Roger Brown

University of Wisconsin–Madison | UW · Schools of Nursing, Medicine & Public Health

Background: More than 20% of Americans do not regularly receive cholesterol screening and flu shots, the two important preventive services for cardiorespiratory self-care. Uncontrolled dyslipidemia leads to cardiovascular diseases (CVD), the leading cause of death and disability among American workers, while influenza contributes to health-related...

Introduction: The purpose of this secondary analysis, from a pilot randomized controlled trial of guided participation (GP), was to describe patterns of coparenting for mother and father dyads caring for an infant with complex congenital heart disease and to examine the influencing factors at infant age 6 months. Our theoretical framework included...

Background Little is known about factors contributing to burnout and intent to leave in cardiologists and other cardiology health care workers. Methods and Results The Coping With COVID survey assessed work conditions, burnout, and intent to leave among physicians, nurses, advanced practice providers, and other clinical staff (OCS) from April 2020...

Background System contributors to resident burnout and well-being have been under-studied. We sought to determine factors associated with resident burnout and identify at risk groups. Methods We performed a US national survey between July 15 2022 and April 21, 2023 of residents in 36 specialties in 14 institutions, using the validated Mini ReZ sur...

This pilot study assessed the feasibility of implementing a pain assessment information visualization (InfoViz) tool to address cultural and language barriers among limited English proficiency (LEP) Hmong patients in primary care. We used a static group comparison design to collect data from 20 patient, interpreter, and provider triads under usual...

Background Social determinants of health (SDH) are mainly comprised of structural and intermediary domains. Emerging evidence suggests that the burden of multiple chronic conditions (MCCs) in older adults is exacerbated by structural determinants (e.g. low income and low education). However, less attention was paid to the intermediary determinants...

Introduction: Burnout amongst cardiologists has nearly doubled since the COVID pandemic, but few data describe burnout or its relationship to work environment factors among cardiology team members. Methods: The National Coping with Covid (CwC) Survey included over 1300 cardiology healthcare workers (HCWs). We determined likelihood of burnout among...

Background Hospitalist physician stress was exacerbated by the pandemic, yet there have been no large scale studies of contributing factors. Objective Assess remediable components of burnout in hospitalists. Participants, Study Design and Measures In this Coping with COVID study, we focused on assessment of stress factors among 1022 hospital-base...

Background and Purpose: Parents of an infant with complex congenital heart disease report caregiving challenges in the infant’s first half year. We studied the issues parent dyads (mothers and fathers) were dealing with and their effect on their coparenting competencies in interactive problem-solving. Methods: The issues 31 parent dyads identified...

Background: Existing self-care measures for the Chinese population are specific to single chronic conditions. No generic self-care measures exist for the Chinese population with multiple chronic conditions. Objectives: To test the structural validity, concurrent validity and reliability of the Self-care of Chronic Illness Inventory (SC-CII) in C...

Background Burnout has risen across healthcare workers during the pandemic, contributing to workforce turnover. While prior literature has largely focused on physicians and nurses, there is a need to better characterize and identify actionable predictors of burnout and work intentions across healthcare role types. Objective To characterize the ass...

Importance The COVID-19 pandemic has affected clinician health and retention. Objective To describe trends in burnout from 2019 through 2021 with associated mitigating and aggravating factors. Design, Setting, and Participants Cross-sectional surveys were sent to physicians and advanced practice clinicians throughout 120 large US health care orga...

Background and Purpose: Parents' competencies in coparenting are critical to adaptive and competent caregiving of an infant with complex congenital heart disease. To date, feasible interventions to support parents in working together-coparenting-for caregiving of these infants have not been developed and systematically examined. The purpose of this...

Objectives: Patients with anorexia nervosa (AN) have autonomic nervous system (ANS) dysfunction as measured by heart rate variability (HRV). Omega-3 fatty acids may improve heart rate regulation. Our aim was to describe ANS response to a mid-day meal in adolescent females with AN in a 12-week treatment program, randomized to receive either omega-3...

INTRODUCTION: Treatment of anemia in dialysis patients has been associated with increased risk of vascular access thrombosis (VAT). Proactive IV irOn Therapy in hemodiALysis Patients (PIVOTAL) was a clinical trial of proactive compared with reactive i.v. iron therapy in patients requiring hemodialysis. We analyzed the trial data to determine whethe...

Background and Purpose Parents’ communication and problem-solving interaction with each other and with clinicians influences the caregiving of infants with a chronic health problem, making in-depth study of this interaction critical for design of interventions to support caregiving. This study, however, has been severely limited by lack of observat...

Abstract Background Prescription opioid misuse is a serious national crisis; in 2018 the top drugs involved in prescription overdose deaths included pain medications (opioids), benzodiazepines, and stimulants. Health information technology (health IT) provides a means to address this crisis through technologies that streamline the prescribing and d...

To describe relationships between compromised integrity (CI), burnout, and intent-to-leave (ITL) practice in critical care (CC) and noncritical care (non-CC) nurses and physicians. Design: CC nurses (RNs) and physicians (MDs) from the American Medical Association Coping with COVID survey were matched by gender, race, years in practice, and role w...

Background: Depressive symptoms are particularly prevalent among low-income overweight or obese mothers with young children, indicating the importance of understanding and addressing this serious health condition. Although lifestyle behavior interventions are promising for alleviating depressive symptoms in low-income overweight or obese mothers w...

Purpose: Trust is an essential component of health care. Clinicians need to trust organizational leaders to provide a safe and effective work environment, and patients need to trust their clinicians to deliver high-quality care while addressing their health care needs. We sought to determine perceived characteristics of clinics by clinicians who t...

Background and Purpose The prenatal preparing women do for infant caregiving is understudied. In this pilot, multimethods study, we examined motivation for preparing for infant caregiving of women in their third trimester of pregnancy expecting either a healthy infant or an infant with complex congenital heart disease (CCHD). Methods Eleven women...

Background: Global health care initiatives emphasize the importance of engaging patients in their health care to improve the patient's experience and outcomes. Assessing patient preferences for engagement is critical, as there are many ways patients can engage in their care and preferences vary across individuals. Objective: The primary purpose...

Introduction Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interve...

Background: Controlling feeding practices are associated with negative child eating behaviors and an increased risk of obesity. Parental stress may be related to feeding practices. Children with developmental disabilities have increased obesity prevalence, and families may also experience increased stress. This study examined the relationship betwe...

Background COVID-19 has put extraordinary stress on healthcare workers. Few studies have evaluated stress by worker role, or focused on experiences of women and people of color. Methods The “Coping with COVID” survey assessed US healthcare worker stress. A stress summary score (SSS) incorporated stress, fear of exposure, anxiety/depression and wor...

Objective Medication list discrepancies between outpatient clinics and pharmacies can lead to medication errors. Within the last decade, a new health information technology (IT), CancelRx, emerged to send a medication cancellation message from the clinic’s electronic health record (EHR) to the outpatient pharmacy’s software. The objective of this s...

Medication safety during care transitions is a significant challenge, especially for older adults prescribed multiple medications. Using a systems approach to understand barriers to and strategies for safe medication management throughout high-risk periods of hospital-to-home transition is one important step in designing effective interventions. Fr...

Objective To assess the impact of the COVID-19 crisis on physician stress and mental health. Participants and Methods The 10-item “Coping with COVID” survey assessed stress among 2373 physicians from April 4 to May 27, 2020. A stress summary score (SSS) with four items (a single item (overall) stress measure, fear of exposure, perceived anxiety/de...

Acute respiratory infections (ARIs) are the most common illness seen in the pediatric ambulatory setting. Research in this area is hampered by the lack of validated ARI measures. The aim of this study was to assess the reliability and validity of the Wisconsin Upper Respiratory Symptom Survey for Kids (WURSS-K), a 15-item instrument, which measures...

Objective: To assess how controlled substance medication discontinuations were communicated over time Data Sources: Secondary data from a midwestern academic health system electronic health record and pharmacy platform were collected 12-months prior to CancelRx implementation and for 12-months post implementation. Study Design: The study utilized a...

This secondary analysis study addressed a gap of knowledge: whether perceived stress reduction created by a lifestyle intervention might serve as a mediator for reducing fat and fast food intakes in low-income overweight or obese mothers of young children. This analysis included 338 low-income overweight or obese mothers of young children who compl...

Background: Little is known about the relevance of existing pain scales for patients with limited English proficiency (LEP). Aims: To determine the ranking and perceptions of four pain intensity scales in LEP Hmong. Design: A sequential mixed-method study. Settings: A Midwestern city, USA. Participants/subjects: Eight-four Hmong aged 19 to...

Background Psychological factors mediating the effect of lifestyle behavior interventions on mothers’ depressive symptoms are unclear. Using data from a community-based lifestyle behavior intervention, this secondary analysis examined whether autonomous motivation, coping self-efficacy, and emotional coping mediated the association between the inte...

Background: Pain management is an essential component of care for pediatric patients following surgery. Massage reduces self-reported post-operative pain in adults with heart disease but has received little attention in post-operative pediatric patients with congenital heart disease (CCHD). Objectives: To evaluate the effectiveness of massage co...

Objectives To assess the benefits of training in mindfulness-based stress reduction (MBSR) or moderate intensity exercise (EX) for improving sleep quality. Design Randomized controlled trial. Setting Outpatient, community-based. Participants Healthy adults (n = 413) aged 30–69 who did not regularly exercise or practice meditation, and who had no...

Introduction Daily bathing with chlorhexidine gluconate (CHG) in hospitalized patients reduces healthcare-associated bloodstream infections and colonization by multidrug-resistant organisms. Achieving compliance with bathing protocols is challenging. This non-intensive care unit multicenter project evaluated the impact of organizational context on...

This study describes a method for collecting data from nonliterate, non-English-speaking populations. Our audio computer-assisted self-interview instrument with color-labeled response categories was designed for use with helper assistance. The study included 30 dyads of nonliterate older Hmong respondents and family helpers answering questions abou...

Objectives: This pilot study examines effectiveness of an innovative pharmacy design change on over-the-counter (OTC) medication misuse in older adults (ages over 64). Few interventions have attempted to decrease older adult OTC misuse, and none have addressed system barriers. A structural redesign of the pharmacy (the Senior Section) was conceptua...

The relationship between worklife factors, clinician outcomes, and time pressure during office visits is unclear. To quantify associations between time pressure, workplace characteristics ,and clinician outcomes. Prospective analysis of data from the Healthy Work Place randomized trial. 168 physicians and advanced practice clinicians in 34 primary...

Purpose: Describe collaborative caregiving of the parents of an infant with congenital heart disease (CHD) with partner, health-care clinicians, and substitute caregivers (SC). Design and methods: In a national online survey, 53 mothers and 12 fathers described collaborative caregiving for infants after CHD intervention with respect to facets of...

Objective In this study, we used human factors (HF) methods and principles to design a clinical decision support (CDS) that provides cognitive support to the pulmonary embolism (PE) diagnostic decision-making process in the emergency department. We hypothesised that the application of HF methods and principles will produce a more usable CDS that im...

Using data from a community-based lifestyle behavioral intervention study, this secondary data analysis investigated whether emotional coping, coping self-efficacy, and autonomous motivation mediated the association between the intervention and perceived stress in low-income overweight or obese mothers of young children. Results showed that coping...

Culture and language affect pain reporting, diagnosis, and treatment. Ethnic subgroup populations, such as the Hmong, are understudied in pain research. The study’s purpose is to qualitatively understand older Hmong adults’ pain expression and their pain communication with providers. Sixty-seven participants were recruited from one healthcare syste...

OBJECTIVE: Pain is challenging to diagnose and manage in primary care, especially when patients have limited English proficiency (LEP). Little is known about whether LEP patients can provide pain information that is consistent with the process and the content that providers expect in a clinical interaction. We explore how LEP Hmong patients communi...

Objective: Using baseline data from a community-based weight-gain prevention intervention study, the authors examined whether coping self-efficacy moderated the associations between chaotic home environment and psychosocial health (perceived psychosocial stress, depressive symptoms, and positive and negative affect) in low-income women who are ove...

Objectives Health-supporting behaviors can be challenging to initiate and maintain. Data from the MEPARI-2 randomized trial were used to assess predictors of sustained exercise and meditation practice. Methods Adults aged 30 to 69 years not exercising regularly and without prior meditation training were randomized to 8-week trainings in mindfulnes...

Objective Past studies have documented links between mindfulness practice and stress-related outcomes, but these links have typically been found over the course of treatment and at the between-person level of analysis. Building on past work, the present study aimed to evaluate practice-stress associations after treatment and at the within-person an...

Introduction: Checklists are used to operationalize care processes and enhance patient safety; however, checklist implementation is difficult within complex health systems. A family-centered rounds (FCR) checklist increased physician performance of key rounding activities, which were associated with improved parent engagement, safety perceptions,...

Importance There is new emphasis on clinician trust in health care organizations but little empirical data about the association of trust with clinician satisfaction and retention. Objective To examine organizational characteristics associated with trust. Design, Setting, and Participants This prospective cohort study uses data collected from 201...

Purpose: Using baseline data from a prevention of weight gain intervention study, we investigated whether self-efficacy mediated the relations between social support and dietary intake of saturated fat, fast food, fruit and vegetable in low-income postpartum women who were overweight or obese. Methods: Participants (N = 740) completed validated...

Background: Infants with complex congenital heart disease (CCHD) often develop neurodevelopmental disabilities. Cognitive abilities are associated with vagally mediated autonomic function. Skin-to-skin contact (SSC) interventions enhance infant neurodevelopment and autonomic function in other high-risk populations. Aim: To examine the effects of...

Background: White matter hyperintensities (WMH) observed on magnetic resonance images are associated with depression and increase risk of stroke, dementia and death. The association between physical activity and WMH has been inconsistently reported in the literature, perhaps because studies did not account for a lifetime of physical activity or de...

Background Mothers in Motion (MIM), a community-based intervention program, was designed to help young, low-income women with overweight or obesity prevent further weight gain by promoting stress management, healthy eating, and physical activity. This paper presents the MIM’s intervention effect on self-efficacy to cope with stress, emotional copin...

Medication list inconsistencies between outpatient clinics and community pharmacies lead to medication dispensing errors and potential adverse drug events. CancelRx is a new functionality that electronically sends a medication cancellation order from the clinic’s electronic health record (EHR) to the pharmacy’s dispensing software—potentially reduc...

Objectives The purpose of this study was to determine the reliability of grayscale median (GSM) measurements across different ultrasound (US) systems and effects of gain on GSM values. Methods Two vessels in a grayscale vascular phantom were imaged with 7 US systems at 3 gain settings. Two human participants were imaged at 3 gain settings. Each im...

Context: There is need for a short validated self-report instrument for assessing the feeling of being loved. The Feeling Loved instrument asks: "Do you feel loved?" and "How loved do you feel?" as well as "Do you love yourself?" and "How much do you love yourself?" with 100 mm visual analogue scales assessing the continuous response options. Obj...

Background Practice of meditation or exercise may enhance health to protect against acute infectious illness. Objective To assess preventive effects of meditation and exercise on acute respiratory infection (ARI) illness. Design Randomized controlled prevention trial with three parallel groups. Setting Madison, Wisconsin, USA. Participants Comm...

CONSORT checklist of information for a randomized trial. (DOC)

TIDieR (Template for Intervention Description and Replication) checklist. (DOCX)

This study investigated the effects of mindfulness and exercise training on indicators of mental health and stress by examining shared mediators of program effects. Community-recruited adults (N = 413) were randomized into one of three conditions: (a) mindfulness-based stress reduction, (b) moderate intensity exercise, or (c) wait-list control. Com...

Telemedicine applications offer innovative approaches for treating and reducing the effects of substance use disorders (SUDs). This analysis assessed the interest in and use of 11 telemedicine applications in a sample of 363 SUD organizations in the United States of America. Fifty percent of the organizations expressed high rates of interest in sev...

Objectives: Many parents report needing to watch over their child's hospital care to prevent mistakes. In this study, we assessed whether needing to watch over care predicts parent performance of recommended safety behaviors to reduce medication errors and health care-associated infections. Methods: At admission, we surveyed 170 parents about th...

Background Symptom distress in patients toward the end of life can change rapidly. Family caregivers have the potential to help patients manage those symptoms, as well as their own stress, if they are equipped with the proper resources. Electronic health (eHealth) systems may be able to provide those resources. Very sick patients may not be able to...

Objective: To evaluate the effect of a community-based lifestyle behavioral intervention on intakes of fat, fruits, vegetables, fast foods, and beverages in low-income young mothers with overweight or obesity. Methods: Participants were randomly assigned to an intervention (watching video lessons at home plus peer support group teleconferences)...

To better understand how clinicians' job satisfaction relates to work conditions and outcomes for clinicians and patients, we examined data from the Healthy Work Place trial. Data were collected from physicians and advanced practice providers at baseline and approximately one year later. At baseline, 74 percent of respondents indicated job satisfac...

This study described co-parenting motivations and quality of co-parenting features for parents of infants with complex congenital heart disease (CCHD), including differences over time by illness severity. Existing transcripts of parenting experience at infant age 1 and 12 months for 23 parent couples were analyzed using directed content analysis. D...

Objectives To explore how clinicians make decision proposals about life-sustaining treatments and to determine if certain decision proposals are more likely to lead surrogates to align with or resist the proposal. Methods We audio-recorded 36 family conferences between clinicians and surrogates and analyzed the interactions using conversation anal...

Aim The purpose of this study was to examine the role of staff nurse emotional intelligence between transformational leadership and nurse intent to stay. Background Nurse intent to stay and transformational leadership are widely recognized as vital components of nurse retention. Staff nurse emotional intelligence that has been confirmed improvable...

Background and objectives: Family-centered rounds (FCRs) have become standard of care, despite the limited evaluation of FCRs' benefits or interventions to support high-quality FCR delivery. This work examines the impact of the FCR checklist intervention, a checklist and associated provider training, on performance of FCR elements, family engageme...

Background Mothers In Motion (MIM), a community-based lifestyle behavioral intervention, was designed and conducted to help low-income overweight and obese young mothers prevent further weight gain via promotion of stress management, healthy eating, and physical activity. This paper presents intervention effect on body weight (primary outcome) and...

Background: Infants with complex congenital heart disease (CCHD) demonstrate impaired autonomic nervous system (ANS) regulation, which may contribute to commonly observed impairments in feeding, growth, and development. Close mother-infant physical contact improves ANS function in other high-risk infant populations. Objective: Our purposes were...