INCLUDE Program: A Perioperative Wellness Program Tailored for Black Surgical Patients

• Wellness Program (Behavioral): The BCBT intervention consists of 8 to 10 structured sessions delivered remotely via phone or Zoom, beginning in the preoperative period and continuing for approximately three months after surgery. The interventionist will offer a protocolized review of current medications with feedback as appropriate, under guidance by the study psychiatrist. As additional optional components of the Wellness Program, the study team will also offer faith-based counseling as well as the option to involve family and friends as active or passive participants in the program.

Primary outcomes

• Reach of the study as measured by number of patients who agree to participate in the study out of total eligible to participate [Through completion of enrollment for all participants (estimated to be 9 months, time for participant 1 day)]
• Reach of the intervention as measured by number of patients who completed the intervention out of patients who agreed to participate in the study [Through completion of follow-up for all participants (estimated to be 12 months, time for participant 3 months)]

Secondary outcomes

• Percentage of instrument or data fields completed for Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) [Baseline, 1 month after surgery, and 3 months after surgery]

Sex: All, ages: 60 Years to any

Inclusion Criteria Patients:

* Age ≥60 years
* Scheduled surgical procedure at BJH or BJWCH (oncologic, cardiac; orthopedic)
* Clinically significant depression or anxiety symptoms screened by the PHQ-ADS (Patient Health Questionnaire Anxiety and Depression Scale) ≥10
* Black or African American.

Exclusion Criteria Patients:

* Inability to provide informed consent;
* Severe cognitive impairment screened by the SBT (Short Blessed Test) ≥10
* Acutely suicidal
* Considered ineligible per the discretion of the surgeon or study PI
* Considered ineligible per the discretion of the surgeon or study PI

Caregiver participants:

If patients identify a caregiver that the patient would like to include in their Wellness Program, the caregiver will be invited to consent. Patients will provide contact information for their caregiver.

• Joanna Abraham, Ph.D., FACMI, FAMIA, Principal investigator, Washington University School of Medicine