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 how the jobs and work environments of health care workers can be improved to increase employee outcomes (e.g., wellbeing, retention) as well as organizational performance (e.g., program implementation, patient safety). He uses theories and frameworks from psychology, organization science, and health services research in his work. Dr. Lai's research has appeared in both management and health care journals, including Academy of Management Discoveries, Health Care Management Review, Medical Care Research and Review, and The Milbank Quarterly. He has an affiliated faculty appointment in the Department of Management and Organizations at NYU Stern.
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, social enterprise strategist, and education researcher. He currently serves as Executive Advisor to the Global Wellbeing Initiative, a collaboration between the Wellbeing for Planet Earth Foundation and Gallup Inc. to foster a more globally inclusive understanding of wellbeing for research, practice, and policy. Dr. Lai also serves as Chair of the Health Care Research Stream for the Industry Studies Association. He is Co-Editor of an upcoming book by Springer on professional development for early career researchers. Previously, he served as Chair of the European Health Psychology Society’s early career researcher division, and was an executive committee member in the Academy of Management's Division of Health Care Management.
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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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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 WorkforceManagerial CognitionPatient SafetyPopulation HealthPrimary CareProactivity at WorkQualitative and Mixed MethodsQualitative ResearchWell-Being at Work
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Consulting and Community Engagement
Asian Venture Philanthropy Network
Carnegie UK Trust
Clinical Directors Network Inc.
Earth Company
G1 Institute Japan
Gallup Inc.
Harvard University Human Flourishing Program
John Templeton Foundation
Unson Foundation
National Healthcare Group
New York City Department of Health and Mental Hygiene
New York City Health + Hospitals
New York City Office of Labor Relations
Nikkei Inc.
OECD Statistics and Data Directorate
OECD Center for Well-Being, Inclusion, Sustainability and Equal Opportunity
Otsuka Pharmaceutical
Oxford University Wellbeing Research Centre
PERSOL Holdings
Physician Affiliate Group of New York
Templeton World Charity Foundation
The Consumer Goods Forum
Wellbeing for Planet Earth Foundation
Woodlands Health Campus
World Happiness Council-
Publications
Publications
A multidimensional assessment of global flourishing: Differential rankings of 145 Countries on 38 wellbeing indicators in the Gallup World Poll, with an accompanying principal components analyses of the structure of flourishing
AbstractLomas, T., Padgett, R. N., Lai, A. Y., Pawelski, J. O., & VanderWeele, T. J. (n.d.).Publication year
2024Journal title
Journal of Positive PsychologyAbstractFor over ten years the World Happiness Report has influentially ranked nations on self-reported life evaluation as measured by the Gallup World Poll. Inspired by this endeavour, this paper aims to broaden our understanding of global flourishing by assessing an expansive battery of 38 items relating to wellbeing in the World Poll, encompassing 386,654 people in 145 countries over three years (2020–2022). The variation in the respective placing of countries across different items reveals a complex picture of flourishing, with many nations ranking highly on certain metrics but faring poorly on others. Additionally, principal components analyses of the items produced a conceptualization of flourishing featuring numerous dimensions (with both a three- and six-factor solution being viable). Together, these findings paint a nuanced picture of both the multifaceted nature of flourishing and its complex manifestations around the world.Barriers and Facilitators to Establishing Partnerships for Substance Use Disorder Care Transitions Between Safety-Net Hospitals and Community-Based Organizations
AbstractLindenfeld, Z., Franz, B., Lai, A., Pagan, J., Fenstemaker, C., Cronin, C. E., & Chang, J. E. (n.d.).Publication year
2024Journal title
Journal of general internal medicineVolume
39Issue
12Page(s)
2150-2159AbstractBackground: The effectiveness of hospital-based transitional opioid programs (TOPs), which aim to connect patients with substance use disorders (SUD) to ongoing treatment in the community following initiation of medication for opioid use disorder (MOUD) treatment in the hospital, hinges on successful patient transitions. These transitions are enabled by strong partnerships between hospitals and community-based organizations (CBOs). However, no prior study has specifically examined barriers and facilitators to establishing SUD care transition partnerships between hospitals and CBOs. Objective: To identify barriers and facilitators to developing partnerships between hospitals and CBOs to facilitate care transitions for patients with SUDs. Design: Qualitative study using semi structured interviews conducted between November 2022-August 2023. Participants: Staff and providers from hospitals affiliated with four safety-net health systems (n=21), and leaders and staff from the CBOs with which they had established partnerships (n=5). Approach: Interview questions focused on barriers and facilitators to implementing TOPs, developing partnerships with CBOs, and successfully transitioning SUD patients from hospital settings to CBOs. Key Results: We identified four key barriers to establishing transition partnerships: policy and philosophical differences between organizations, ineffective communication, limited trust, and a lack of connectivity between data systems. We also identified three facilitators to partnership development: strategies focused on building partnership quality, strategic staffing, and organizing partnership processes. Conclusions: Our findings demonstrate that while multiple barriers to developing hospital-CBO partnerships exist, stakeholders can adopt implementation strategies that mitigate these challenges such as using mediators, cross-hiring, and focusing on mutually beneficial services, even within resource-limited safety-net settings. Policymakers and health system leaders who wish to optimize TOPs in their facilities should focus on adopting implementation strategies to support transition partnerships such as inadequate data collection and sharing systems.Love over gold and mind over matter? Identifying capabilities that preserve medical assistants’ sustainable employability
AbstractFleuren, B. P., Lai, A. Y., Gruenewald-Schmitz, L., Larkin, J., & Yuan, C. T. (n.d.).Publication year
2024Journal title
Human Resources for HealthVolume
22Issue
1AbstractBackground: Medical assistants (MAs) are crucial for affordable, high-quality primary care, but what motivates this low-wage occupational group to stay in their job remains underexplored. This paper identifies the work aspects that MAs value (“capabilities”), and how they affect sustainable employability, which refers to employees’ long-term ability to function and remain in their job. Methods: We used structural equation modelling to assess how capabilities relate to four outcomes among MAs: burnout, job satisfaction, intention to quit, and experiencing work as meaningful. Results: We find that earning a good income, developing knowledge and skills, and having meaningful relationships at work relate to the outcomes. Meaningful relationships represent a stronger predictor than salary for one’s intention to quit. Conclusions: Competitive salaries are necessary but not sufficient to motivate low-wage health care workers like MAs to stay in their job. Health care leaders and managers should also structure work so that MAs can foster meaningful relationships with others as well as develop competencies.Managing Surges in Demand: A Grounded Conceptual Framework of Surge Management Capability
AbstractLarson, J. D., Lai, A. Y., DePuccio, M. J., & Hilligoss, B. (n.d.).Publication year
2024Journal title
Medical Care Research and ReviewVolume
81Issue
3Page(s)
245-258AbstractSurge 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.Proactive behaviors and health care workers: A systematic review
AbstractLai, A. Y., Wee, K. Z., & 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.The world prefers a calm life, but not everyone gets to have one: global trends in valuing and experiencing calmness in the Gallup World Poll
AbstractLomas, T., Diego-Rosell, P., Shiba, K., Standridge, P., Lee, M. T., & Lai, A. Y. (n.d.).Publication year
2024Journal title
Journal of Positive PsychologyVolume
19Issue
6Page(s)
1023-1036AbstractPsychology has paid relatively little attention to low arousal positive states like calmness. To remedy this lacuna, this study draws on the most globally comprehensive study to date on calmness (121,207 participants in 116 countries in the 2020 Gallup World Poll), featuring two items asking whether people: (a) prefer a calm life or an exciting life; and (b) experienced calmness yesterday. By intersecting these, we could categorise people in four categories of calmness: satisfied (both prefer and experience it); unwanted (experience calmness but prefer excitement); longed-for (prefer calmness but don’t experience it); and unmissed (neither prefer nor experience it). The results reveal a nuanced picture that challenges certain stereotypes (e.g. calmness had no particular association here with Eastern cultures), and shed new light on this overlooked topic (e.g. poorer people and countries are more likely to prefer calmness yet are less likely to actually experience it).Complexifying Individualism Versus Collectivism and West Versus East: Exploring Global Diversity in Perspectives on Self and Other in the Gallup World Poll
AbstractLomas, T., Diego-Rosell, P., Shiba, K., Standridge, P., Lee, M. T., Case, B., Lai, A. Y., & VanderWeele, T. J. (n.d.).Publication year
2023Journal title
Journal of Cross-Cultural PsychologyVolume
54Issue
1Page(s)
61-89AbstractA wealth of research has suggested the West tends toward individualism and the East toward collectivism. We explored this topic on an unprecedented scale through two new items in the 2020 Gallup World Poll, involving 121,207 participants in 116 countries. The first tapped into orientations toward self-care versus other-care (“Do you think people should focus more on taking care of themselves or on taking care of others?”). The second enquired into self-orientation versus other-orientation (“Which of the following is closest to your main purpose in life? Being good at what you do in your daily life, Caring for family and close friends, or Helping other people who need help?”). We anticipated that self-care and self-orientation would index individualism (hence be higher in the West), while other-care and other-orientation would index collectivism (hence be higher in the East). However, contrary to expectation, there was greater self-care in the East (45.82%) than in the West (41.58%). As predicted though, there was greater self-orientation in the West (30.20%) than in the East (23.08.%). Greater self-care in the East invites one of two interpretations. Either these items: (a) index individualism and collectivism as anticipated, so in some ways the East is more individualistic and the West less individualistic than assumed; or (b) do not index individualism and collectivism as anticipated, so the concepts are more complex than often realized (e.g., collectivism may involve prioritizing self-care over other-care). Either way, the findings help complexify these concepts, challenging common cross-cultural generalizations in this area.Delivering High-Quality Primary Care Requires Work That Is Worthwhile for Medical Assistants
AbstractLai, A. Y., Fleuren, B. P., Yuan, C. T., Sullivan, E. E., & Mark McNeill, S. (n.d.).Publication year
2023Journal title
Journal of the American Board of Family MedicineVolume
36Issue
1Page(s)
193-199AbstractMedical assistants are core members of the primary care team, but health care organizations struggle to hire and retain them amid the ongoing exodus of health care workers as part of the “Great Resignation.” To sustain a stable and engaged workforce of medical assistants, we argue that efforts to hire and retain them should focus on making their work worthwhile. Work that is worthwhile includes adequate pay, benefits, and job security, but additionally enables employees to experience a sense of contribution, growth, social connectedness, and autonomy. We highlight opportunities during team huddles, the rooming of patients, and career development where the work of medical assistants can be made worthwhile. We also connect these components to the work design literature to show how clinic managers and supervising clinicians can promote worthwhile work through decision-making and organizational climate. Going beyond financial compensation, these components target the latent occupational needs of medical assistants and are likely to forge employee-employer relationships that are mutually valued and sustained over time.Starting from scratch: New work design to enact entrance screening during the COVID-19 pandemic
AbstractLai, A. Y., 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.A double-edged sword: The effects of social network ties on job satisfaction in primary care organizations
AbstractYuan, C. T., Lai, A. Y., Benishek, L. E., Marsteller, J. A., Mahabare, D., Kharrazi, H., & Dy, S. M. (n.d.).Publication year
2022Journal title
Health Care Management ReviewVolume
47Issue
3Page(s)
180-187AbstractBACKGROUND: Social ties between health care workers may be an important driver of job satisfaction; however, research on this topic is limited.PURPOSE: We used social network methods to collect data describing two types of social ties, (a) instrumental ties (i.e., exchange of advice that enables work) and (b) expressive ties (i.e., exchange of social support), and related those ties to workers' job satisfaction.METHODOLOGY: We surveyed 456 clinicians and staff at 23 primary care practices about their social networks and workplace attitudes. We used multivariable linear regression to estimate the relationship between an individual's job satisfaction and two network properties: (a) eigenvector centrality (a measure of the importance of an individual in a network) and (b) ego network density (a measure of the cohesiveness of an individual's network). We examined this relationship for both instrumental and expressive ties.RESULTS: Individuals who were more central in the expressive network were less satisfied in their job, b = -0.40 (0.19), p < .05, whereas individuals who had denser instrumental networks were more satisfied in their job, b = 0.49 (0.21), p < .05.CONCLUSION: Workplace relationships affect worker well-being. Centrality in an expressive network may require greater emotional labor, increasing workers' risk for job dissatisfaction. On the other hand, a dense instrumental network may promote job satisfaction by strengthening workers' access to full information, supporting competence and confidence.PRACTICE IMPLICATIONS: Efforts to increase job satisfaction should consider both the positive and negative effects of social networks on workers' sense of well-being.Association of Implementation and Social Network Factors With Patient Safety Culture in Medical Homes: A Coincidence Analysis
AbstractDy, S. M., Acton, R. M., Yuan, C. T., Hsu, Y. J., Lai, A. Y., Marsteller, J., Ye, F. C., McGee, N., Kharrazi, H., Mahabare, D., Kim, J., Gurses, A. P., Bittle, M., & Scholle, S. H. (n.d.).Publication year
2022Journal title
Journal of Patient SafetyVolume
18Issue
1Page(s)
E249-E256AbstractObjectives: The patient-centered medical home (PCMH) may provide a key model for ambulatory patient safety. Our objective was to explore which PCMH and patient safety implementation and social network factors may be necessary or sufficient for higher patient safety culture. Methods: This was a cross-case analysis study in 25 diverse U.S. PCMHs. Data sources included interviews of a clinician and an administrator in each PCMH, surveys of clinicians and staff, and existing data on the PCMHs' characteristics. We used coincidence analysis, a novel method based on set theory and Boolean logic, to evaluate relationships between factors and the implementation outcome of patient safety culture. Results: The coincidence analysis identified 5 equally parsimonious solutions (4 factors), accounting for all practices with higher safety culture. Three solutions contained the same core minimally sufficient condition: the implementation factor leadership priority for patient safety and the social network factor reciprocity in advice-seeking network ties (advice-seeking relationships). This minimally sufficient condition had the highest coverage (5/7 practices scoring higher on the outcome) and best performance across solutions; all included leadership priority for patient safety. Other key factors included self-efficacy and job satisfaction and quality improvement climate. The most common factor whose absence was associated with the outcome was a well-functioning process for behavioral health. Conclusions: Our findings suggest that PCMH safety culture is higher when clinicians and staff perceive that leadership prioritizes patient safety and when high reciprocity among staff exists. Interventions to improve patient safety should consider measuring and addressing these key factors.Balance and harmony in the Gallup World Poll: The development of the Global Wellbeing Initiative module
AbstractLomas, T., Ishikawa, Y., Diego-Rosell, P., Daly, J., English, C., Harter, J., Standridge, P., Clouet, B., Diener, E., & Lai, A. Y. (n.d.).Publication year
2022Journal title
International Journal of WellbeingVolume
12Issue
4Page(s)
1-19AbstractOver recent decades, scholarship on wellbeing has flourished. However, this has been critiqued as Western-centric, firstly in terms of the location of research participants and scholars, and moreover in terms of the very ideas and values through which wellbeing is understood. In response to such issues, the Global Wellbeing Initiative – a partnership between Gallup and the Wellbeing for Planet Earth foundation – was created to look at wellbeing from a more global perspective. The centrepiece of this initiative is a survey module in the Gallup World Poll. This paper charts the evolution of this module to date, from its initial incarnation in the 2020 poll (featuring items on various aspects of wellbeing) to a finalized 2022 iteration (which focuses specifically on balance and harmony). With the 2022 version now intended to stay consistent longitudinally, this paper establishes a valuable baseline for this important project which will contribute to a more inclusive and comprehensive understanding of wellbeing.Being “low on the totem pole”: What makes work worthwhile for medical assistants in an era of primary care transformation
AbstractLai, A. Y., Fleuren, B. P., Larkin, J., Gruenewald-Schmitz, L., & Yuan, C. T. (n.d.).Publication year
2022Journal title
Health Care Management ReviewVolume
47Issue
4Page(s)
340-349AbstractBackground Primary care is undergoing a transformation to become increasingly team-based and multidisciplinary. The medical assistant (MA) is considered a core occupation in the primary care workforce, yet existing studies suggest problematic rates and costs of MA turnover. Purpose We investigated what MAs perceive their occupation to be like and what they value in it to understand how to promote sustainable employability, a concept that is concerned with an employee's ability to function and remain in their job in the long term. Approach We used a case of a large, integrated health system in the United States that practices team-based care and has an MA career development program. We conducted semistructured interviews with 16 MAs in this system and performed an inductive analysis of themes. Results Our analysis revealed four themes on what MAs value at work: (a) using clinical competence, (b) being a multiskilled resource for clinic operations, (c) building meaningful relationships with patients and coworkers, and (d) being recognized for occupational contributions. MAs perceived scope-of-practice regulations as limiting their use of clinical competence. They also perceived task similarity with nurses in the primary care setting and expressed a relative lack of performance recognition. Conclusion Some of the practice changes that enable primary care transformation may hinder MAs' ability to attain their work values. Extant views on sustainable employability assume a high bar for intrinsic values but are limited when applied to low-wage health care workers in team-based environments. Practice Implications Efforts to effectively employ and retain MAs should consider proactive communications on scope-of-practice regulations, work redesign to emphasize clinical competence, and the establishment of greater recognition and respect among MAs and nurses.Challenges and Strategies for Patient Safety in Primary Care: A Qualitative Study
AbstractYuan, C. T., Dy, S. M., Yuanhong Lai, A., Oberlander, T., Hannum, S. M., Lasser, E. C., Heughan, J. A., Dukhanin, V., Kharrazi, H., Kim, J. M., Gurses, A. P., Bittle, M., Scholle, S. H., & Marsteller, J. A. (n.d.).Publication year
2022Journal title
American Journal of Medical QualityVolume
37Issue
5Page(s)
379-387AbstractAlthough most health care occurs in the ambulatory setting, limited research examines how providers and patients think about and enact ambulatory patient safety. This multimethod qualitative study seeks to identify perceived challenges and strategies to improve ambulatory safety from the perspectives of clinicians, staff, and patients. Data included interviews (N = 101), focus groups (N = 65), and observations of safety processes (N = 79) collected from 10 patient-centered medical homes. Key safety issues included the lack of interoperability among health information systems, clinician-patient communication failures, and challenges with medication reconciliation. Commonly cited safety strategies leveraged health information systems or involved dedicated resources (eg, providing access to social workers). Patients also identified strategies not mentioned by clinicians, emphasizing the need for their involvement in developing safety solutions. This work provides insight into safety issues of greatest concern to clinicians, staff, and patients and strategies to improve safety in the ambulatory setting.Final Thoughts
AbstractKwasnicka, D., & Lai, A. Y. (n.d.). In Survival Guide for Early Career Researchers: A Fulfilling Scholarly Career (1–).Publication year
2022Page(s)
253-257AbstractAs Early Career Researchers (ECRs), we face many competing demands in our work that require distinct skillsets to effectively be involved in research, acquiring funding, teaching, mentoring, service, professional development or any of the other numerous demands placed on us. We may encounter imposter syndrome. We may want to work towards better work-life balance. We may find ourselves suddenly thrusted into the limelight to talk about our research with the media. This book is foremost an acknowledgement of the challenges that ECRs face, and we have therefore sought to put together a compendium of hacks that you can use to deal with those challenges. In this chapter, we share main themes that have emerged throughout this book: self-discovery, building your support team, having a career strategy and having an impact. These key issues were highlighted by our contributing authors as some of the key drivers to their career success.Global Trends of Mean and Inequality in Multidimensional Wellbeing: Analysis of 1.2 Million Individuals From 162 Countries, 2009–2019
AbstractShiba, K., Cowden, R. G., Gonzalez, N., Lee, M. T., Lomas, T., Lai, A. Y., & VanderWeele, T. J. (n.d.).Publication year
2022Journal title
Frontiers in Public HealthVolume
10AbstractIntroduction: Human flourishing is a multidimensional concept characterized by a state of complete wellbeing. However, much of the prior research on wellbeing has principally focused on population averages assessed using a single item of wellbeing. This study examined trends in population averages and inequalities for a multidimensional index of wellbeing and compared emergent patterns with those found for Cantril's ladder, a measure of life satisfaction commonly used as a unidimensional index of wellbeing. Methods: Data were from the Gallup World Poll from the years 2009 to 2019, a repeated cross-sectional survey of nationally representative samples comprising ~1.2 million individuals from 162 countries. We assessed five domains of flourishing: (1) happiness, (2) health, (3) purpose, (4) character, and (5) social relationships. We used the Gini Index to estimate inequalities in wellbeing within populations. We examined and compared country ranking, global and region-specific trajectories of mean and inequality, and relationships with age for flourishing and Cantril's ladder. Results: Although all trends were highly correlated across the two metrics of wellbeing, we identified distinct patterns in flourishing concerning geography, time, and age relationships that were not observed for Cantril's ladder. Temporal trends and age relationships were different across domains of flourishing. Evidence of changing inequalities in wellbeing was also found, even when population averages were high or stable over time. Conclusion: Comprehensive measures of wellbeing are needed to capture the complex and changing patterns of wellbeing both within and across populations.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. Y., & 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.Setting Up for a Thriving Career
AbstractLai, A. Y. (n.d.). In Survival Guide for Early Career Researchers: Assessing Your Scholarly Identity and Institutional Environment (1–).Publication year
2022Page(s)
13-25AbstractWhat 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.State-level unemployment and negative emotions throughout the Covid-19 pandemic in the United States
AbstractHagen, D., Lai, A. Y., & 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.Trends in negative emotions throughout the COVID-19 pandemic in the United States
AbstractHagen, D., Lai, A. Y., & Goldmann, E. (n.d.).Publication year
2022Journal title
Public HealthVolume
212Page(s)
4-6AbstractObjectives: This study aimed to identify trends in the prevalence of negative emotions in the United States throughout the COVID-19 pandemic between March 2020 and November 2021. Study design: This was a descriptive, repeated cross-sectional analysis of nationally representative survey data. Methods: Data originated from Gallup's COVID-19 web survey, encompassing 156,684 observations. Prevalence estimates for self-reported prior-day experience of sadness, worry, stress, anger, loneliness, depression, and anxiety were computed, plotted using descriptive trend graphs, and compared with 2019 estimates from the Gallup World Poll. Differences between estimates were evaluated by inspecting confidence intervals. Results: Stress and worry were the most commonly experienced negative emotions between March 2020 and November 2021; worry and anger were significantly more prevalent than prepandemic. The prevalence of sadness, worry, stress, and anger fluctuated considerably over time and declined steadily to prepandemic levels by mid-2021. Distinctive spikes in the prevalence of several negative emotions, especially sadness and anger, were observed following the murder of George Floyd. Conclusions: Several negative emotions exhibited excess prevalence during the pandemic, especially in spring/summer 2020. Despite recent reductions to prepandemic levels, continued monitoring is necessary to inform policies and interventions to promote population well-being.Work Engagement and Patient Quality of Care: A Meta-Analysis and Systematic Review
AbstractWee, K. Z., & Lai, A. Y. (n.d.).Publication year
2022Journal title
Medical Care Research and ReviewVolume
79Issue
3Page(s)
345-358AbstractPast research has demonstrated that work engagement among health care professionals influences patient quality of care. There is, however, no estimate of the strength of this relationship, and existing reviews have not always explained conflicting findings. We conduct a meta-analysis and review of 25 articles, and find a small to medium mean effect size (r =.26, p <.01) for the positive association between engagement and quality of care. Moderator analyses on five factors (type, data source, level of analysis of the quality of care measure, profession, and work engagement measure) indicate that only data source is significant, providing preliminary evidence that the relationship is stronger if quality of care is measured via self-assessments. Although a more consistent conceptualization of quality of care is needed to better determine its association with work engagement, our findings suggest that work engagement is as important as burnout in predicting quality of care.Work Hard, Snore Hard
AbstractGatari, E., Fleuren, B., & Lai, A. Y. (n.d.). In Survival Guide for Early Career Researchers: Recovery from Work for Early Career Researchers (1–).Publication year
2022Page(s)
41-51AbstractBeing an early career researcher often means having to work intensely on projects and articles. Periods with heavy workloads are common, and proper recovery during breaks or after work can sometimes not take place because of limited time. As prolonged periods of intense work with little rest may lead to long-term negative effects, this chapter discusses the importance of recovery and several actionable tips to consider for early career researchers. We begin with a brief personal example that illustrates why sufficient rest is needed. Next, we introduce recovery from work concepts. We explain that optimal recovery from work on a daily basis is necessary to offset negative long-term effects such as fatigue and burnout. Based on research in occupational health psychology, we provide several practical tips on how to recover well and overcome challenges related to recovery from work. The aim is to help early career researchers in preventing exhaustion or eventually burnout, so they can keep doing their work in a sustainable way.Community Health Needs Predict Population Health Partnerships Among U.S. Children’s Hospitals
AbstractFranz, B., Cronin, C. E., Wainwright, A., Lai, A. Y., & Pagán, J. A. (n.d.).Publication year
2021Journal title
Medical Care Research and ReviewVolume
78Issue
6Page(s)
771-779AbstractCross-sector collaboration is critical to improving population health, but data on partnership activities by children’s hospitals are limited, and there is a need to identify service delivery gaps for families. The aim of this study is to use public community benefit reports for all children’s hospitals in the United States to assess the extent to which children’s hospitals partner with external organizations to address five key health needs: health care access, chronic disease, social needs, mental health, and substance abuse. Strategies that involved partnering with community organizations were most common in addressing social needs and substance abuse. When adjusted for institutional and community characteristics hospitals in a multilevel regression model, hospitals had higher odds of partnering to address chronic illness and social needs. To encourage hospital engagement with complex social and behavioral health needs and promote health equity, support should be provided to help hospitals establish local population health networks.Even superheroes need rest
AbstractFleuren, B. P., Stephenson, A. L., Sullivan, E. E., Raj, M., Tietschert, M. V., Sriharan, A., Lai, A. Y., Depuccio, M. J., Thomas, S. C., & McAlearney, A. S. (n.d.). In Advances in Health Care Management: A guide to facilitating recovery from work for health-care workers during covid-19 and beyond (1–).Publication year
2021Volume
20Page(s)
273-282AbstractThe COVID-19 pandemic burdens health-care workers (HCWs) worldwide. Amid high-stress conditions and unprecedented needs for crisis management, organizations face the grand challenge of supporting the mental health and well-being of their HCWs. The current literature on mental health and well-being primarily focuses on improving personal resilience among HCWs. However, this puts the responsibility for coping with COVID-19-related stress almost fully on the individual. This chapter discusses an important alternative framing of this issue – how health-care organizations (HCOs) can facilitate recovery from work processes (i.e., returning to a baseline level by engaging in nonwork activities after work) for their workers. Based on a narrative review of the occupational health psychology literature, we provide practical strategies for supporting the four key recovery experiences of detachment, control, mastery, and relaxation, as well as present general recommendations about how to promote recovery. These strategies can help HCOs facing the grand challenge of sustaining worker well-being and functioning during the COVID-19 pandemic, as well as during future pandemics and for workers facing high work pressure in general.