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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 36 Research Studies DisplayedEnayat M, Farahani NZ, Chaudhry AP
Incorporating RTLS-based spatiotemporal information in studying physical activities of clinical staff.
This research used Real-Time location systems (RTLS) to study the amount of physical activity exerted by physicians, residents, nurses, and staff in the emergency department (ED). The goal of this research is to examine how low and high physical activity can affect the physical and mental health of clinicians, which can lead to fatigue and burnout. The authors used one year worth of raw RFID data that covers the movement records of 38 physicians, 13 residents, 163 nurses, and 33 staff in the ED. They compared results to the values reported in the literature and showed despite the low spatial resolution of RTLS, their non-invasive estimations were closely comparable to the ones measured by Fitbit or other wearable pedometers.
AHRQ-funded; HS026622.
Citation: Enayat M, Farahani NZ, Chaudhry AP .
Incorporating RTLS-based spatiotemporal information in studying physical activities of clinical staff.
Annu Int Conf IEEE Eng Med Biol Soc 2021 Nov;2021:2386-91. doi: 10.1109/embc46164.2021.9630597..
Keywords: Provider: Physician, Provider: Clinician, Stress, Burnout
Linton SL, Leifheit KM, McGinty EE
Association between housing insecurity, psychological distress, and self-rated health among US adults during the COVID-19 pandemic.
This research letter describes a survey study conducted to examine the association between housing insecurity and health during the COVID-19 pandemic. Data used was from wave 3 of the Johns Hopkins COVID-19 Civic Life and Public Health Survey, which was conducted online from November 11-30, 2020 using the National Opinion Research Center’s AmeriSpeak panel. The survey included 1218 participants who were 51% female, 560 participants aged 30 to 54 years, 549 participants aged 55 years or older; 13% self-identified as Hispanic, 13% self-identified as non-Hispanic Black, and 69% self-identified as non-Hispanic White. In November 2020, 128 participants (12%) reported housing insecurity. Among survey participants reporting housing insecurity, 42 reported being behind on housing payments, 55 reported having little to no confidence in their ability to make their next housing payment, and 31 reported both. Renters had disproportionately higher housing insecurity than homeowners, as did those were non-Hispanic Black race, were aged 30 to 54 years, earned less than $35,000 in 2019, lived with children, or resided in metropolitan counties. Forty-six percent of participants reported severe to moderate psychological distress and 18% reported fair to poor health. Participants with housing insecurity reported higher distress (57% vs 45%) and lower self-rated health (30% vs 16%). The association between housing insecurity and lower self-rated health was found to be statistically significant, while the association between housing insecurity and higher distress was not.
AHRQ-funded; HS000046.
Citation: Linton SL, Leifheit KM, McGinty EE .
Association between housing insecurity, psychological distress, and self-rated health among US adults during the COVID-19 pandemic.
JAMA Netw Open 2021 Sep;4(9):e2127772. doi: 10.1001/jamanetworkopen.2021.27772..
Keywords: COVID-19, Health Status, Stress, Social Determinants of Health
Wallace DD, Lytle LA, Albrecht S
All of that causes me stress: an exploration of the sources of stress experienced by Latinxs living with prediabetes.
Latinxs immigrants in the United States experience sources of stress (i.e., stressors) that can limit their ability to engage in healthy behaviors. Stress has been linked to increased type 2 diabetes (T2D) risk in Latinxs living with prediabetes, a group disproportionately affected by T2D. The purpose of this qualitative study was to describe and contextualize the variety of stressors experienced by Latinxs immigrants diagnosed with prediabetes.
AHRQ-funded; HS000032.
Citation: Wallace DD, Lytle LA, Albrecht S .
All of that causes me stress: an exploration of the sources of stress experienced by Latinxs living with prediabetes.
J Lat Psychol 2021 Aug;9(3):204-16. doi: 10.1037/lat0000168..
Keywords: Stress, Racial and Ethnic Minorities, Diabetes, Chronic Conditions, Behavioral Health
Hickey EJ, Stransky M, Kuhn J
Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder.
This study examined trajectories of parenting stress, coping, and perceived family impact over time throughout the autism diagnostic process among Hispanic and non-Hispanic families. Findings showed that Hispanic families reported lower levels of parenting stress, coping, and negative family impact across time. Further, there were differences in the change in use of coping and the amount of negative family impact reported between Hispanic and non-Hispanic parents over time.
AHRQ-funded; HS022242.
Citation: Hickey EJ, Stransky M, Kuhn J .
Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder.
Autism 2021 Aug;25(6):1694-708. doi: 10.1177/13623613211001611..
Keywords: Children/Adolescents, Autism, Stress, Behavioral Health, Racial and Ethnic Minorities
Ellis RJ, Nicolas JD, Cheung E
Comprehensive characterization of the general surgery residency learning environment and the association with resident burnout.
Researchers sought to characterize the learning environment and to evaluate associations with burnout using a cross-sectional survey administered to all U.S. general surgery residents. They found that the overall burnout rate was 43.0%, and residents were more likely to report burnout if they also identified problems with residency workload, efficiency, social support, organizational culture, meaning in work, or experienced workplace mistreatment. They recommended efforts to help programs identify and address weaknesses in a targeted fashion in order to improve trainee burnout.
AHRQ-funded; HS000078.
Citation: Ellis RJ, Nicolas JD, Cheung E .
Comprehensive characterization of the general surgery residency learning environment and the association with resident burnout.
Ann Surg 2021 Jul 1;274(1):6-11. doi: 10.1097/sla.0000000000004796..
Keywords: Burnout, Surgery, Stress, Provider: Physician
Riley AR, Williams CN, Moyer D
Parental posttraumatic stress symptoms in the context of pediatric post intensive care syndrome: impact on the family and opportunities for intervention.
Pediatric intensive care unit (PICU) survivors and their families experience ongoing impacts on physical, cognitive, and psychosocial functioning, described as Post-Intensive Care Syndrome (PICS). The objective of this study was to determine whether the posttraumatic stress symptoms (PTSS) of parents predict the impact of critical illness on families following PICU admission beyond other factors (e.g., sex, race/ethnicity, age, insurance status, illness severity, family involvement or death).
AHRQ-funded; HS022981.
Citation: Riley AR, Williams CN, Moyer D .
Parental posttraumatic stress symptoms in the context of pediatric post intensive care syndrome: impact on the family and opportunities for intervention.
Clin Pract Pediatr Psychol 2021 Jun;9(2):156-66. doi: 10.1037/cpp0000399..
Keywords: Children/Adolescents, Caregiving, Intensive Care Unit (ICU), Family Health and History, Stress
McGinty EE, Presskreischer R, Anderson KE
Psychological distress and COVID-19-related stressors reported in a longitudinal cohort of US adults in April and July 2020.
The authors investigated how psychological distress has changed over the course of the COVID-19 pandemic. They found that more than 60% of adults with serious distress reported that pandemic-related disruptions to education, employment, and finances negatively affected their mental health. Thirty-five percent of adults with serious distress cited inability to obtain health care as a contributing factor, highlighting the need to facilitate safe and affordable health care access during the pandemic and beyond.
AHRQ-funded; HS000029.
Citation: McGinty EE, Presskreischer R, Anderson KE .
Psychological distress and COVID-19-related stressors reported in a longitudinal cohort of US adults in April and July 2020.
JAMA 2020 Dec 22;324(24):2555-57. doi: 10.1001/jama.2020.21231..
Keywords: COVID-19, Behavioral Health, Stress
Campbell AM, Mattoni M, Yefimov MN
Improving cognitive workload in radiation therapists: a pilot EEG neurofeedback study.
The authors employed an accelerated alpha-theta neurofeedback (NF) protocol to test if 12 radiation therapy therapists (RTTs) could learn the protocol and exhibit behavior and brain performance-related benefits. Following the 3-week protocol, participants showed a decrease in subjective cognitive workload and a decrease in response time during a performance task, as well as a decrease in desynchrony of the alpha electroencephalogram band. The authors concluded that the RTTs successfully learned the protocol and improved in perceived cognitive workload following 3 weeks of neurofeedback.
AHRQ-funded; HS025597.
Citation: Campbell AM, Mattoni M, Yefimov MN .
Improving cognitive workload in radiation therapists: a pilot EEG neurofeedback study.
Front Psychol 2020 Dec 3;11:571739. doi: 10.3389/fpsyg.2020.571739..
Keywords: Provider, Burnout, Stress, Workforce
Umoren RA, Sawyer TL, Ades A
Team stress and adverse events during neonatal tracheal intubations: a report from NEAR4NEOS.
This study aimed to examine the association between team stress level and adverse tracheal intubation (TI)-associated events during neonatal intubations. TIs from 10 academic neonatal intensive care units were analyzed. Team stress level was rated immediately after TI using a 7-point Likert scale (1 = high stress). Associations among team stress, adverse TI-associated events, and TI characteristics were evaluated. The investigators concluded that high team stress levels during TI were more frequently reported among TIs with adverse events.
AHRQ-funded; HS024511.
Citation: Umoren RA, Sawyer TL, Ades A .
Team stress and adverse events during neonatal tracheal intubations: a report from NEAR4NEOS.
Am J Perinatol 2020 Dec;37(14):1417-24. doi: 10.1055/s-0039-1693698..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Critical Care, Teams, Stress, Adverse Events
Shechter A, Diaz F, Moise N
Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic.
The mental health toll of COVID-19 on healthcare workers (HCW) is not yet fully described. In this study the authors, using a cross-sectional web survey, characterized distress, coping, and preferences for support among NYC HCWs during the COVID-19 pandemic. They concluded that NYC HCWs, especially nurses and advanced practice providers, were experiencing COVID-19-related psychological distress.
AHRQ-funded; HS024262.
Citation: Shechter A, Diaz F, Moise N .
Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic.
Gen Hosp Psychiatry 2020 Sep-Oct;66:1-8. doi: 10.1016/j.genhosppsych.2020.06.007..
Keywords: COVID-19, Stress, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider: Health Personnel, Behavioral Health
Darling KE, Ranzenhofer LM, Hadley W
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
This cross-sectional study examined the association between stressful life events and weight-related outcomes including weight status, disordered eating behaviors, and insulin sensitivity in treatment-seeking adolescents with overweight and obesity. The authors were also looking at the potential mediating role of depression. The study included 170 adolescents (mean age 14.8, 62% female) enrolled in an interdisciplinary weight management program. Findings were that stressful childhood experiences were significantly related to weight status and disordered eating but not insulin sensitivity. Depressive symptoms were related to stressful experiences and disordered eating patterns but not weight status or insulin sensitivity.
AHRQ-funded; HS027071.
Citation: Darling KE, Ranzenhofer LM, Hadley W .
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
Eat Behav 2020 Aug;38:101402. doi: 10.1016/j.eatbeh.2020.101402..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Stress, Depression, Behavioral Health, Trauma
Poghosyan L, Ghaffari A, Liu J
Organizational support for nurse practitioners in primary care and workforce outcomes.
Lack of organizational support in healthcare settings has been linked to high levels of clinician stress, burnout, and job dissatisfaction. Little research exists on organizational support for nurse practitioners. In this study, the researchers investigated the relationship between organizational support and nurse practitioner outcomes, including job satisfaction, intent to leave, and quality of care. The investigators concluded that nurse practitioners from primary care practices with higher levels of organizational support were more likely to be satisfied with their jobs, have less intent to leave their jobs, and report better quality of care.
AHRQ-funded; HS024758.
Citation: Poghosyan L, Ghaffari A, Liu J .
Organizational support for nurse practitioners in primary care and workforce outcomes.
Nurs Res 2020 Jul/Aug;69(4):280-88. doi: 10.1097/nnr.0000000000000425..
Keywords: Provider: Clinician, Provider, Primary Care, Burnout, Stress, Workforce, Organizational Change
Bansal P, Bingemann TA, Greenhawt M
Clinician wellness during the COVID-19 pandemic: extraordinary times and unusual challenges for the allergist/immunologist.
This article describes current challenges for the allergy/immunology community due to the COVID-19 pandemic. The need for social distancing adds to complexity of care and can create isolation and anxiety. The authors suggests that tools such as the Strength-Focused and Meaning-Oriented Approach to Resilience and Transformation approach, wellness apps, mindfulness and gratitude can be used to help reduce issues contributing to burnout, depression, anxiety, substance abuse, and posttraumatic stress disorder.
AHRQ-funded; HS024599.
Citation: Bansal P, Bingemann TA, Greenhawt M .
Clinician wellness during the COVID-19 pandemic: extraordinary times and unusual challenges for the allergist/immunologist.
J Allergy Clin Immunol Pract 2020 Jun;8(6):1781-90.e3. doi: 10.1016/j.jaip.2020.04.001..
Keywords: COVID-19, Burnout, Stress, Provider: Clinician, Provider: Physician
Kennedy-Metz L, Weiss P, Parker SH
Results of exploratory investigation into adherence to auditory coping instructions during an acutely stressful task.
Healthcare providers often perform under significant stress, during which their performance must be optimal, but is known to suffer. Stress management interventions in this context can provide cognitive support to rescue performance. This exploratory study sought to evaluate the effect of stress intervention components on stress and performance while clinicians engaged in two versions of a computer-based task, differing in overall level of demand: one high-stress and one low-stress.
AHRQ-funded; HS023465.
Citation: Kennedy-Metz L, Weiss P, Parker SH .
Results of exploratory investigation into adherence to auditory coping instructions during an acutely stressful task.
Stress 2020 Mar;23(2):144-52. doi: 10.1080/10253890.2019.1660317..
Keywords: Stress, Provider: Clinician, Provider
Voisin DR, Kim DH, Bassett SM
Pathways linking family stress to youth delinquency and substance use: exploring the mediating roles of self-efficacy and future orientation.
African American adolescents in poorer neighborhoods experience significant sanctions related to drug use and delinquency. In this study, the investigators examined whether high self-esteem and positive future orientation mediated parental stress and youth substance use and delinquency. The investigators concluded that major findings indicated that self-esteem mediated the relationship between family stress and both drug use and delinquency.
AHRQ-funded; HS000078.
Citation: Voisin DR, Kim DH, Bassett SM .
Pathways linking family stress to youth delinquency and substance use: exploring the mediating roles of self-efficacy and future orientation.
J Health Psychol 2020 Feb;25(2):139-51. doi: 10.1177/1359105318763992..
Keywords: Children/Adolescents, Family Health and History, Stress, Substance Abuse
Ramchand R, Ayer L, Kotzias V
Suicide risk among women veterans in distress: perspectives of responders on the veterans crisis line.
The researchers used a qualitative approach to gain insight about the concerns and nature of comments regarding suicidal ideation and intent among women veterans calling the Veterans Crisis Line (VCL). Interviewing 54 VCL call responders, the authors concluded that efforts to prevent and treat the consequences of military sexual trauma; to recognize, prevent, and treat non-suicidal self-harm; and to restrict access to lethal means most commonly reported among women veteran callers may be helpful to mitigate suicide risk in this vulnerable group of veterans.
AHRQ-funded; HS000029.
Citation: Ramchand R, Ayer L, Kotzias V .
Suicide risk among women veterans in distress: perspectives of responders on the veterans crisis line.
Womens Health Issues 2016 Nov - Dec;26(6):667-73. doi: 10.1016/j.whi.2016.07.005.
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Keywords: Behavioral Health, Prevention, Stress, Women
Sumner JA, Khodneva Y, Muntner P
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
Using data from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study, the authors examined associations among depressive symptoms and stress, alone and in combination, and incident cardiovascular disease (CVD) and all-cause mortality as a function of socioeconomic status. They found that screening for a combination of elevated depressive symptoms and stress in low-income persons may help identify those at increased risk of incident CVD and mortality.
AHRQ-funded; HS023009.
Citation: Sumner JA, Khodneva Y, Muntner P .
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
J Am Heart Assoc 2016 Oct 10;5(10). doi: 10.1161/jaha.116.003930.
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Keywords: Cardiovascular Conditions, Depression, Social Determinants of Health, Stress, Stroke
Garfield CF, Simon CD, Rutsohn J
Paternal and maternal testosterone in parents of NICU infants transitioning home.
This study examined testosterone levels for parents of very low-birth-weight infants, including links between salivary testosterone and infant factors (such as breast-feeding), psychosocial stress, and changes over time. Using multilevel modeling approaches, the researchers reported significant associations between paternal testosterone by time and psychosocial adjustment and between both paternal and maternal testosterone and infant feeding mode.
AHRQ-funded; R21 HS020316.
Citation: Garfield CF, Simon CD, Rutsohn J .
Paternal and maternal testosterone in parents of NICU infants transitioning home.
J Perinat Neonatal Nurs 2016 Oct/Dec;30(4):349-58. doi: 10.1097/jpn.0000000000000218.
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Keywords: Newborns/Infants, Stress, Caregiving, Hospital Discharge
Senders A, Sando K, Wahbeh H
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
Psychological stress can negatively impact multiple sclerosis. To further understand how stress is addressed in the multiple sclerosis medical visit, 34 people with multiple sclerosis participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological well-being in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in multiple sclerosis.
AHRQ-funded; HS017582.
Citation: Senders A, Sando K, Wahbeh H .
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
J Health Psychol 2016 Aug;21(8):1676-87. doi: 10.1177/1359105314562084.
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Keywords: Care Management, Neurological Disorders, Ambulatory Care and Surgery, Stress
Witt WP, Mandell KC, Wisk LE
Infant birthweight in the US: the role of preconception stressful life events and substance use.
The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women's alcohol and tobacco use before and during pregnancy, and infant birthweight. It concluded that PSLEs and women's tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Infant birthweight in the US: the role of preconception stressful life events and substance use.
Arch Womens Ment Health 2016 Jun;19(3):529-42. doi: 10.1007/s00737-015-0595-z.
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Keywords: Newborns/Infants, Pregnancy, Stress, Substance Abuse, Women
Kaplan RM, Milstein A
AHRQ Author: Kaplan RM
Financial strain and cancer outcomes.
This editorial discusses an article by Lathan et al. in the same issue that documents the strong associations between socioeconomic status and longevity. The editorial argues that many of the variables in that article are measured with error and, as a result, the multivariable analysis resulted in only partial adjustment. Two variables of particular importance, education and ethnicity, are discussed.
AHRQ-authored.
Citation: Kaplan RM, Milstein A .
Financial strain and cancer outcomes.
J Clin Oncol 2016 May 20;34(15):1711-2. doi: 10.1200/jco.2016.66.8079.
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Keywords: Cancer, Health Status, Healthcare Costs, Low-Income, Outcomes, Social Determinants of Health, Stress
Rhoten BA
Body image disturbance in adults treated for cancer - a concept analysis.
The author analyzed the concept of body image disturbance in adults who have been treated for cancer as a phenomenon of interest to nurses. Rhoten used Walker and Avant's 8-step method of concept analysis and concluded that a better understanding of body image disturbance in adults treated for cancer will assist nurses and other clinicians in identifying this phenomenon and will assist nurse scientists in developing instruments that accurately measure this condition, along with interventions that will promote a better quality of life for survivors.
AHRQ-funded; HS022990.
Citation: Rhoten BA .
Body image disturbance in adults treated for cancer - a concept analysis.
J Adv Nurs 2016 May;72(5):1001-11. doi: 10.1111/jan.12892.
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Keywords: Behavioral Health, Cancer, Stress
Mathur MB, Epel E, Kind S
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
The researchers conducted a systematic review and meta-analysis to determine the association between self-reported, perceived psychological stress (PS) and telomere length (TL). They found that increased PS was associated with a very small decrease in TL and that this relationship was similar between sexes. They concluded that the association may be stronger with known major stressors and is similar in magnitude to that noted between obesity and TL. The authors recommended that futre research assess for potential confounders and use longitudinal, multidimensional models of stress.
AHRQ-funded; HS019816.
Citation: Mathur MB, Epel E, Kind S .
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
Brain Behav Immun 2016 May;54:158-69. doi: 10.1016/j.bbi.2016.02.002.
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Keywords: Evidence-Based Practice, Genetics, Stress
Rocque GB, Taylor RA, Acemgil A
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
This study assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014. It concluded that lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.
AHRQ-funded; HS013852.
Citation: Rocque GB, Taylor RA, Acemgil A .
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
J Natl Compr Canc Netw 2016 Apr;14(4):407-14.
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Keywords: Elderly, Cancer, Tools & Toolkits, Stress, Behavioral Health
Heberlein EC, Picklesimer AH, Billings DL
The comparative effects of group prenatal care on psychosocial outcomes.
This study compared the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care. It used a prospective cohort study of women who chose CP group or individual prenatal care. Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 percent greater increase in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 percent greater decrease in postpartum depressive symptom scores.
AHRQ-funded; HS021975.
Citation: Heberlein EC, Picklesimer AH, Billings DL .
The comparative effects of group prenatal care on psychosocial outcomes.
Arch Womens Ment Health 2016 Apr;19(2):259-69. doi: 10.1007/s00737-015-0564-6.
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Keywords: Pregnancy, Stress, Depression, Outcomes