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Principal Investigator: Jennifer Streiffer Mascaro
Organization: EMORY UNIVERSITY
Fiscal Year: 2024
Award: $150,229
Funding agency: National Center for Complementary and Integrative Health
Project Summary/Abstract:
Healthcare provider burnout is pervasive in oncology, and it imparts harm to providers and patients, increases
healthcare and workforce disparities, and exacerbates projected physician and nursing shortages. Although
burnout is primarily caused by organizational stressors, supportive and cooperative interdisciplinary teams
foster psychological safety and are protective against burnout. For this reason, interventions to improve
burnout require organization-directed approaches that address team dynamics and working environment (as
opposed to only focusing on individual resilience). Although there has been a multitude of small studies
investigating several interventions to prevent burnout, the evidence base remains extremely low due to the
poor quality of data and measurement approaches. As a first step to address the critical and unmet need for
evidence-based, acceptable, and scalable team-based interventions to improve burnout, we developed
Compassion Centered Spiritual Health Team Intervention (CCSH-TI), which includes mindfulness and
compassion-based approaches to bolster compassion for self and others and to improve psychological safety
and team civility. CCSH-TI is delivered by hospital chaplains who comprise a well-established and highly
acceptable non-sectarian clinical service present in nearly two-thirds of all US hospitals and trained to provide
emotional, psychosocial, and spiritual care to a broad range of patients and staff. The current proposal will use
a phase 1 clustered randomized, wait-list controlled, and mixed-method study to (1) examine the feasibility and
acceptability of CCSH-TI and (2) develop and validate a novel, low-burden ambulatory assessment “toolkit” to
improve the measurement of psychological safety and burnout. Employees (n = 80; nurses, advanced practice
providers (APPs), physicians, staff) working at an NCI-designated Comprehensive Cancer Center will be
randomized by team to CCSH-TI or wait-list. We will evaluate CCSH-TI feasibility (accrual, retention, CCSH-TI
attendance) and acceptability (satisfaction, credibility, perceived benefit). Focus groups will identify contextual
determinants of feasibility, acceptability, and implementation success. At pre/post-intervention and 12-week
follow-up, we will conduct 3-day ambulatory assessments: (1) Ecological Momentary Assessments (EMA) of
social connection, incivility, and burnout; and (2) Electronically Activated Recorder (EAR), a method of
periodically and unobtrusively sampling acoustic observations that has been validated and established outside
the healthcare environment. We will develop and validate EAR behavioral codebooks tailored to the healthcare
environment to quantify behavioral indices of psychological safety, incivility, and interprofessional teamwork.
This proposal is an innovative and ‘real world’ approach to increase access, equity, and inclusion of burnout
prevention and mitigation among all healthcare providers and that improves scientific rigor of research on
burnout by developing a novel, objective, low-burden assessment toolkit.
Terms: <Acoustics><Active Follow-up><Address><Behavioral><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Cancer Treatment><Cessation of life><Chaplain><Chaplaincy><Chronic Disease><Chronic Illness><Clinic><Clinical Oncology><Clinical Services><Collaborations><Compassion><Comprehensive Cancer Center><Consolidated Framework for Implementation Research><Consolidated Framework for Implementation Science><Consolidated Framework for Implementing Change><Consultations><Data><Death><Discipline of Nursing><Disparities><Disparity><Ecological momentary assessment><Elements><Emotional><Employee><Enrollment><Environment><Equity><Feasibility Studies><Feeling><Feeling suicidal><Focus Groups><Fostering><Frequencies><Goals><Health><Health Care Providers><Health Care Team><Health Personnel><Healthcare><Healthcare Providers><Healthcare Team><Healthcare worker><Hospitals><Individual><Intervention><Intervention Strategies><Malignant Neoplasm Therapy><Malignant Neoplasm Treatment><Measurement><Measures><Medical Care Team><Medical Errors><Medical Mistakes><Mental Depression><Methodology><Methods><Nurses><Nursing><Nursing Field><Nursing Profession><Oncology><Oncology Cancer><Pain><Painful><Participant><Patient Self-Report><Patients><Personal Satisfaction><Phase><Physicians><Pilot Projects><Preventative intervention><Prevention><Process><Provider><Psychosocial Assessment and Care><Randomized><Religion><Research><Risk><Role><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Safety><Sampling><Self-Report><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Social support><Spiritual care><Spirituality><Substance abuse problem><Suicidal thoughts><Survey Instrument><Surveys><Training><Waiting Lists><Work><Work Load><Workload><abuse of substances><acceptability and feasibility><active followup><anti-cancer therapy><assess effectiveness><burn-out><burnout><cancer therapy><cancer-directed therapy><chronic disorder><consultation><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cost><depression><determine effectiveness><effectiveness assessment><effectiveness evaluation><enroll><evaluate effectiveness><evidence base><examine effectiveness><exhaustion><feelings><follow up><follow-up><followed up><followup><health care><health care personnel><health care worker><health provider><health workforce><healthcare personnel><help seeking><help-seeking behavior><high risk><improved><indexing><innovate><innovation><innovative><intervention for prevention><interventional strategy><job environment><medical personnel><member><microaggression><mindfulness><novel><nurse><participant enrollment><patient enrollment><patient safety><peer><pilot study><post intervention><prevent><preventing><prevention intervention><preventional intervention strategy><preventive intervention><professional atmosphere><psychologic><psychological><psychosocial assessment><psychosocial care><psychosocial studies><psychosocial support><randomisation><randomization><randomly assigned><recruit><religious><resilience><resilient><retention rate><retention strategy><satisfaction><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><side effect><social><social role><social support network><stressor><substance abuse><success><suicidal ideation><suicidal thinking><suicide ideation><thoughts about suicide><treatment planning><treatment provider><waitlist><well-being><wellbeing><work atmosphere><work environment><workplace climate><workplace environment>