Background Physician burnout is often assessed by healthcare organizations. Yet, scores from diff... more Background Physician burnout is often assessed by healthcare organizations. Yet, scores from different burnout measures cannot currently be directly compared, limiting the interpretation of results across organizations or studies. Objective To link common measures of burnout to a single metric in psychometric analyses such that group-level scores from different assessments can be compared. Design Cross-sectional survey. Setting US practices. Participants A total of 1355 physicians sampled from the American Medical Association Physician Masterfile. Main Measures We linked the Stanford Professional Fulfillment Index (PFI) and Mini-Z Single-Item Burnout (MZSIB) scale to the Maslach Burnout Inventory (MBI) in item response theory (IRT) fixed-calibration and equipercentile analyses and created crosswalks mapping PFI and MZSIB scores to corresponding MBI scores. We evaluated the accuracy of the results by comparing physicians’ actual MBI scores to those predicted by linking and described ...
BACKGROUND A growing body of evidence for digital interventions to improve sleep quality shows pr... more BACKGROUND A growing body of evidence for digital interventions to improve sleep quality shows promising effects. The interventions investigated so far have been primarily web-based, while app-based interventions that may reach a wider audience and be more suitable for daily use. OBJECTIVE The aim of this study is to evaluate the intervention effects, adherence and acceptance of an unguided app-based intervention for individuals who wish to improve their sleep. METHODS In a randomized controlled trial, we evaluated the effects of an app-based short intervention (Refresh) to improve sleep quality compared to a waitlist condition. Refresh is an eight-week unguided intervention covering the principles of cognitive behavioral therapy for insomnia (CBT-I) and including a sleep diary. The primary outcome was sleep quality as self-assessed by the Regensburg Insomnia Scale (RIS). Secondary outcomes were depression (PHQ-9 score) and perceived sleep-related impairment. RESULTS We included 371...
We conducted an exploratory study to identify risk factors of dropout in an 8-week e-mail-based c... more We conducted an exploratory study to identify risk factors of dropout in an 8-week e-mail-based cognitive-behavioral therapy for insomnia (REFRESH) to improve sleep among university students with insomnia symptoms. University and graduate students in Hong Kong and Korea who scored higher than 10 on the Insomnia Severity Index participated in REFRESH. Of 158 participants from Hong Kong (n = 43) and Korea (n = 115), 90 (57%) did not complete all 7 sessions, while 52 of 90 (57.8%) dropped out prior to the fourth session. ROC analysis was conducted on the entire sample of 158 participants with intervention completion vs. dropout (non-completion) as the outcome variable. Predictors of dropout were wake time after sleep onset (WASO) < 7.1 min on the weekly sleep diary and expectations for sleep (a subscale of dysfunctional beliefs and attitudes about sleep; DBAS) < 18 at baseline. These findings indicate that shorter WASO and less expectations for sleep at baseline were associated with risk of dropout from e-mail delivered self-help CBT-I-based intervention. Our results highlight the importance of identifying and tailoring treatment formats to students based on their presenting sleep characteristics.
Thin ideal internalization is a risk factor for disordered eating behaviors, poor body image, and... more Thin ideal internalization is a risk factor for disordered eating behaviors, poor body image, and eating disorders (EDs). This paper evaluated the psychometric properties of a novel measure, the Perceived Benefits of Thinness Scale (PBTS), which assesses how individuals feel being thinner would affect various aspects of their lives. Three separate studies with unique samples of college-aged women over 18 years were conducted to assess reliability and validity. In Study 1, exploratory and confirmatory factor analyses suggested all PBTS items loaded onto one factor that was distinct from a measure of weight and shape concerns. A large correlation between changes in PTBS scores and changes in ED psychopathology scores over 8 months (r = .57, p < .01) suggested sensitivity to change. Greater severity in ED pathology was also associated with higher scores on the PBTS. In Study 2, the PBTS showed good test-retest reliability (r = .84, p < .001) and, in Study 3, expected correlations with existing measures of thin ideal internalization (rs = .38-.60, ps < .001). Overall, the PBTS displayed good factor structure, reliability, concurrent validity, and sensitivity to change. By emphasizing social, emotional, and quality of life benefits, the PBTS may serve clinicians, researchers, and patients in understanding thin ideal internalization and associated ED risk.
Background Disparities in US physician burnout rates across age, gender, and specialty groups as ... more Background Disparities in US physician burnout rates across age, gender, and specialty groups as measured by the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI) are well documented. We evaluated whether disparities in US physician burnout are explained by differences in the MBI’s functioning across physician age, gender, and specialty groups. Methods We assessed the measurement equivalence of the MBI across age, gender, and specialty groups in multi-group item response theory- (IRT-) based differential item functioning (DIF) analyses using secondary, cross-sectional survey data from US physicians (n = 6577). We detected DIF using two IRT-based methods and assessed its impact by estimating the overall average difference in groups’ subscale scores attributable to DIF. We assessed DIF’s practical significance by comparing differences in individuals’ subscale scores and burnout prevalence estimates from models unadjusted and adjusted for DIF. Results We detec...
A culture of wellness in medicine can drive professional fulfilment in all physicians and lift up... more A culture of wellness in medicine can drive professional fulfilment in all physicians and lift up those at greatest risk for burnout. However, some factors in medical culture today create barriers to cultivating a culture of wellness. These include a number of explicit or implicit assumptions: believing that dedication to patients necessitates deferring self-care—perpetually, assuming medical safety requires punitive responses to errors and suspecting that physicians who seek mental health resources are unfit to practice medicine. Cultural factors that promote physician well-being include a sense of community, supportive leadership qualities such as gratitude, and alignment between organizational and personal values.
Physicians start their careers with better than average mental health indices. During their caree... more Physicians start their careers with better than average mental health indices. During their careers, however, physicians have higher than average work-specific distress indicated by burnout and higher associated suicide risk. Factors of medical training and practice culture that contribute to physician burnout include (1) a work ethos that demands deferral of self-care to care for patients and (2) a shame-and-blame response to errors. Both of these factors are addressable via an individual and organizational compassionate self-improvement mind-set. Specifically, addressing these cultural contributors to burnout requires understanding the clinical performance benefits of (1) self-care and (2) focus on compassionate learning to mitigate future suffering rather than a shame-and-blame response to errors. Cognitive therapy methods are effective for physicians interested in cultivating a compassionate self-improvement mind-set. A compassionate organizational improvement mind-set that supp...
OBJECTIVE To evaluate the prevalence of suicidal ideation (SI) and attitudes regarding help seeki... more OBJECTIVE To evaluate the prevalence of suicidal ideation (SI) and attitudes regarding help seeking among US physicians relative to the general US working population. PARTICIPANTS AND METHODS A secondary analysis of a cross-sectional survey of US physicians and a probability-based sample of the US working population was conducted between October 12, 2017, and March 15, 2018. Among 30,456 invited physicians, 5197 (17.1%) completed the primary survey. Suicidal ideation in the last year, attitudes regarding help seeking, symptoms of depression, and burnout were assessed by standardized questions. RESULTS Among the 4833 physicians who responded regarding SI, 316 (6.5%) reported having suicidal thoughts in the last 12 months. Most physicians (3527 [72.9%]) reported that they would seek professional help if they had a serious emotional problem. Physicians with SI were less likely to report that they would seek help (203/316 [64.2%]) than physicians without SI (3318/4517 [73.5%]; P=.001). On multivariable analysis, symptoms of depression (odds ratio [OR], 4.42; 95% CI, 1.89 to 11.52), emotional exhaustion (OR, 1.07 each 1-point increase; 95% CI, 1.03 to 1.11), and self-valuation (OR, 0.84 each 1-point increase; 95% CI, 0.70 to 0.99) were associated with SI. Among individuals aged 29 to 65 years, physicians were more likely than workers in other fields to report SI (7.1% vs 4.3%; P<.001), a finding that persisted on multivariable analysis. CONCLUSION In this national study conducted before the COVID-19 pandemic, 1 in 15 US physicians had thoughts of taking their own life in the last year, which exceeded the prevalence of SI among US workers in other fields.
OBJECTIVE To compare physicians with workers in other fields on measures of self-valuation (SV) a... more OBJECTIVE To compare physicians with workers in other fields on measures of self-valuation (SV) and determine the effect of adjusting for SV on the relationship between being a physician and risk for burnout. PATIENTS AND METHODS A random sample of physicians from the American Medical Association Physician Masterfile and a probability sample from the general US population were used. Data were collected for this cross-sectional study between October 12, 2017 and March 15, 2018. Burnout was indicated by a score of 27 or higher on Emotional Exhaustion or 10 or higher on Depersonalization, using the Maslach Burnout Inventory. Self-valuation was measured with Self-valuation Scale items. RESULTS Physicians (248/832=29.8%) more than workers in other fields (1036/5182=20.0%) "often" or "always" felt more self-condemnation than self-encouragement to learn from the experience when they made a mistake. Physicians (435/832=52.3%) more than workers in other fields (771/5182=14.9%) "often" or "always" put off taking care of their own health due to time pressure. Physicians had greater odds of burnout before (odds ratio [OR], 1.51; 95% CI, 1.30 to 1.76) but not after adjusting for SV responses (OR, 0.93; 95% CI, 0.78 to 1.11). After adjustment for SV, work hours, sex, and age, physicians had lower odds of burnout than workers in other fields (OR, 0.82; 95% CI, 0.68 to 0.99). CONCLUSION Self-valuation is lower in physicians compared with workers in other fields and adjusting for SV eliminated the association between being a physician and higher risk for burnout. Experimental design research is needed to determine whether the association of SV with burnout is causal and the degree to which SV is malleable to intervention at individual, organization, and professional culture levels.
BACKGROUND Prior research has revealed a gender gap in physician burnout. Our study attempts to e... more BACKGROUND Prior research has revealed a gender gap in physician burnout. Our study attempts to elucidate the cause for the differences in burnout among male and female general surgeons (GS). METHODS The study is based on a sample of 431 GS from 11 healthcare organizations participating in the Physician Wellness Academic Consortium. RESULTS Female (N = 154) and male (N = 277) GS significantly differed in burnout (46% vs 33%, p = 0.008) and professional fulfillment (PF), (37% vs 56% p < 0.001). Male surgeons reported a higher sense of control over their schedule (COS) (5.0 vs 4.2, p = 0.001). Mediation analyses showed that the gender effect on burnout was fully mediated through PF and COS. CONCLUSIONS This study demonstrates that the observed differences in burnout between female and male GS are due to their differences in PF and COS. Longitudinal research is needed to determine whether interventions targeting PF and COS may mitigate burnout among female GS.
There is increasing evidence that diet can mitigate fatigue. The objective of this study was to a... more There is increasing evidence that diet can mitigate fatigue. The objective of this study was to assess the associations between dietary habits and sleep-related impairment (SRI) in a cohort of community physicians. In this cross-sectional study, we analyzed data from 245 physicians who had completed a wellness survey in March 2016 (98% response rate). Three dietary patterns were derived using principal component analysis: plant based, high protein, and high saturated fat and sugar. In the adjusted analysis, every SD increase in the plant-based dietary pattern score was associated with a 0.71-point decrease ( β = −0.72; SE = 0.32; P = .027; 95% CI = −1.35 to −0.08) in the SRI score, and every SD increase in the high saturated fat and sugar dietary pattern score was associated with a 0.77-point increase ( β = 0.77; SE = 0.32; P = .015; 95% CI = 0.15 to 1.39) in the SRI score. There were no associations between high protein diets and SRI scores. Physicians adhering to diets that are hi...
Internet-delivered health promotion/disease prevention programs need to be effective and engaging... more Internet-delivered health promotion/disease prevention programs need to be effective and engaging to both universal and targeted populations. We will illustrate the utility of organic programming (OP), a model to rapidly evaluate, revise, and re-deliver Internet-based programs, to achieve these aims. The project, which was conducted in two phases, included seven classes of ninth-grade student participants over two semesters. The first phase of the project examined the effects of InJoy, a psychoeducational program designed to teach skills related to positive psychology and depression prevention to adolescents. Data were compared with prespecified target benchmarks, and used to revise and recompile the program, which was then re-evaluated in the second phase. Compared to the initial version, the revised program was rated by students as higher on the targeted social learning domains and significantly more engaging, as reflected in being more helpful (d = 1.2), interesting (d = 1.1), and fun (d = 1.1). These data suggest that OP can rapidly improve engagement for adolescent student users of Internet-based prevention programs.
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, Apr 17, 2017
Background.Physician wellness is a vital element of a well-functioning health care system. Not on... more Background.Physician wellness is a vital element of a well-functioning health care system. Not only is physician wellness empirically associated with quality and patient outcomes, but its ramifications span individual, interpersonal, organizational, and societal levels. The purpose of this study was to explore academic physicians’ perceptions about their work-related wellness, including the following questions: (a) What are the workplace barriers and facilitators to their wellness? (b) What workplace solutions do theythinkwouldimprove their wellness? (c)What motivates their work? and (d) What existing wellness programs are they aware of?Methods.A multi-method design was applied to conduct a total of 19 focus group sessions in 17 clinical departments. All academic faculty ranks and career lines were represented in the 64 participating physicians, who began the sessions with five open-ended survey questions pertaining to physician wellness in their work environment. Participants enter...
Background Physician burnout is often assessed by healthcare organizations. Yet, scores from diff... more Background Physician burnout is often assessed by healthcare organizations. Yet, scores from different burnout measures cannot currently be directly compared, limiting the interpretation of results across organizations or studies. Objective To link common measures of burnout to a single metric in psychometric analyses such that group-level scores from different assessments can be compared. Design Cross-sectional survey. Setting US practices. Participants A total of 1355 physicians sampled from the American Medical Association Physician Masterfile. Main Measures We linked the Stanford Professional Fulfillment Index (PFI) and Mini-Z Single-Item Burnout (MZSIB) scale to the Maslach Burnout Inventory (MBI) in item response theory (IRT) fixed-calibration and equipercentile analyses and created crosswalks mapping PFI and MZSIB scores to corresponding MBI scores. We evaluated the accuracy of the results by comparing physicians’ actual MBI scores to those predicted by linking and described ...
BACKGROUND A growing body of evidence for digital interventions to improve sleep quality shows pr... more BACKGROUND A growing body of evidence for digital interventions to improve sleep quality shows promising effects. The interventions investigated so far have been primarily web-based, while app-based interventions that may reach a wider audience and be more suitable for daily use. OBJECTIVE The aim of this study is to evaluate the intervention effects, adherence and acceptance of an unguided app-based intervention for individuals who wish to improve their sleep. METHODS In a randomized controlled trial, we evaluated the effects of an app-based short intervention (Refresh) to improve sleep quality compared to a waitlist condition. Refresh is an eight-week unguided intervention covering the principles of cognitive behavioral therapy for insomnia (CBT-I) and including a sleep diary. The primary outcome was sleep quality as self-assessed by the Regensburg Insomnia Scale (RIS). Secondary outcomes were depression (PHQ-9 score) and perceived sleep-related impairment. RESULTS We included 371...
We conducted an exploratory study to identify risk factors of dropout in an 8-week e-mail-based c... more We conducted an exploratory study to identify risk factors of dropout in an 8-week e-mail-based cognitive-behavioral therapy for insomnia (REFRESH) to improve sleep among university students with insomnia symptoms. University and graduate students in Hong Kong and Korea who scored higher than 10 on the Insomnia Severity Index participated in REFRESH. Of 158 participants from Hong Kong (n = 43) and Korea (n = 115), 90 (57%) did not complete all 7 sessions, while 52 of 90 (57.8%) dropped out prior to the fourth session. ROC analysis was conducted on the entire sample of 158 participants with intervention completion vs. dropout (non-completion) as the outcome variable. Predictors of dropout were wake time after sleep onset (WASO) < 7.1 min on the weekly sleep diary and expectations for sleep (a subscale of dysfunctional beliefs and attitudes about sleep; DBAS) < 18 at baseline. These findings indicate that shorter WASO and less expectations for sleep at baseline were associated with risk of dropout from e-mail delivered self-help CBT-I-based intervention. Our results highlight the importance of identifying and tailoring treatment formats to students based on their presenting sleep characteristics.
Thin ideal internalization is a risk factor for disordered eating behaviors, poor body image, and... more Thin ideal internalization is a risk factor for disordered eating behaviors, poor body image, and eating disorders (EDs). This paper evaluated the psychometric properties of a novel measure, the Perceived Benefits of Thinness Scale (PBTS), which assesses how individuals feel being thinner would affect various aspects of their lives. Three separate studies with unique samples of college-aged women over 18 years were conducted to assess reliability and validity. In Study 1, exploratory and confirmatory factor analyses suggested all PBTS items loaded onto one factor that was distinct from a measure of weight and shape concerns. A large correlation between changes in PTBS scores and changes in ED psychopathology scores over 8 months (r = .57, p < .01) suggested sensitivity to change. Greater severity in ED pathology was also associated with higher scores on the PBTS. In Study 2, the PBTS showed good test-retest reliability (r = .84, p < .001) and, in Study 3, expected correlations with existing measures of thin ideal internalization (rs = .38-.60, ps < .001). Overall, the PBTS displayed good factor structure, reliability, concurrent validity, and sensitivity to change. By emphasizing social, emotional, and quality of life benefits, the PBTS may serve clinicians, researchers, and patients in understanding thin ideal internalization and associated ED risk.
Background Disparities in US physician burnout rates across age, gender, and specialty groups as ... more Background Disparities in US physician burnout rates across age, gender, and specialty groups as measured by the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI) are well documented. We evaluated whether disparities in US physician burnout are explained by differences in the MBI’s functioning across physician age, gender, and specialty groups. Methods We assessed the measurement equivalence of the MBI across age, gender, and specialty groups in multi-group item response theory- (IRT-) based differential item functioning (DIF) analyses using secondary, cross-sectional survey data from US physicians (n = 6577). We detected DIF using two IRT-based methods and assessed its impact by estimating the overall average difference in groups’ subscale scores attributable to DIF. We assessed DIF’s practical significance by comparing differences in individuals’ subscale scores and burnout prevalence estimates from models unadjusted and adjusted for DIF. Results We detec...
A culture of wellness in medicine can drive professional fulfilment in all physicians and lift up... more A culture of wellness in medicine can drive professional fulfilment in all physicians and lift up those at greatest risk for burnout. However, some factors in medical culture today create barriers to cultivating a culture of wellness. These include a number of explicit or implicit assumptions: believing that dedication to patients necessitates deferring self-care—perpetually, assuming medical safety requires punitive responses to errors and suspecting that physicians who seek mental health resources are unfit to practice medicine. Cultural factors that promote physician well-being include a sense of community, supportive leadership qualities such as gratitude, and alignment between organizational and personal values.
Physicians start their careers with better than average mental health indices. During their caree... more Physicians start their careers with better than average mental health indices. During their careers, however, physicians have higher than average work-specific distress indicated by burnout and higher associated suicide risk. Factors of medical training and practice culture that contribute to physician burnout include (1) a work ethos that demands deferral of self-care to care for patients and (2) a shame-and-blame response to errors. Both of these factors are addressable via an individual and organizational compassionate self-improvement mind-set. Specifically, addressing these cultural contributors to burnout requires understanding the clinical performance benefits of (1) self-care and (2) focus on compassionate learning to mitigate future suffering rather than a shame-and-blame response to errors. Cognitive therapy methods are effective for physicians interested in cultivating a compassionate self-improvement mind-set. A compassionate organizational improvement mind-set that supp...
OBJECTIVE To evaluate the prevalence of suicidal ideation (SI) and attitudes regarding help seeki... more OBJECTIVE To evaluate the prevalence of suicidal ideation (SI) and attitudes regarding help seeking among US physicians relative to the general US working population. PARTICIPANTS AND METHODS A secondary analysis of a cross-sectional survey of US physicians and a probability-based sample of the US working population was conducted between October 12, 2017, and March 15, 2018. Among 30,456 invited physicians, 5197 (17.1%) completed the primary survey. Suicidal ideation in the last year, attitudes regarding help seeking, symptoms of depression, and burnout were assessed by standardized questions. RESULTS Among the 4833 physicians who responded regarding SI, 316 (6.5%) reported having suicidal thoughts in the last 12 months. Most physicians (3527 [72.9%]) reported that they would seek professional help if they had a serious emotional problem. Physicians with SI were less likely to report that they would seek help (203/316 [64.2%]) than physicians without SI (3318/4517 [73.5%]; P=.001). On multivariable analysis, symptoms of depression (odds ratio [OR], 4.42; 95% CI, 1.89 to 11.52), emotional exhaustion (OR, 1.07 each 1-point increase; 95% CI, 1.03 to 1.11), and self-valuation (OR, 0.84 each 1-point increase; 95% CI, 0.70 to 0.99) were associated with SI. Among individuals aged 29 to 65 years, physicians were more likely than workers in other fields to report SI (7.1% vs 4.3%; P<.001), a finding that persisted on multivariable analysis. CONCLUSION In this national study conducted before the COVID-19 pandemic, 1 in 15 US physicians had thoughts of taking their own life in the last year, which exceeded the prevalence of SI among US workers in other fields.
OBJECTIVE To compare physicians with workers in other fields on measures of self-valuation (SV) a... more OBJECTIVE To compare physicians with workers in other fields on measures of self-valuation (SV) and determine the effect of adjusting for SV on the relationship between being a physician and risk for burnout. PATIENTS AND METHODS A random sample of physicians from the American Medical Association Physician Masterfile and a probability sample from the general US population were used. Data were collected for this cross-sectional study between October 12, 2017 and March 15, 2018. Burnout was indicated by a score of 27 or higher on Emotional Exhaustion or 10 or higher on Depersonalization, using the Maslach Burnout Inventory. Self-valuation was measured with Self-valuation Scale items. RESULTS Physicians (248/832=29.8%) more than workers in other fields (1036/5182=20.0%) "often" or "always" felt more self-condemnation than self-encouragement to learn from the experience when they made a mistake. Physicians (435/832=52.3%) more than workers in other fields (771/5182=14.9%) "often" or "always" put off taking care of their own health due to time pressure. Physicians had greater odds of burnout before (odds ratio [OR], 1.51; 95% CI, 1.30 to 1.76) but not after adjusting for SV responses (OR, 0.93; 95% CI, 0.78 to 1.11). After adjustment for SV, work hours, sex, and age, physicians had lower odds of burnout than workers in other fields (OR, 0.82; 95% CI, 0.68 to 0.99). CONCLUSION Self-valuation is lower in physicians compared with workers in other fields and adjusting for SV eliminated the association between being a physician and higher risk for burnout. Experimental design research is needed to determine whether the association of SV with burnout is causal and the degree to which SV is malleable to intervention at individual, organization, and professional culture levels.
BACKGROUND Prior research has revealed a gender gap in physician burnout. Our study attempts to e... more BACKGROUND Prior research has revealed a gender gap in physician burnout. Our study attempts to elucidate the cause for the differences in burnout among male and female general surgeons (GS). METHODS The study is based on a sample of 431 GS from 11 healthcare organizations participating in the Physician Wellness Academic Consortium. RESULTS Female (N = 154) and male (N = 277) GS significantly differed in burnout (46% vs 33%, p = 0.008) and professional fulfillment (PF), (37% vs 56% p < 0.001). Male surgeons reported a higher sense of control over their schedule (COS) (5.0 vs 4.2, p = 0.001). Mediation analyses showed that the gender effect on burnout was fully mediated through PF and COS. CONCLUSIONS This study demonstrates that the observed differences in burnout between female and male GS are due to their differences in PF and COS. Longitudinal research is needed to determine whether interventions targeting PF and COS may mitigate burnout among female GS.
There is increasing evidence that diet can mitigate fatigue. The objective of this study was to a... more There is increasing evidence that diet can mitigate fatigue. The objective of this study was to assess the associations between dietary habits and sleep-related impairment (SRI) in a cohort of community physicians. In this cross-sectional study, we analyzed data from 245 physicians who had completed a wellness survey in March 2016 (98% response rate). Three dietary patterns were derived using principal component analysis: plant based, high protein, and high saturated fat and sugar. In the adjusted analysis, every SD increase in the plant-based dietary pattern score was associated with a 0.71-point decrease ( β = −0.72; SE = 0.32; P = .027; 95% CI = −1.35 to −0.08) in the SRI score, and every SD increase in the high saturated fat and sugar dietary pattern score was associated with a 0.77-point increase ( β = 0.77; SE = 0.32; P = .015; 95% CI = 0.15 to 1.39) in the SRI score. There were no associations between high protein diets and SRI scores. Physicians adhering to diets that are hi...
Internet-delivered health promotion/disease prevention programs need to be effective and engaging... more Internet-delivered health promotion/disease prevention programs need to be effective and engaging to both universal and targeted populations. We will illustrate the utility of organic programming (OP), a model to rapidly evaluate, revise, and re-deliver Internet-based programs, to achieve these aims. The project, which was conducted in two phases, included seven classes of ninth-grade student participants over two semesters. The first phase of the project examined the effects of InJoy, a psychoeducational program designed to teach skills related to positive psychology and depression prevention to adolescents. Data were compared with prespecified target benchmarks, and used to revise and recompile the program, which was then re-evaluated in the second phase. Compared to the initial version, the revised program was rated by students as higher on the targeted social learning domains and significantly more engaging, as reflected in being more helpful (d = 1.2), interesting (d = 1.1), and fun (d = 1.1). These data suggest that OP can rapidly improve engagement for adolescent student users of Internet-based prevention programs.
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, Apr 17, 2017
Background.Physician wellness is a vital element of a well-functioning health care system. Not on... more Background.Physician wellness is a vital element of a well-functioning health care system. Not only is physician wellness empirically associated with quality and patient outcomes, but its ramifications span individual, interpersonal, organizational, and societal levels. The purpose of this study was to explore academic physicians’ perceptions about their work-related wellness, including the following questions: (a) What are the workplace barriers and facilitators to their wellness? (b) What workplace solutions do theythinkwouldimprove their wellness? (c)What motivates their work? and (d) What existing wellness programs are they aware of?Methods.A multi-method design was applied to conduct a total of 19 focus group sessions in 17 clinical departments. All academic faculty ranks and career lines were represented in the 64 participating physicians, who began the sessions with five open-ended survey questions pertaining to physician wellness in their work environment. Participants enter...
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Papers by Mickey Trockel