Accepted for/Published in: JMIR Medical Education
Date Submitted: Apr 16, 2021
Date Accepted: Aug 1, 2021
Self-reported preferences for help-seeking and barriers to utilizing mental health supports among internal medicine residents: An exploratory use of an econometric best-worst scaling framework for gathering physician wellness preferences
ABSTRACT
Background:
Burnout interventions are limited by low utilization. Understanding resident physician preferences for burnout interventions may increase utilization and improve assessment of interventions.
Objective:
An econometric best-worst scaling (BWS) framework was used to survey internal medicine resident physicians to establish help-seeking preferences for burnout and barriers to utilizing wellness supports.
Methods:
Internal medicine resident physicians at our institution completed an anonymous online BWS survey during the 2020-2021 academic year. This cross-sectional study was analyzed with multinomial logistic regression and latent class modeling to determine relative rank-ordering of factors for seeking support for burnout and barriers to utilizing wellness supports. ANOVA with post-hoc Tukey HSD was used to analyze differences in mean utility scores representing choice for barriers and support options.
Results:
77 residents completed the survey (47% response rate). Top-ranking factors for seeking wellness supports were seeking informal peer support (best: 71%/worst: 0.6%) and support from friends and family (best: 70%/worst: 1.6%). Top-ranking barriers to seeking counseling were time (best: 75%/worst: 5%) and money (best: 35%/worst: 21%). Latent class analysis identified two segments, a Formal Help-Seeking group (n=6) that preferred seeking therapy as their 2nd-ranking factor (best: 63%/worst: 0%), and an Open to Isolating group (n=20) that preferred to not seek support from others as their 3rd ranking factor (best: 14%/worst: 18%).
Conclusions:
Overall, resident physicians reported high preference for informal peer support, though there exists a segment that prefer counseling services and a segment that prefers not to seek help at all. Time and cost are more significant barriers compared to stigma against utilizing wellness supports. Using BWS-informed studies are a promising and easy-to-administer methodology for clinician wellness programs to gather specific information on clinician preferences to determine best practices for wellness programs. Clinical Trial: N/A
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