coronavirus; covid-19

Debora Goetz Goldberg, PhD, MHA, MBA

College of Public Health

Tech inefficiencies, piles of (electronic) paperwork, and increased patient volume contribute to burnout of primary care physicians, study finds

Mary Cunningham — Tue, 30 Jan 2024 18:11:13 +0000

Tech inefficiencies, piles of (electronic) paperwork, and increased patient volume contribute to burnout of primary care physicians, study finds Mary Cunningham Tue, 01/30/2024 - 13:11

In This Story

Burnout is an occupational phenomenon that results from chronic workplace stress, according to the World Health Organization.

Burnout often includes emotional exhaustion, negative feelings or mental distance from one’s job, and a low sense of accomplishment at work. COVID-19 increased feelings of burnout in primary care physicians, and a new study, sought to understand primary care clinicians’ perspectives on burnout during the COVID-19 pandemic, the causes of burnout, and strategies to improve clinician well-being.

Debora Goldberg

Inefficiencies of electronic health records systems and high levels of documentation contribute to burnout, according to clinicians participating in a recent study led by Debora Goldberg, associate professor in ��AV’s College of Public Health. Other contributors to burnout included high patient volume, staffing shortages, and expectations for responding to patient emails and telephone calls. Most participants also described the need to work after clinic hours to complete documentation.

“The results of this study provide an in-depth view of participating clinicians’ experiences and perceptions of burnout and other mental health challenges. These viewpoints can improve awareness of the issues and strategies to improve the health and well-being of our clinician workforce,” said Goldberg, the principal investigator.

Most of the suggested strategies to improve clinician well-being were changes at the organizational level and included increasing efforts to improve work-life balance, enhancing the use of team-based care models, optimizing electronic health record functions, providing accessible mental health services, granting additional administrative time to complete documentation, and increasing institutional awareness and recognition of the issues surrounding burnout.

Additionally, clinicians reported experiencing traumatic events during the pandemic and in some cases reported both burnout and depression. The study findings align with previous research that reported primary care physicians indicated dramatic increases in their workload since the beginning of the pandemic and an escalation in staffing issues, both contributing to an increase in burnout and stress among clinicians.

This research was funded by the Health Resources and Services Administration, Health and Public Safety Workforce Resiliency Training Program (1 U3NHP45404-01-00), and ��AV College of Public Health Intramural Pilot Study Funding.

“Anxiety, COVID, Burnout and Now Depression”: a Qualitative Study of Primary Care Clinicians’ Perceptions of Burnout” was published in the Journal of General Internal Medicine in November 2023. Tulay Soylu from Temple University; Carolyn Faith Hoffman, a Mason doctoral student; and Rachel E. Kishton and Peter F. Cronholm from the University of Pennsylvania are co-authors.

Topics

Research

Mason Momentum

Afar: Dr. Amira Roess comments on the effectiveness of vaccine shots and boosters in the fight against COVID-19

eander6 — Thu, 03 Nov 2022 16:50:07 +0000

Afar: Dr. Amira Roess comments on the effectiveness of vaccine shots and boosters in the fight against COVID-19 eander6 Thu, 11/03/2022 - 12:50

In This Story

5 Things I Wish I’d Known Before I Caught COVID on a Cruise.

Topics

GCH Faculty

pandemic

College of Public Health

High COVID vaccine hesitancy in sub-saharan Africa

Mary Cunningham — Fri, 14 Oct 2022 00:34:02 +0000

High COVID vaccine hesitancy in sub-saharan Africa Mary Cunningham Thu, 10/13/2022 - 20:34

In This Story

Dongqing Wang, PhD, MPH

A new study by Dongqing Wang, assistant professor of Global and Community Health, finds there is high COVID-19 vaccine hesitancy among adolescents in five sub-Saharan African countries mostly because of perceived lack of safety and perceived lack of effectiveness of COVID-19 vaccines.

Only 22% of people living in Africa are fully vaccinated for COVID-19, according to Africa CDC, and this falls well below the global average of 64%. Vaccine hesitancy is one of multiple reasons that Africa has the lowest vaccination rate of any populated continent.

A new study by Dongqing Wang, assistant professor of Global and Community Health, assessed the prevalence and determinants of COVID-19 vaccine hesitancy among adolescents in five sub-Saharan African countries (Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania) and found vaccine hesitancy to be high in all five countries and extremely high in Tanzania.

“COVID-19 vaccination campaigns among adolescents in sub-Saharan Africa should address adolescents' concerns and misconceptions about COVID-19 vaccine safety and effectiveness,” said Wang. “Health care workers, parents, schoolteachers, peers, religious leaders, and social media could all be leveraged as channels of advocacy to support vaccination efforts.”

Individual characteristics associated with greater vaccine hesitancy were female sex, perceived lack of safety, and perceived lack of effectiveness of COVID-19 vaccines.

“Beyond COVID-19 vaccine hesitancy, it is crucial to ensure that vaccines are accessible should adolescents desire to be vaccinated, and it rests upon the global medical community to get the shots into the arms of the often-neglected population of sub-Saharan African adolescents,” said Wang.

The research was a multi-country survey in 2021 using computer-assisted telephone interviewing. This work was jointly supported by institutional support from Harvard T.H. Chan School of Public Health, Harvard University Center for African Studies, Heidelberg Institute of Global Health (Germany), and the George Washington University Milken Institute School of Public Health.

COVID-19 vaccine hesitancy and its determinants among sub-Saharan African adolescents was published October 2022 in PLOS Global Public Health.

Topics

COVID vaccine coverage questions abound for health insurers.

Fierce Healthcare: Affiliate faculty member Peter Kongstvedt is quoted in an article on COVID-19 vaccine coverage questions for insurers

eander6 — Fri, 09 Sep 2022 20:35:31 +0000

Fierce Healthcare: Affiliate faculty member Peter Kongstvedt is quoted in an article on COVID-19 vaccine coverage questions for insurers eander6 Fri, 09/09/2022 - 16:35

In This Story

Peter Kongstvedt, MD

Topics

Healthcare

Vaccines

Health Policy

HAP Faculty

College of Health and Human Services Department of Health Administration and Policy

Medical News Today: Dr. Amira Roess comments on what to expect as COVID-19 continues to mutate

eander6 — Thu, 14 Jul 2022 13:50:03 +0000

Medical News Today: Dr. Amira Roess comments on what to expect as COVID-19 continues to mutate eander6 Thu, 07/14/2022 - 09:50

In This Story

BA.4/BA.5 Omicron subvariants over 4 times more resistant to mRNA vaccines.

Topics

College of Health and Human Services Department of Global and Community Health

South Florida Reporter: Dr. Amira Roess comments on what to expect as COVID-19 continues to mutate

eander6 — Thu, 14 Jul 2022 13:43:40 +0000

South Florida Reporter: Dr. Amira Roess comments on what to expect as COVID-19 continues to mutate eander6 Thu, 07/14/2022 - 09:43

In This Story

BA.4/BA.5 Omicron Subvariants Over 4 Times More Resistant To mRNA Vaccines.

Topics

College of Health and Human Services Department of Global and Community Health

NPR: Dr. Amira Roess comments on the recent spike in COVID cases in the DMV

eander6 — Thu, 19 May 2022 12:50:53 +0000

NPR: Dr. Amira Roess comments on the recent spike in COVID cases in the DMV eander6 Thu, 05/19/2022 - 08:50

In This Story

What we do (and don't) know about the spread of COVID-19 in the D.C. region right now.

Topics

College of Health and Human Services Department of Global and Community Health

DCist: Dr. Amria Roess comments on COVID spread

eander6 — Fri, 13 May 2022 17:06:47 +0000

DCist: Dr. Amria Roess comments on COVID spread eander6 Fri, 05/13/2022 - 13:06

In This Story

What We Do (And Don’t) Know About The Spread Of COVID-19 In The Region Right Now.

Topics

College of Health and Human Services Department of Global and Community Health

Coming Full-Circle: A Career Dedicated to Making Health Visible, Bookended by Two Pandemics

Mary Cunningham — Mon, 09 May 2022 20:18:57 +0000

Coming Full-Circle: A Career Dedicated to Making Health Visible, Bookended by Two Pandemics Mary Cunningham Mon, 05/09/2022 - 16:18

Dr. Germaine Louis gives a patient a COVID-19 vaccine at the Mason and Partners Clinic vaccination event with Prince William Health District on February 23, 2021.

As Dean Germaine Louis retires at the end of the 2021-22 school year, we reshare this story where she reflects on the similarities in the beginning and end of her career.

When Germaine Louis became Dean of the College of Health and Human Services, she never envisioned serving during a pandemic like COVID-19. “Certainly, when I accepted the position in 2017, a pandemic was not on my horizon—what was on my horizon was bringing together the College’s faculty, staff, and students to become a college of public health.”

When asked about leading the future college of public health during COVID-19, Louis is quick to point out that the COVID-19 is not the first pandemic in her lifetime or her 30+ year career as an epidemiologist, referencing the AIDS pandemic which peaked in the U.S. while Louis was completing her graduate studies. “Becoming an epidemiologist during the AIDS pandemic was impactful for me on so many levels, as this new infectious agent disproportionately took the lives of young men and women. I sadly recall the stereotyping and other shaming actions on the part of some towards affected individuals. As a reproductive epidemiologist, I understood why individuals with risky behaviors were often being blamed for their disease, and I recall with great pride the many scientific advances that led to successful treatment and a more compassionate understanding of AIDS."

“Of course, COVID-19 is very different from AIDS in many regards with a larger susceptible population and its airborne transmission,” says Louis. Still, COVID-19 is an important reminder why public health is essential for contemporary life. “COVID-19 has taught us that it’s almost impossible to imagine a world without a strong public health infrastructure to protect the health and safety of all people.”

Louis credits the College's faculty, staff, students, and alumni for their many contributions in fighting COVID-19 and protecting communities, saying “I’ve been incredibly impressed with everyone in the College each of whom has stepped up to make sure we deliver on our academic mission and one that includes practice and community service.”

Leading by example, the Dean has also been active in the University’s response to COVID-19 – from helping develop Mason’s randomized surveillance testing plans to administering vaccines for the community at the Mason and Partner Clinics. Louis can clearly see how her early career as a nurse and then as an epidemiologist led to this moment.

“I used to tell my nursing colleagues that being a nurse made me a better epidemiologist. What I’d learned in a hospital setting really helped me design better study protocols when focusing on clinical populations. I could think about what it meant to implement a research protocol in a hospital setting for busy nurses and physicians or patients under varying stages of duress. And I really do think that my experience as a nurse was formidable in the success that I experienced with clinical studies (e.g., Buffalo Women’s Health Study, ENDO Study, and NICHD Fetal Growth Study). What I didn’t expect at the time was that I would be using some nurse skills as an epidemiologist in responding to a pandemic,” says Louis.

She reports that prior to volunteering at the MAP Clinic vaccination events, after years of not administering an intramuscular (IM) injection, she was required to refresh her injection skills and have her competency checked. “All of a sudden, I was very anxious about vaccinating after years of not doing so as some technical guidance had changed. Mason’s student nurses were a great source of reassurance, and they shared tips with me. I have found that early training really never leaves you, and it kicked in when I needed it most. It does remind me of the importance of lifelong learning.

Louis shares a story about an opportunity to also bring her training in reproductive epidemiology to bear while vaccinating a group of early childhood workers. A young female worker asked if Louis had a few moments to talk with her after her vaccination. She wanted advice on when to safely begin trying for pregnancy following her vaccination. “And I thought, 'Now that is something I know about,’” said Louis.

Dr. Germaine Louis began her career in nursing before becoming an epidemiologist.

After 30 years as a reproductive epidemiologist and working with couples trying for pregnancy, she was reminded how desperate people are for reliable information about pregnancy-related exposures and lingering data gaps. “My advice to her was that healthy pregnancies and babies start with healthy women and mothers. And, first and foremost, unless there is a contraindication from her physician, the woman was doing the right thing to ensure her own health by being vaccinated. I could see the woman’s smile behind her mask and knew there was a good chance she would take that message back to sisters, friends, and coworkers who may have similar questions about the vaccine.”

“It is rewarding to think about taking nursing skills to epi and now epi skills back to nursing,” says Louis.

When asked for advice she would share with future generations of men and women about empowering women who wish to make history in science, health, and leadership - Louis’ response is simple and clear: mentorship.

“I know what made a difference it made in my life – and that was having a mentor (who happened to be a man) who believed in me. When I was worried about finishing my dissertation, he was already talking about my first faculty appointment—before I was even thinking about a position. When I was in my first faculty position and worried about tenure, he was already talking about my next career move. Having someone believe in you or to see something in you that you may not see in yourself is impactful - you need to pay attention to that.”

Louis believes that academicians have an obligation to seek out students who may have natural leadership abilities or who otherwise have a skillset or narrative that sets them apart and to talk with them ... encourage them for even more. “We should support everyone, but we will always need leaders,” she says. “We also need to do a better job of cultivating hunger in our graduates. By that, I mean helping students really think about and become excited about pursuing a career beyond having a job.

Louis closed the conversation by sharing a story about Ruth Kirschstein (former director of the National Institute of General Medical Sciences, deputy director of National Institutes of Health (NIH) in the 1990s, and acting director of the NIH in 1993 and 2000-2002) who during a presentation to female leaders at NIH once said that women sometimes need to ‘remind people to think of you.’ “Her advice has always resonated with me,” said Louis. “It’s ok to self-nominate or to apply for positions even if not invited to do so, as long as you have the qualifications.” Louis also says that women can help others by nominating them for awards and special recognitions. “Most nominations take time and effort to do well," cautions Louis, “But, if we don't create a culture of recognition for women and for future women leaders then we will never have the same recognition as others.”

Topics

Epidemiology

Public health leadership