Jessica Watrous

BACKGROUND Workplace burnout is a pervasive response to chronic emotional and interpersonal work-related stressors, negatively affecting workers’ mental health across industries, organizational levels, and geographic regions. OBJECTIVE The current study investigated risk factors of workplace burnout and the impact of an employee-sponsored digital mental health platform. METHODS Burnout (exhaustion, cynicism, professional efficacy), mental health (anxiety, depression, well-being), belonging, psychological safety, and organizational climate were assessed in 534 working adults at baseline. Burnout was re-assessed at 3 and 12 months. Participants used the platform at least once by using therapy (23.22%), coaching (36.14%), or digital resources (43.26%). RESULTS At baseline, risk factors for higher burnout included lower mental health symptoms, belonging, and psychological safety, and worse organizational climate. Participants with subscale-specific elevated burnout reported significant improvements at 3 months, with progress sustained at 12 months. CONCLUSIONS The current findings suggest that digital mental health interventions can have meaningful improvement on workplace outcomes.

A quarter of US adults face mental health challenges, yet less than half receive treatment, partly due to therapist shortages. Scaling trained paraprofessionals to provide effective care could address this gap. We evaluated the impact of evidence-based coaching within a real-world blended care digital mental health platform. 266 working adults (62% women, M _age =33 years, 40% people of color) newly enrolled (2021–2022) in the platform (Modern Health) completed surveys at baseline and 3-months. Participants primarily engaged with certified professional coaches and could also access therapy and digital resources. We examined pre-post changes in outcomes and differences by baseline clinical status. Participants used an average of 2.5 coaching sessions and improved in distress tolerance (+ 4.1%), perceived stress (-8.4%), self-compassion (+ 5.9%), and mindfulness (+ 2.6%) ( p s < 0.01). Although elevated risk users (vs. lower risk) reported descriptively greater improvements in distress tolerance (+ 4.7% vs. +3.7%), perceived stress (-10% vs. -3.7%), self-compassion (+ 7.6% vs. +5.2%), and mindfulness (+ 3.3% vs. +2.1%), these differences were not statistically significant ( p s > 0.05). Depression (-22.5%) and anxiety (-12%) improved ( p s < 0.001), with elevated risk users reporting greater reductions ( b =-3.15, p < .001 for depression; b =-2.61, p < .001 for anxiety). Among elevated risk users, 71.7% improved or recovered from depression or anxiety and 96.1% of lower risk users maintained lower depression and anxiety. Technology-enabled coaching, as part of a blended care platform, improved depression, anxiety, and transdiagnostic emotional processes. Participants with higher baseline depression and anxiety reported greater improvements, highlighting coaching’s effectiveness for people with elevated needs. By redefining care and leveraging technology, coaching may be a scalable treatment solution.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Poor sleep is closely linked to mental health and workplace burnout, and many struggle to get enough restorative sleep. Objective: This study examined how engagement with a multi-modal employer-sponsored digital mental health platform impacted perceived sleep quality over time, and whether improvements were associated with changes in mental health and burnout. Methods: Working adults (N = 578, 61.1% women, Mage = 33.9 years, 40.3% people of color) newly registered for the platform completed measures of self-rated sleep quality, depression, anxiety, and burnout, at baseline, 3-months, and 12-months. Participants engaged with at least one care modality (virtual therapy, coaching, or digital resources). We examined baseline associations, changes in sleep quality, and longitudinal associations with mental health and burnout. Results: At baseline, 42% reported poor sleep quality and were more likely to have higher depression, anxiety, and burnout. Each month of platform use increased the odds of good sleep quality by 3.73% (p = .02). Higher sleep quality over time was associated with improvements in depression, anxiety, and burnout (ps < .001). The 44% of participants who improved their sleep from baseline to 12-months showed reduced depression (-48.25%) and anxiety (-38.33%), and increased cynicism burnout, though cynicism levels remained below the cut-off for high burnout (+24%; ps < .01). Conclusions: Use of a digital mental health platform was associated with meaningful improvements in sleep quality over 12-months. These gains were linked to reductions in depression, anxiety, and burnout, highlighting broader well-being benefits of integrated mental health care.

BACKGROUND Poor sleep is closely linked to mental health and workplace burnout, and many struggle to get enough restorative sleep. OBJECTIVE This study examined how engagement with a multi-modal employer-sponsored digital mental health platform impacted perceived sleep quality over time, and whether improvements were associated with changes in mental health and burnout. METHODS Working adults (N = 578, 61.1% women, Mage = 33.9 years, 40.3% people of color) newly registered for the platform completed measures of self-rated sleep quality, depression, anxiety, and burnout, at baseline, 3-months, and 12-months. Participants engaged with at least one care modality (virtual therapy, coaching, or digital resources). We examined baseline associations, changes in sleep quality, and longitudinal associations with mental health and burnout. RESULTS At baseline, 42% reported poor sleep quality and were more likely to have higher depression, anxiety, and burnout. Each month of platform use increased the odds of good sleep quality by 3.73% (p = .02). Higher sleep quality over time was associated with improvements in depression, anxiety, and burnout (ps < .001). The 44% of participants who improved their sleep from baseline to 12-months showed reduced depression (-48.25%) and anxiety (-38.33%), and increased cynicism burnout, though cynicism levels remained below the cut-off for high burnout (+24%; ps < .01). CONCLUSIONS Use of a digital mental health platform was associated with meaningful improvements in sleep quality over 12-months. These gains were linked to reductions in depression, anxiety, and burnout, highlighting broader well-being benefits of integrated mental health care.

BACKGROUND Poor sleep is closely linked to mental health and workplace burnout, and many struggle to get enough restorative sleep. OBJECTIVE This study examined how engagement with a multi-modal employer-sponsored digital mental health platform impacted perceived sleep quality over time, and whether improvements were associated with changes in mental health and burnout. METHODS Working adults (N = 578, 61.1% women, Mage = 33.9 years, 40.3% people of color) newly registered for the platform completed measures of self-rated sleep quality, depression, anxiety, and burnout, at baseline, 3-months, and 12-months. Participants engaged with at least one care modality (virtual therapy, coaching, or digital resources). We examined baseline associations, changes in sleep quality, and longitudinal associations with mental health and burnout. RESULTS At baseline, 42% reported poor sleep quality and were more likely to have higher depression, anxiety, and burnout. Each month of platform use increased the odds of good sleep quality by 3.73% (p = .02). Higher sleep quality over time was associated with improvements in depression, anxiety, and burnout (ps < .001). The 44% of participants who improved their sleep from baseline to 12-months showed reduced depression (-48.25%) and anxiety (-38.33%), and increased cynicism burnout, though cynicism levels remained below the cut-off for high burnout (+24%; ps < .01). CONCLUSIONS Use of a digital mental health platform was associated with meaningful improvements in sleep quality over 12-months. These gains were linked to reductions in depression, anxiety, and burnout, highlighting broader well-being benefits of integrated mental health care.

Background: Military amputee patient care programs offer extensive services, including advanced prosthetic devices, to restore function and improve quality of life (QOL) among veterans and service members with combat-related limb loss, but research on satisfaction with these devices is limited. Objective: To assess prosthesis satisfaction and QOL in US service members and veterans with combat-related major lower-limb amputation. Study design: Cross-sectional study. Methods: Eighty-six participants with combat-related major lower-limb amputation completed the Orthotics and Prosthetics Users' Survey (OPUS) Satisfaction with Device scale and Quality of Well-Being Scale, Self-Administered, for the Wounded Warrior Recovery Project. Results: Most participants (62%–88%) responded Agree or Strongly Agree to OPUS Satisfaction with Device items on the fit, weight, comfort, ease of donning, appearance, and durability of their prosthesis. By contrast, the majority of participants (55%–79%) responded Disagree or Strongly Disagree to items on clothes being free of wear and tear, skin free of abrasions and irritations, and the affordability of their prosthesis. In linear regression analysis, total OPUS Satisfaction with Device score was positively associated with Quality of Well-Being Scale, Self-Administered score (β = 0.0058; P = 0.004). Conclusions: Findings indicate the majority of participants were satisfied with the overall functionality of their prosthesis, but dissatisfied with the effect of their prosthesis on clothing and skin, as well as expenses related to their prosthesis. Additionally, prosthesis satisfaction was positively associated with QOL.

Background: The relationship between traumatic injury and subsequent mental health diagnoses is not well understood and may have significant implications for patient screening and clinical intervention. We sought to determine the adjusted association between traumatic injury and the subsequent development of post‐traumatic stress disorder (PTSD), depression, and anxiety.Methods: Using Department of Defense and Veterans Affairs datasets between February 2002 and June 2016, we conducted a retrospective cohort study of 7,787 combat‐injured United States service members matched 1:1 to combat‐deployed, uninjured service members. The primary exposure was combat injury versus no combat injury. Outcomes were diagnoses of PTSD, depression, and anxiety, defined by International Classification of Diseases 9th and 10th Revision Clinical Modification codes.Results: Compared to noninjured service members, injured service members had higher observed incidence rates per 100 person‐years for PTSD (17.1 vs. 5.8), depression (10.4 vs. 5.7), and anxiety (9.1 vs. 4.9). After adjustment, combat‐injured patients were at increased risk of development of PTSD (HR 2.92, 95%CI 2.68–3.17), depression (HR 1.47, 95%CI 1.36–1.58), and anxiety (HR 1.34, 95%CI 1.24–1.45).Conclusions: Traumatic injury is associated with subsequent development of PTSD, depression, and anxiety. These findings highlight the importance of increased screening, prevention, and intervention in patients with exposure to physical trauma.

Low back pain is a prevalent military and veteran health problem and individuals injured on deployment may be at particularly high risk of pain conditions. Given that increasing numbers of active duty and veteran military personnel are seeking care in community settings, it is critical that health care providers are aware of military health issues. The current study examined the prevalence of low back pain among individuals with deployment-related injuries, compared their self-reported pain intensity and interference ratings, and assessed the relationship between low back pain, self-reported pain ratings, and quality of life. Almost half of participants had low back pain diagnoses, and individuals with low back pain reported significantly higher intensity and interference due to their pain than individuals without low back pain. Finally, the relationship between low back pain and quality of life was explained by self-reported pain indices, underscoring the importance of patient-centered metrics in pain treatment.

Introduction: The ‘golden hour’ is a universal paradigm that suggests trauma patients have lower morbidity and mortality when provided with medical care within 1 hour after injury. The objective of this study was to examine whether transport time from point of injury to a military treatment facility (MTF) in-theatre was associated with patient-reported outcomes, such as post-traumatic stress disorder (PTSD), depression and quality of life (QOL), among US service members with combat-related injury. Methods: Participants were injured between March 2003 and March 2016 and completed standardised assessments of PTSD, depression and QOL for theWounded Warrior Recovery Project (WWRP) between January 2013 and November 2017. Multivariable regressions were used to assess the relationship between transport time (≤1 hour or >1 hour from injury to MTF) and positive screens for PTSD and depression, and QOL, respectively. Overall, 45.6% of participants (n=879) arrived at an MTF within 1 hour postinjury. About 8 years passed between when participants were injured on deployment and when they completed their first WWRP assessment. Approximately 48% of participants screened positive for PTSD and 51.3% for depression, with a mean QOL score of 0.513 (SD=0.150). After adjusting for covariates, transport time was not significantly associated with PTSD (OR 1.04, 95% CI 0.79 to 1.38; p=0.77), depression (OR 0.92, 95% CI 0.69 to 1.21; p=0.55) or QOL (β=0.009; p=0.38). Conclusion: Transport time was not associated with patient-reported outcomes among US service members with combat-related injury. These findings are important as we seek to understand how combat casualties may be affected by extended medical evacuation or transport times anticipated in future expeditionary operations.