Digital phenotyping and ASCVD risk: An exploratory cross-sectional analysis using online behavioral data

American Heart Journal Plus Cardiology Research and Practice · 2026-01-09

A retrospective, exploratory cross-sectional analysis exploring whether social media data is associated with cardiovascular disease (CVD) risk beyond traditional clinical models. While social media data may capture behavioral and social markers relevant to CVD, their associations with CVD risk remains uncertain. • Associations between social media data, like Facebook wall posts and ASCVD risk warrants further exploration and validation. • Combined Facebook wall posts and electronic health records to examine cardiovascular disease risk factors. • Our analysis found no associations between Facebook wall posts and ASCVD risk, while prior work suggests stronger associations between Facebook language and mental health conditions.

Linkage of Emergency Department Patients With Public Benefits Navigators via Text Messages

JAMA Health Forum · 2026-02-06 · 1 citations

Importance: Enrollment in public benefits is associated with improved health outcomes, yet many eligible individuals do not claim them. Public benefit programs are important policy tools to address health-related social needs. Health systems have developed new partnerships with community organizations to assist patients with enrollment in benefits. Objective: To determine whether text messages were more effective than paper referrals in prompting patients to contact benefits navigators following discharge from the emergency department. Design, Setting, and Participants: This 2-arm, nonblinded, randomized clinical trial was conducted from November 2023 to April 2024 at 2 academic hospital emergency departments in Philadelphia, Pennsylvania, and included adult individuals in stable condition with Medicaid or Medicare insurance who were discharged from the emergency department and eligible for at least 1 of 10 public benefit programs. Individuals were excluded if they were unable to read English or did not have access to a mobile phone. Data were analyzed from May 2024 to November 2024. Interventions: Eligible participants were randomized in a 1:1 ratio. Participants allocated to the intervention received a series of 4 automated text messages over 14 days that prompted them to contact a benefits navigator telephone line operated by a community partner; those allocated to the control group received a paper flyer. Main Outcomes and Measures: The primary outcome was whether study participants called benefits navigators within 14 days. Secondary outcomes included whether study participants submitted any benefits application within 14 days. Results: Of 1778 patients screened, there were 160 participants enrolled. Participants' mean (SD) age was 44 (17) years; 94 (59%) were women, 145 (91%) were non-Hispanic Black, and 11 (7%) were non-Hispanic White. In the intervention group, 20 participants (25%) contacted benefits navigators vs 0 in the control group (difference, 25 percentage points; 95% CI, 16%-35%). In the intervention group, 11 participants (14%) submitted at least 1 application for public benefits compared with 0 in the control group (difference, 14 percentage points; 95% CI, 6-22). Conclusions and Relevance: The trial results suggest that text messages were more effective than paper referrals to help eligible emergency department patients seek assistance with public benefits applications. Text messages may offer a tool to allow health systems, in collaboration with community partners, to address health-related social needs. Trial Registration: ClinicalTrials.gov Identifier: NCT05654220.

Perspectives of female and under-represented physicians on well-being in medicine: a qualitative study from an academic medical centre in the USA

BMJ Open · 2026-03-01

BACKGROUND: Stress and burnout are pervasive among physicians. Academic physicians who are female and physicians who are under-represented in medicine (URM) face inequities in the workplace and beyond. Understanding their experiences is crucial for workforce sustainability and diversity, especially given the disproportionate effects on these individuals and overall workforce capacity. OBJECTIVE: To qualitatively explore the perspectives of academic female and URM physicians and identify key themes affecting their careers and well-being. DESIGN: Semi-structured interviews were conducted with 30 physicians at an urban academic health system. Interviews were audio-recorded, transcribed and thematically analysed using a general inductive approach. Interview guides were informed by prior literature and constructs. INTERVENTION: None. SETTING AND PARTICIPANTS: Female and URM physicians from a large, academic medical centre were recruited via email. Participants self-reported demographic information, including sex, race, ethnicity and tenure. OUTCOMES AND MEASURES: The primary outcomes encompassed the main themes identified through the analysis of interviews with female and URM physicians regarding their perspectives on well-being, mental health and academic medicine. RESULTS: 30 female or URM physicians were interviewed (27 (90%) female; 14 (47%) black, Asian or multi-racial). Thematic analysis revealed four key themes: physician identity (URM, female, family), well-being in the workplace (emotional health, staffing burden, non-clinical responsibilities), barriers to accessing well-being resources (workplace environment, culture, overgeneralisation) and facilitators to well-being (physician camaraderie, leadership support). Physicians discussed how their identities influenced their experiences of well-being. They highlighted emotional health challenges, staffing burdens and administrative tasks contributing to stress. Barriers to accessing resources included workplace culture and broad-based interventions, while supportive leadership and camaraderie were identified as facilitators of access. CONCLUSION: Female and URM physicians face systemic challenges impacting their well-being and careers. These findings underscore the need to address systemic changes and specifically design programmes focused on promoting the well-being and inclusivity of female and URM physicians. Tailored interventions to these individuals, supportive leadership structures and collaborative working cultures are crucial for addressing these issues and sustaining a diverse physician workforce.

Differential Impact of a Digital Mental Health Engagement Platform on Black and Female Health Care Workers: A Secondary Analysis of a Randomized Trial

Journal of General Internal Medicine · 2026-04-17

IMPORTANCE: Health care workers (HCWs), particularly those identifying as female or Black, face disproportionate mental health strain. Digital mental health platforms have grown in popularity and, for health systems, may offer scalable solutions, but their differential impact across demographic groups remains understudied. DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of a randomized controlled trial enrolled 1275 HCWs from an urban academic health system between January and May 2022. Participants were randomized to usual care or proactive digital engagement via the Cobalt platform. Female and Black HCWs were oversampled to assess subgroup effects. INTERVENTION: Monthly digital outreach, including mental health symptom screening and linkage to resources via the Cobalt platform, compared with usual care. MAIN OUTCOMES AND MEASURES: Primary outcomes were changes in depression (PHQ-9) and anxiety (GAD-7) scores at 6 and 9 months. Secondary outcomes included well-being (WHO-5, WBI-9) and work productivity (LEAPS). Generalized linear models assessed HTE by gender and race. RESULTS: Of 1275 randomized participants (mean age 38.6 years; 83.4% female; 25.1% Black), both intervention and control groups showed significant reductions in anxiety and depression scores over time. No significant HTE was observed by gender or race for primary outcomes. Female HCWs receiving the intervention reported significantly greater improvement in work productivity at 6 months (LEAPS score difference: 1.70; p = 0.03). Black HCWs in the intervention arm showed a sustained improvement in depression scores at 9 months (- 2.21; p < 0.001), though adjusted models did not confirm statistical significance. CONCLUSIONS AND RELEVANCE: A proactive digital mental health strategy coupled with a well-being platform improved mental health outcomes across HCWs, with modest differential effects in productivity and depression among female and Black participants. These findings support the scalability of digital interventions and highlight the need for culturally tailored approaches to enhance equity and impact.

International Consensus on Evidence Gaps and Research Opportunities in Extracorporeal Cardiopulmonary Resuscitation for Refractory Out‐of‐Hospital Cardiac Arrest: A Report From the National Heart, Lung, and Blood Institute Workshop

Journal of the American Heart Association · 2025-03-05 · 11 citations

The increased accessibility of extracorporeal membrane oxygenation following the COVID-19 pandemic and the publication of the first randomized trial of extracorporeal cardiopulmonary resuscitation (ECPR) prompted the National Heart, Lung, and Blood Institute to sponsor a workshop on ECPR. Two more randomized trials have since been published in 2022 and 2023. Based on the combined findings and review of the evidence, an international panel of authors identified gaps in science, inequities in care and diversity in outcomes, and suggested research opportunities and next steps. The science pertaining to ECPR would benefit from the United States contributing uniform data to existing registries and sharing common data with the ELSO (Extracorporeal Life Support Organization) international registry to increase the sample size for observational research. In addition, well-designed efficacy trials, recruiting across different regions of care evaluating long-term follow-up, including patient reported outcomes, cost effectiveness, and equity measures, would contribute significantly to the body of science. Workshop participants defined the population of patients with out-of-hospital cardiac arrest most likely to benefit from ECPR. ECPR-eligible patients include those aged 18 to 75 years functioning independently without comorbidity; before suffering a witnessed out-of-hospital cardiac arrest and without any obvious cause of the cardiac arrest; presenting in a shockable rhythm and transported with mechanical cardiopulmonary resuscitation to an ECPR-capable institute within 30 minutes, which is recommended after 3 rounds of advanced life support treatment without return of spontaneous circulation. There are significant inequities in out-of-hospital cardiac arrest care that need to be addressed such that outcomes are optimized for each target region before implementing ECPR in a clinical or implementation trial.

Race is not associated with medical emergency team evaluation prior to in-hospital cardiac arrest

Resuscitation · 2025-04-17 · 1 citations

Colorectal Cancer and Quality of Life: A Medicare Advantage Study by Race, Ethnicity, and Language

Journal of Surgical Oncology · 2025-01-13 · 1 citations

BACKGROUND AND METHODS: Colorectal cancer (CRC) treatment can influence health-related quality of life (HRQOL). This study examined HRQOL among older adults undergoing CRC treatment, and the conditional effects of race, ethnicity, and primary language. We conducted a retrospective cohort study of Medicare Advantage enrollees ≥ 65 years old who completed the Medicare Health Outcomes Survey (MHOS) (2016-2020). The exposure group answered "Yes" to the current CRC treatment and the control group answered "No." The primary outcomes were physical component summary (PCS) and mental component summary (MCS) scores. Conditional effects by race and ethnicity were analyzed using interaction terms. RESULTS: Among 184 486 adults, 676 (0.4%) reported current CRC treatment. Those receiving treatment had significantly lower PCS scores (β coefficient -1.98, p < 0.001) and lower MCS scores (β coefficient -0.81, p = 0.018), compared to nontreatment. In the treatment group, Hispanic respondents and Spanish speakers had higher PCS scores (β coefficient 1.96, p = 0.019 and 3.19, p = 0.023, respectively), and respondents identifying as American Indian or Alaska Native had higher MCS scores (β coefficient 8.72, p = 0.016). CONCLUSION: Individuals receiving CRC treatment exhibit worse HRQOL. Outcomes differed by race and ethnicity. This study suggests the need to invest in targeted interventions to improve overall HRQOL during treatment for CRC.

The Burden of Colorectal Cancer Treatment on Quality of Life: A Paired Longitudinal Analysis of Medicare Advantage Enrollees

Journal of Surgical Oncology · 2025-06-02

BACKGROUND AND OBJECTIVES: Treatment of colorectal cancer (CRC) can have prolonged effects on health-related quality of life (HRQOL). Using the Medicare Health Outcomes Survey (MHOS), this study examines HRQOL outcomes among those undergoing CRC treatment and those who completed CRC treatment. METHODS: We performed a paired longitudinal retrospective cohort study of Medicare Advantage enrollees ≥ 65 years of age who completed the baseline and follow-up MHOS from 2016 to 2020 and answered survey questions regarding current CRC treatment. Outcomes included Physical Component Summary (PCS) scores and Mental Component Summary (MCS) scores. Multivariable logistic regression analyses were used. RESULTS: 574 Respondents met the inclusion criteria. Those currently undergoing treatment for CRC had significantly lower PCS scores (β coefficient -3.08 points, p < 0.001) and significantly lower MCS scores (β coefficient -1.40 points, p = 0.008) at follow-up compared to when they were not undergoing CRC treatment at baseline. Respondents who completed CRC treatment had PCS and MCS scores that remained similar over time (β coefficient 0.54 points, p = 0.466 and 0.07 points, p = 0.924, respectively). DISCUSSION: Treatment of CRC negatively influences HRQOL. These findings emphasize the importance of informing patients of the long-term effects of CRC treatment and support the implementation of interventions aimed at providing sustained recovery throughout the survivorship continuum.

Proactively Delivered Digital Mental Health Support for Health Care Workers: Usability and Acceptability Evaluation

JMIR Formative Research · 2025-12-09

BACKGROUND: Health systems are investing in mental health and well-being support tools and resources for health care workers (HCW). Considering the mental health strain facing HCWs, there is a need to optimize the current mental health delivery model. OBJECTIVE: This study aimed to evaluate the usability and acceptability of a proactive digital mental health approach (Cobalt+;Penn Medicine), which included services proactively sent to HCWs via text messaging, including (1) monthly automated text messaging reminders and links to Cobalt, and (2) bimonthly text-message-based measures of depression and anxiety. METHODS: This study used the System Usability Scale (SUS), Net Promoter Score (NPS), and open-ended questions to capture Cobalt+ participants who received proactive digital mental health tools and resources. Descriptive summary statistics were used for SUS and NPS outcome measures, and a chi-square test was used to detect group differences. Open-ended questions were analyzed using a qualitative open coding process by 2 coders. Research team members calculated interrater agreement (Cohen κ above 0.80). RESULTS: A total of 162 of 642 HCWs randomized to Cobalt+ (25.2%) visited Cobalt due to a proactive text message and completed usability and acceptability measures. The mean age was 38.9 years, most were female (90.7%), 56.8% White, 53.1% married or partnered, and 34.6% engaged in shift work. The mean SUS score was 74.43 (median score 72.5). Participants said they mostly "browsed" the online mental health platform. Cobalt+ received an NPS of 13.7. When asked to elaborate on their experience, 2 categories (eg, positive and negative experiences) with 13 subcategories were identified. Most participants noted the brief process that helped prioritize mental health: "Forget otherwise. Puts in forefront of my mind," and "Your texts do remind me to take stock of my current feelings." CONCLUSIONS: A proactive digital mental health approach may help overcome barriers in the uptake of services that are otherwise passively available to HCWs. This study demonstrated that the proactive approach is generally usable, modestly acceptable, and further supplemented by HCW feedback. These findings suggest the approach's viability and the need for additional research toward improvement and broader implementation. TRIAL REGISTRATION: ClinicalTrials.gov NCT05028075; https://clinicaltrials.gov/study/NCT05028075.

Evaluating Factors Associated with Suicidal Ideation Among Healthcare Workers: A Secondary Analysis

Journal of General Internal Medicine · 2025-04-24