Autonomy in work location decision and burnout in behavioral health providers: Lessons learned from COVID-19.

Objective: The ability to choose one's work-location can influence burnout from employment. We sought to evaluate potential associations between autonomy in work-location decision and burnout.

Methods: We used 2020 Veterans Health Administration Annual All Employee Survey data from behavioral health providers at 129 medical facilities.

Impact of Loneliness and Social Support on Acute Health Service Use and Symptom Exacerbation Among Adults with Asthma and COPD.

Loneliness and low social support are associated with negative health outcomes among adults with asthma or COPD. Although social support is correlated with loneliness, low social support is neither necessary nor sufficient for the experience of loneliness. This study compares the relative association of loneliness and social support on symptom exacerbation (i.

An Automatically Adaptive Digital Health Intervention to Decrease Opioid-Related Risk While Conserving Counselor Time: Quantitative Analysis of Treatment Decisions Based on Artificial Intelligence and Patient-Reported Risk Measures.

Background: Some patients prescribed opioid analgesic (OA) medications for pain experience serious side effects, including dependence, sedation, and overdose. As most patients are at low risk for OA-related harms, risk reduction interventions requiring multiple counseling sessions are impractical on a large scale.

Objective: This study evaluates whether an intervention based on reinforcement learning (RL), a field of artificial intelligence, learned through experience to personalize interactions with patients with pain discharged from the emergency department (ED) and decreased self-reported OA misuse behaviors while conserving counselors' time.

Providing a Purposeful and Stimulating Volunteer Opportunity for Older Adults With Mild Cognitive Impairment: A Pilot Study.

Social interactions have cognitive and emotional benefits for older adults with mild cognitive impairment (MCI). The prevalence of loneliness and isolation in this population has been repeatedly noted, but interventions remain limited. We designed a program to connect older adults with MCI with an engaging volunteering opportunity, through videoconferencing conversations with another adult practicing English (English language learner).

Impacts of Post-Hospitalization Accessible Health Technology and Caregiver Support on 90-Day Acute Care Use and Self-Care Assistance: A Randomized Clinical Trial.

Hospitalized patients often are readmitted soon after discharge, with many hospitalizations being potentially preventable. The authors evaluated a mobile health intervention designed to improve post-hospitalization support for older adults with common chronic conditions. All participants enrolled with an informal caregiver or "CarePartner" (CP).

Diabetic and Obese Patient Clinical Outcomes Improve During a Care Management Implementation in Primary Care.

Background: To address the increasing burden of chronic disease, many primary care practices are turning to care management and the hiring of care managers to help patients coordinate their care and self-manage their conditions. Care management is often, but not always, proving effective at improving patient outcomes, but more evidence is needed.

Methods: In this pair-matched cluster randomized trial, 5 practices implemented care management and were compared with 5 comparison practices within the same practice organization.

Feasibility of an interactive voice response system for monitoring depressive symptoms in a lower-middle income Latin American country.

Background: Innovative, scalable solutions are needed to address the vast unmet need for mental health care in low- and middle-income countries (LMICs).

Methods: We conducted a feasibility study of a 14-week automated telephonic interactive voice response (IVR) depression self-care service among Bolivian primary care patients with at least moderately severe depressive symptoms. We analyzed IVR call completion rates, the reliability and validity of IVR-collected data, and participant satisfaction.

Interactive Voice Response-An Innovative Approach to Post-Stroke Depression Self-Management Support.

Automated interactive voice response (IVR) call systems can provide systematic monitoring and self-management support to depressed patients, but it is unknown if stroke patients are able and willing to engage in IVR interactions. We sought to assess the feasibility and acceptability of IVR as an adjunct to post-stroke depression follow-up care. The CarePartner program is a mobile health program designed to optimize depression self-management, facilitate social support from a caregiver, and strengthen connections between stroke survivors and primary care providers (PCPs).

Improving Post-Hospitalization Transition Outcomes through Accessible Health Information Technology and Caregiver Support: Protocol for a Randomized Controlled Trial.

Objective: The goal of this trial is to evaluate a novel intervention designed to improve post-hospitalization support for older adults with chronic conditions via: direct tailored communication to patients using regular automated calls post discharge, support for informal caregivers outside of the patient's household via structured automated feedback about the patient's status plus advice about how caregivers can help, and support for care management including a web-based disease management tool and alerts about potential problems.

Methods: 846 older adults with common chronic conditions are being identified upon hospital admission. Patients are asked to identify a "CarePartner" (CP) living outside their household, i.

Confirming the theoretical structure of expert-developed text messages to improve adherence to anti-hypertensive medications.

Background: Text messages can improve medication adherence and outcomes in several conditions. For this study, experts developed text messages addressing determinants of medication adherence: disease beliefs, medication necessity, medication concerns, and forgetfulness, as well as positive reinforcement messages for patients who were adherent.

Objectives: To validate expert-developed text messages to address medication non-adherence with a group of non-researchers.

Structured Caregiver Feedback Enhances Engagement and Impact of Mobile Health Support: A Randomized Trial in a Lower-Middle-Income Country.

Background: Patients' engagement in mobile health (m-health) interventions using interactive voice response (IVR) calls is less in low- and middle-income countries (LMICs) than in industrialized ones. We conducted a study to determine whether automated telephone feedback to informal caregivers ("CarePartners") increased engagement in m-health support among diabetes and hypertension patients in Bolivia.

Materials And Methods: Patients with diabetes and/or hypertension were identified through ambulatory clinics affiliated with four hospitals.

A randomized trial of mobile health support for heart failure patients and their informal caregivers: impacts on caregiver-reported outcomes.

Background: Mobile health services may improve chronic illness care, but interventions rarely support informal caregivers' efforts.

Objectives: To determine whether automated feedback to caregivers of chronic heart failure patients impacts caregiving burden and assistance with self-management.

Research Design: Randomized comparative effectiveness trial.

Diabetes self-management support using mHealth and enhanced informal caregiving.

Objective: To characterize diabetes patient engagement and clinician notifications for an mHealth interactive voice response (IVR) service.

Design: Observational study.

Methods: For three to six months, VA patients with diabetes received weekly IVR calls assessing health status and self-care along with tailored education.