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Background Chronic pain is a prevalent and costly problem that often has occupational origins. Home care workers (HCWs) are at high risk for work-related injuries, pain, and disability. Current treatments for chronic pain emphasize medications, which are an inadequate stand-alone treatment and can produce significant adverse effects. Methods In this translational study, we will adapt an established work-based injury prevention and health promotion program (COMmunity of Practice And Safety Support: COMPASS) to address the needs of HCWs experiencing chronic pain. COMPASS employs peer-led, scripted group meetings that include educational content, activities, goal setting, and structured social support. The translated intervention, named COMPASS for Navigating Pain (COMPASS-NP), will be delivered in an online group format. Safety protections will be strengthened through an ergonomic self-assessment and vouchers for purchasing ergonomic tools. Educational content will integrate a self-management approach to chronic pain using proven cognitive-behavioral therapy (CBT) principles. We will use a mixed-methods hybrid type 2 evaluation approach to assess effectiveness and implementation. A cluster-randomized waitlist control design will involve 14 groups of 10 HCWs ( n  = 140) recruited from Washington, Oregon, and Idaho. Half of the groups will be randomly selected to complete the intervention during the first 10 weeks, while the waitlist groups serve as controls. During weeks 10–20, the waitlist groups will complete the intervention while the original intervention groups complete a follow-up period without further intervention. Our primary hypothesis is that COMPASS-NP will reduce pain interference with work and life. Secondary outcomes include injury and pain prevention behaviors, pain severity, changes in medication use, risk for opioid misuse, well-being, physical activity, and sleep. Qualitative data, including phone interviews with group facilitators and organizational partners, will evaluate the implementation and guide dissemination. Discussion The results will advance the use and knowledge of secondary prevention interventions such as ergonomic tools and cognitive behavior therapy, to reduce injury, pain, and disability and to encourage appropriate uses of analgesic medications among HCWs. Trial registration ClinicalTrials.gov NCT05492903. Registered on 08 August 2022

Background. Mental health is declining in health care workers. Objectives. To provide a comprehensive assessment of intervention literature focused on the support and treatment of mental health within the health care workforce. Search Methods. We searched online databases (e.g., Medline, PsycINFO). Selection Criteria. We selected manuscripts published before March 2022 that evaluated the target population (e.g., nurses), mental health outcomes (e.g., burnout, depression), and intervention category (e.g., mindfulness). Data Collection and Analysis. Of 5158 publications screened, 118 interventions were included. We extracted relevant statistics and information. Main Results. Twenty (17%) earned study quality ratings indicating design, analysis, and implementation strengths. Randomized controlled trials were used by 52 studies (44%). Thirty-eight percent were conducted in the United States (n = 45). Ninety (76%) reported significant changes, and 46 (39%) reported measurable effect sizes. Multiple interventions significantly reduced stress (n = 29; 24%), anxiety (n = 20; 17%), emotional exhaustion or compassion fatigue (n = 16; 14%), burnout (n = 15; 13%), and depression (n = 15; 13%). Authors’ Conclusions. Targeted, well-designed mental health interventions can improve outcomes among health care workers. Public Health Implications. Targeted health care‒focused interventions to address workers’ mental health could improve outcomes within this important and vulnerable workforce. ( Am J Public Health. 2024;114(S2):S213–S226. https://doi.org/10.2105/AJPH.2023.307556 )

Objectives. The COVID-19 pandemic imposed unprecedented safety challenges on health care facilities. This study examined whether health care workers who deemed a better safety response to the pandemic by their units or employers experienced lower psychological distress. Methods. Patient care workers at a health care system in the Pacific Northwest were surveyed every 6 to 8 months from May 2020 to May 2022 (n = 3468). Psychological distress was measured with the Well-being Index (range: −2 to 7 points). Safety response was scored on the basis of participants’ ratings (on a 1–5 scale) of equipment sufficiency and responsiveness to safety concerns by their health care system and unit. Results. Adjusted multilevel regressions showed an inverse association between safety responsiveness and psychological distress at the individual level (b = −0.54; 95% confidence interval [CI] = −0.67, −0.41) and the unit level (b = −0.73; 95% CI = −1.46, −0.01). The cross-level interaction was also statistically significant (b = −0.46; 95% CI = −0.87, −0.05). Conclusions. Health care workers who deemed a better response to safety challenges reported lower psychological distress. This study highlights the need for continued efforts to ensure adequate safety resources. ( Am J Public Health. 2024;114(S2):S204–S212. https://doi.org/10.2105/AJPH.2024.307582 )

Abstract Objective The pharmacist’s role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient’s point of view. This qualitative study explores the pharmacist’s role in promoting opioid safety from the perspective of pharmacists and patients. Design Focus groups. Setting Patient groups were held in person, and pharmacist groups were held online. Subjects Oregon pharmacists (N = 19, Mage = 39.0 years, range = 26–57 years, 58% female) and patients (N = 18, Mage = 60.1 years, range = 30–77 years, 71% female) with current experience dispensing or receiving opioid medications. Methods Pharmacists were asked about the challenges and opportunities for opioid safety monitoring and prescription dispensing. Patients were asked about their experiences accessing care, medications, and safety information. Focus group data were analyzed by a multidisciplinary team using an immersion-crystallization approach. Results Pharmacists and patients agreed that pharmacists are responsible for medication safety. Pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing. Patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers’ clinical decisions. Conclusions Feedback from both pharmacists and patient participants suggests that there is uncertainty in the degree to which pharmacists can and should confront the prescription opioid epidemic directly. Ambiguities in the pharmacist’s role may be best clarified through structured training promoting enhanced between-party communication.

Abstract Objective Many states have begun implementing enhancements to PDMP patient profiles such as summaries or graphics to highlight issues of concern and enhance comprehension. The purpose of this study was to examine how physicians respond to sample enhanced PDMP profiles based on patient vignettes. Design Brief semistructured interviews with physicians. Setting Three national medical conferences for targeted specialties. Subjects Ninety-three physicians practicing in primary care, emergency medicine, or pain management. Methods We presented participants with one of three patient vignettes with corresponding standard and enhanced PDMP profiles and conducted brief interviews. Results Findings indicated that enhanced profiles could increase ease of comprehension, reduce time burden, and aid in communicating with patients about opioid risks. Physicians also expressed concern about liability for prescribing when the enhanced profile indicates risk and cautioned against any implication that risk warnings should override clinical judgment based on the patient’s complete medical history or presenting condition. Physicians emphasized the need for transparency of measures and evidence of validation of risk scores. We found little indication that enhanced profiles would change opioid prescribing decisions, though decisions varied by physician. Conclusions Our study underscores the importance of involving prescribers in developing and testing PDMP profile enhancements, as well as providing guidance in the interpretation and clinical use of enhanced profiles. Reduced time burden is an important benefit to consider as the number of states mandating PDMP use increases.

Prior research on eating behaviors has shown that romantic partners actively merge their dietary preferences throughout the course of a relationship and find significant value in cooking and eating the same foods together at the same times. Yet, little is known regarding the impacts of specific dietary support processes involved in maintaining said communal diet when one partner drastically alters his or her eating patterns. The current study defined dietary sacrifice as a phenomenon within the context of Celiac Disease (CD): a chronic illness that requires strict adherence to the gluten-free diet (GFD). Drawing from existing research on sacrifice within romantic relationships (e.g., Impett & Gordon, 2008), this project examined whether non-Celiac partners' adherence to the GFD during shared mealtimes impacted relationship satisfaction for both couple members. Female Celiacs and their non-Celiac cohabitating partners (N=152 couples) were recruited for an online survey through various support organizations. Given the dyadic design of this study, the Actor-Partner Interdependence Mediation Model (APIMeM; Ledermann, Macho, & Kenny, 2011) was used to examine the mediating influence of Dietary Approach and Avoidance Motives. Results indicated that partner support in the form of shared GFD adherence bolstered couple happiness to the extent that it was performed for positive gains (e.g., promoting health and well-being) by the non-Celiac. While dietary sacrifice was positively associated with Celiacs' relationship satisfaction above and beyond non-Celiacs' endorsement of Dietary Avoidance Motives, both dyad members experienced significantly lower relationship satisfaction when non-Celiac partners adhered to the diet to deflect negative outcomes (e.g., rejection, fighting). This study serves as the first application of relationship sacrifice research to a specific health issue, and the first psychological exploration into intimate partners' dietary support processes within the Celiac population.