Hot, cold, or both? A person-centered perspective on death awareness during the COVID-19 pandemic.

The COVID-19 pandemic-as an omnipresent mortality cue-heightens employees' awareness of their mortality and vulnerability. Extant research has identified two distinct forms of death awareness: death anxiety and death reflection. Because researchers have exclusively examined death anxiety and death reflection as independent and unique variables across individuals while overlooking their interplay and co-existence within individuals, we know little about whether and why employees can have different combined experiences of two forms of death awareness over a certain period of time (e.g., during the pandemic), and how these different employee experiences relate to theoretically and practically important work-relevant consequences. To address this gap in our knowledge, we adopted a person-centered approach using latent profile analysis to consider death anxiety and death reflection conjointly within employees during the COVID-19 pandemic. Across two studies, we identified three distinct death awareness profiles-the disengaged, calm reflectors, and anxious reflectors-and found membership in these profiles systematically varied according to health- (e.g., risk of severe illness from COVID-19), work- (e.g., job-required human contact), and community-related (e.g., the number of regional infections) factors influencing the self-relevance of COVID-19 as a mortality cue. In addition, we found that these death awareness profiles differentially predicted important employee outcomes, including well-being (i.e., depression and emotional exhaustion) and prosocial behaviors at work (i.e., organizational citizenship behaviors and pro-diversity behavior). (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Disseminating alcohol screening and brief intervention at trauma centers: a policy-relevant cluster randomized effectiveness trial.

BACKGROUND AND AIMS: In 2005 the American College of Surgeons passed a mandate requiring that level I trauma centers have mechanisms to identify and intervene with problem drinkers. The aim of this investigation was to determine if a multi-level trauma center intervention targeting both providers and patients would lead to higher-quality alcohol screening and brief intervention (SBI) when compared with trauma center mandate compliance without implementation enhancements. DESIGN: Cluster randomized trial in which intervention site (site n = 10, patient n = 409) providers received 1-day workshop training on evidence-based motivational interviewing (MI) alcohol interventions and four 30-minute feedback and coaching sessions; control sites (site n = 10, patient n = 469) implemented the mandate without study team training enhancements. SETTING: Trauma centers in the United States of America. PARTICIPANTS: A total of 878 blood alcohol-positive in-patients with and without traumatic brain injury (TBI). MEASUREMENTS: MI skills of providers were assessed with fidelity coded standardized patient interviews. All patients were interviewed at baseline and 6- and 12-months post-injury with the Alcohol Use Disorders Identification Test (AUDIT). FINDINGS: Intervention site providers consistently demonstrated enhanced MI skills compared with control providers. Intervention patients demonstrated an 8% reduction in AUDIT hazardous drinking relative to controls over the course of the year after injury (relative risk = 0.88, 95%, confidence interval = 0.79, 0.98). Intervention patients were more likely to demonstrate improvements in alcohol use problems in the absence of traumatic brain injury (TBI) (P = 0.002). CONCLUSION: Trauma center providers can be trained to deliver higher-quality alcohol screening and brief intervention (SBI) than untrained providers, which is associated with modest reductions in alcohol use problems, particularly among patients without TBI.

Disseminating Organizational Screening and Brief Intervention Services (DO-SBIS) for alcohol at trauma centers study design.

OBJECTIVE: In 2005, the American College of Surgeons passed a mandate requiring that Level I trauma centers have a mechanism to identify patients who are problem drinkers and have the capacity to provide an intervention for patients who screen positive. The aim of the Disseminating Organizational Screening and Brief Intervention Services (DO-SBIS) cluster randomized trial is to test a multilevel intervention targeting the implementation of high-quality alcohol screening and brief intervention (SBI) services at trauma centers. METHOD: Twenty sites selected from all United States Level I trauma centers were randomized to participate in the trial. Intervention site providers receive a combination of workshop training in evidence-based motivational interviewing (MI) interventions and organizational development activities prior to conducting trauma-center-based alcohol SBI with blood-alcohol-positive injured patients. Control sites implement care as usual. Provider MI skills, patient alcohol consumption, and organizational acceptance of SBI implementation outcomes are assessed. RESULTS: The investigation has successfully recruited provider, patient and trauma center staff samples into the study, and outcomes are being followed longitudinally. CONCLUSION: When completed, the DO-SBIS trial will inform future American College of Surgeons' policy targeting the sustained integration of high-quality alcohol SBI at trauma centers nationwide.

The effect of perceived person-job fit on employee attitudes toward change in trauma centers.

BACKGROUND: Employee attitudes toward change are critical for health care organizations implementing new procedures and practices. When employees are more positive about the change, they are likely to behave in ways that support the change, whereas when employees are negative about the change, they will resist the changes. PURPOSE: This study examined how perceived person-job (demands-abilities) fit influences attitudes toward change after an externally mandated change. Specifically, we propose that perceived person-job fit moderates the negative relationship between individual job impact and attitudes toward change. METHODOLOGY: We examined this issue in a sample of Level 1 trauma centers facing a regulatory mandate to develop an alcohol screening and brief intervention program. A survey of 200 providers within 20 trauma centers assessed perceived person-job fit, individual job impact, and attitudes toward change approximately 1 year after the mandate was enacted. RESULTS: Providers who perceived a better fit between their abilities and the new job demands were more positive about the change. Further, the impact of the alcohol screening and brief intervention program on attitudes toward change was mitigated by perceived fit, where the relationship between job impact and change attitudes was more negative for providers who perceived a worse fit as compared with those who perceived a better fit. PRACTICAL IMPLICATIONS: Successful implementation of changes to work processes and procedures requires provider support of the change. Management can enhance this support by improving perceived person-job fit through ongoing training sessions that enhance providers' abilities to implement the new procedures.