Should Mindfulness for Health Care Workers Go Virtual? A Mindfulness-Based Intervention Using Virtual Reality and Heart Rate Variability in the Emergency Department.

BACKGROUND: Research on burnout in the medical community has extensively studied the impact of mindfulness-based interventions (MBIs), which can include meditation, outdoor retreats, in-person didactics, and/or online wellness modules. However, in addition to these MBIs lacking objective, physiological measures for wellness, there has been little to no research involving virtual reality (VR) as an MBI modality for healthcare professionals in the United States. METHODS: A randomized controlled intervention trial was used to study the impact of VR-based guided-meditations in the form of brief paced-breathing exercises. Heart-rate variability (HRV), a biomarker for relaxation, was measured during each session. Thirty-two participants, consisting of primarily medical students, resident physicians, and registered nurses, were recruited to complete brief guided-meditations via a VR headset or a standalone mobile app in the emergency department (ED) on-call room of a large urban academic medical center. RESULTS: A total of 213 guided-meditation sessions were completed over the course of 4 weeks. Self-reported ratings of anxiety improved in both VR and mobile groups post-study. However, the VR group demonstrated higher intrasession HRV progress, indicating increased state of relaxation that also correlated with the number of sessions completed. Analysis by gender revealed disparity in HRV metrics between male and female VR participants. CONCLUSION/APPLICATION TO PRACTICE: VR-based guided meditations prove to be a feasible and accessible MBI that does not require extensive time commitment for healthcare workers. VR may be a more effective meditation platform compared with standalone mobile meditation apps, especially when used on a routine basis.

Environmental Health Burdens and Socioeconomic Status in Rhode Island: Using Geographic Information Systems to Examine Health Disparities in Medical School.

Race and class are major predictors of health outcomes in the United States. Health disparities among racial and low-income minorities often have environmental etiologies. Using Rhode Island as a case study, we geocoded and visualized several environmental determinants of health via Geographic Information Systems (GIS) in the entire state and conducted a geospatial analysis to determine whether or not patterns existed along racial and class lines. The variables that we geocoded include elementary schools, fast food restaurants, Superfund sites, and community parks. From a census tract level, we then analyzed the racial and income makeup of each geocoded site. We discovered that, on average, the worst-performing elementary schools, fast food restaurants, and Superfund sites in Rhode Island were clustered in neighborhoods with a larger black population and lower household income. Conversely, community parks and the best elementary schools in Rhode Island tended to be located near neighborhoods with a larger White population and higher household income. Our results provide additional evidence for the pervasiveness of the unequal distribution of environmental health burdens between low-income, minority communities and affluent, predominantly White communities. This summer experiential student project demonstrates the feasibility of incorporating GIS as a practical tool for learning health disparities material at a U.S. medical school. Our study also highlights the value of digital technology and citizen science in helping the public recognize and understand the various environmental factors that perpetuate health disparities.

Evaluating the Impact of Personalized Stroke Management Tool Kits on Patient Experience and Stroke Recovery.

Hallmarks of the difficult period of transition from hospital to home following stroke include stroke survivor and caregiver uncertainty about actionable steps toward recovery and prevention and unfamiliarity with related resources. Current research shows that interdisciplinary interventions focusing on patient experience and patient education enable health-care providers to activate and empower patients, potentially leading to better clinical outcomes. Tool kit approaches have been successfully used to aid patients through ongoing education after hospital discharge and to improve patient experience. In this article, we describe our efforts to iteratively develop and test personalized stroke management tool kits aimed at connecting stroke survivors and their caregivers to empowering resources, while soliciting feedback from patients and family members.