Feasibility and acceptability of a text messaging enhanced intervention (TXT COPE-HF) for African American patients with heart failure, depression, and anxiety during COVID

We examined the feasibility and acceptability of Creating Opportunities for Personal Empowerment (COPE), a cognitive behavioral intervention enhanced with text messaging boosters, among African American patients with heart failure (HF), depression, and anxiety. Using a longitudinal one-group comparison design, we collected data at two time points. Twenty-one participants, 42 to 81 years (mean 59.8 years, SD 9.30), completed the COPE intervention followed by one month of text messaging boosters (TXT COPE-HF). While the intervention was feasible and acceptable; it did not result in statistically significant reductions in state and trait anxiety, lifestyle beliefs and lifestyle behaviors. Additionally, it was associated with a significant increase in depression among African American heart failure patients during COVID-19. These findings underscore the complex relationship between psychosocial interventions and mental health outcomes in African American heart failure patients, particularly during the COVID-19 pandemic. The pandemic disproportionately affected African American communities, leading to increased psychological distress due to higher rates of illness, mortality, and socioeconomic stressors. This heightened distress may have influenced the effectiveness of interventions like COPE. These results highlight the need for culturally tailored interventions that address the specific challenges faced by this population to effectively improve mental health outcomes.