Background African Americans have a higher incidence rate of heart failure (HF) and an earlier age of HF onset compared to those of other racial and ethnic groups. Scientific literature suggests that by 2030, African Americans will have a 30% increased prevalence rate of HF coupled with depression. In addition to depression, anxiety is a predictor of worsening functional capacity, decreased quality of life, and increased hospital readmission rates. There is no consensus on the best way to treat patients with HF, depression, and anxiety. One promising type of treatment—cognitive behavioral therapy (CBT)—has been shown to significantly improve patients’ quality of life and treatment compliance, but CBT has not been used with SMS text messaging reminders to enhance the effect of reducing symptoms of depression and anxiety in racial and ethnic minority patients with HF. Objective The objectives of our study are to (1) adapt and modify the Creating Opportunities for Personal Empowerment (COPE) curriculum for delivery to patients with HF by using an SMS text messaging component to improve depression and anxiety symptoms, (2) administer the adapted intervention to 10 patients to examine the feasibility and acceptability of the approach and modify it as needed, and (3) examine trends in depression and anxiety symptoms postintervention. We hypothesize that patients will show an improvement in depression scores and anxiety symptoms postintervention. Methods The study will comprise a mixed methods approach. We will use the eight steps of the ADAPT-ITT (assessment, decision, administration, production, topical expert, integration, training, and testing) model to adapt the intervention. The first step in this feasibility study will involve assembling individuals from the target population (n=10) to discuss questions on a specific topic. In phase 2, we will examine the feasibility and acceptability of the enhanced SMS text messaging intervention (TXT COPE-HF [Texting With COPE for Patients With HF]) and its preliminary effects with 10 participants. The Beck Depression Inventory will be used to assess depression, the State-Trait Anxiety Inventory will be used to assess anxiety, and the Healthy Beliefs and Lifestyle Behavior surveys will be used to assess participants’ lifestyle beliefs and behavior changes. Changes will be compared from baseline to end point by using paired 2-tailed t tests. An exit focus group (n=10) will be held to examine facilitators and barriers to the SMS text messaging protocol. Results The pilot feasibility study was funded by the Academy for Clinical Research and Scholarship. Institutional review board approval was obtained in April 2021. Data collection and analysis are expected to conclude by November 2021 and April 2022, respectively. Conclusions The study results will add to the literature on the effectiveness of an SMS text messaging CBT-enhanced intervention in reducing depression and anxiety among African American patients with HF. International Registered Report Identifier (IRRID) PRR1-10.2196/32550

The call for articles for the International Journal of Environmental Research and Public Health Special Issue “Using mobile technology to promote adolescent sexual and reproductive health (SRH)” was proposed to identify efforts to provide adolescent SRH services during the COVID-19 pandemic [...]

BACKGROUND African Americans have a higher rate of having heart failure (HF) with an earlier age of onset when compared to other racial/ethnic groups. Scientific literature suggests that by 2030 African Americans will have a 30% increased prevalence rate of HF coupled with depression and anxiety. In addition to depression, anxiety is a predictor of worsening functional capacity, decreased quality of life, and increased hospital readmissions. Currently, there is no consensus on the best way to treat HF patients with depression and anxiety. One promising type of treatment-cognitive behavior therapy (CBT) – has shown to significantly improve patients’ quality of life and treatment compliance but CBT has not been used with text messaging reminders to enhance the effect of reducing symptoms of depression and anxiety in minority heart failure patients. OBJECTIVE The purpose of this study is to: 1) Adapt/modify the COPE curriculum for delivery to HF patients using a text-messaging component to improve depression and anxiety symptoms; 2) Administer the adapted intervention to 10 patients to examine feasibility and acceptability of the approach and modify as needed; and 3) Examine trends in depression and anxiety symptoms post-intervention. We hypothesize that patients will show an improvement in depression scores and anxiety symptoms post-intervention. METHODS This study will comprise a mixed methods approach. We will use the 8-steps of the ADAPT-ITT model to adapt the intervention. The first step in this exploratory feasibility research involves assembling individuals of the targeted population (n= 10) to discuss questions on a specific topic. We will gather data in focus groups during both phases by creating an environment that encourages participants to discuss their beliefs, perceptions, and points of view on the COPE for young adults curriculum and its applicability to African-American HF patients with enhanced text messaging reminders (TXT COPE HF). In Phase 2, we will examine the feasibility and acceptability of the enhanced text messaging intervention; (TXT COPE HF) and its preliminary effects with 10 participants. The Beck Depression Inventory will assess depression and the State Trait Anxiety Inventory will assess their anxiety. Changes will be compared from baseline to endpoint using paired t-tests. An exit focus group (n=10) will be held to examine facilitators and barriers with the text messaging protocol. RESULTS The pilot feasibility study was funded in November 2019. Institutional review board approval was delayed due to COVID but was obtained April 2021. Recruitment will occur June to August 2021 and results are expected by December 2021. CONCLUSIONS The findings of this study will add to the body of literature on the treatment of patients with heart failure.

Background Suicide is a major public health problem, which affects people of all ages and ethnicities. Despite being preventable, the rates of suicide have steadily climbed (more than a third) over the past 2 decades. Objective Nurse practitioners (NPs) must be responsible for recognizing suicide risk and providing appropriate treatment referrals in addition to having an important role in suicide prevention. The reasons why NPs may not pursue suicide prevention training are their lack of suicide awareness and prevention, limited experiences with suicidal patients, and the stigma associated with mental illness. Before we begin to address the gaps within suicide awareness and prevention skills, we need to first examine NPs’ knowledge of and attitudes (stigma) toward suicide prevention. Methods This study will comprise a mixed methods approach. First, quantitative data will be collected using the Suicide Knowledge and Skills Questionnaireand the Suicide Stigma Scale (Brief version) questionnaire. An email will be sent to the NPs explaining the purpose of the study. If they consent, they will click on a link to access the surveys on a secure site. In our previous research with this sample, email reminders to nonresponders after 2 and 4 weeks were sent. The quantitative component will be used to inform the qualitative interviews of this study. The Suicide Knowledge and Skills Questionnaire is a 13-item questionnaire comprising 2 subscales: suicide knowledge and suicide skills. All questions are rated on a 5-point Likert scale (1=completely disagree to 5=completely agree). The survey has been shown to differentiate between those with suicide training and those without and has a Cronbach α score of .84. The Suicide Stigma Scale (Brief version) is a 16-item survey that assesses stigma regarding suicide. The items are measured on a 5-point Likert scale (1: strongly disagree to 5: strongly agree) and have a Cronbach α of .98. Results This study was funded by the Faculty Research Grants program through the Office of the Vice Chancellor for Research and Economic Development at the University of North Carolina at Charlotte. Institutional review board approval was obtained in April 2022. Recruitment occurred between summer and winter 2022. Interview conduction began in December 2022 and will conclude in March 2023. Data will be analyzed during spring and summer 2023. Conclusions The study results will add to the literature on NPs’ knowledge of and attitudes (stigma) toward suicide prevention. It represents a first step in addressing gaps within suicide awareness and prevention skills, among NPs in their respective practice settings. International Registered Report Identifier (IRRID) PRR1-10.2196/39675

BACKGROUND Suicide is a major public health problem, which affects people of all ages and ethnicities. Despite being preventable, the rates of suicide have steadily climbed (more than a third) over the past 2 decades. OBJECTIVE Nurse practitioners (NPs) must be responsible for recognizing suicide risk and providing appropriate treatment referrals in addition to having an important role in suicide prevention. The reasons why NPs may not pursue suicide prevention training are their lack of suicide awareness and prevention, limited experiences with suicidal patients, and the stigma associated with mental illness. Before we begin to address the gaps within suicide awareness and prevention skills, we need to first examine NPs’ knowledge of and attitudes (stigma) toward suicide prevention. METHODS This study will comprise a mixed methods approach. First, quantitative data will be collected using the <i>Suicide Knowledge and Skills Questionnaire</i> <i>and the Suicide Stigma Scale (Brief version)</i> questionnaire. An email will be sent to the NPs explaining the purpose of the study. If they consent, they will click on a link to access the surveys on a secure site. In our previous research with this sample, email reminders to nonresponders after 2 and 4 weeks were sent. The quantitative component will be used to inform the qualitative interviews of this study. <i>The Suicide Knowledge and Skills Questionnaire</i> is a 13-item questionnaire comprising 2 subscales: suicide knowledge and suicide skills. All questions are rated on a 5-point Likert scale (1=completely disagree to 5=completely agree). The survey has been shown to differentiate between those with suicide training and those without and has a Cronbach α score of .84. <i>The Suicide Stigma Scale</i> (<i>Brief version</i>) is a 16-item survey that assesses stigma regarding suicide. The items are measured on a 5-point Likert scale (1: strongly disagree to 5: strongly agree) and have a Cronbach α of .98. RESULTS This study was funded by the Faculty Research Grants program through the Office of the Vice Chancellor for Research and Economic Development at the University of North Carolina at Charlotte. Institutional review board approval was obtained in April 2022. Recruitment occurred between summer and winter 2022. Interview conduction began in December 2022 and will conclude in March 2023. Data will be analyzed during spring and summer 2023. CONCLUSIONS The study results will add to the literature on NPs’ knowledge of and attitudes (stigma) toward suicide prevention. It represents a first step in addressing gaps within suicide awareness and prevention skills, among NPs in their respective practice settings. CLINICALTRIAL INTERNATIONAL REGISTERED REPORT PRR1-10.2196/39675