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Griffis CA, Bamgbose E, Van Pelt M, DeVon H, Wilhalme H, Choi K. Preliminary Investigation: Pilot Study of Program Directors' Perceptions of Wellness and Suicide Prevention for Student Registered Nurse Anesthetists. AANA J 2024; 92:17-26. [PMID: 38289683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
The purpose of this pilot study was to investigate wellness and student suicidality in nurse anesthesia programs. Graduate students such as student registered nurse anesthetists (SRNAs) are at increased risk of suicide from environmental and educational stressors. Wellness interventions may help. An observational, anonymous online survey of all program directors (PDs) was conducted. Identical responses on a simultaneous pilot SRNA study were compared. Quantitative data were analyzed using Wilcoxon rank sum and Fisher's exact tests. Three PDs reported student suicides. Anxiety, depression, and emotional lability were warning signs. Student and PD responses to wellness program assessments were varied, with PD responses more positive and students more negative. PDs were as stressed as students and struggled to meet their own wellness needs. Most PDs reported no or insufficient training in suicide risk and prevention. Suggestions for improving wellness initiatives included to improve and standardize activities and make initiatives more accessible and seek innovative solutions to fit more content into an overcrowded curriculum. PDs and SRNAs need suicide prevention training and improved wellness efforts at local and national levels. Approaches are needed to counter stigma and reluctance to discuss mental health challenges. Suicide is multidimensional, but with proactive awareness, it may be preventable.
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Affiliation(s)
- Charles A Griffis
- Clinical Instructor at the University of Southern California Program of Nurse Anesthesia, Los Angeles, California.
| | - Elizabeth Bamgbose
- is Clinical Assistant Professor of Anesthesiology and Program Director of the University of Southern California Program of Nurse Anesthesia, Los Angeles, California.
| | - Maria Van Pelt
- is a Clinical Professor at Northeastern University, School of Nursing, Nurse Anesthesia Program, Boston, Massachusetts.
| | - Holli DeVon
- is Professor and Associate Dean for Research at the University of California, Los Angeles School of Nursing Los Angeles, California.
| | - Holly Wilhalme
- is Principal Statistician at the University of California Los Angeles Department of Medicine Statistics Core, Division of General Internal Medicine and Health Services Research, Los Angeles, California.
| | - Kristen Choi
- is an Assistant Professor, University of California Los Angeles School of Nursing, Los Angeles, California.
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Mota JF, Lopes LC, Trottier CF, Johnson ST, Lieffers J, Prado CM. A Randomized Controlled Trial of the Effects of a Web-Based Intervention on Perceived Stress and Diet Quality Among First-Year University Students. Telemed Rep 2023; 4:327-335. [PMID: 37908625 PMCID: PMC10615051 DOI: 10.1089/tmr.2023.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 11/02/2023]
Abstract
Background e-Health interventions can potentially improve health care. My Viva Plan® (MVP) is a web-based program that focuses on mindfulness, nutrition, and physical fitness. The aim of this study was to evaluate the effects of this platform on stress indicators and diet quality among first-year university students. Methods Ninety-seven university students were enrolled in a randomized, controlled clinical trial. Participants were randomized into control (n = 49) and MVP (n = 48) groups. Perceived stress was measured using the self-report Stress Indicator Questionnaire. Diet quality was assessed by the nutrient-rich foods index, and body composition was assessed by a hand-to-foot, multifrequency, bioelectrical impedance analysis. Results There were no differences in physical, sleep, behavioral, emotional, and personal habit indicators between groups. Diet quality and body composition were similar between groups, except among women in the MVP group with decreased body fat (-1.2 ± 2.6 kg, p < 0.05). Participant engagement was low: 50% of the MVP group did not access the platform. Conclusions The MVP web-based intervention was not associated with improvements in stress indicators, diet quality, and body composition, likely due to the characteristics of our cohort of healthy young individuals. Future studies should focus on enhancing motivational approaches to explore the potential of e-health interventions that improve health behavior. Clinical Trial Registration number: NCT03579264A.
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Affiliation(s)
- Joao F. Mota
- School of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Lorena C.C. Lopes
- School of Nutrition, Federal University of Goiás, Goiânia, Brazil
- Department of Bioscience, Centro Universitário de Mineiros–Unifimes, Mineiros, Brazil
| | - Claire F. Trottier
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Steve T. Johnson
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Jessica Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Carla M. Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
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Weinstein M. Strategic Choice and Implementation of Workplace Wellness Programs in the United States. Healthcare (Basel) 2022; 10. [PMID: 35885743 DOI: 10.3390/healthcare10071216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/21/2022] [Accepted: 06/26/2022] [Indexed: 11/16/2022] Open
Abstract
Despite widespread discussion and public policy support for workplace wellness programs in the United States, their diffusion has been slow. Using data from the 2017 Workplace Health Administration Survey, this paper explored the importance of establishment characteristics, unionization, and strategic choice in the adoption of workplace health initiatives and employee participation in these programs. An ordinary least squares analysis revealed that unionization (β = 1.59, 95% CI = 1.20−1.97, p < 0.001) and management support (β = 1.67, 95% CI = 1.25−2.10, p < 0.001) were the strongest predictors of the number of programs adopted by an establishment. In logistic regression analyses of nine workplace wellness programs, it was also found that unionization and management were the strongest predictors of the adoption of these programs. Management support was also correlated with employee participation of in nutrition (OR = 2.66, 95% CI = 1.23−5.71, p < 0.05) and obesity programs (OR = 3.66, 95% CI = 1.03−12.97, p < 0.05).
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Weinstein SM, Reilly E, Garland N, Zimmerman V, Jacobs D. Impact of a Virtual Wellness Program on Quality of Life Measures for Patients Living With Multiple Sclerosis During the COVID-19 Pandemic. Int J MS Care 2022; 24:282-286. [PMID: 36545649 PMCID: PMC9749834 DOI: 10.7224/1537-2073.2021-134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with multiple sclerosis (MS) were vulnerable to the effects of physical inactivity during the COVID-19 pandemic. As patients returned to in-person visits, providers reported seeing increased weakness, balance issues, falls, worsening pain, and spasticity. Social isolation also contributed to increased stress, depression, and anxiety. This study explored whether attending virtual wellness programs was associated with improvements in standard quality of life questionnaire scores for patients with MS. METHODS The purposive convenience sample consisted of 43 patients in the treatment group and 28 in the control group. Patients in the treatment group attended 2 monthly programs for 6 months and completed a demographic questionnaire, the 36-Item Short Form Health Survey (SF-36), the Modified Fatigue Impact Scale, and the Medical Outcomes Study Pain Effects Scale (PES). Patients requested additional topics, resulting in 5 additional programs. The control group consisted of patients who chose not to attend the programs but agreed to complete the questionnaires. RESULTS In comparing questionnaire responses (6 months minus baseline) among the participants in the treatment group, an association was found between higher meeting attendance and improvements in emotional well-being (P = .038), pain on the PES (P = .011), mindfulness on the SF-36 pain scale (P = .0472), and exercise on the PES (P = .0115). CONCLUSIONS The results of this study suggest that a virtual wellness program may provide beneficial emotional support, physical exercise, and health promotion activities resulting in improved quality of life in people with MS. In addition, mindfulness and exercise programs may be beneficial in pain management.
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Affiliation(s)
- Sarah M. Weinstein
- The Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA (SMW)
| | | | - Nora Garland
- From the Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA (DJ, NG, VZ)
| | - Vanessa Zimmerman
- From the Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA (DJ, NG, VZ)
| | - Dina Jacobs
- From the Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA (DJ, NG, VZ)
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Ernawati E, Mawardi F, Roswiyani R, Melissa M, Wiwaha G, Tiatri S, Hilmanto D. Workplace wellness programs for working mothers: A systematic review. J Occup Health 2022; 64:e12379. [PMID: 36522291 PMCID: PMC9755005 DOI: 10.1002/1348-9585.12379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This systematic review aimed to uncover the evidence and benefits of employers' commitment to delivering workplace wellness programs for working mothers. METHODS The articles published in PubMed, Embase, Scopus, and AgeLine-Medline databases between 2012 and 2021 were searched to evaluate the workplace wellness programs for working mothers with at least one resultant wellness or wellbeing (e.g., physical health, less stress, mental health, burnout, depression, smoking, bullying, alcohol consumption, overweight), work-life balance outcome, or job satisfaction. RESULTS Eight studies that met the criteria were retrieved from databases. They showed some effective workplace wellness programs that can reduce depression, stress, and burnout, improve mental health, healthy behaviors, work-family balance and work-life balance. Working mothers participating in a workplace wellness program generally gain some benefits; one of which is reduced stress typically related to childcare, economic, and personal health issues. CONCLUSIONS The implementation of workplace wellness programs for working mothers showed positive effects on their health problems and health costs. These eight studies revealed that workplace wellness programs specifically designed for working mothers can lead to time efficiency by holding the programs in or near the workplace and implementing them during the workdays. This greatly suits the conditions of many working mothers whose limited time and energy to balance the household, family and work tasks.
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Affiliation(s)
- Ernawati Ernawati
- Public Health Department, Faculty of MedicineUniversitas TarumanagaraJakarta BaratIndonesia
- Medicine Study Program, Faculty of MedicineUniversitas PadjadjaranBandungIndonesia
| | - Fitriana Mawardi
- Medicine Study Program, Faculty of MedicineUniversitas PadjadjaranBandungIndonesia
| | | | - Melissa Melissa
- Faculty of PsychologyUniversitas TarumanagaraJakarta BaratIndonesia
| | - Guswan Wiwaha
- Public Health Department, Faculty of MedicineUniversitas PadjadjaranBandungIndonesia
| | - Sri Tiatri
- Faculty of PsychologyUniversitas TarumanagaraJakarta BaratIndonesia
| | - Dany Hilmanto
- Pediatry Department Faculty of MedicineUniversitas PadjadjaranBandungIndonesia
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Wahbeh H, Yount G, Vieten C, Radin D, Delorme A. Exploring Personal Development Workshops' Effect on Well-Being and Interconnectedness. J Integr Complement Med 2022; 28:87-95. [PMID: 35085021 DOI: 10.1089/jicm.2021.0043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Personal development workshops are increasingly popular. This study evaluated the relationships between the measures of well-being, interconnectedness, and extended perception in various workshops and explored which kinds of workshops and individual characteristics predicted changes in these outcomes. Materials and Methods: In a prospective, uncontrolled, within-participant design study, adult participants completed questionnaires and online tasks before and after personal development workshops. Three analyses were conducted: (1) examining the relationships between measures by using only pre-workshop measures using Spearman correlations; (2) exploring change scores pre- to post-workshop and workshop using Wilcoxon signed-rank test; (3) assessing workshop format and content, and individual characteristics as predictors of those change scores multivariate nonparametric regression. The following outcomes were collected: Well-being-Arizona Integrative Outcomes Scale, positive and negative affect, Dispositional Positive Emotions Scale-Compassion subscale, Sleep Quality Scale, Numeric Pain Rating Scale; Interconnectedness-Cloninger Self-Transcendence Scale, Inclusion of Nature in Self and Inclusion of the Other in Self; and Extended perception tasks-Intuition Jar, Quick Remote Viewing, Psychokinesis Bubble, and Time Estimation. The following potential predictor variables were collected: demographic, mental health, psychiatric and meditation history, Single General Self-Rated Health Question, Brief Five-Factor Inventory-10, and the Noetic Experience and Belief Scale. Workshop leaders also selected which format and content characteristics applied to their workshop. Results: Interconnectedness measures were significantly and positively correlated with well-being (ρ: 0.27 to 0.33), positive affect (ρ: 0.20 to 0.27), and compassion (ρ: 0.21 to 0.32), and they were negatively correlated with sleep disturbance (ρ: -0.13 to -0.16) and pain (ρ: -0.11 to -0.16). Extended perception task performance was not correlated with interconnectedness or well-being. General personal development workshops improved subjective interconnectedness, well-being, positive emotion, and compassion, and they reduced sleep disturbances, negative emotion, and pain (all p's < 0.00005). The lecture (p = 0.03), small groups (p = 0.001), pairs (p = 0.01), and discussion (p = 0.03) workshop formats were significant predictors of well-being outcomes. The workshop content categories of meditation (p = 0.0002) and technology tools (p = 0.01) were also predictive of well-being outcomes, with meditation being the most consistent predictor of positive well-being changes. Conscientiousness was the only significant individual characteristic predictor (p = 0.002), although it was associated with increases in some well-being measures and decreases in others. Conclusions: This study provides preliminary evidence for the positive relationship between the subjective sense of interconnectedness and multiple well-being measures and the beneficial effects of some personal development workshops.
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Affiliation(s)
- Helané Wahbeh
- Department of Research, Institute of Noetic Sciences, Petaluma, CA, USA
| | - Garret Yount
- Department of Research, Institute of Noetic Sciences, Petaluma, CA, USA
| | - Cassandra Vieten
- Department of Research, Institute of Noetic Sciences, Petaluma, CA, USA
| | - Dean Radin
- Department of Research, Institute of Noetic Sciences, Petaluma, CA, USA
| | - Arnaud Delorme
- Department of Research, Institute of Noetic Sciences, Petaluma, CA, USA
- Institute of Neural Computation, SCCN, University of California, San Diego, La Jolla, CA, USA
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Trottier CF, Lieffers JRL, Johnson ST, Mota JF, Gill RK, Prado CM. The Impact of a Web-Based Mindfulness, Nutrition, and Physical Activity Platform on the Health Status of First-Year University Students: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e24534. [PMID: 33688844 PMCID: PMC7991982 DOI: 10.2196/24534] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 12/11/2022] Open
Abstract
Background First-year university students are at an increased risk for developing mental health issues and a poor nutritional status. Self-care plays an essential role in optimizing mental health and can prevent or manage stress, anxiety, and depression. Web-based self-monitoring of diet and physical activity can lead to similar or improved health outcomes compared with conventional methods. Such tools are also popular among university students. Objective The primary aim of this 12-week randomized controlled trial is to assess the impact of a web-based wellness platform on perceived stress among first-year university students. The secondary aim is to assess the effects of the platform on diet quality. The exploratory objectives are to explore the effects of the platform on body composition, health-related quality of life, mindfulness, mental well-being, and physical activity. Methods A total of 97 first-year undergraduate students were randomized to either the intervention (n=48) or control (n=49) group. The intervention consisted of access to a web-based platform called My Viva Plan (MVP), which aims to support healthy living by focusing on the topics of mindfulness, nutrition, and physical activity. The platform is fully automated and guided by the principles of cognitive behavioral theory. Participants in the intervention group were instructed to use the MVP as frequently as possible over 12 weeks. The control group did not receive access to MVP. Perceived stress was assessed using the Stress Indicators Questionnaire at baseline, week 6, and week 12. Three-day food records were used to analyze the dietary intake at baseline and week 12. Health-related quality of life, mindfulness, mental well-being, and physical activity questionnaires were completed at baseline, week 6, and week 12. Body composition was assessed at baseline and week 12. Study assessments were completed in person at baseline and week 12 and electronically at week 6. Results Study recruitment started in August 2018, with batch enrollment for students registered in the fall (September 2018 to December 2018) and winter (January 2019 to April 2019) academic terms at the University of Alberta, Edmonton, Alberta. Conclusions This study is the first to explore the impact of a web-based platform designed to promote health and wellness on perceived stress and diet quality among first-year university students. Trial Registration ClinicalTrials.gov NCT03579264; https://clinicaltrials.gov/ct2/show/NCT03579264. International Registered Report Identifier (IRRID) DERR1-10.2196/24534
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Affiliation(s)
- Claire F Trottier
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Jessica R L Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Steven T Johnson
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - João F Mota
- Clinical and Sports Nutrition Research Laboratory (LABINCE), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Roshni K Gill
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
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Petrini LA, Thottathil P, Shih G, Henderson A, Pasquariello C, Black SA. Ask the question, be the solution: Fostering well-being through contextualized assessment and strategy development. Paediatr Anaesth 2021; 31:68-73. [PMID: 33217761 DOI: 10.1111/pan.14087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022]
Abstract
In recent years, optimizing provider well-being and mitigating the effects of physician burnout have become increasingly important in the field of medicine. These efforts are in part of consequence because of significant costs associated with provider burnout, for both individuals and their workplace. Accordingly, robust work has focused on development of strategies to decrease the incidence of burnout or mitigate its effects, including both individual efforts and systematic organizational change. This article describes the development and implementation of a unique assessment strategy to identify the driving factors hindering well-being in our general anesthesiology division. We describe how collected data allowed us to identify important areas for improvement, build community, and target novel interventions to ultimately improve the well-being of our division for all members. This manuscript does not describe survey results in any detail, but rather aims to present a creative application of the Hawthorne Effect as it applies to understanding physician well-being.
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Affiliation(s)
- Laura A Petrini
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Princy Thottathil
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Grace Shih
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Alicia Henderson
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Carol Pasquariello
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Stephanie A Black
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Salana K, Maty S, Hage R. Alive and Well: Encouraging Long Term Health Habits Through Implementation of Student Driven Wellness Programs in Medical Schools. Glob Adv Health Med 2020; 9:2164956120973622. [PMID: 33282544 PMCID: PMC7683844 DOI: 10.1177/2164956120973622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/29/2020] [Accepted: 09/24/2020] [Indexed: 12/30/2022] Open
Abstract
Purpose A lack of coping mechanisms has been linked to increased rates of anxiety, depression, and imposter syndrome among medical students. In response, schools have been searching for methods to negate these results through wellness programs focused on student life. Methods A survey comprised of three multiple choice questions was disseminated amongst first year basic science medical students to determine their current state of well-being and potential interest in an educational course focused on wellness. Questions inquired about students’ current coping strategies and their interest in engaging in wellness focused activities. Participants’ responses were then used to create a Well-being selective. The course design was centered around a small points reward system in order to promote autonomous decision making and encourage balance of body, mind, and spirit. Results/Discussion Initial survey data suggests student interest in the creation of a wellness centered selective. Students engaged in a diverse array of activities to support the whole of their being. By tracking student choices of activities to engage in and feedback sent to the selective director, the selective design is being adapted to fit the needs of the student body. Conclusion Through promotion of on and off-campus extracurricular activities, the Well-being selective offers a non-threatening and self-paced approach to a balanced mind, body, and spirit. In this selective, students participate in diverse activities that support health and life balance, ranging from sunset group yoga to local botany. Student feedback suggests that through the selective they have experienced increased community engagement and support during their basic sciences medical education.
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Affiliation(s)
- Kristen Salana
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies
| | - Shauna Maty
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies
| | - Robert Hage
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies
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Hendricks-Sturrup RM, Cerminara KL, Lu CY. A Qualitative Study to Develop a Privacy and Nondiscrimination Best Practice Framework for Personalized Wellness Programs. J Pers Med 2020; 10:jpm10040264. [PMID: 33287396 PMCID: PMC7761887 DOI: 10.3390/jpm10040264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022] Open
Abstract
Employers in the United States (US) increasingly offer personalized wellness products as a workplace benefit. In doing so, those employers must be cognizant of not only US law but also European Union (EU) law to the extent that the EU law applies to European immigrants or guest workers in the US. To the extent that wellness programs are implemented in either public health or employment contexts within the US and/or EU, sponsors of these programs can partner with direct-to-consumer (DTC) genetic testing companies and other digital health companies to generate, collect, and process sensitive health information that are loosely or partially regulated from a privacy and nondiscrimination standpoint. Balancing claims about the benefits of wellness programs are concerns about employee health privacy and discrimination and the current unregulated nature of consumer health data. We qualitatively explored the concerns and opinions of public and legislative stakeholders in the US to determine key themes and develop privacy and nondiscrimination best practices. Key themes emerged as promoting a culture of trust and wellness. Best practices within these themes were: (1) have transparent and prominent data standards and practices, (2) uphold employee privacy and nondiscrimination standards, (3) remove penalties associated with biometric outcomes and nondisclosure of sensitive health information, (4) reward healthy behavior regardless of biometric outcomes, and (5) make program benefits accessible regardless of personal status. Employers, DTC genetic testing companies, policymakers, and stakeholders broadly should consider these themes and best practices in the current absence of broad regulations on nondiscriminatory workplace wellness programs.
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Affiliation(s)
- Rachele M. Hendricks-Sturrup
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA 02215, USA;
- Correspondence: ; Tel.: +1-617-867-4274
| | - Kathy L. Cerminara
- Shepard Broad College of Law, Nova Southeastern University, Fort Lauderdale, FL 33314, USA;
| | - Christine Y. Lu
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA 02215, USA;
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Nizamuddin SL, Nizamuddin J, Latif U, Tung A, Klafta JM, Lee SM, Ku CM, Stahl DL, Lee J, Shahul SS. Be Active and Be Well? A Cross-sectional Survey of US Anesthesia Residents. J Educ Perioper Med 2020; 22:E640. [PMID: 32939368 PMCID: PMC7485433 DOI: 10.46374/volxxii-issue2-nizamuddin] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Wellness among resident physicians is important to their well-being and ability to provide clinical care. The relationship between physical activity and wellness among anesthesia residents has not yet been evaluated. We surveyed anesthesia residents to evaluate their levels of physical activity and self-perceived wellness scores. We hypothesized that residents with high self-reported physical activity levels would be more likely to have higher wellness scores. METHODS Three hundred and twenty-three anesthesia residents were invited to participate in this cross-sectional survey study. The survey included questions regarding demographics (age, gender, clinical anesthesia year, work hours), physical activity (based off the US Department of Health and Human Services [USDHHS] guidelines), and wellness (using the Satisfaction With Life Scale). The relationship between wellness and physical activity levels was evaluated. RESULTS One hundred forty-one residents responded (43.6% response rate). Thirty-eight (27.1%) residents met our activity threshold for physically active. Eighty-six respondents (61.4%) were classified as having high wellness based on their survey answers. No significant associations were found between demographic data and wellness, including age or clinical anesthesia training year. Among those residents who described physical activity consistent with USDHHS guidelines, 29 (76.3%) had high wellness scores. After logistic regression analysis, residents who achieved the physical activity guidelines were more likely to have high wellness scores (odds ratio 2.54, 95% confidence interval 1.13-6.20, P value .03). CONCLUSIONS Anesthesia resident physicians with high physical activity levels had higher self-perceived wellness scores.
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Koul PA, Swaminathan S, Rajgopal T, Ramsubramanian V, Joseph B, Shanbhag S, Mishra A, Raut SK. Adult Immunization in Occupational Settings: A Consensus of Indian Experts. Indian J Occup Environ Med 2020; 24:3-15. [PMID: 32435109 PMCID: PMC7227733 DOI: 10.4103/ijoem.ijoem_50_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 12/18/2022] Open
Abstract
There is an increasing focus on instituting wellness programs at the workplace among organizations in India. Such programs are aimed at improving employee health, which in turn, helps in reducing absenteeism, as well as in increasing work productivity and improving employee engagement. Of note, adult vaccination plays a significant role in ensuring the well-being of employees, as well as in keeping an organization profitable. The burden of vaccine-preventable diseases (VPDs) in adults is increasing in India, causing significant morbidity and disability. Moreover, adult immunization is an underpublicized concept in India. There is an urgent need to create awareness about adult immunization in India, particularly in occupational health settings-both at the employee and employer levels. In view of this, an expert meeting was held under the aegis of the Indian Association of Occupational Health (IAOH) to discuss key issues pertaining to the burden of VPDs in the working population in India and to formulate guidelines on adult vaccination in occupational health settings. This consensus guideline document may act as a guide for organizations across India to create awareness about adult vaccination and also to design workplace vaccination programs to promote better health among employees.
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Affiliation(s)
- Parvaiz A. Koul
- Professor and Head, Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Subramanium Swaminathan
- Senior Consultant, Infectious Diseases, Gleneagles Global Health City, Chennai, Tamil Nadu, India
| | - Thirumalai Rajgopal
- Vice President, Global Medical and Occupational Health, Unilever, Mumbai, Maharashtra, India
| | - V. Ramsubramanian
- Senior Consultant, Infectious Diseases and Tropical Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Bobby Joseph
- Professor, Community Health; Head, Occupational Health Services, St. John's Medical College, Bangalore, Karnataka, India
| | - Shrinivas Shanbhag
- Medical Advisor, Chairman's Office, Reliance Industries Limited, Mumbai, Maharashtra, India
| | - Ashish Mishra
- Health Director – Europe, Middle East, Africa and India, Dow Chemical International Pvt. Ltd. and President, Indian Association of Occupational Health, Mumbai Branch, Maharashtra, India
| | - Sidram K. Raut
- Director, Noble Hospital; Head of Blood Bank, Corporate and Overseas Business and Clinical Research, Noble Hospital, Pune, Maharashtra and President, Indian Association of Occupational Health, India
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Abstract
AIM The aim of this concept analysis is to report a synthesis of the extant literature and define emotional wellbeing in youth as a concept of emerging importance. BACKGROUND Emotional wellbeing is a national research priority in the United States. It is not well defined nor understood in the context of its ontology, mechanisms, biomarkers, or promotion. As a result, interventional research cannot be adequately informed. DESIGN A comprehensive review of the literature was conducted to inform the sample. DATA SOURCE The scientific databases PubMed, Cochrane Library, Ovid Medline, PsycINFO, NCBI, Allied and Complementary Medicine, EMBASE, EBSCO, JAMAevidence, CINAHL, Joanna Briggs Institute, and Reporter were queried. REVIEW METHODS The Walker and Avant method was utilized to analyze the resultant sample for common themes of antecedents, attributes, and consequences of emotional wellbeing. RESULTS Seventeen scientific research studies were included in the final sample. CONCLUSION Attributes of emotional wellbeing in youth include overall positive emotions, positive self-esteem, and resilience. Antecedents are safe and stable nurturing relationships; family and social connectedness, hope, and positive body-image. The consequences of emotional wellbeing in youth include self-efficacy, self-actualization, the presence of positive health behaviors, and the absence of high-risk behaviors.
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Affiliation(s)
| | - Mary Beth Flynn Makic
- Adult Gerontology Clinical Nurse Specialist Program, University of Colorado College of Nursing, Aurora, Colorado
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Talley KMC, Cheung C, Mathiason MA, Schorr E, McMahon S, Wyman JF. Aging Adults' Preferences for Wellness Program Activities and Delivery Characteristics: A Cross-Sectional Survey. Top Geriatr Rehabil 2019; 35:289-299. [PMID: 32099271 PMCID: PMC7041904 DOI: 10.1097/tgr.0000000000000247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lifestyle wellness programs help prevent and manage chronic diseases, yet few are designed for aging adults. PURPOSE Identify characteristics associated with aging adults' preferences for wellness program activities and delivery characteristics. SUBJECTS/METHODS Cross-sectional, self-administered survey of a convenience sample of 386 adults aged ≥55 years. Logistic regression models identified characteristics influencing preferences. RESULTS Current healthy behaviors, gender, and age influenced many preferences, while BMI, multiple chronic conditions, self-rated general health status, and quality of life did not. DISCUSSION Incorporating aging adults' preferences for wellness programs will help design appealing and engaging programs.
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Affiliation(s)
| | - Corjena Cheung
- School of Nursing, University of Minnesota, Minneapolis, MN
| | | | - Erica Schorr
- School of Nursing, University of Minnesota, Minneapolis, MN
| | | | - Jean F Wyman
- School of Nursing, University of Minnesota, Minneapolis, MN
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Liu Y, Guthrie KD, May JR, DiDonato KL. Community Pharmacist-Provided Wellness and Monitoring Services in an Employee Wellness Program: A Four-Year Summary. Pharmacy (Basel) 2019; 7:E80. [PMID: 31269732 PMCID: PMC6789580 DOI: 10.3390/pharmacy7030080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 06/22/2019] [Accepted: 06/28/2019] [Indexed: 12/26/2022] Open
Abstract
Objective: To assess the clinical outcomes of participants of an employee wellness program during four years of service implementation. Methods: A prospective cohort study was conducted at 15 independent community pharmacy chain locations in northwest and central Missouri. A total of 200 participants were enrolled in an employee wellness program, and the program included five monitoring groups-cholesterol, blood pressure, blood glucose, weight, and healthy participant groups. Participants selected a pharmacist wellness coordinator and wellness appointments were conducted, consisting of education, goal-setting, and monitoring through physical assessment and point of care testing. The primary outcome measures were total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), body mass index (BMI), and waist circumference (WC). The secondary outcome measures were the proportion of patients who achieved the clinical value goals at baseline versus 48 months. The primary outcome measures among data collection time points were compared using one-way analysis of variance (ANOVA) tests, and the secondary outcomes were compared between baseline and 48 months by Chi-square or Fisher's exact tests. One-way ANOVA post hoc tests were also performed using least significant difference, to further identify which time points differed from each other. Results: At baseline, there were 134 patients in the cholesterol monitoring group, 129 in the weight monitoring group, 117 in the blood pressure monitoring group, 46 in the blood glucose monitoring group, and 26 in the healthy participant monitoring group. For patients in the blood pressure monitoring group, compared with baseline, there was a significant decrease in DBP at months 12, 24, 36, and 48, and a significant increase in the proportion of patients achieving blood pressure goals at 48 months. For patients in the blood glucose monitoring group, compared with baseline, there was a significant decrease in FBG at months 12, 24, 36, and 48, and a significant increase in the proportion of patients achieving blood glucose goals at 48 months. Conclusions: Pharmacist-led wellness visits provided to employee wellness patients in a community pharmacy may lead to improvements in BP and FBG values.
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Affiliation(s)
- Yifei Liu
- Division of Pharmacy Practice and Administration, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Kendall D Guthrie
- Division of Pharmacy Practice and Administration, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
| | - Justin R May
- Bothwell Regional Health Center, Sedalia, MO 65301, USA
| | - Kristen L DiDonato
- The Kroger Co. Columbus Division, Kroger Pharmacy, Toledo, OH 43615, USA
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16
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Singer R, Kruse K. Art and health care: A dialog about interdisciplinary collaboration. Nurs Forum 2019; 54:403-409. [PMID: 31016734 DOI: 10.1111/nuf.12347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/01/2019] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
Tell Well is an innovative creative writing and storytelling workshop developed by a public health nursing scholar and educator and a writer and educator. The demonstration project was a writing workshop designed especially for nurses. While the overall objective of Tell Well is to teach writing and storytelling as self-care tools for health care workers to address professional quality of life, the interdisciplinary collaboration has proven to be a vital component of the program's development. After an exploration of the importance of bringing the arts and humanities to nurses and their nursing practice, the writer and the nurse engage in a dialog about the collaboration, its origins, the challenges faced, and the value of such interdisciplinary endeavors.
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Affiliation(s)
- Rebecca Singer
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Kathryn Kruse
- Executive Director of Residency on the Farm, Chicago, Illinois
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Einav L, Lee S, Levin J. The impact of financial incentives on health and health care: Evidence from a large wellness program. Health Econ 2019; 28:261-279. [PMID: 30450769 DOI: 10.1002/hec.3840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 09/24/2018] [Accepted: 10/17/2018] [Indexed: 06/09/2023]
Abstract
Workplace wellness programs have become increasingly common in the United States, although there is not yet consensus regarding the ability of such programs to improve employees' health and reduce health care costs. In this paper, we study a program offered by a large U.S. employer that provides substantial financial incentives directly tied to employees' health. The program has a high participation rate among eligible employees, around 80%, and we analyze the data on the first 4 years of the program, linked to health care claims. We document robust improvements in employee health and a correlation between certain health improvements and reductions in health care cost. Despite the latter association, we cannot find direct evidence causally linking program participation to reduced health care costs, although it seems plausible that such a relationship will arise over longer horizons.
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Affiliation(s)
- Liran Einav
- Department of Economics, Stanford University, Stanford, California
| | - Stephanie Lee
- Foster School of Business, University of Washington, Seattle, Washington
| | - Jonathan Levin
- Department of Economics and Graduate School of Business, Stanford University, Stanford, California
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18
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Hager ER, Song HJ, Lane HG, Guo HH, Jaspers LH, Lopes MA. Pilot-Testing an Intervention to Enhance Wellness Policy Implementation in Schools: Wellness Champions for Change. J Nutr Educ Behav 2018; 50:765-775. [PMID: 30196883 PMCID: PMC7717577 DOI: 10.1016/j.jneb.2018.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To develop and pilot-test Wellness Champions for Change (WCC) to enhance local wellness policy (LWP) implementation by forming wellness teams. DESIGN Randomized, controlled school-level pilot study. SETTING Five Maryland school districts. PARTICIPANTS A total of 63 elementary, middle, or high schools. INTERVENTION(S) Developed from stakeholder interviews, focus groups, and existing programs. Schools were randomized within district to (1) WCC training (6-hour, single-day teacher training), (2) WCC training plus technical assistance (TA), or (3) delayed training (control). MAIN OUTCOME MEASURE(S) Online teacher/administrator survey pre-post (spring, 1 year apart) that examined the direct effect of the intervention on active wellness team formation (postintervention, 8-item sum score) and LWP implementation (29 items, not implemented to fully implemented)/indirect effect of intervention on LWP implementation via active wellness team formation. ANALYSIS Adjusted linear or logistic regression and mediation modeling. RESULTS Postintervention, WCC plus TA and WCC had more active wellness teams (vs control, β = 1.49, P = .02 and β = 1.42, P = .03, respectively). No direct effect of intervention on LWP implementation was found. Formation of active wellness teams mediated the association between both WCC plus TA and WCC and LWP implementation (WCC plus TA confidence interval [CI], 1.22-16.25; WCC CI, 10.98-15.61 [CI was significant without 0]). CONCLUSIONS AND IMPLICATIONS The WCC intervention approaches indirectly affected LWP implementation through the formation of active wellness teams. These results support building and school-level wellness teams.
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Affiliation(s)
- Erin R Hager
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD.
| | - Hee-Jung Song
- Department of Nutrition and Food Science, University of Maryland, College Park, MD
| | - Hannah G Lane
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Hallene H Guo
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Lea H Jaspers
- Maryland State Department of Education, Baltimore, MD
| | - Megan A Lopes
- Maryland State Department of Education, Baltimore, MD
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Tran EM, Scott IU, Clark MA, Greenberg PB. Assessing and Promoting the Wellness of United States Ophthalmology Residents: A Survey of Program Directors. J Surg Educ 2018; 75:95-103. [PMID: 28693982 DOI: 10.1016/j.jsurg.2017.06.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/28/2017] [Accepted: 06/10/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To report on the status of residency-based wellness initiatives in ophthalmic graduate medical education and identify strategies for promoting ophthalmology resident wellness by surveying US ophthalmology program directors (PDs). DESIGN The PDs were each sent an e-mail containing a link to an anonymous online 15-question survey. The PDs also received a letter with the survey link and a $1 incentive. After 2 weeks, nonresponders received 2 weekly reminder e-mails and phone calls. Descriptive statistics were used to analyze the multiple choice responses and categorize the free response answers. SETTING National survey. PARTICIPANTS All 111 US ophthalmology PDs were invited to participate. RESULTS Of 111 PDs, 56 (50%) responded; 14 (26%) of 53 respondents reported that their programs faced an issue involving resident depression, burnout, or suicide within the last year; 25 (45%) of 56 reported that their department had a resident wellness program. Respondents without wellness programs reported a shortage of time (19/30; 63%) and lack of training and resources (19/30; 63%) as barriers to instituting these programs. Respondents reported that the Accreditation Council for Graduate Medical Education could better promote resident wellness by providing training resources for burnout and depression screening (35/53; 66%), resilience skills building (38/53; 72%), and wellness program development (36/53; 68%). CONCLUSIONS This survey suggests that there is a substantial burden of burnout and depression among residents in ophthalmic graduate medical education and that this burden can be addressed by promoting the training of educators to recognize the signs of burnout and depression, and providing resources to develop and expand formal wellness programs.
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Affiliation(s)
- Elaine M Tran
- Program in Liberal Medical Education, Brown University, Providence, Rhode Island; Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island
| | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Melissa A Clark
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Paul B Greenberg
- Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Ophthalmology, Rhode Island Hospital, Providence, Rhode Island; Section of Ophthalmology, Providence Veterans Affairs Medical Center, Providence, Rhode Island.
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Frates EP, Xiao RC, Sannidhi D, McBride Y, McCargo T, Stern TA. A Web-Based Lifestyle Medicine Curriculum: Facilitating Education About Lifestyle Medicine, Behavioral Change, and Health Care Outcomes. JMIR Med Educ 2017; 3:e14. [PMID: 28893726 PMCID: PMC5613210 DOI: 10.2196/mededu.7587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/21/2017] [Accepted: 07/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Lifestyle medicine is the science and application of healthy lifestyles as interventions for the prevention and treatment of disease, and has gained significant momentum as a specialty in recent years. College is a critical time for maintenance and acquisition of healthy habits. Longer-term, more intensive web-based and in-person lifestyle medicine interventions can have a positive effect. Students who are exposed to components of lifestyle medicine in their education have improvements in their health behaviors. A semester-long undergraduate course focused on lifestyle medicine can be a useful intervention to help adopt and sustain healthy habits. OBJECTIVE To describe a novel, evidence based curriculum for a course teaching the concepts of Lifestyle Medicine based on a web-based course offered at the Harvard Extension School. METHODS The course was delivered in a web-based format. The Lifestyle Medicine course used evidence based principles to guide students toward a "coach approach" to behavior change, increasing their self-efficacy regarding various lifestyle-related preventive behaviors. Students are made to understand the cultural trends and national guidelines that have shaped lifestyle medicine recommendations relating to behaviors. They are encouraged to engage in behavior change. Course topics include physical activity, nutrition, addiction, sleep, stress, and lifestyle coaching and counseling. The course addressed all of the American College of Preventive Medicine/American College of Lifestyle Medicine competencies save for the competency of office systems and technologies to support lifestyle medicine counseling. RESULTS The course was well-received, earning a ranking of 4.9/5 at the school. CONCLUSIONS A novel, semester-long course on Lifestyle Medicine at the Harvard Extension School is described. Student evaluations suggest the course was well-received. Further research is needed to evaluate whether such a course empowers students to adopt behavior changes.
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Affiliation(s)
- Elizabeth Pegg Frates
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Harvard Medical School, Harvard University, Boston, MA, United States
| | - Ryan C Xiao
- Harvard Medical School, Harvard University, Boston, MA, United States
| | - Deepa Sannidhi
- Division of Family Medicine, Department of Family and Preventative Medicine, University of California San Diego, La Jolla, CA, United States
| | - Yasamina McBride
- Harvard Extension School, Harvard University, Cambridge, MA, United States
| | - Tracie McCargo
- Harvard Extension School, Harvard University, Cambridge, MA, United States
| | - Theodore A Stern
- Harvard Medical School, Harvard University, Boston, MA, United States
- Massachusetts General Hospital, Boston, MA, United States
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Schrager JD, Shayne P, Wolf S, Das S, Patzer RE, White M, Heron S. Assessing the Influence of a Fitbit Physical Activity Monitor on the Exercise Practices of Emergency Medicine Residents: A Pilot Study. JMIR Mhealth Uhealth 2017; 5:e2. [PMID: 28143805 PMCID: PMC5309436 DOI: 10.2196/mhealth.6239] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/07/2016] [Accepted: 12/17/2016] [Indexed: 11/13/2022] Open
Abstract
Background Targeted interventions have improved physical activity and wellness of medical residents. However, no exercise interventions have focused on emergency medicine residents. Objective This study aimed to measure the effectiveness of a wearable device for tracking physical activity on the exercise habits and wellness of this population, while also measuring barriers to adoption and continued use. Methods This pre-post cohort study enrolled 30 emergency medicine residents. Study duration was 6 months. Statistical comparisons were conducted for the primary end point and secondary exercise end points with nonparametric tests. Descriptive statistics were provided for subjective responses. Results The physical activity tracker did not increase the overall self-reported median number of days of physical activity per week within this population: baseline 2.5 days (interquartile range, IQR, 1.9) versus 2.8 days (IQR 1.5) at 1 month (P=.36). There was a significant increase in physical activity from baseline to 1 month among residents with median weekly physical activity level below that recommended by the Centers for Disease Control and Prevention at study start, that is, 1.5 days (IQR 0.9) versus 2.4 days (IQR 1.2; P=.04), to 2.0 days (IQR 2.0; P=.04) at 6 months. More than half (60%, 18/30) of participants reported a benefit to their overall wellness, and 53% (16/30) reported a benefit to their physical activity. Overall continued use of the device was 67% (20/30) at 1 month and 33% (10/30) at 6 months. Conclusions The wearable physical activity tracker did not change the overall physical activity levels among this population of emergency medicine residents. However, there was an improvement in physical activity among the residents with the lowest preintervention physical activity. Subjective improvements in overall wellness and physical activity were noted among the entire study population.
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Affiliation(s)
- Justin David Schrager
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Philip Shayne
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Sarah Wolf
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Shamie Das
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | | | - Melissa White
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Sheryl Heron
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
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Spanakis EG, Santana S, Tsiknakis M, Marias K, Sakkalis V, Teixeira A, Janssen JH, de Jong H, Tziraki C. Technology-Based Innovations to Foster Personalized Healthy Lifestyles and Well-Being: A Targeted Review. J Med Internet Res 2016; 18:e128. [PMID: 27342137 PMCID: PMC4938884 DOI: 10.2196/jmir.4863] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 12/09/2015] [Accepted: 03/21/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND New community-based arrangements and novel technologies can empower individuals to be active participants in their health maintenance, enabling people to control and self-regulate their health and wellness and make better health- and lifestyle-related decisions. Mobile sensing technology and health systems responsive to individual profiles combined with cloud computing can expand innovation for new types of interoperable services that are consumer-oriented and community-based. This could fuel a paradigm shift in the way health care can be, or should be, provided and received, while lessening the burden on exhausted health and social care systems. OBJECTIVE Our goal is to identify and discuss the main scientific and engineering challenges that need to be successfully addressed in delivering state-of-the-art, ubiquitous eHealth and mHealth services, including citizen-centered wellness management services, and reposition their role and potential within a broader context of diverse sociotechnical drivers, agents, and stakeholders. METHODS We review the state-of-the-art relevant to the development and implementation of eHealth and mHealth services in critical domains. We identify and discuss scientific, engineering, and implementation-related challenges that need to be overcome to move research, development, and the market forward. RESULTS Several important advances have been identified in the fields of systems for personalized health monitoring, such as smartphone platforms and intelligent ubiquitous services. Sensors embedded in smartphones and clothes are making the unobtrusive recognition of physical activity, behavior, and lifestyle possible, and thus the deployment of platforms for health assistance and citizen empowerment. Similarly, significant advances are observed in the domain of infrastructure supporting services. Still, many technical problems remain to be solved, combined with no less challenging issues related to security, privacy, trust, and organizational dynamics. CONCLUSIONS Delivering innovative ubiquitous eHealth and mHealth services, including citizen-centered wellness and lifestyle management services, goes well beyond the development of technical solutions. For the large-scale information and communication technology-supported adoption of healthier lifestyles to take place, crucial innovations are needed in the process of making and deploying usable empowering end-user services that are trusted and user-acceptable. Such innovations require multidomain, multilevel, transdisciplinary work, grounded in theory but driven by citizens' and health care professionals' needs, expectations, and capabilities and matched by business ability to bring innovation to the market.
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Affiliation(s)
- Emmanouil G Spanakis
- Computational BioMedicine Laboratory (CBML), Institute of Computer Science (ICS), Foundation for Research and Technology (FORTH), Heraklion, Greece.
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Jarman L, Martin A, Venn A, Otahal P, Sanderson K. Does workplace health promotion contribute to job stress reduction? Three-year findings from Partnering Healthy@Work. BMC Public Health 2015; 15:1293. [PMID: 26703459 PMCID: PMC4690240 DOI: 10.1186/s12889-015-2625-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/16/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Workplace health promotion (WHP) has been proposed as a preventive intervention for job stress, possibly operating by promoting positive organizational culture or via programs promoting healthy lifestyles. The aim of this study was to investigate whether job stress changed over time in association with the availability of, and/or participation in a comprehensive WHP program (Healthy@Work). METHOD This observational study was conducted in a diverse public sector organization (~28,000 employees). Using a repeated cross-sectional design with models corroborated using a cohort of repeat responders, self-report survey data were collected via a 40 % employee population random sample in 2010 (N = 3406) and 2013 (N = 3228). Outcomes assessed were effort and reward (self-esteem) components of the effort-reward imbalance (ERI) measure of job stress. Exposures were availability of, and participation in, comprehensive WHP. Linear mixed models and Poisson regression were used, with analyses stratified by sex and weighted for non-response. RESULTS Higher WHP availability was positively associated with higher perceived self-esteem among women. Women's mean reward scores increased over time but were not statistically different (p > 0.05) after 3 years. For men, higher WHP participation was associated with lower perceived effort. Men's mean ERI increased over time. Results were supported in the cohort group. CONCLUSIONS For women, comprehensive WHP availability contributed to a sense of organizational support, potentially impacting the esteem component of reward. Men with higher WHP participation also benefitted but gains were modest over time and may have been hindered by other work environment factors.
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Affiliation(s)
- Lisa Jarman
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, 7000, TAS, Australia
| | - Angela Martin
- Tasmanian School of Business and Economics, University of Tasmania, Hobart, 7000, TAS, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, 7000, TAS, Australia
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, 7000, TAS, Australia
| | - Kristy Sanderson
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, 7000, TAS, Australia.
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Abstract
Wellness programs are being increasingly employed with performing artists. Given their aim of reducing injuries, injury tracking is commonly employed as an outcome measure. Evaluating the development and process of a wellness program can also enhance its effectiveness. Developmental evaluation offers one methodological framework within which to conduct such investigations. This paper reports on a 2-year process involving feedback from professional ballet dancers, management and artistic staff, and healthcare providers at a ballet company in order to develop a dancer screening and wellness program. Following a consultation phase, an initial program composed of an expanded medical team and annual injury prevention screen was proposed. Alongside implementation with 30 professional ballet dancers, formal and informal feedback was sought from stakeholders and members across all levels of the ballet company to facilitate ongoing development, evaluation, and revision of the wellness program. The use of a process informed by developmental evaluation helped identify strengths and limitations within the screening process. The collective expertise of the assessors was used to modify the components and process of the screen to strive for ecological appropriateness. The process also fostered buy-in from all involved. Participant feedback helped refine the medical team available to the dancers and influenced the treatment and referral pathways via which dancers are able to access each member of the medical team. Furthermore, reflective discussions with artistic and management staff brought to light potential interactions between repertoire programming, fitness, and injury patterns. This prompted a reconsideration of how artists are trained and supported. Evaluation methods that focus on experiences and insight gained during program development stand to result in more efficient screening programs and health-promotion models and, ultimately, healthier performing artists.
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Affiliation(s)
- Terry Clark
- Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of CalgaryCalgary, AB, Canada
| | - Arun Gupta
- Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of CalgaryCalgary, AB, Canada
| | - Chester H. Ho
- Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Faculty of Medicine, University of CalgaryCalgary, AB, Canada
- Hotchkiss Brain Institute, University of CalgaryCalgary, AB, Canada
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25
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Roux G, DiMarco N, Gu Y, Ballard E, Scott S, Ellison A, Efesoa MA. Eating, activity, and supportive environment (EASE) for nursing students. Nurs Forum 2014; 49:49-58. [PMID: 24456553 DOI: 10.1111/nuf.12047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The feasibility study was designed as a potential model for prevention of obesity at a large college of nursing in the Southwest. CONCLUSIONS Pretest median body mass index was 30.4 in the intervention group and 30.5 in the control group, indicating obesity in the student sample. There were no significant changes in posttest measures in the small sample. The thigh circumference change in the experimental group trended toward change with significance of .06. IMPLICATION The American Nursing Association launched a Healthy Nurse program in 2012, as healthy nurses are role models for a healthy nation. Updating nursing curriculum and active participation of students in weight management programs will promote their own health and positive role modeling.
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Affiliation(s)
- Gayle Roux
- College of Nursing, Texas Woman's University, Denton, TX
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26
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Lee MK, Park HA, Yun YH, Chang YJ. Development and formative evaluation of a web-based self-management exercise and diet intervention program with tailored motivation and action planning for cancer survivors. JMIR Res Protoc 2013; 2:e11. [PMID: 23612029 PMCID: PMC3628152 DOI: 10.2196/resprot.2331] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Revised: 11/16/2012] [Accepted: 11/17/2012] [Indexed: 01/23/2023] Open
Abstract
Background Most dietary and exercise interventions developed to date for cancer survivors have employed intensive clinic-based face-to-face counseling sessions. However, when the clinic-based face-to-face intervention ends, the participants cannot receive feedback from the experts, and the motivation for regular exercise and diet practices decreases. One way to overcome the shortcomings of clinic-based face-to-face intervention is to employ the Internet to this end. To maximize effectiveness when providing Web-based interventions, action planning should be able to start at the right time, education should be tailored to motivational readiness, and self-efficacy should be enhanced at appropriate intervals. Objective The aim of this study was to develop a Web-based self-management diet and exercise intervention program with the aid of the transtheoretical model (TTM) and to conduct formative evaluations. Methods The Web-based self-management exercise and diet intervention program was developed employing a 5-phase system development life-cycle (SDLC) method. The 5 phases were 1) identification of user requirements, 2) system design, 3) system development, 4) system evaluation, and 5) system application. An expert group composed of 3 content experts, a Web developer, and 2 Web designers, evaluated the usability and accuracy of the content. The program was evaluated by 30 breast cancer survivors for perceived ease of use. Results The Web-based self-managed exercise and diet intervention program contained 5 components differing in screen layout. These components are introduction, assessment, education (tailored information provision), action planning (goal setting, scheduling, keeping a diary), and automatic feedback. Education, action planning, and automatic feedback were tailored to each participant through the assessment. The processes of change, self-efficacy, and decisional balance, which are the principal strategies encouraging behavioral change according to the TTM theory, were reflected in the education, and self-efficacy was also reflected in the automatic feedback. After iterative testing by experts on problems that arose in terms of usability and content accuracy during system operation, the perceived ease of use of the program was evaluated by 29 breast cancer survivors. The end users rated the program as being easy to understand and use (a total usability score of 81.3 points). In addition, program feasibility was evaluated using the percentage of patients (27/30, 90%) who consistently used the program. Conclusions The use of Internet technology allowed immediate and easy access to interventions, real-time monitoring of progress, online education, tailored action planning, and tailored short message services using mobile phones.
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Affiliation(s)
- Myung Kyung Lee
- Department of Nursing, Dong-A University, Busan, Korea, Republic Of
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27
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Abstract
CONTEXT Employers have pursued many strategies over the years to control health care costs and improve care. Disappointed by efforts to manage costs through the use of insurance-related techniques (e.g., prior authorization, restricted provider networks), employers have also begun to try to manage health by addressing their employees' key lifestyle risks. Reducing obesity (along with tobacco use and inactivity) is a priority for employers seeking to lower the incidence and severity of chronic illness and the associated demand for health services. METHODS This article describes the employer's perspective on the cost impact of obesity, discusses current practices in employer-sponsored wellness and weight management programs, provides examples from U.S. companies illustrating key points of employers' leverage and opportunities, and suggests policy directions to support the expansion of employers' initiatives, especially for smaller employers. FINDINGS Researchers and policymakers often overlook the extensive efforts and considerable impact of employer-sponsored wellness and health improvement programs. Greater focus on opportunities in the workplace is merited, however, for the evidence base supporting the economic and health impacts of employer-sponsored health promotion and wellness is growing, although not as quickly as the experience base of large employers. CONCLUSIONS Public and private employers can serve their own economic interests by addressing obesity. Health care organizations, particularly hospitals, as well as public employers can be important role models. Policy development is needed to accelerate change, especially for smaller employers (those with fewer than 500 employees), which represent the majority of U.S. employers and are far less likely to offer health promotion programs.
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Affiliation(s)
- LuAnn Heinen
- National Business Group on Health, 50 F Street NW, Washington, DC 20001, USA.
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