The Differential Impacts of Person- and System-Level Determinants of Health on Dyadic Heart Failure Management Study: Methodology and Design

Background: Compared with what is known about how adults with heart failure (HF) and their care partners engage in the physical aspects of illness, we know little about how they manage psychological aspects of living with HF, and the role that social determinants play in how HF dyads manage illness.The purpose of this article is to describe the background, methodology, and design of the Differential Impacts of Person and System Level Determinants of Health on Dyadic Heart Failure Management (IMPACT-D) Study.Methods and results: IMPACT-D is a prospective, multi-site, and explanatory sequential mixed-methods study of adults with HF and their adult care partners.The aims are to (1) quantify the relationships among symptoms and social determinants of health, and contributions to care in adults with HF and their care partners, and (2) characterize dyadic contributions to the maintenance, monitoring and management of mental health.Conclusions: This innovative study will allow us to gain insight into the role of mental health in the dyadic management of HF, how HF dyads maintain, monitor, and manage their mental health, and the influence of social determinants on dyadic HF management.The findings will have an important influence on intervention development.