Individual-level Strategies Research Articles

A holistic approach to sustain and support lifelong practices of wellness among healthcare professionals: generating preliminary solid steps towards a culture of wellness

BackgroundThe COVID-19 pandemic has served as a catalyst for recognizing the challenging environments in which healthcare workers operate, underscoring the urgent need to enhance their wellness to better support themselves and others. The implementation of a culture of wellness within the context of healthcare education, with a particular emphasis on individual-level strategies, allows for the realization of its intrinsic value and significance as a foundation for broader organizational strategies. This approach facilitates the establishment of a sustainable culture of wellness that benefits both current and subsequent generations of healthcare professionals.MethodsWe implemented our wellness program using a pragmatic pre-post study design for different settings. Our wellness intervention program was tested in three ways by creating combinations of different intensities (high, moderate, or low), delivery methods (face-to-face vs. virtual), different motivations (incentive, mandatory, or volunteer participation), and different timings (during medical programs or before entering into healthcare programs) among medical and nursing students. The effects of the wellness program were measured on quality of life, emotional intelligence, and efficacy scores among healthcare students. Statistical methods included repeated measures analysis of variance and paired t-tests.ResultsA total of 224 students (13 in high, 145 in moderate, and 66 in low-dose interventions) participated in our study program. Most scores were significantly improved except for a few factors in the high-dose face-to-face Well-Teach intervention cohort. Among quality of life components, the average psychological scores were markedly increased after high (13.2 vs. 14.7, p = .018), moderate (13.9 vs. 14.8, p < .001), and low (12.8 vs. 13.4, p < .001) intensity intervention cohorts. The moderate and low intensity of wellness intervention cohorts had the highest impact on the total emotional intelligence scores (mean difference = 3.021, 95%CI:0.553–5.488, p = .008) and (mean difference = 5.197, 95%CI:3.057–7.337, p = < 0.001), respectively. The low-dose healthcare intervention program yielded improvements in all components of all scores to a greater extent than moderate-dose or high-dose with face-to-face intervention programs.ConclusionsThis study demonstrates that our multifaceted Well-Teach model can be used to improve the quality of life, emotional intelligence, and self-efficacy of healthcare students. Low- or moderate-intensity intervention programs integrated into the curriculum may be more practical in health sciences education to sustain and promote lifelong wellness practices as solid steps toward attaining a “culture of wellness”. Our model should be considered to be beneficial, sustainable, cost-effective, comprehensive, and effective for current and future generations of healthcare providers.

Exploring strategies to mitigate Internet's environmental damage: An investigation of intrinsic, extrinsic, and price‐based strategies

AbstractThe internet infrastructure, for example, the data centers, is purported to be making substantial damage to the environment. While there are many studies on the national or global interventions and technology developments to minimize environmental damage from the internet, very few have investigated the individual level strategies. This study examines individual‐level strategies, including intrinsic motivation (IM), extrinsic motivation, and price‐based interventions, that internet‐based organizations can implement to minimize the environmental impact of internet usage. The research aims to identify the most effective strategy for reducing individual internet usage after individuals become aware of the environmental consequences. The survey experiment results demonstrate that combining all three strategies proves most effective in mitigating the environmental damage caused by internet usage. Extrinsic motivation is particularly effective, both in combination with other strategies and when utilized independently after raising awareness. The results also depict that when taken individually, price‐based strategies (PPSs) show a lower impact, while IM exhibits the lowest impact on behavior change. Additionally, males exhibit a higher inclination towards extrinsic motivation strategies based on the multi‐group analysis. Remarkably, individuals, regardless of gender, age, income, or level of internet activity, show a willingness to adopt PPSs to decrease internet usage after exposure to an informational video. These findings provide valuable insights for the development of strategies to minimize the environmental impact of individual internet usage.

Challenges and strategies for navigating Australian healthcare access: experience from Chinese international students

BackgroundAustralia hosts over 680,000 international students, contributing $47.8 billion to the Australian economy in 2023, and Chinese students rank first among all nationalities. However, despite their considerable numbers, research focusing on their access to healthcare services is scant. This study aimed to explore barriers and supports regarding the utilisation of healthcare services among Chinese international students studying in Australia.MethodsSemi-structured interviews were conducted in Chinese between October and December 2023 with 25 Chinese international students (age range, 19–30; female/male, n = 18/7; undergraduate/postgraduate/doctoral, n = 1/18/6) enrolled in three Australian universities to understand the healthcare challenges they encountered and the coping strategies they recommended. These interviews were recorded, and thematic analysis was applied to the interview data. An adapted social-ecological model was used to identify barriers and pragmatic strategies to deal with the challenges at different levels.ResultsChinese international students in Australia faced healthcare barriers at different levels. Individual barriers included language and cultural disparities, lack of knowledge about the healthcare system, and reluctance to seek help. Institutional barriers involved high costs, difficulties regarding appointments, and procedures related to the referral system. Policy barriers included insurance coverage and reimbursement issues. The students interviewed for this study proposed individual-level strategies, such as trying various methods to reduce language barriers, seeking information online, and using online resources and consultations. A central appointment platform and multilingual medical service were recommended from students to medical institutions, while medical service guidance and psychological support were suggested to education institutions. Higher-level strategies were also reported, which were mainly pertaining to insurance terms and coverage for overseas students and improving the accessibility of medical information.ConclusionsOur study identifies barriers to healthcare access for Chinese international students in Australia, including culture-specific challenges. To mitigate these issues, we recommend self-directed health promotion, targeted support by education institutions, enhanced cross-cultural communication and expanded telemedicine by hospitals, and attention to insurance coverage. Future research should explore optimising these approaches to improve support systems and policy frameworks.

Workplace violence against female healthcare workers: a systematic review and meta-analysis

BackgroundWorkplace violence (WPV) is highly prevalent in the health sector and remains a major occupational issue causing significant harm, ranging from bodily and psychological harm to death. Female healthcare workers...

Collective incentives reduce over-exploitation of social information in unconstrained human groups

Collective dynamics emerge from countless individual decisions. Yet, we poorly understand the processes governing dynamically-interacting individuals in human collectives under realistic conditions. We present a naturalistic immersive-reality experiment where groups of participants searched for rewards in different environments, studying how individuals weigh personal and social information and how this shapes individual and collective outcomes. Capturing high-resolution visual-spatial data, behavioral analyses revealed individual-level gains—but group-level losses—of high social information use and spatial proximity in environments with concentrated (vs. distributed) resources. Incentivizing participants at the group (vs. individual) level facilitated adaptation to concentrated environments, buffering apparently excessive scrounging. To infer discrete choices from unconstrained interactions and uncover the underlying decision mechanisms, we developed an unsupervised Social Hidden Markov Decision model. Computational results showed that participants were more sensitive to social information in concentrated environments frequently switching to a social relocation state where they approach successful group members. Group-level incentives reduced participants’ overall responsiveness to social information and promoted higher selectivity over time. Finally, mapping group-level spatio-temporal dynamics through time-lagged regressions revealed a collective exploration-exploitation trade-off across different timescales. Our study unravels the processes linking individual-level strategies to emerging collective dynamics, and provides tools to investigate decision-making in freely-interacting collectives.

Cardiovascular Risk Factors in China.

The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. This section dissects cardiovascular risk factors in China which including hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease, metabolic syndrome and air pollution. Hypertension prevalence has steadily increased in China, with efforts to control it facing challenges in achieving optimal rates, especially in rural areas. Interventions like salt substitutes and intensive blood pressure control show promise but need improvement. Abnormal lipid levels, indicative of dyslipidemia, have risen significantly, posing a risk for cardiovascular diseases. Despite efforts, many patients struggle to achieve target lipid levels, necessitating improved treatment strategies. Both type 1 and type 2 diabetes mellitus affect millions of adults in China, with long-term complications adding to the disease burden. Early intervention and effective management are crucial to mitigate its impact. Prevalent among older adults, chronic kidney disease is associated with diabetes mellitus, hypertension, and cardiovascular diseases, necessitating comprehensive management approaches. The prevalence of metabolic syndrome, characterized by a cluster of risk factors, has increased in both adults and adolescents, calling for lifestyle modifications and public health interventions. Ambient and household air pollution remain significant environmental risk factors, despite some improvements in air quality. Continued efforts to reduce emissions are essential for mitigating associated health risks. Addressing these risk factors requires a multifaceted approach, including public health initiatives, policy interventions, and individual-level strategies to promote healthy lifestyles and reduce environmental exposures. Surveillance and research efforts are crucial for monitoring trends and developing effective strategies to lessen the burden of cardiovascular diseases in China.

CARE-RESISTANT BEHAVIOR TRAJECTORIES OF PERSONS WITH DEMENTIA IN NURSING HOMES AND DISTAL OUTCOMES IN ORAL HEALTH

Abstract Persons with dementia (PWD) who exhibit care-resistant behaviors (CRB) are likely to resist mouthcare and have poor oral health. This study aimed to examine predictors and describe the characteristics of CRB trajectories and their distal outcome in oral health among PWD in nursing homes (NH). Group-based trajectory modeling was used to analyze dynamic changes in CRB intensity over 21 days with two time-points (morning and afternoon) among 75 PWD. Sub-group analysis demonstrated the characteristics of each trajectory group membership. Distal-outcome models explored the association between oral health variation and mouthcare completion to CRB trajectories. The most influential predictors included CRB intensity at baseline, duration of mouthcare, and the number of antipsychotics prescribed. Three distinctive CRB trajectories were identified for both morning and afternoon in the context of mouthcare. Oral health status and the mouthcare completion rates differed by CRB trajectory groups, and worse oral health status was associated with higher level of CRB intensity trajectories. The High-start CRB groups had the worst oral health status and lowest mouthcare completion in both model estimation and pre-post test. Oral health showed improvement across all three trajectory groups. A tailored individual-level strategy based on a daily pattern of CRB intensity may provide the key to developing interventions that find the “sweet spot” between providing optimal mouthcare while minimizing CRB. Results imply that balancing CRB and mouthcare by providing morning-only mouthcare to those with high CRBs may allocate resources to PLWD most in need of mouthcare. Antipsychotics have not shown usefulness in managing CRB.

Organisational Strategies for Women Nurses to Advance in Healthcare Leadership: A Systematic Review

Aim. We aimed to undertake a systematic review focusing on organisational strategies that specifically advance women nurses in healthcare leadership. Background. Despite nursing being the largest health workforce and being dominated by women, they face significant barriers in career progression and have limited leadership opportunities, with a need to move from a focus on individuals to organisational level change. Methods. Methods for our overarching systematic review are published and follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Databases searched include MEDLINE via OVID; MEDLINE in-process and other nonindexed citations via OVID; PsycINFO; and Scopus. Any study describing a strategy that was not implemented for nurses and all non-peer-reviewed studies were excluded. Included studies were appraised using CASP checklists. A thematic analysis approach was employed to facilitate the systematic generation of themes. Results. Findings were reported under two main themes: leadership barriers and enablers and organisational strategies for advancing women nurses to leadership. The latter included: mentorship, leadership training, career planning and coaching, opportunities for networking, sponsorship, and targeted recruitment processes for increasing gender diversity in leadership roles. Conclusion. This review synthesises organisational-level strategies that advance women nurses in healthcare leadership. Barriers and individual-level strategies for advancing women nurses in healthcare leadership have been extensively studied in the current literature. Systems and organisational strategies are less studied yet show that they can advance women in nursing into healthcare leadership. Implications for Nursing Management. This paper suggests that optimising women nurses’ leadership attainment needs to shift focus from individual strategies to systemic level and organisational strategies and use tailored evidenced-based approaches.

Strategies to support midlife women to reduce their alcohol consumption: an Australian study using human-centred design.

Alcohol consumption is causally associated with long-term health-related consequences, such as cancer and cardiovascular disease, and short-term harms, such as accidents and injuries. Alcohol consumption has increased among midlife women (aged 40-65) over the last two decades in high-income countries. This study aimed to centre women's voices by using co-design methodologies to investigate what women identify as strategies that could assist them and other women their age to reduce their alcohol consumption. Human-centred design workshops were undertaken with 39 women, and conventional qualitative content analysis was used to analyse information from written workshop materials to develop categories in the data and count their occurrence. Six categories, or strategies, emerged, listed here from most to least represented: 'Participate in alternative activities to drinking alcohol', 'Track alcohol consumption and set goals', 'Seek support from family and friends', 'Drink alcohol-free beverages', 'Reduce supply of alcohol in the home' and 'Seek professional support'. Our findings identify strategies that are realistic and feasible to midlife women; our sample, however, likely reflects a more affluent subsection of this group, and as such, any focus on individual-level strategies must be complemented by policies that increase equitable access to healthcare and act on the social and commercial determinants of health. An intersectional approach to alcohol and other drug research is required to examine how the interplay of gender and other markers of social identities shape alcohol consumption.

It’s not her fault: Trust through anthropomorphism among young adult Amazon Alexa users

Voice assistants (VAs) like Alexa have been integrated into hundreds of millions of homes, despite persistent public distrust of Amazon. The current literature explains this trend by examining users’ limited knowledge of, concern about, or even resignation to surveillance. Through in-depth, semi-structured interviews ( n = 16), we explore how young adult Alexa users make sense of continuing to use the VA while generally distrusting Amazon. We identify three strategies that participants use to manage distrust: separating the VA from the company through anthropomorphism, expressing digital resignation, and occasionally taking action, like moving Alexa or even unplugging it. We argue that these individual-level strategies allow users to manage their concerns about Alexa and integrate the VA into domestic life. We conclude by discussing the implications these individual choices have for personal privacy and the rapid expansion of surveillance technologies into intimate life.

Fighting the infodemic: the 4 i Framework for Advancing Communication and Trust

BackgroundThe proliferation of false and misleading health claims poses a major threat to public health. This ongoing “infodemic” has prompted numerous organizations to develop tools and approaches to manage the spread of falsehoods and communicate more effectively in an environment of mistrust and misleading information. However, these tools and approaches have not been systematically characterized, limiting their utility. This analysis provides a characterization of the current ecosystem of infodemic management strategies, allowing public health practitioners, communicators, researchers, and policy makers to gain an understanding of the tools at their disposal.MethodsA multi-pronged search strategy was used to identify tools and approaches for combatting health-related misinformation and disinformation. The search strategy included a scoping review of academic literature; a review of gray literature from organizations involved in public health communications and misinformation/disinformation management; and a review of policies and infodemic management approaches from all U.S. state health departments and select local health departments. A team of annotators labelled the main feature(s) of each tool or approach using an iteratively developed list of tags.ResultsWe identified over 350 infodemic management tools and approaches. We introduce the 4 i Framework for Advancing Communication and Trust (4 i FACT), a modified social-ecological model, to characterize different levels of infodemic intervention: informational, individual, interpersonal, and institutional. Information-level strategies included those designed to amplify factual information, fill information voids, debunk false information, track circulating information, and verify, detect, or rate the credibility of information. Individual-level strategies included those designed to enhance information literacy and prebunking/inoculation tools. Strategies at the interpersonal/community level included resources for public health communicators and community engagement approaches. Institutional and structural approaches included resources for journalists and fact checkers, tools for managing academic/scientific literature, resources for infodemic researchers/research, resources for infodemic managers, social media regulation, and policy/legislation.ConclusionsThe 4 i FACT provides a useful way to characterize the current ecosystem of infodemic management strategies. Recognizing the complex and multifaceted nature of the ongoing infodemic, efforts should be taken to utilize and integrate strategies across all four levels of the modified social-ecological model.

(001) Black Women's Experiences of Sexual Anxiety

Abstract Introduction Sexual anxiety is one of the root causes of female sexual dysfunction (Pyke, 2020). Increased anxiety during sexual intercourse can cause women to avoid sexual activity altogether (Gerrier et al., 2015; Sanoff, 2016), experience reduced sexual satisfaction (Brassard et al., 2015), and lead to sexual difficulties such as anorgasmia, lack of arousal, and lack of sexual desire (McCabe, 2005). However, little is known about sexual anxiety beyond the narrow White male-focused quantitative research on sexual performance anxiety. Research fails to account for intersecting sociocultural oppression Black women face that may precipitate anxiety within a sexual context. For Black women, who experience sexual stereotypes about their sexual prowess (Collins, 2000), pressures to conform Eurocentric body standards (Awad et al., 2015), and reproductive health disparities that often precipitate sexual pain (Eltoukhi et al., 2014), examining sexual anxiety requires an intersectional lens, from onset to treatment (Hargons et al., 2022). Objective To counter the deficit-based narratives of Black women’s sexualities this study takes an intersectional approach and is rooted in Black feminist perspectives to center the voices of Black women in sex science and advance the research on Black women’s sexuality through a holistic lens. The purpose of this study is to understand Black women’s experiences of sexual anxiety using a phenomenological approach. This study makes a unique contribution to the literature by being the first study to our knowledge to 1) explore Black women’s experiences of sexual anxiety, including their self-reported precipitants and coping strategies, and 2) develop a working definition of sexual anxiety for Black women that capture the nuances of this phenomenon among them. Methods Data comes from Phase 2 of a larger explanatory mixed methods study on Black women’s sexual pain and sexual pleasure. To be eligible for Phase 1, participants had to be 1) premenopausal, 2) under the age of 50, 4) identify as a cisgender Black woman, and 5) live in the Southern region of the US. N=24 Participants completed a 60-min Zoom interview in April 2021. Interview data was analyzed using an interpretative phenomenological analysis. Results Participants reported three components of sexual anxiety as a phenomenon: 1) causes of sexual anxiety, 2) characteristics of sexual anxiety, and 3) coping strategies (see Figure 1). Causes of sexual anxiety contained five elements: partner unfamiliarity, oppressive body standards, rape culture and fears of sexual violence, pressure to meet societal sexual expectations, and anticipation of sexual pain. Characteristics of sexual anxiety included elements such as somatic, emotional, and cognitive symptoms and resultant behaviors. Coping strategies ranged from individual-level strategies to partnered coping strategies. Additionally, we composed a working description of sexual anxiety based on participant responses which account for sociocultural factors distinct for Black women. Conclusions This study highlights the importance of investigating, preventing, and treating barriers that exacerbate sexual difficulties, such as sexual anxiety, so Black women can engage in pleasurable sex and feel safe, mentally present, and confident during sexual experiences. Implications for intersectionality-informed interventions and suggestions for mental health professionals and partners will be discussed. Disclosure No

Opportunities to Enhance the Implementation of Veterans Affairs Video-Based Care: Qualitative Perspectives of Providers from Diverse Specialties

Increasing the adoption of digital care tools, including video visits, is a long-term goal for the US Department of Veterans Affairs (VA). While previous work has highlighted patient-specific barriers to the use of video visits, few have examined how clinicians view such barriers and how they have overcome them during the rapid uptake of web-based care. This study sought input from providers, given their role as critical participants in video visit implementation, to qualitatively describe successful strategies providers used to adapt their practices to a web-based care setting. We conducted interviews with 28 VA providers (physicians and nurse practitioners) from 4 specialties that represent diverse clinical services: primary care (n=11), cardiology (n=7), palliative care (n=5), and spinal cord injury (n=5). All interviews were audio recorded and transcribed, and transcripts were reviewed and coded according to an iteratively created codebook. To identify themes, codes were grouped together into categories, and participant comments were reviewed for repetition and emphasis on specific points. Finally, themes were mapped to Expert Recommendations for Implementing Change (ERIC) strategies to identify evidence-based opportunities to support video visit uptake in the VA. Interviewees were mostly female (57%, 16/28), with an average age of 49 years and with 2-20 years of experience working in the VA across 16 unique VA facilities. Most providers (82%, 23/28) worked in urban facilities. Many interviewees (78%, 22/28) had some experience with video visits prior to the COVID-19 pandemic, though a majority (61%, 17/28) had conducted fewer than 50 video visits in the quarter prior to recruitment. We identified four primary themes related to how providers adapt their practices to a web-based care setting: (1) peer-based learning and support improved providers' perceived value of and confidence in video visits, (2) providers developed new and refined existing communication and clinical skills to optimize video visits, (3) providers saw opportunities to revisit and refine team roles to optimize the value of video visits for their care teams, and (4) implementing and sustaining web-based care requires institutional and organizational support. We identified several ERIC implementation strategies to support the use of video visits across the individual-, clinic-, and system-levels that correspond to these themes: (1) individual-level strategies include the development of educational materials and conducting education meetings, (2) clinic-level strategies include identifying champions and revising workflows and professional roles, and (3) system-level strategies include altering incentive structures, preparing implementation blueprints, developing and implementing tools for quality monitoring, and involving executive leadership to encourage adoption. This work highlights strategies to support video visits that align with established ERIC implementation constructs, which can be used by health care systems to improve video visit implementation.

What would a population-level approach to dementia risk reduction look like, and how would it work?

Dementia is a leading global public health challenge. Prevention approaches have traditionally focused on individual-level strategies. However, such approaches have limited potential, particularly for resource-constrained populations in which exposure to risk factors is greatest, and exposure to protective factors is lowest. A population-level approach to dementia risk reduction is therefore essential to meet the scale of the challenge and to tackle global inequalities in risk and incidence of disease. Such approaches can be highly cost effective. In this viewpoint article, we describe what such an approach should look like, barriers and facilitators to success, and how we should go about achieving it. We include 10 strategic goals to achieve population-level dementia risk reduction and protection enhancement, targeted at researchers, professionals, funders, science communicators, governments, businesses, and policy makers. If we are to significantly reduce the prevalence of dementia there must be increased emphasis on population-level approaches. HIGHLIGHTS: Dementia risk reduction is a global public health priority Population-level approaches change societal conditions to make them less conducive to dementia's modifiable risk factors, and increase exposure to protective factors. Urgent development of population-level approaches is required to reduce the prevalence of, and inequalities in, dementia Action is required from researchers, governments and business, funders, public health professionals, and science communicators.

Prison officers' experiences of aggression: implications for sleep and recovery.

Prison officers are at high risk of assault that can impair their mental as well as physical health. Such experiences can also disrupt sleep, with negative implications for well-being and job performance. To manage this risk, insight is needed into the mechanisms by which experiencing aggression from prisoners can affect officers' sleep quality. By impairing recovery processes, work-related hypervigilance and rumination might be key factors in this association. To examine prison officers' personal experiences of aggression and associations with sleep quality. Also, to consider whether work-related hypervigilance and rumination mediate the relationship between exposure to aggression and sleep. We assessed prison officers' experiences of aggression and violence, work-related hypervigilance and rumination via an online survey. The PROMIS was used to measure the quality of sleep. The study sample comprised 1,806 prison officers (86.8% male). A significant relationship was found between the frequency of experiences of aggression at work and the quality of sleep. Work-related hypervigilance and rumination were significantly associated with sleep quality and mediated the relationship between workplace aggression and sleep quality. Our findings suggest that enhancing the safety climate in prisons might improve officers' quality of sleep that, in turn, could benefit their wellbeing and performance. Implementing individual-level strategies to help prison officers manage hypervigilance and rumination, and therefore facilitate recovery, should also be effective in improving their sleep.

The role of trauma-informed practices and individual factors on perceptions of safety among staff in secure juvenile detention settings

ABSTRACT Despite an increased focus on trauma-informed care within the juvenile justice system, we still know very little about the impact of trauma on juvenile justice professionals or their perceptions of trauma-informed interventions. To fill this gap, this study used an organizational assessment to examine perceptions of trauma-informed care among juvenile professionals in a juvenile detention setting. Participants included 204 staff members in two secure juvenile detention facilities. Staff who reported greater availability of trauma-informed practices were more likely to perceive that youth and families felt safe and those who reported that the facility was taking steps to address secondary trauma were more likely to report a sense of staff safety. Regarding individual factors, only age and gender were related to perceptions of youth and family safety. Frontline staff were more likely than supervisory staff to feel they had received adequate training in trauma and had the skills necessary to deescalate youth. These findings suggest that staff are open to trauma-informed practices in juvenile detention, but a greater focus on supervisory staff is needed. Shifting from individual-level strategies to facility-level improvements could have a greater impact on enhancing staff members’ perceptions of safety, which improves their ability to care for youth.

Providing Positive Individuating Information to Reduce Stereotype-Based Negativity in Service Encounters

With the increasingly diverse workforce in the hospitality and tourism industry, it is imperative to identify strategies to reduce biases in the workplace. Across two studies, we examined the utility of providing individual-level positive individuating information as a strategy to combat customers’ stereotypes in service encounters. In Study 1, we explored the effectiveness of providing either positive stereotypical or counter-stereotypical individuating information to remediate negative perceptions toward older workers in an experimental vignette study using a hypothetical customer service encounter. In Study 2, we demonstrated the robustness of this technique with a group that has opposing stereotypes compared with older workers (Asian adults). Across these two studies, we found that providing positive counter-stereotypical individuating information most strongly affected customers’ satisfaction ratings of employees by boosting positive counter-stereotypical perceptions of both older and Asian targets. We discuss the implications of our study along with possible future research related to individual-level strategies to reduce workplace discrimination.

Activating Worksites to Implement Policy, Systems, and Environmental Changes: Outcomes and Overcoming Challenges.

Although workplaces are prime settings for health promotion, little is known about the implementation of policy, systems, and environmental (PSE) changes focused on chronic disease. PSEs have broader reach and are more sustainable than individual level strategies. non-experimental, one group design with no control.Setting: West Virginia, a state with significant chronic disease-related health disparities. Convenience sample of 27 workplaces, representing 6 industry types. $1000 in micro funding awarded to workplaces to participate in Centers for Disease Control and Prevention (CDC) Work@Health®/ScoreCard, and implement PSEs. ScoreCard baseline results; post project survey results. Descriptive analysis of ScoreCard; survey responses coded into PSE and I (individual level strategies) categories; frequencies were calculated. 63% of the workplaces were very small (1-100 employees). Chronic disease-related organizational practices (ScoreCard) were minimal: nutrition (5/24), physical activity (7/22), diabetes (5/15), cholesterol (4/13), and high blood pressure (6/16). Workplaces reported a total of 95 PSEs: P-8, S-55, and E-32. Policy change was the least frequently attempted and reported PSE strategy. More research with a stronger study design is needed to determine if (1) baseline organizational practices (Scorecard scores) improve, (2) PSEs (especially P) can be implemented without micro funding/TA, (3) workplace-type is related to use of the funds/TA, and (4) enacting PSE changes leads to healthier employees.

Sleep health among U.S. Hispanic/Latinx children: An examination of correlates of meeting sleep duration recommendations

ObjectivesThe objective of this study was to examine the association between sociodemographic, behavioral, and environmental factors and adherence to sleep duration recommendations among 1165 U.S. Hispanic/Latinx children. MethodsIn this cross-sectional study, the following parent-reported variables were examined as correlates of whether children met age-appropriate nightly sleep duration recommendations: caretaker and child demographics (eg, gender, age, poverty level), presence of TV in child's bedroom, child's daily screen time and bedtime. ResultsMost (61.4%) children (mean age: 6.39 years, SD = 2.66) met sleep duration guidelines. Multivariable regression results revealed the odds of meeting recommendations were significantly higher among children 6-12 years old living above the poverty threshold (odds ratio [OR] = 1.57; 95% confidence interval [95%CI]: 1.08, 2.31) and those with a regular bedtime (“Some of the time:” OR = 2.05; 95%CI: 1.07, 3.92; “Most of the time:” OR = 3.19; 95%CI: 1.77, 5.74; “Always:” OR = 4.46; 95%CI: 2.43, 8.13). ConclusionsSleep health disparities must be addressed through culturally and contextually appropriate interventions that combine individual-level strategies with those that address social and environmental factors.

Physician Path to Wellness. A Qualitative Investigation of Self-Reported Strategies to Shift from Detrimental Health to Optimal Wellness.

Background: A healthy physician performs better clinically and provides superior care to patients than a physician struggling with burnout. Objective: The purpose of this study is to assess the physician perception of "health" and "burnout," to identify successful wellness-promoting behaviors, and to build a model characterizing the successful transition from poor health to wellness. Methods: Utilizing a qualitative approach, the team conducted one-on-one, in-depth, semi-structured interviews with physicians from different specialties. Questions focused on behaviors, beliefs, and system changes that facilitated their transition from poor health/burnout to wellness. Interviews were recorded and responses qualitatively coded from a set of definitions of wellness and burnout. These coded responses were quantified, and code prevalence was analyzed. Results: Fourteen physicians completed interviews. The codebook consisted of 74 total themes, with nine occurring in more than 10 (71%) of the interviews. Most themes yielded to categories of Wellness, Unwell, and Burnout, with several themes related to individual agency in facilitating wellness. Highly prevalent themes included support systems, nutrition, exercise, and cognitive health. Subjects generally described comprehensive approaches to successfully transitioning to wellness. Conclusion: This study describes strategies for the successful transition to wellness: physician-level factors such as a healthy support system, maintaining a healthy lifestyle, and developing consistent daily routines. These findings support the importance of physician autonomy and individual-level wellness-promoting strategies for a physician's transition to wellness. More research should investigate the overall effect of individual-level strategies versus system-level interventions.