PROJECT SUMMARY/ABSTRACT
Nurses experience high levels of stress due to the demands of their occupation, and, unsurprisingly, they
evidence significantly greater prevalence of affective disorders compared to the general population. In addition
to the personal toll, impoverished mental health of nurses negatively impacts the quality of care of their
patients. There is a well-documented relation between depression and presenteeism (i.e., reduced work
productivity due to a health condition). Furthermore, presenteeism in nurses is associated with impaired patient
care, including increased patient falls and medication errors. Burnout is another major concern for nurses,
experienced by as many as 64% of the nursing workforce, and has also been linked to compromised patient
care and decreased patient safety. Although the need for mental healthcare in nurses is high, engagement in
traditional mental health services is low. Factors including time limitations, stigma, and lack of stakeholder
engagement have contributed to a critical gap between the mental health resources nurses need, and those
that are actually available to them.
This application proposes that Anxiety Sensitivity (AS), a well-documented risk factor for psychopathology, may
be a mechanism underlying occupational functional impairments in nurses. Evidence-based autonomous
mHealth interventions that target AS, such as the Cognitive Anxiety Sensitivity Treatment (CAST) intervention,
may adequately address the treatment gap. Aligned with the NIH Stage Model of behavioral intervention
development, the proposed study will involve the assessment of nurses and use of mediational structural
equation modelling to examine the relations among AS, mental health (anxiety, burnout, and depression), and
occupational outcomes (presenteeism and quality of patient care). A sample of administrative stakeholders will
also be surveyed to identify organizational and system level factors that may promote or impede uptake and
sustainability of CAST in the nursing workforce. A third sample, comprised of nurses, will complete the CAST
intervention and provide feedback on
intervention format, content, and engagement. Together, these aims will
directly inform future intervention tailoring and optimization of intervention dissemination strategies to enhance
stakeholder engagement and maximize the benefits to the wellbeing of nurses and their patients.
The applicant is applying for an F31 award to receive high caliber training in the treatment of the cognitive-
affective vulnerability anxiety sensitivity (Goal 1), transdiagnostic treatment implementation and optimization
(Goal 2), theory and application of measurement and data analytic strategies (Goal 3), and interdisciplinary
research dissemination skills (Goal 4). The research and training plan will lay the foundation for the applicant’s
future pursuit of translational research initiatives in the treatment and prevention of affective psychopathology.
Receiving an F31 award will relieve the applicant from her time-intensive teaching assistantship to effectively
conduct research and establish a strong interdisciplinary network in the translational clinical science field.
