Abstract
Background: Burnout is high among healthcare workers in minority-serving, provider shortage areas [1], negatively impacting their health [2], and ability to deliver quality care [3]. Little work has been done to identify unique needs of lower wage workers in these settings, who comprise the administrative backbone and fill the majority of patient-facing roles. Art based assessments have emerged as an effective way to access information about needs and preferences [4], allowing for the development of burnout mitigation strategies to support pandemic recovery.
Purpose: To explore safety net healthcare worker sense of purpose (their "why") inspiring their on-going work during pandemic recovery, and to use these qualitative findings/themes to inform future burnout mitigating activities as part of a larger systemwide wellbeing initiative.
Methods: This cross-sectional project captured data via a community-based art workshop among safety net healthcare workers (n=30). Our team hosted a lunchtime art workshop, participants were given a plastic double-walled cup with a paper insert that could be decorated and asked to illustrate their sense of purpose (deemed their "why") in community health. We provided examples and art supplies. Finished artwork was photographed; our team coded for overarching themes and engaged in memoing to control for bias. An emergent theme was discussed with key informants (theoretical sampling). Comments were used to further refine our theme and provided insight into preferred activities, and needs of the group.
Results: Most attendees completed the workshop activity (25/30). The majority were Latino/x (23/25), unlicensed clinical support or administrative staff (24/25). The primary theme represented across participants was "being the breadwinner for a large extended family". In discussion, some described family members' increased financial burdens associated with layoffs, illness (COVID-19), or loss of their primary residence (evictions due to non-payment), resulting in expanded, multi-generational family living situations. Despite experiencing these challenges, discussions with key informants revealed that support/administrative staff often failed to access free or low-cost services, as they were seen as "for the patients". Instead, they organized collections amongst themselves to address emergent financial and personal concerns (such as legal aid for incarceration, deportation issues, or domestic violence).
Conclusion: Using art, our participants described financial motivations and family obligations as their primary motivators (their "why") for staying in their current position/role within the clinic. This is inconsistent with burnout mitigation literature, which often focuses on more abstract needs such as "love & belonging", or "esteem, cognitive or aesthetic needs" [5]. Our findings indicate that safety net clinic employees may be grappling with foundational "safety & physiological" needs that reflect identities more closely matching the patient population than that of the high-paid, highly educated primary care providers in the clinic. This group may benefit from a neutral/de-stigmatized reintroduction to available free/low-cost resources. Safety net health systems should consider screening for the social needs, and trauma history (including Adverse Childhood Experiences [ACES]) of their lower wage workers.
Notes
References:
1. Bradley, M., Chahar, P., 2020. Burnout of healthcare providers during COVID-19. Cleveland Clinic Journal of Medicine. doi:10.3949/ccjm.87a.ccc051
2. Hayashi, A. Seiji, et al. \"Stress and Provider Retention in Underserved Communities.\" Journal of Health Care for the Poor and Underserved, vol. 20 no. 3, 2009, p. 597-604. Project MUSE, doi:10.1353/hpu.0.0163.
3. Health, S. (2018). How does provider burnout impact patient care quality, care access? Patient Care Access News. Retrieved from: https://patientengagementhit.com/news/how-does-provider-burnout-impact-patient-care-quality-care-access
4. Martinez-Hollingsworth, A.S., Edwards, C. & Partlow, K. (2020). Mural painting to collect \nsensitizing data and encourage research participation among US Latinos. Health Promotion Practice.
5. Maslach C. Finding solutions to the problem of burnout. Consul Psychol J. 2017;69(2):143–152. doi: 10.1037/cpb0000090
Sigma Membership
Gamma Tau at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Qualitative Research
Keywords:
Burnout, Well-Being, Staffing Shortages, Art Workshops
Recommended Citation
Martinez-Hollingsworth, Adrienne S.; Caffe, Isadora; Edwards, Kiersten; Fong, Elissa; Kim, Linda Y.; Scherer, Monika; and Jeffers, Kia Skrine, "Take Your "Why" With You: Arts-Based Wellbeing Needs Assessment to Support Safety Net Healthcare Workers" (2025). Creating Healthy Work Environments (CHWE). 6.
https://www.sigmarepository.org/chwe/2023/presentations_2023/6
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Austin, Texas, USA and Virtual
Conference Year
2023
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-10-14
Take Your "Why" With You: Arts-Based Wellbeing Needs Assessment to Support Safety Net Healthcare Workers
Austin, Texas, USA and Virtual
Background: Burnout is high among healthcare workers in minority-serving, provider shortage areas [1], negatively impacting their health [2], and ability to deliver quality care [3]. Little work has been done to identify unique needs of lower wage workers in these settings, who comprise the administrative backbone and fill the majority of patient-facing roles. Art based assessments have emerged as an effective way to access information about needs and preferences [4], allowing for the development of burnout mitigation strategies to support pandemic recovery.
Purpose: To explore safety net healthcare worker sense of purpose (their "why") inspiring their on-going work during pandemic recovery, and to use these qualitative findings/themes to inform future burnout mitigating activities as part of a larger systemwide wellbeing initiative.
Methods: This cross-sectional project captured data via a community-based art workshop among safety net healthcare workers (n=30). Our team hosted a lunchtime art workshop, participants were given a plastic double-walled cup with a paper insert that could be decorated and asked to illustrate their sense of purpose (deemed their "why") in community health. We provided examples and art supplies. Finished artwork was photographed; our team coded for overarching themes and engaged in memoing to control for bias. An emergent theme was discussed with key informants (theoretical sampling). Comments were used to further refine our theme and provided insight into preferred activities, and needs of the group.
Results: Most attendees completed the workshop activity (25/30). The majority were Latino/x (23/25), unlicensed clinical support or administrative staff (24/25). The primary theme represented across participants was "being the breadwinner for a large extended family". In discussion, some described family members' increased financial burdens associated with layoffs, illness (COVID-19), or loss of their primary residence (evictions due to non-payment), resulting in expanded, multi-generational family living situations. Despite experiencing these challenges, discussions with key informants revealed that support/administrative staff often failed to access free or low-cost services, as they were seen as "for the patients". Instead, they organized collections amongst themselves to address emergent financial and personal concerns (such as legal aid for incarceration, deportation issues, or domestic violence).
Conclusion: Using art, our participants described financial motivations and family obligations as their primary motivators (their "why") for staying in their current position/role within the clinic. This is inconsistent with burnout mitigation literature, which often focuses on more abstract needs such as "love & belonging", or "esteem, cognitive or aesthetic needs" [5]. Our findings indicate that safety net clinic employees may be grappling with foundational "safety & physiological" needs that reflect identities more closely matching the patient population than that of the high-paid, highly educated primary care providers in the clinic. This group may benefit from a neutral/de-stigmatized reintroduction to available free/low-cost resources. Safety net health systems should consider screening for the social needs, and trauma history (including Adverse Childhood Experiences [ACES]) of their lower wage workers.
Description
Summary: This art-based needs assessment explored pandemic recovery/burnout mitigation needs among rural safety net healthcare workers. Participants decorated a water bottle with inspirational images that reflected their why (or sense of purpose) for working in community health. Systematic underuse of free/low-cost resources was identified among the low-wage community clinic workers.