Type I Hybrid Effectiveness-Implementation Trial of Primary Care Brief Mindfulness Training for Veterans

The Depression Anxiety and Stress Scale (DASS-21) is a widely used measurement for psychological symptoms and distress. It consists of 21 items measured on a 4-point scale. The three subscale scores for depression, anxiety, and stress are also valid measures of their constructs and will be used as secondary outcomes. Depression subscale range: 0-42 with higher scores meaning a worse outcome. Anxiety subscale range: 0-42 with higher scores meaning a worse outcome. Stress subscale range 0-21 with higher scores indicative of greater symptom severity.

Satisfaction with Life Scale (SWLS) is a 5-item scale measuring global judgements of life satisfaction. The possible range of scores is 5-35, with a score of 20 representing a neutral point on the scale. Scores between 5-9 indicate the respondent is extremely dissatisfied with life, whereas scores between 31-35 indicate the respondent is extremely satisfied.

The PCL-5 is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. PTSD Checklist-5 scale range 0-63 with 63 indicating highest PTSD severity.

The Generalized Anxiety Disorder-7 (GAD-7) is a 7-item anxiety measure that uses a 4-point scale. Scores are summed to create a total score ranging from 0 to 21 indicating severity of anxiety symptoms; higher scores indicate more severe symptoms.

The Patient Health Questionnaire-9 (PHQ-9) assesses 9 symptoms of depression on a 4-point scale. Patient Health Questionnaire-9 range 0-27, with 27 indicating the greatest amount of depression.

The BOMC is a six-item cognitive screening test that evaluates orientation, concentration, and memory. The higher the total weighted score, the more likely the patient has cognitive disability. For this study a score equal to or greater than 16 would mean study exclusion.

The P4 screener asks about the "4 P's": past suicide attempts, suicide plan, probability of completing suicide, and preventive factors. Patients were classified as minimal, lower, and higher risk based upon responses to these 4 items.

The Five Facet Mindfulness Questionnaire (FFMQ) is a 15-item scale that measures observing, describing, acting with awareness, non-judging, and non-reactivity. The total subscale will be used as the primary measure of mindfulness. For all FFMQ-15 subscales, scores range from 3-15. Higher scores are indicative of someone who is more mindful in their everyday life.

The ERQ is a 10-item self-report measure designed to assess the use cognitive reappraisal and expressive suppression. The Emotion Regulation Questionnaire (ERQ) has a range of 7-70. The higher the score, the greater the use of that particular emotion regulation strategy or strategies.

The AAQ-II measures psychological flexibility (the inverse of experiential avoidance) with 7-items. Score range: 7-49. Higher scores equal greater levels of psychological inflexibility.

The White Bear Suppression Inventory (WBSI) is a 15-item questionnaire designed to measure thought suppression. The total score is derived from summing the responses, and scores range from 15 to 75. Higher scores indicate higher levels of thought suppression.

The PRAPARE will measure social determinants of health and unmet social needs. This reliable and valid measure consists of 17-items assessing race, education, ethnicity, employment, insurance, income, language, material security, housing status/ stability, transportation, social integration and support, neighborhood, stress, safety, domestic violence and incarceration history.

The Demographics and Military Background Questionnaire was adapted from the George W. Bush Institute's Warrior Wellness Alliance (WWA) questionnaire "Common Questions to Better Serve Our Vets" to collect pertinent demographics and military information.