Co-Designing Interventions to Improve Mental Health Awareness and Recognition for Individuals with Heart Failure and their Caregivers: A Participatory Action Research Approach in the Brain-Heart Dyad

Title: Co-Designing Interventions to Improve Mental Health Awareness and Recognition for Individuals with Heart Failure and Their Caregivers: A Participatory Action Research Approach in the Brain-Heart Dyad

Introduction: Individuals with heart failure are at a higher risk of experiencing mental health challenges such as depression, anxiety, and stress. However, these concerns are often overlooked in cardiac and primary care settings, leaving many without the knowledge and support needed to manage their cardiac and mental health conditions. Community paramedics are well-positioned to bridge this gap by increasing primary care capacity and helping high-risk patients better manage their conditions and connect to community services. 

Objectives: This participatory action research study leverages the expertise of a Research Coalition of patients, caregivers, cardiac, mental, and primary care clinicians, as well as Ontario Health Team representatives to co-design a community-driven intervention. The goal is to equip patients and care providers with knowledge and tools to support interconnected mental health and cardiac needs. 

Methods: From July to November 2024, we conducted 20–40-minute semi-structured interviews with heart failure patients (n=22), caregivers, care providers (n=8), and service organizations (n=4) across the Ottawa-Cornwall region to identify gaps in heart failure and mental health care, as well as access to community resources. These insights guided a rapid scoping review of possible interventions, followed by co-design sessions with the Research Coalition from February to April 2025 to develop a tailored community-based intervention. 

Results: Our findings highlighted three key gaps: (1) both patients and healthcare providers lack awareness of available community mental health resources; (2) mental health concerns are rarely discussed in cardiac and primary care settings, limiting early intervention opportunities; and (3) patients often do not recognize the value of preventive and self-management strategies such as coaching programs, support groups, nutrition, and regular exercise. Our co-designed intervention seeks to address these gaps by equipping care providers, including community paramedics, with education and resources to facilitate discussions about mental health and connect patients to community services. 

Conclusion: Strengthening partnerships between community-based primary care providers and research teams is an important step toward integrating brain-heart care. The next phase of the project we are seeking partnerships with community paramedicine programs in Eastern Ontario to implement, pilot test, and evaluate our intervention as part of their regular clinical practice.