Abstract
The newly discovered respiratory disease, COVID-19, has caused significant physical and psychological strain for frontline healthcare providers (HCPs). Researchers have found higher levels of anxiety, stress, depression, and poor sleep quality in HCPs during this time. It is crucial to ensure the well-being of HCPs to secure a functioning health system amid a pandemic. This work explores how HCPs might interact with a Just-in-Time Adaptive Intervention (JITAI) system that collects their biopsychosocial metrics using off-the-shelf fitness trackers and ecological momentary assessments (EMAs) for providing actionable interventions in real-time. We found that different healthcare-related life factors influenced our participant HCPs’ engagement with the technological tools in the study. HCPs also expressed the need for better tools to help them convey their emotional exhaustion from a year-long pandemic. We also observed that HCPs sometimes could not maintain their psychological well-being due to other external factors, especially workload. These findings point to important design requirements for JITAIs to support frontline providers’ psychological well-being, both within healthcare and beyond.
A. Flis and M. Mickens—Both authors had equal contribution.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Battalio, S.L., et al.: Sense2Stop: a micro-randomized trial using wearable sensors to optimize a just-in-time-adaptive stress management intervention for smoking relapse prevention. Contemp. Clin. Trials 109, 106534 (2021)
Buysse, D.J., Reynolds, C.F., III., Monk, T.H., Berman, S.R., Kupfer, D.J.: The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 28(2), 193–213 (1989)
Cai, H., et al.: Psychological impact and coping strategies of frontline medical staff in Hunan between January and March 2020 during the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China. Med. Sci. Monit. Int. Med. J. Exp. Clin. Res. 26, e924171-1 (2020)
Cao, J., et al.: A study of basic needs and psychological wellbeing of medical workers in the fever clinic of a tertiary general hospital in Beijing during the COVID-19 outbreak. Psychother. Psychosom. 89(1) (2020)
Carver, C.S.: You want to measure coping but your protocol’ too long: consider the brief cope. Int. J. Behav. Med. 4(1), 92–100 (1997). https://doi.org/10.1207/s15327558ijbm0401_6
Cohen, S., Kamarck, T., Mermelstein, R.: Perceived stress scale. In: Measuring Stress: A Guide for Health and Social Scientists (1994)
Cucinotta, D., Vanelli, M.: WHO declares COVID-19 a pandemic. Acta Bio Medica: Atenei Parmensis 91(1), 157 (2020)
Daskalova, N., et al.: SleepCoacher: a personalized automated self-experimentation system for sleep recommendations. In: Proceedings of the 29th Annual Symposium on User Interface Software and Technology, pp. 347–358 (2016)
Fessell, D., Cherniss, C.: Coronavirus disease 2019 (COVID-19) and beyond: micropractices for burnout prevention and emotional wellness. J. Am. Coll. Radiol. 17(6), 746 (2020)
Fitabase. https://www.fitabase.com/. Accessed 4 Aug 2021
Fitbit. https://www.fitbit.com/global/us/products/smartwatches/versa. Accessed 1 Sept 2021
Fritz, T., Huang, E.M., Murphy, G.C., Zimmermann, T.: Persuasive technology in the real world: a study of long-term use of activity sensing devices for fitness. In: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp. 487–496 (2014)
Garmin: Heart rate variability and stress level. https://www8.garmin.com/manuals/webhelp/vivosmart4/EN-US/GUID-9282196F-D969-404D-B678-F48A13D8D0CB.html. Accessed 1 Sept 2021
Ghalichi, L., Pournik, O., Ghaffari, M., Vingard, E.: Sleep quality among health care workers. Arch. Iran. Med. 16(2), 100–103 (2013)
Gracey, C.D.: Anxiety and Asperger’s syndrome: an investigation into the delivery of a novel real-time stress management approach. The University of Manchester, United Kingdom (2011)
Greenberg, N., Docherty, M., Gnanapragasam, S., Wessely, S.: Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. BMJ 368, m1211 (2020)
Harkness, A.: The pandemic stress index (2020)
Kristensen, T.S., Borritz, M., Villadsen, E., Christensen, K.B.: The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress. 19(3), 192–207 (2005)
Kroenke, K., Spitzer, R.L.: The PHQ-9: a new depression diagnostic and severity measure. Psychiatr. Ann. 32(9), 509–515 (2002)
Krystal, J.H.: Responding to the hidden pandemic for healthcare workers: stress. Nat. Med. 26(5), 639–639 (2020)
Künzler, F., Mishra, V., Kramer, J.N., Kotz, D., Fleisch, E., Kowatsch, T.: Exploring the state-of-receptivity for mHealth interventions. Proc. ACM Interact. Mob. Wearable Ubiquit. Technol. 3(4), 1–27 (2019)
Levin, M.E., Haeger, J., Cruz, R.A.: Tailoring acceptance and commitment therapy skill coaching in the moment through smartphones: results from a randomized controlled trial. Mindfulness 10(4), 689–699 (2019). https://doi.org/10.1007/s12671-018-1004-2
Liang, Z., Ploderer, B.: Sleep tracking in the real world: a qualitative study into barriers for improving sleep. In: Proceedings of the 28th Australian Conference on Computer-Human Interaction, pp. 537–541 (2016)
Liu, S., et al.: Online mental health services in china during the COVID-19 outbreak. The Lancet Psychiatry 7(4), e17–e18 (2020)
Madison, K.M.: The risks of using workplace wellness programs to foster a culture of health. Health Aff. 35(11), 2068–2074 (2016)
Murphy, A., Steele, H., Steele, M., Allman, B., Kastner, T., Dube, S.R.: The clinical adverse childhood experiences (ACEs) questionnaire: implications for trauma-informed behavioral healthcare. In: Briggs, R.D. (ed.) Integrated Early Childhood Behavioral Health in Primary Care, pp. 7–16. Springer, Cham (2016). https://doi.org/10.1007/978-3-319-31815-8_2
Nahum-Shani, I., Hekler, E.B., Spruijt-Metz, D.: Building health behavior models to guide the development of just-in-time adaptive interventions: a pragmatic framework. Health Psychol. 34(S), 1209 (2015)
Nguyen-Feng, V.N.: A randomized controlled trial of a mobile ecological momentary stress management intervention for students with and without a history of emotional abuse. Ph.D. thesis, University of Minnesota (2019)
Panagioti, M., et al.: Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern. Med. 177(2), 195–205 (2017)
Pomeranz, J.L.: Participatory workplace wellness programs: reward, penalty, and regulatory conflict. Milbank Q. 93(2), 301–318 (2015)
Radloff, L.S.: The CES-D scale: a self-report depression scale for research in the general population. Appl. Psychol. Measur. 1(3), 385–401 (1977)
Rahman, A., Plummer, V.: COVID-19 related suicide among hospital nurses; case study evidence from worldwide media reports. Psychiatry Res. 291, 113272 (2020)
REDCap. https://redcap01.brisc.utah.edu/ccts/redcap/. Accessed 4 Aug 2021
Ring, O.: What is heart-rate variability? https://ouraring.com/blog/what-is-heart-rate-variability/. Accessed 2 Aug 2021
Rose, S.C., Bisson, J., Churchill, R., Wessely, S.: Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst. Rev. (2), 1–39 (2002). https://doi.org/10.1002/14651858.CD000560. John Wiley & Sons, Ltd. ISSN 1465-1858
Ruzek, J.I., Brymer, M.J., Jacobs, A.K., Layne, C.M., Vernberg, E.M., Watson, P.J.: Psychological first aid. J. Ment. Health Couns. 29(1), 17–49 (2007)
Sarason, I.G., Levine, H.M., Basham, R.B., Sarason, B.R.: Assessing social support: the social support questionnaire. J. Pers. Soc. Psychol. 44(1), 127 (1983)
Sasangohar, F., Jones, S.L., Masud, F.N., Vahidy, F.S., Kash, B.A.: Provider burnout and fatigue during the COVID-19 pandemic: lessons learned from a high-volume intensive care unit. Anesth. Analg. 131, 106–111 (2020)
Schmidt, H., et al.: Carrots, sticks, and health care reform problems with wellness incentives. N. Engl. J. Med. 362(2), 192 (2010)
Shanafelt, T.D., Noseworthy, J.H.: Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. In: Mayo Clinic Proceedings, vol. 92, pp. 129–146. Elsevier (2017)
Shreffler, J., Petrey, J., Huecker, M.: The impact of COVID-19 on healthcare worker wellness: a scoping review. West. J. Emerg. Med. 21(5), 1059 (2020)
Smith, B.W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., Bernard, J.: The brief resilience scale: assessing the ability to bounce back. Int. J. Behav. Med. 15(3), 194–200 (2008). https://doi.org/10.1080/10705500802222972
Smyth, J.M., Heron, K.E.: Is providing mobile interventions “just-in-time” helpful? An experimental proof of concept study of just-in-time intervention for stress management. In: 2016 IEEE Wireless Health (WH), pp. 1–7. IEEE (2016)
Spielberger, C.D.: State-trait anxiety inventory. In: The Corsini Encyclopedia of Psychology, p. 1 (2010)
Spitzer, R.L., Kroenke, K., Williams, J.B., Löwe, B.: A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch. Intern. Med. 166(10), 1092–1097 (2006)
Twillio: https://www.twilio.com/. Accessed 4 Aug 2021
Wang, N., Li, Y., Wang, Q., Lei, C., Liu, Y., Zhu, S.: Psychological impact of COVID-19 pandemic on healthcare workers in china Xi’an central hospital. Brain Behav. 11(3), e02028 (2021)
W.H.O.: Coronavirus. https://www.who.int/health-topics/coronavirus. Accessed 28 July 2021
W.H.O.: Who coronavirus (COVID-19) dashboard. https://covid19.who.int/. Accessed 28 July 2021
Acknowledgment
This research was supported by an award from the Immunology, Inflammation and Infectious Diseases Initiative and the Office of the Vice President for Research at the University of Utah. The authors would like to acknowledge Heidi Hansen and Alyssa Louise Duenes for their support in coordinating with different stakeholders of this study.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering
About this paper
Cite this paper
Kabir, K.S., Flis, A., Mickens, M., Trapp, S.K., Wiese, J. (2022). “We’re Not Meant to Deal with Crisis for a Year”: Supporting Frontline Healthcare Providers’ Wellness During a Pandemic. In: Lewy, H., Barkan, R. (eds) Pervasive Computing Technologies for Healthcare. PH 2021. Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering, vol 431. Springer, Cham. https://doi.org/10.1007/978-3-030-99194-4_11
Download citation
DOI: https://doi.org/10.1007/978-3-030-99194-4_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-99193-7
Online ISBN: 978-3-030-99194-4
eBook Packages: Computer ScienceComputer Science (R0)