication uptake and clinical outcomes among hospitalized cardiovascular patients with hypertension and diabetes.

Background: In the United States, hypertension and diabetes are more common among blacks and Hispanics than among others; the comorbidity is associated with worse clinical outcomes than each condition alone. Racial/ethnic differences in outcomes may be related to differential uptake of antihypertensive therapies, but data to evaluate this in real-world settings are limited. We aimed to determine the association between race/ethnicity and odds of rehospitalization or death, accounting for medication prescription, among a cohort of patients with hypertension and diabetes hospitalized for cardiovascular disease.

National women's knowledge of stroke warning signs, overall and by race/ethnic group.

Background And Purpose: Recognition of stroke warning signs may reduce treatment delays. The purpose of this study was to evaluate contemporary knowledge of stroke warning signs and knowledge to call 9-1-1, among a nationally representative sample of women, overall and by race/ethnic group.

Methods: A study of cardiovascular disease awareness was conducted by the American Heart Association in 2012 among English-speaking US women ≥25 years identified through random-digit dialing (n=1205; 54% white, 17% black, 17% Hispanic, and 12% other).

Racial and ethnic differences in statin prescription and clinical outcomes among hospitalized patients with coronary heart disease.

We aimed to evaluate the association among race and ethnicity, statin prescription, and clinical outcomes among hospitalized patients with coronary heart disease (CHD), adjusted for confounders. Racial and ethnic disparities in CHD outcomes may be related to differential uptake of preventive medications, but data from real-world settings are limited. This was a 1-year prospective study of patients with preexisting CHD without a documented contraindication to statin (n = 3,067, 35% black or Hispanic, 65% white or Asian, 35% women) who participated in an National Heart, Lung and Blood Institute clinical outcome study of patients admitted to a cardiovascular service.

Effect of an intervention to improve the cardiovascular health of family members of patients with coronary artery disease: a randomized trial.

Background: Family members of patients with coronary artery disease (CAD) have higher risk of vascular events. We conducted a trial to determine if a family heart-health intervention could reduce their risk of CAD.

Methods: We assessed coronary risk factors and randomized 426 family members of patients with CAD to a family heart-health intervention (n = 211) or control (n = 215).

Gender differences in clinical outcomes among diabetic patients hospitalized for cardiovascular disease.

Background: The risk of incident cardiovascular disease (CVD) has been shown to be greater among diabetic women than men, but gender differences in clinical outcomes among diabetic patients hospitalized with CVD are not established. We aimed to determine if hemoglobin A1c (HbA1c) was associated with 30-day and 1-year CVD rehospitalization and total mortality among diabetic patients hospitalized for CVD, overall and by gender.

Methods: This was a prospective analysis of diabetic patients hospitalized for CVD, enrolled in an National Heart, Lung and Blood Institute-sponsored observational clinical outcomes study (N = 902, 39% female, 53% racial/ethnic minority, mean age 67 ± 12 years).

Fifteen-year trends in awareness of heart disease in women: results of a 2012 American Heart Association national survey.

Background: The purpose of this study was to evaluate trends in awareness of cardiovascular disease (CVD) risk among women between 1997 and 2012 by racial/ethnic and age groups, as well as knowledge of CVD symptoms and preventive behaviors/barriers.

Methods And Results: A study of awareness of CVD was conducted by the American Heart Association in 2012 among US women >25 years of age identified through random-digit dialing (n=1205) and Harris Poll Online (n=1227), similar to prior American Heart Association national surveys. Standardized questions on awareness were given to all women; additional questions about preventive behaviors/barriers were given online.

Caregiver status: a simple marker to identify cardiac surgery patients at risk for longer postoperative length of stay, rehospitalization, or death.

Background: Patients who have undergone cardiac surgery, especially those with greater comorbidities, may be cared for by family members or paid aides.

Objective: The purpose of this study was to evaluate the association between having a caregiver among patients who underwent cardiac surgery and clinical outcomes at 1 year. We hypothesized that patients with a caregiver would have longer lengths of stay and higher rehospitalization or death rates 1 year after surgery.

Caregiver burden and nonachievement of healthy lifestyle behaviors among family caregivers of cardiovascular disease patients.

Purpose: To determine whether caregiver burdens are associated with lifestyle behaviors 1 year following the hospitalization of a family member with cardiovascular disease (CVD).

Design: Prospective follow-up study of National Heart Lung and Blood Institute sponsored Family Intervention Trial for Heart Health participants.

Setting: Hospital-based recruitment/baseline visit with 1-year follow-up.

Effect of gender, caregiver, on cholesterol control and statin use for secondary prevention among hospitalized patients with coronary heart disease.

Women with coronary heart disease (CHD) are consistently less likely than men with CHD to be at low-density lipoprotein (LDL) cholesterol goals, and the reasons for the gender gap are not established. We studied 2,190 patients with CHD or equivalent (34% women, 42% racial/ethnic minority) who participated in the Family Cardiac Caregiver Investigation to Evaluate Outcomes (FIT-O) Study and had baseline lipid data to determine whether having a paid or informal caregiver was independently associated with adherence to LDL cholesterol goals (<100, <70 mg/dl) and statin use and to determine if the association varied by gender. Caregiver status was assessed by standardized questionnaire and lipid levels/statin use were obtained from a hospital-based informatics system.

Racial/ethnic and age differences in women's awareness of heart disease.

Background: The purpose of this study was to examine differences in awareness of heart disease among women according to race/ethnicity by age group, adjusted for confounders.

Methods: American Heart Association (AHA) National Surveys conducted in 2006 (n=1005) and 2009 (n=1142) were pooled using common variables (n=2147) and reweighted to reflect the 2010 United States Census. Surveys comprised standardized, interviewer-assisted demographic and awareness questions.