The Hamilton Rating Scale total score indicates the interviewer-rated severity of depression symptoms. Total scores can range from 0 to 52, with higher scores indicating worse depression. Patients who score 0-9 are considered to be nondepressed. Scores of 10-13 represent mild, 14-17 mild to moderate, and >17 moderate to severe depression.

Actigraphy was used to track the patient's physical activity level. However, actigraphy had to be discontinued during the first few months of the trial due to the COVID-19 pandemic.

Participants will receive individually-tailored heart failure self-care education and support, i.e., a Tailored Self-Care (TSC) intervention. With the participant's permission, his or her personal physician will be notified about the patient's depression. The participant will be asked to discuss depression treatment options with his or her personal physician.

Total of all reporting groups

NYHA class indicates the functional or symptomatic severity of heart failure. Class I indicates asymptomatic (i.e., best class), class IV indicates severe heart failure (patient is unable to engage in normal physical activities), and classes II and II represent intermediate levels of functional impairment or symptom severity. Lower NYHA ratings represent better functioning or milder symptoms. Participants were classified at baseline as NYHA class I-II vs. class III-IV. The table values refer to the number and column percentage of patients in class I-II.

The Patient Health Questionnaire (PHQ-9) is a 9-item patient self-report questionnaire that assesses the presence and severity of major depression. Each item represents one of the Diagnostic and Statistical Manual (DSM-5) symptoms of major depression. The item ratings range in symptom frequency from 0 (absent) to 3 (nearly every day). Scores of 5, 10, 15, and 20 represent cutpoints for mild, moderate, moderately severe and severe depression, respectively. Total scores on the PHQ-9 can range from 0 to 27. Lower PHQ-9 scores represent better outcomes.

The Beck Depression Inventory (BDI-2) is a 21-item patient self-report measure of the severity of depression. Each item is rated on a 4-point scale ranging from 0 to 3. The minimum total score is zero and the maximum total score is 63. A total score of 0-13 is considered nondepressed, 14-19 represents mild depression, 20-28 represents moderate depression, and 29-63 represents severe depression. Lower scores represent better outcomes.

The Hamilton Rating Scale for Depression (HAM-D-17) is a 17-item interviewer-rated measure of the severity of depression. The total score is created by summing the item ratings. Total scores can range from zero to 52. Scores of 0-7 are considered to be in the nondepressed range, 8-16 indicate mild depression, 17-23 indicate moderate depression, and scores over 24 indicate severe depression. Lower scores represent better outcomes.

The 10-item Self-Care of Heart Failure (SCHFI v6.2) Maintenance scale assesses the frequency of engagement in heart failure-related health behaviors. The total score is standardized and can range from 0 (worst) to 100 (best). Adequate self-care maintenance behavior is defined as a score of 70 or higher

The 6-item Self-Care of Heart Failure (SCHFI v6.2) Management scale assesses the patient's responses to signs or symptoms of acute or worsening heart failure. The total score is standardized and can range from 0 (worst) to 100 (best). Adequate self-care management behavior is defined as a score of 70 or higher.

The 6-item Self-Care of Heart Failure (SCHFI v6.2) Confidence scale assesses the patient's confidence in his/her ability to manage the signs and symptoms of heart failure. The total score is standardized and can range from 0 (worst) to 100 (best). Adequate self-care confidence behavior is defined as a score of 70 or higher.

The Beck Anxiety Inventory (BAI) is a 21-item patient-self report questionnaire about symptoms of anxiety. Each symptom is rated on a four-point scale ranging from 0 (not at all) to 3 (severe - it bothered me a lot). Total scores can range from 0 (best) to 63 (worst). Scores of 0-21 indicate little or no anxiety, 22-35 moderate anxiety, and 36-63 severe anxiety.

The 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary score is scaled to range from 0 (worst) to 100 (best) heart-failure-related quality of life. Scores of 0 to 24 represent very poor to poor qualify to life; 25 to 49 poor to fair quality of life; 50 to 74 fair to good quality of life; and 75 to 100 good to excellent quality of life.

Participants will receive individually-tailored heart failure self-care education and support, i.e., a Tailored Self-Care (TSC) intervention. With the participant's permission, his or her personal physician will be notified about the patient's depression. The participant will be asked to discuss depression treatment options with his or her personal physician.

The SCHFI Maintenance scale assesses self-reported heart failure self-care behaviors. The Maintenance score was the trial's primary self-care outcome measure. Scores range from 0 (worst) to 100 (best), with scores of 70 or higher consistent with adequate self-care.

The BAI measures the self-reported severity of anxiety symptoms. Total BAI scores range from 0 (best) to 63 (worst). A total score of 0-7 is considered nonanxious; scores between 8-15 are consistent with mild, 16-25 moderate, and 26-63 severe anxiety.

The KCCQ assesses the patient's self-reported, heart failure-related functioning and quality of life. Scores range from 0 (worst) to 100 (best). Scores between 0-24 are consistent with very poor to poor health status, 25-49 poor to fair health status, 50-74 fair to good health status, and 75-100 good to excellent health status.

The Hamilton Rating Scale total score indicates the interviewer-rated severity of depression symptoms. Total scores can range from 0 to 52, with higher scores indicating worse depression. Patients who score 0-9 are considered to be nondepressed. Scores of 10-13 represent mild, 14-17 mild to moderate, and >17 moderate to severe depression.

Actigraphy was used to track the patient's physical activity level. However, actigraphy had to be discontinued during the first few months of the trial due to the COVID-19 pandemic.

Although we planned to collect actigraphy data at baseline and 16 weeks and report the 16-week data as an outcome, we were unable to collect actigraphy data due to the coronavirus (COVID-19) pandemic.

Participants will receive individually-tailored heart failure self-care education and support, i.e., a Tailored Self-Care (TSC) intervention. With the participant's permission, his or her personal physician will be notified about the patient's depression. The participant will be asked to discuss depression treatment options with his or her personal physician.