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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 66 Research Studies Displayed
Akingbade O, Peek ME, Tung EL. O, Peek ME, Tung EL
Network size or proximity? Association of network characteristics with violence-related stress and PTSD among racial/ethnic minorities in Chicago.
This research brief examined the association of network size compared to network size and proximity and the psychosocial health and PTSD rates among high-risk racial/ethnic minorities in two Chicago neighborhoods. A sample of 504 adults were surveyed from one South and one West side Chicago clinic in 2018. Only participants who self-reported lifetime exposure in the Brief Trauma Questionnaire to community violence were included, decreasing the sample size to 297. The majority of participants were female (69%) and non-Hispanic Black (75%). Two-thirds were direct victims of robbery or assault, and one-third tested positive for PTSD. Median number of network confidants was found to be 2. A larger network size (> 3 confidants) within 30 minutes from home was significantly associated with 67% lower adjusted odds of PTSD compared to those with no confidants within 30 minutes from home.
Citation: Akingbade O, Peek ME, Tung EL. O, Peek ME, Tung EL . Network size or proximity? Association of network characteristics with violence-related stress and PTSD among racial/ethnic minorities in Chicago. J Gen Intern Med 2022 Jan;37(1):255-57. doi: 10.1007/s11606-021-06607-w..
Keywords: Behavioral Health, Racial / Ethnic Minorities, Stress, Domestic Violence
Enayat 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.
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.
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.
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 / 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.
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 / 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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
Rudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
Citation: Rudd BN, Last BS, Gregor C . Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy. Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Hu YY, Ellis RJ, Hewitt DB
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
A cross-sectional national survey of general surgery residents, administered with the 2018 American Board of Surgery In-Training Examination, assessed mistreatment, burnout, and suicidal thoughts during the past year. The authors assessed the association of mistreatment with burnout and suicidal thoughts; they found that mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.
Citation: Hu YY, Ellis RJ, Hewitt DB . Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training. N Engl J Med 2019 Oct 31;381(18):1741-52. doi: 10.1056/NEJMsa1903759..
Keywords: Education: Continuing Medical Education, Burnout, Stress, Surgery, Provider: Physician, Provider, Training
Cook JM, Newman E, Simiola V
Trauma training: competencies, initiatives, and resources.
Traumatic stress is currently not a required component of the standard curricula in graduate-level education in clinical and counseling psychology. However, due to the high prevalence of trauma and its potentially deleterious physical and mental health effects in the general and clinical populations, it is imperative that psychology graduate students and practitioners understand the relevance of trauma in their clients' lives and its impact in clinical research. This paper discusses competencies, initiatives and resources related to trauma training.
Citation: Cook JM, Newman E, Simiola V . Trauma training: competencies, initiatives, and resources. Psychotherapy 2019 Sep;56(3):409-21. doi: 10.1037/pst0000233..
Keywords: Education: Continuing Medical Education, Behavioral Health, Provider, Stress, Training, Trauma
Kroth PJ, Morioka-Douglas N, Veres S
Association of electronic health record design and use factors with clinician stress and burnout.
The authors sought to determine which electronic health record (EHR) design and use factors are associated with clinician stress and burnout and to identify other sources that contribute to this problem. Surveying ambulatory primary care and subspecialty clinicians from 3 institutions, they found that, although EHR design and use factors are associated with clinician stress and burnout, other challenges, such as chaotic clinic atmospheres and workload control, explain considerably more of the variance in these adverse clinician outcomes.
Citation: Kroth PJ, Morioka-Douglas N, Veres S . Association of electronic health record design and use factors with clinician stress and burnout. JAMA Netw Open 2019 Aug 2;2(8):e199609. doi: 10.1001/jamanetworkopen.2019.9609..
Keywords: Burnout, Stress, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider: Clinician, Provider: Physician, Provider: Nurse
Papaleontiou M, Reyes-Gastelum D, Gay BL
Worry in thyroid cancer survivors with a favorable prognosis.
Researchers investigated cancer-related worry in thyroid cancer survivors with favorable prognosis. A diverse cohort of patients diagnosed with differentiated thyroid cancer, selected from the Surveillance, Epidemiology, and End Results (SEER) Program registries were surveyed for two to four years after diagnosis. The researchers recommended that physicians be aware that worry is a major issue for thyroid cancer survivors with favorable prognosis. Efforts should be undertaken to alleviate worry, especially among vulnerable groups, including female patients, younger patients, those with lower education, and racial/ethnic minorities.
Citation: Papaleontiou M, Reyes-Gastelum D, Gay BL . Worry in thyroid cancer survivors with a favorable prognosis. Thyroid 2019 Aug;29(8):1080-88. doi: 10.1089/thy.2019.0163..
Keywords: Cancer, Anxiety, Stress, Health Status
Anton NE, Mizota T, Whiteside JA
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
The authors hypothesize that surgery residents trained on mental skills would outperform controls under increased stress conditions in the simulated operating room. They find that their comprehensive mental skills curriculum implemented with surgery residents at two institutions was effective at minimizing the deterioration of resident technical performance under stressful conditions compared with controls. They conclude that their results provide further evidence for the effectiveness of mental skills training to optimize surgery trainees' technical performance during challenging clinical situations.
AHRQ-funded; R18 HS022080.
Citation: Anton NE, Mizota T, Whiteside JA . Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study. Surgery 2019 Jun;165(6):1059-64. doi: 10.1016/j.surg.2019.01.011..
Keywords: Surgery, Education: Continuing Medical Education, Stress, Provider Performance, Training, Provider: Physician, Provider
Nocon RS, Fairchild PC, Gao Y
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
This study examined the impact of adopting the patient-centered medical home (PCMH) on clinicians and staff at primary care practices. A longitudinal study was done comparing baseline (201) and post-intervention (2013-2014) survey results. Five-hundred thirty-six providers and staff at baseline and 589 were surveyed post-intervention. Almost half of all clinics reported improved better job morale, job satisfaction, and freedom from burnout. However, there were some clinics that saw a decrease in the percentage of providers reporting high job satisfaction and freedom from burnout. Control clinics were not used in this study, so it is impossible to know if results were similar in non-PCMH primary care practices.
Citation: Nocon RS, Fairchild PC, Gao Y . Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention. J Gen Intern Med 2019 Jun;34(6):952-59. doi: 10.1007/s11606-019-04893-z..
Keywords: Burnout, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Provider, Provider: Clinician, Stress
Baskind MJ, Taveras EM, Gerber MW
Parent-perceived stress and its association with children's weight and obesity-related behaviors.
Psychosocial stress is associated with obesity in adult and pediatric populations, but few studies have examined the relationship between parent-perceived stress and risk of child obesity and related behaviors. In this study, the investigators studied 689 pairs of parents and children aged 2 to 12 in Massachusetts with a body mass index (BMI) at or above the 85th percentile. The investigators found that among children with overweight or obesity, parent-perceived stress was associated with fast-food consumption and physical activity.
AHRQ-funded; HS024332; HS022986.
Citation: Baskind MJ, Taveras EM, Gerber MW . Parent-perceived stress and its association with children's weight and obesity-related behaviors. Prev Chronic Dis 2019 Mar 28;16:E39. doi: 10.5888/pcd16.180368..
Keywords: Children/Adolescents, Family Health and History, Lifestyle Changes, Obesity, Obesity: Weight Management, Risk, Stress
Gowey MA, Khodneva Y, Tison SE
Depressive symptoms, perceived stress, and metabolic health: the REGARDS study.
The purpose of this study was to describe the relationship between metabolic health parameters and depressive symptoms and perceived stress, and determine whether the co-occurrence of these two psychological stressors had an additive influence on metabolic dysregulation in adults at different levels of body mass index (BMI) without diabetes. The investigators found that elevated depressive symptoms in conjunction with high levels of perceived stress were more strongly associated with several parameters of metabolic health than only one of these psychological constructs in a large, diverse cohort of adults.
AHRQ-funded; HS023009; HS013852.
Citation: Gowey MA, Khodneva Y, Tison SE . Depressive symptoms, perceived stress, and metabolic health: the REGARDS study. Int J Obes 2019 Mar;43(3):615-32. doi: 10.1038/s41366-018-0270-3..
Keywords: Depression, Behavioral Health, Obesity, Stress