Alden Lai
Alden Lai
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Assistant Professor of Public Health Policy and Management
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Professional overview
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Alden Lai studies the quality of jobs and work environments (i.e., “work design”) of workers to achieve better employee outcomes and organizational performance in health care. He uses qualitative and mixed methods to examine workplace behaviors that have important implications for employees, patients, and organizations, such as proactive behavior among frontline workers. With an aim of enhancing worker wellbeing, his research has been published in both management and health care journals, including Academy of Management Discoveries, Health Care Management Review, Medical Care Research and Review, Journal of General Internal Medicine, and The Milbank Quarterly. He is an editorial board member for Health Care Management Review and Medical Care Research and Review, and has served as a national and international expert for the National Academies of Sciences, Engineering, and Medicine (NASEM) and Organisation for Economic Co-operation and Development (OECD) on workforce issues. He is an affiliated faculty member in the Department of Management and Organizations at NYU Stern.
Dr. Lai has received international recognition for his research, teaching, and contributions to his field. They include an Early Career Achievement Award, Outstanding Early Career Educator Award, and Outstanding Paper based on a Dissertation Award from the Academy of Management’s Health Care Management Division, and a Teaching Excellence Award from GPH.
At GPH, he teaches courses on management, leadership, and strategy in public health.
Dr. Lai has advised federal and state governments, health systems, international and non-profit organizations, corporations, and philanthropies internationally. His professional experiences include being a management consultant and social enterprise strategist. He is currently a board member for the Wellbeing for Planet Earth Foundation, whose mission is to foster a more globally inclusive understanding of wellbeing for research, practice, and policy.
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Education
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BA, Psychology, National University of Singapore, SingaporeMPH, Social & Behavioral Sciences, The University of Tokyo, JapanPhD, Health Policy & Management (Organizational Behavior), Johns Hopkins University, Baltimore, MD
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Honors and awards
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Outstanding Early Career Educator Award, Health Care Management Division, Academy of Management (2025)Early Career Teaching Excellence Award, NYU GPH (2025)Early Career Achievement Award, Health Care Management Division, Academy of Management (2024)“40 Under 40 in Public Health” Award, Boston Congress of Public Health (2023)Denny Gioia Award for Best Qualitative Paper, Managerial and Organizational Cognition Division, Academy of Management (2023)“Best Paper” (top 10%), Managerial and Organizational Cognition Division, Academy of Management (2023)Goddard Faculty Award, NYU GPH (2023)NYU GPH Leadership Development Award (2021)19 Washington Square North Faculty Fellowship (2021)Outstanding Paper based on a Dissertation Award, Division of Health Care Management, Academy of Management (2021)Show Chwan Scholar in Health Care Management (2018)Sir Arthur Newsholme Scholar (2015)The University of Tokyo President Award (2013)University of Copenhagen-International Alliance of Research Universities Scholar (2012)Government of Japan Monbukagakusho Scholar (2011)Sato-Yo International Foundation Scholar (2009)
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Areas of research and study
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Health Care ManagementHealth Care WorkforceKnowledge WorkersPrimary CareProactivity at WorkQualitative ResearchWell-Being at WorkWork Design
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Consulting and Community Engagement
1199 Benefit and Pension Funds
Ajinomoto
Ando Foundation
Ashoka
Asian Venture Philanthropy Network
Australian Sports Commission
Carnegie UK Trust
Clinical Directors Network Inc.
Columbia University Department of East Asian Languages and Cultures
Columbia University School of International and Public Affairs
Diplomatic Courier
Earth Company
G1 Institute Japan
Gallup Inc.
Government of Australia, Treasury
Harvard University Human Flourishing Program
John Templeton Foundation
Katsuiku Foundation
Learned Society of Wales
National Healthcare Group
Nestle
New York City Department of Health and Mental Hygiene, Bureau of Equitable Health Systems
New York City Health + Hospitals
New York City Office of Labor Relations
New York City Department of Education, Office of School Health
Nikkei
OECD Center for Well-Being, Inclusion, Sustainability and Equal Opportunity
Otsuka Pharmaceutical
Oxford University Wellbeing Research Centre
Permanent Delegation of Japan to the OECD
PERSOL Holdings
Physician Affiliate Group of New York
Prime Minister’s Office, Iceland
Tecnologico de Monterrey, Human Flourishing Projects
Templeton World Charity Foundation
The Consumer Goods Forum
The Hastings Center
The HOW Institute for Society
The Leadership and Happiness Laboratory, Harvard Kennedy School
KRC Research and United Minds, The Weber Shandwick Collective
UNICEF Office of Global Insight and Policy
United Nations Human Development Report Office
United Nations Statistics Division
Unson Foundation
WHO Commission on Social Connection
Woodlands Health Campus
World Happiness Council-
Publications
Publications
Making the most of proactive behaviors in health care: From research to practice
AbstractLai, A. (n.d.).Publication year
2022AbstractPanel: Jiang, W., Moskovitz, J., Parker, S., Wei, E., Frimpong, J. A., and Lai, A. Y. (2022, July 20). Making the most of proactive behaviors in health care: From research to practice. New York University 19 Washington Square North, virtual.Managing Surges in Demand : A Grounded Conceptual Framework of Surge Management Capability
AbstractLarson, J. D., Lai, A., DePuccio, M. J., & Hilligoss, B. (n.d.).Publication year
2024Journal title
Medical Care Research and ReviewAbstractSurge management is important to hospital operations, yet surge literature has mostly focused on the addition of resources (e.g., 25% more beds) during events like pandemics. Such views are limiting, as meeting surge demands requires hospitals to engage in practices tailored to a surge’s unique contingencies. We argue that a dynamic view of surge management should include surge management capability, which refers to how resources are deployed to respond to surge contingencies. To understand this capability, we qualitatively studied five hospital systems experiencing multiple surges due to COVID-19 between April 2020 and March 2022. We develop a framework showing that managing surges involves preserving capacity, expanding capacity, smoothing capacity demand, and enabling surge management. We contribute to surge literature by identifying practices hospitals can adopt to address surges and offering a better understanding of surge conditions (e.g., degree of novelty) that make some surge management practices more appropriate than others.MODES OF ADJUSTMENT : THERE IS MORE THAN ONE WAY TO ORGANIZE FOR RESILIENCE
AbstractHilligoss, B., Larson, J. D., Lai, A., Depuccio, M. J., & Wong, E. M. (n.d.).Publication year
2023Journal title
Academy of Management Annual Meeting ProceedingsVolume
2023Issue
1AbstractDespite growing concerns that unexpected events have become regular features of environments, we know little about organizing for resilience—the process by which leaders attempt to positively adjust operations to adversity. To address this gap, we conducted longitudinal case studies of eight U.S. health care organizations adjusting operations through successive phases of the COVID-19 pandemic. We discovered these adjustments demonstrated considerable variety during different phases of the pandemic, even when made by the same leaders in similar situations. We explain this variety through an inductively derived process model of organizing for resilience that traces how the enactment of different adverse situations leads to alternative modes of adjustment that target different resilience outcomes. In contrast to definitions that imply resilience entails both absorbing strain and preserving functioning, our study shows these, along with a third resilience outcome of anticipating and preparing for immanent threat, exist in three-way tension. Leaders must trade off one in pursuit of others. How leaders perceive the relative adversity of conditions and the alignment of organizational capabilities with those conditions shapes this trade-off and modes of adjustment made in pursuit of one, or at most a mix of two, of these three resilience outcomes.Modes of adjustment: There's more than one way to organize for resilience
AbstractHilligoss, B., Larson, J. D., Lai, A., DePuccio, M., & Wong, E. M. (n.d.).Journal title
Administrative Science QuarterlyAbstract~Non-adherence in patients on peritoneal dialysis : A systematic review
AbstractGriva, K., Lai, A., Lim, H. A., Yu, Z., Foo, M. W., & Newman, S. P. (n.d.).Publication year
2014Journal title
PloS oneVolume
9Issue
2AbstractBackground: It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). Methods: A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. Results: The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of nonadherence varied across studies: 2.6-53% for dialysis exchanges, 3.9-85% for medication, and 14.4-67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Conclusion: Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population.Organizing for resilience: How to organize in a world of diversity and flux
AbstractLai, A. (n.d.).Publication year
2022AbstractHarboth, L., Hayirli, T. C., Hilligoss, B. H., Lai, A.Y., Larson, J., Lloyd-Smith, and M., Sutcliffe, K. M. (2022, August 9). Organizing for resilience: How to organize in a world of diversity and flux. The 82nd Annual Meeting of the Academy of Management, Seattle, WA, USA.- Designated Showcase Symposium by the Division of Health Care Management, and organized jointly with the Divisions of Organization Management and Theory, and Organization Change and DevelopmentPatient perceptions of safety in primary care : a qualitative study to inform care
AbstractLasser, E. C., Heughan, J. A., Lai, A., Yuan, C. T., Dy, S. M., Bittle, M., Oberlander, T., Pitts, S. I., Marsteller, J., & Hannum, S. M. (n.d.).Publication year
2021Journal title
Current Medical Research and OpinionVolume
37Issue
11Page(s)
1991-1999AbstractPatients’ perspectives on patient safety have rarely been incorporated into quality initiatives in primary care. Our objective was to understand the patient perspective on patient safety in patient-centered medical homes (PCMHs). We conducted 12 patient focus groups/interviews in nine sites with 65 patients at a geographically diverse sample of National Committee on Quality Assurance Level 3 recognized PCMHs across three states. Using a patient safety framework, we coded and analyzed interviews for overarching themes and subthemes across patient safety domains. Overarching themes focused on (1) both clear and timely communication with and between clinicians and (2) trust in the care team, including being heard, respected, and treated as a whole person. Other themes important to specific patient safety domains included sharing of and access to information, patient education and patient-centered medication reconciliation process, clear documentation for the diagnostic process, patient-centered comprehensive visits, and timeliness of care. Communication and trust are key to patient perceptions of safe primary care. Focusing on these themes across safety domains may help to make primary care both more patient-centered and safer, and should be considered in future ambulatory safety initiatives.Patient safety in primary care : Conceptual meanings to the health care team and patients
AbstractLai, A., Yuan, C. T., Marsteller, J. A., Hannum, S. M., Lasser, E. C., Heughan, J. A., Oberlander, T., Berger, Z. D., Gurses, A. P., Kharrazi, H., Pitts, S. I., Scholle, S. H., & Dy, S. M. (n.d.).Publication year
2020Journal title
Journal of the American Board of Family MedicineVolume
33Issue
5Page(s)
754-764AbstractIntroduction: Patient safety in primary care is an emerging priority, and experts have highlighted medications, diagnoses, transitions, referrals, and testing as key safety domains. This study aimed to (1) describe how frontline clinicians, administrators, and staff conceptualize patient safety in primary care; and (2) compare and contrast these conceptual meanings from the patient’s perspective. Methods: We conducted interviews with 101 frontline clinicians, administrators and staff, and focus groups with 65 adult patients at 10 patient-centered medical homes. We used thematic analysis to approach coding. Results: Findings indicate that frontline personnel conceptualized patient safety more in terms of work functions, which reflect the grouping of tasks or responsibilities to guide how care is being delivered. Frontline personnel and patients conceptualized patient safety in largely consistent ways. Discussion: Function-based conceptualizations of patient safety in primary care may better reflect frontline personnel and patients’ experiences than domain-based conceptualizations, which are favored by experts.Perceived Unintended Consequences of Prescription Drug Monitoring Programs
AbstractLai, A., Yuanhong Lai, A., Smith, K. C., Vernick, J. S., Davis, C. S., Caleb Alexander, G., & Rutkow, L. (n.d.).Publication year
2019Journal title
Substance Use and MisuseVolume
54Issue
2Page(s)
345-349AbstractBackground: Opioid-related injuries and deaths continue to present challenges for public health practitioners. Prescription Drug Monitoring Programs (PDMPs) are a prevalent policy option intended to address problematic opioid pain reliever (OPR) prescribing, but previous research has not thoroughly characterized their unintended consequences. Objectives: To examine state actors’ perceptions of the unintended consequences of PDMPs. Methods: We conducted 37 interviews with PDMP staff, law enforcement officials, and administrative agency employees in Florida, Kentucky, New Jersey, and Ohio from May 2015 to June 2016. Results: We identified six themes from the interviews. Perceived negative unintended consequences included: access barriers for those with medical needs, heroin use as OPR substitute and related deaths, and need for adequate PDMP security infrastructure and management. Perceived positive unintended consequences were: community formation and problem awareness, proactive population-level OPR monitoring, and increased knowledge about population-level drug diversion. Conclusions/Importance: State actors perceive a range of both negative and positive unintended consequences of PDMPs. Our findings suggest that there may be unintended risks of PDMPs that states should address, but also opportunities to maximize certain benefits.Perspectives of patients, families, and health care professionals on decision-making about dialysis modality-the good, the bad, and the misunderstandings!
AbstractGriva, K., Li, Z. H., Lai, A., Choong, M. C., & Foo, M. W. (n.d.).Publication year
2013Journal title
Peritoneal Dialysis InternationalVolume
33Issue
3Page(s)
280-289AbstractObjectives: This study explored the factors influencing decision-making about dialysis modality, integrating the perspectives of patients, their families, and health care professionals within an Asian population. The study further sought to understand the low penetration rate of peritoneal dialysis (PD) in Singapore. Methods: A sample of 59 participants comprising pre-dialysis patients, dialysis patients, caregivers, and health care professionals (HCPs) participated in semi-structured interviews to explore the decision-making process and their views about various dialysis modalities. Data were thematically analyzed using NVivo9 (QSR International, Doncaster, Australia) to explore barriers to and facilitators of various dialysis modalities and decisional support needs. Results: Fear of infection, daily commitment to PD, and misperceptions of PD emerged as barriers to PD. Side effects, distance to dialysis centers, and fear of needling and pain were barriers to hemodialysis (HD). The experiences of other patients, communicated informally or opportunistically, influenced the preferences and choices of patients and family members for a dialysis modality. Patients and families value input from HCPs and yet express strong needs to discuss subjective experiences of life on dialysis (PD or HD) with other patients before making a decision about dialysis modality. Conclusions: Pre-dialysis education should expand its focus on the family as the unit of care and should provide opportunities for interaction with dialysis patients and for peer-led learning. Barriers to PD, especially misperceptions and misunderstandings, can be targeted to improve PD uptake.Positive Reframing: How physicians adapt functionally during stressful work situations
AbstractLai, A. (n.d.).Journal title
Journal of General Internal MedicineAbstract~Prescription drug monitoring program design and function : A qualitative analysis
AbstractRutkow, L., Smith, K. C., Lai, A., Vernick, J. S., Davis, C. S., & Alexander, G. C. (n.d.).Publication year
2017Journal title
Drug and alcohol dependenceVolume
180Page(s)
395-400AbstractBackground Opioid-related overdose deaths are a major public health challenge. Forty-nine states have implemented Prescription Drug Monitoring Programs (PDMPs) that collect information about individuals’ prescription medications. Little is known about state governments’ implementation of PDMPs. We conducted semi-structured interviews with PDMP staff, law enforcement officials, and administrative agency employees to learn about their attitudes and experiences with PDMPs. Methods From May 2015 to June 2016, we conducted 37 semi-structured interviews with state actors in four states. Questions focused on interviewees’ perceptions about PDMP goals, home agency characteristics, and future PDMP initiatives. States were selected purposively. Interviewees were identified through purposive and snowball sampling. Results Interviewees identified key PDMP goals as: improve patient treatment decisions; influence prescribing practices; assist in the identification of “doctor shoppers” and serve as a tool for law enforcement. Interviewees identified the following characteristics as key for a PDMP's home agency: regulatory and enforcement authority; intra- and inter-agency collaboration; and commitment to data quality and protection. Interviewees identified three promising areas for future PDMP efforts: data sharing and analysis; integration of PDMP data with electronic medical records; and training for current and potential PDMP users. Conclusions Our findings reveal areas that states may want to prioritize, including improving prescribers’ knowledge and use of the PDMP as well as fostering inter-agency collaborations that include PDMP staff. By capitalizing on these opportunities, state governments may improve the effectiveness of their PDMPs, potentially making them more useful tools to curb the morbidity and mortality associated with opioid use disorders.Proactive behaviors and health care workers : A systematic review
AbstractLai, A., Wee, K. Z., Frimpong, J. A., & Frimpong, J. A. (n.d.).Publication year
2024Journal title
Health Care Management ReviewVolume
49Issue
3Page(s)
239-251AbstractBackground Proactive behaviors at work refer to discretionary actions among workers that are self-starting, change oriented, and future focused. Proactive behaviors reflect the idiosyncratic actions by individual workers that shape the delivery and experience of professional services, highlight a bottom-up perspective on workers' agency and motivation that can influence organizational practices, and are associated with a variety of employee and organizational outcomes. Purpose This systematic review aims to understand the various forms of proactive behaviors in health care workers that have been studied, and how these proactive behaviors are associated with employee-level outcomes and quality of care. Methods Systematic review of articles published to date on proactive behaviors in health care workers. Results Based on the identification of 40 articles, we find that job crafting, active problem solving, voice, extra-role behaviors, and idiosyncratic deals have been investigated as proactive behaviors among health care workers. Among these, job crafting is the most commonly studied (35% of articles), and it has been conceptualized and measured in the most consistent way, including as individual- and group-level phenomena, and as organizational interventions. Studies on active problem solving, which refers to workers accepting responsibility, exercising control, and taking action around anticipated or experienced problems at work, have not been consistently investigated as a form of proactive behavior but represent 25% of the articles identified in this review. Overall, this review finds that proactive behaviors in health care is a burgeoning area of research, with the majority of studies being cross-sectional in design and published after 2010, and focused on workers' job satisfaction as the outcome. Practice Implications Health care workers and managers should consider the distinct influences and contributions of proactive behaviors as ways to improve employee-level outcomes and quality of care.Proactivity, relationships, and inclusivity : Emerging topics in work design for health care management research
AbstractLai, A. (n.d.).Publication year
2025Journal title
Health Care Management ReviewVolume
50Issue
3Page(s)
163-164Abstract~Proactivity, Relationships, and Inclusivity: Emerging Topics in Work Design for Health Care Management Research
AbstractLai, A. (n.d.).Publication year
2025Journal title
Health Care Management ReviewAbstract~Racial/ethnic disparities in the availability of hospital based opioid use disorder treatment
AbstractChang, J. E., Franz, B., Cronin, C. E., Lindenfeld, Z., Lai, A., & Pagán, J. A. (n.d.).Publication year
2022Journal title
Journal of Substance Abuse TreatmentVolume
138AbstractIntroduction: While racial/ethnic disparities in the use of opioid use disorder (OUD) treatment in outpatient settings are well documented in the literature, little is known about racial/ethnic disparities in access to hospital-based OUD services. This study examines the relationship between hospital-based or initiated OUD services and the racial/ethnic composition of the surrounding community. Methods: We constructed a dataset marking the implementation of eight OUD strategies for a 20% random sample of nonprofit hospitals in the United States based on 2015–2018 community health needs assessments. We tested the significance of the relationship between each OUD strategy and the racial/ethnic composition of the surrounding county using two-level mixed effects logistic regression models that considered the hierarchical structure of the data of hospitals within states while controlling for hospital-level county-level, and state-level covariates. Results: In both unadjusted and adjusted models, we found that hospital adoption of several OUD services significantly varied based on the percentage of Black or Hispanic residents in their communities. Even after controlling for hospital size, the overdose burden in the community, community socioeconomic characteristics, and state funding, hospitals in communities with high percentage of Black or Hispanic residents had significantly lower odds of offering the most common hospital-based programs to address OUD – including programs that increase access to formal treatment services, prescriber guidelines, targeted risk education and harm reduction, and community coalitions to address opioid use. Conclusions: Hospital adoption of many OUD services varies based on the percentage of Black or Hispanic residents in their communities. More attention should be paid to the role, ability, and strategies that hospitals can assume to address disparities among OUD treatment and access needs, especially those that serve communities with a high concentration of Black and Hispanic residents.Rapid Transition to Telehealth and the Digital Divide : Implications for Primary Care Access and Equity in a Post-COVID Era
AbstractChang, J. E., Lai, A., Gupta, A., Nguyen, A. M., Berry, C. A., & Shelley, D. R. (n.d.).Publication year
2021Journal title
Milbank QuarterlyVolume
99Issue
2Page(s)
340-368AbstractPolicy Points Telehealth has many potential advantages during an infectious disease outbreak such as the COVID-19 pandemic, and the COVID-19 pandemic has accelerated the shift to telehealth as a prominent care delivery mode. Not all health care providers and patients are equally ready to take part in the telehealth revolution, which raises concerns for health equity during and after the COVID-19 pandemic. Without proactive efforts to address both patient- and provider-related digital barriers associated with socioeconomic status, the wide-scale implementation of telehealth amid COVID-19 may reinforce disparities in health access in already marginalized and underserved communities. To ensure greater telehealth equity, policy changes should address barriers faced overwhelmingly by marginalized patient populations and those who serve them. Context: The COVID-19 pandemic has catalyzed fundamental shifts across the US health care delivery system, including a rapid transition to telehealth. Telehealth has many potential advantages, including maintaining critical access to care while keeping both patients and providers safe from unnecessary exposure to the coronavirus. However, not all health care providers and patients are equally ready to take part in this digital revolution, which raises concerns for health equity during and after the COVID-19 pandemic. Methods: The study analyzed data about small primary care practices’ telehealth use and barriers to telehealth use collected from rapid-response surveys administered by the New York City Department of Health and Mental Hygiene's Bureau of Equitable Health Systems and New York University from mid-April through mid-June 2020 as part of the city's efforts to understand how primary care practices were responding to the COVID-19 pandemic following New York State's stay-at-home order on March 22. We focused on small primary care practices because they represent 40% of primary care providers and are disproportionately located in low-income, minority or immigrant areas that were more severely impacted by COVID-19. To examine whether telehealth use and barriers differed based on the socioeconomic characteristics of the communities served by these practices, we used the Centers for Disease Control and Prevention Social Vulnerability Index (SVI) to stratify respondents as being in high-SVI or low-SVI areas. We then characterized respondents’ telehealth use and barriers to adoption by using means and proportions with 95% confidence intervals. In addition to a primary analysis using pooled data across the five waves of the survey, we performed sensitivity analyses using data from respondents who only took one survey, first wave only, and the last two waves only. Findings: While all providers rapidly shifted to telehealth, there were differences based on community characteristics in both the primary mode of telehealth used and the types of barriers experienced by providers. Providers in high-SVI areas were almost twice as likely as providers in low-SVI areas to use telephones as their primary telehealth modality (41.7% vs 23.8%; PReligious/Spiritual Connection and Subjective Wellbeing Around the World: A Cross-Sectional Analysis of Nationally Representative Samples from 121 Countries
AbstractLai, A. (n.d.).Publication year
2024Abstract~Rural-urban disparities in the availability of hospital-based screening, medications for opioid use disorder, and addiction consult services
AbstractFranz, B., Cronin, C. E., Lindenfeld, Z., Pagan, J. A., Lai, A., Krawczyk, N., Rivera, B. D., & Chang, J. E. (n.d.).Publication year
2024Journal title
Journal of Substance Use and Addiction TreatmentVolume
160AbstractIntroduction: Hospitals are an ideal setting to stage opioid-related interventions with patients who are hospitalized due to overdose or other substance use–related complications. Transitional opioid programs—which initiate care and provide linkages upon discharge, such as screening, initiation of medications for opioid use disorder, and addiction consult services—have become the gold standard, but implementation has been uneven. The purpose of this study was to assess disparities in the availability of hospital-based transitional opioid programs, across rural and urban hospital settings in the United States. Methods: Using hospital administrative data paired with county-level demographic data, we conducted bivariate and regression analyses to assess rural-urban differences in the availability of transitional opioid services including screening, addiction consult services, and MOUD in U.S general medical centers, controlling for hospital- and community-level factors. Our sample included 2846 general medical hospitals that completed the 2021 American Hospital Association (AHA) Annual Survey of Hospitals. Our primary outcomes were five self-reported measures: whether the hospital provided screening in the ED; provided screening in the inpatient setting; whether the hospital provided addiction consult services in the ED; provided addiction consult services in the inpatient setting; and whether the hospital provided medications for opioid use disorder. Results: Rural hospitals did not have lower odds of screening for OUD or other SUDs than urban hospitals, but both micropolitan rural counties and noncore rural counties had significantly lower odds of having addiction consult services in either the ED (OR: 0.74, 95 % CI: 0.58, 0.95; OR: 0.68, 95 % CI: 0.50, 0.91) or inpatient setting (OR: 0.76, 95 % CI: 0.59, 0.97; OR: 0.68, 95 % CI: 0.50, 0.93), respectively, or of offering MOUD (OR: 0.69, 95 % CI: 0.52, 0.90; OR: 0.52, 95 % CI: 0.37, 0.74). Conclusions: Our study suggests that evidence-based interventions, such as medications for opioid use disorder and addiction consult services, are less often available in rural hospitals, which may contribute to rural-urban disparities in health outcomes secondary to OUD. A priority for population health improvement should be developing implementation strategies to support rural hospital adoption of transitional opioid programs.Rural-urban disparities in the availability of hospital-based screening, medications for opioid use disorder, and addiction consult services
AbstractLai, A., Franz, B., Cronin, C. E., Lindenfeld, Z., Pagan, J. A., Lai, A. Y., Krawczyk, N., Rivera, B. D., & Chang, J. E. (n.d.).Publication year
2023Journal title
Journal of substance use and addiction treatmentVolume
160Page(s)
209280AbstractHospitals are an ideal setting to stage opioid-related interventions with patients who are hospitalized due to overdose or other substance use-related complications. Transitional opioid programs-which initiate care and provide linkages upon discharge, such as screening, initiation of medications for opioid use disorder, and addiction consult services-have become the gold standard, but implementation has been uneven. The purpose of this study was to assess disparities in the availability of hospital-based transitional opioid programs, across rural and urban hospital settings in the United States.Setting Up for a Thriving Career : Assessing Your Scholarly Identity and Institutional Environment
AbstractAbstractWhat does it mean to be thriving in our early careers as researchers? In this chapter, I discuss the need to assess our scholarly identity and our institutional environment so that we can maximize the fit between them to craft a thriving career for ourselves. I also discuss how assessing our scholarly identities requires continuous reflection on what we do at work, as well as the communities and places that we belong to, and the ways we most want to spend our time. I consider the fundamental elements of scholarly institutional environments - research, funding, teaching, mentoring, service, and professional development activities - and look at how they shape the norms of an institution and define the extent to which we can assert our scholarly identity. This chapter aims to clarify how we can better align what our institutions expect with what we individually value as early career researchers so that we can sustainably enjoy our work and be good at it, and thus thrive.Starting from scratch : New work design to enact entrance screening during the COVID-19 pandemic
AbstractLai, A., Larson, J. D., Depuccio, M. J., & Hilligoss, B. (n.d.).Publication year
2023Journal title
Health Care Management ReviewVolume
48Issue
3Page(s)
260-273AbstractBackground Health care organizations are constantly creating new work to achieve evolving goals such as digitalization, equity, value, or well-being. However, scholars have paid less attention to how such work becomes "work"in the first place, despite implications for the design, quality, and experience of work and, consequently, employee and organizational outcomes. Purpose The aim of this study was to investigate how new work becomes enacted in health care organizations. Methodology A longitudinal, qualitative case study on the enactment of entrance screening - a new operation in response to COVID-19 - in a multihospital academic medical center was performed. Results Entrance screening comprised four tasks, whose design was initially influenced by institutional guidelines (e.g., Centers for Disease Control and Prevention recommendations) and clinical experts. Organizational-level influences (e.g., resource availability) then became more prominent, necessitating multiple feedback-response loops to calibrate the performance of entrance screening. Finally, entrance screening was integrated into existing operations of the organization to ensure operational sustainability. The treatment of entrance screening as an operation changed over time - initially seen as infection control work, it eventually bifurcated into patient care and clerical work. Conclusion The enactment of new work is constrained by the fit between resources and its intended output. Furthermore, the schema of work influences how and when organizational actors calibrate this fit. Practice Implications Health care leaders and managers should continuously update their schemas of work so that they can develop more sufficient and accurate representations of the employee capabilities that are required for the performance of new work.Starting on haemodialysis : A qualitative study to explore the experience and needs of incident patients
AbstractLai, A., Loh, A. P., Mooppil, N., Krishnan, D. S., & Griva, K. (n.d.).Publication year
2012Journal title
Psychology, Health and MedicineVolume
17Issue
6Page(s)
674-684AbstractDialysis can be very stressful with the initial months onto treatment being highly critical in terms of both adaptation and mortality. This qualitative study aimed to explore the lived experiences of incident haemodialysis patients in Singapore. Topics related to the end-stage renal disease diagnosis and haemodialysis treatment were raised with 13 incident haemodialysis patients in the form of semi-structured interviews, and interpretative phenomenological analysis was undertaken as the framework for data analysis. Emotional distress, treatment-related concerns and social support emerged as main issues following a critical review of themes. Our study revealed that incident haemodialysis patients have emotional and informational needs, highlighting the importance of intervention programmes in particular to this patient group to promote better psychosocial adjustment to the disease and its treatment.State-level unemployment and negative emotions throughout the Covid-19 pandemic in the United States
AbstractHagen, D., Lai, A., & Goldmann, E. (n.d.).Publication year
2022Journal title
Preventive MedicineVolume
164AbstractAlthough prior research has assessed public mental health in the U.S. throughout the COVID-19 pandemic, it is unclear how area-level unemployment impacted psychological well-being; moreover, studies that examine potential effect heterogeneity of the impact of area-level unemployment on well-being by employment status are lacking. To address these shortcomings, this study utilized data from Gallup's repeated cross-sectional, nationally representative COVID-19 web survey collected between April 2020 and July 2021 (n = 132,971). Survey modified Poisson regression models were estimated to determine the association between current unemployment rate in respondents' state of residence and experience of each of the following negative emotions during a lot of the prior day: sadness, worry, stress, anger, loneliness, depression, and anxiety. These models were stratified by employment status and sequentially adjusted for individual-level covariates, state fixed effects, and current state-level COVID-19 mortality. State-level unemployment was most strongly associated with sadness, followed by worry, anger, loneliness, stress, and anxiety; no associations were observed for depression. For sadness, worry, and stress, associations were strongest among full-time employed and retired individuals, and weakest among unemployed respondents and homemakers. Moreover, there was some evidence that state-level unemployment was negatively associated with the experience of anger in the early stages of the pandemic, and positively in its later stages. In sum, these findings suggest that Americans' emotional experience during the COVID-19 pandemic was considerably impacted by the state of the economy, highlighting the need for risk-buffering social policies.Survival Guide for Early Career Researchers
AbstractAbstractNavigating research careers is often highly challenging for early career researchers (ECRs) in the social sciences. The ability to thrive in research careers is complex and requires "soft" people and management skills and resilience that often cannot be formally taught through university coursework. Written from a peer perspective, this book provides guidance and establishes emotional rapport on topical issues relevant for ECRs in academia and industry. The authors are ECRs who have been successful in navigating their careers, and they seek to connect with readers in a supportive and collegial manner. Each chapter includes elements of story-telling and scientific thinking and is organized into three parts: (1) a personal story that is relevant to the topic; (2) key content on professional and personal effectiveness based on evidence in the psychological, sociological, and/or management sciences; and (3) action points and practical recommendations. The topics covered are specifically curated for people considering undertaking research careers or already working in research, including: • Work Hard, Snore Hard: Recovery from Work for Early Career Researchers • Networking and Collaborating in Academia: Increasing Your Scientific Impact and Having Fun in the Process • Accelerating Your Research Career with Open Science • Engaging with the Press and Media • Make Your Science Go Viral: How to Maximize the Impact of Your Research • Exploring the Horizon: Navigating Research Careers Outside of Academia • Thinking like an Implementation Scientist and Applying Your Research in Practice Survival Guide for Early Career Researchers summarizes relevant evidence-based research to offer advice in strategic but also supportive ways to ECRs. It is an essential go-to practical resource for PhD students, postdoctoral fellows, and junior faculty. This book will also benefit senior researchers who are serving as mentors or delivering professional development programs, administrators and educators in institutions of higher learning, and anyone with an interest in building a successful research career.